When you're studying for an exam, it’s no secret that spending extra time on the areas you’re less confident with can help you succeed. But how do you identify your individual knowledge gaps? CHEST Board Review faculty share their advice for pinpointing which topics to emphasize as you prepare.
Consider your daily clinical environment
The key to identifying your knowledge gaps is reflecting on your specific clinical context. Your unique clinical environment will likely have a significant impact on what your gaps are.
“All of us have aspects of practice that we see routinely and therefore feel confident in. And then there are those other areas that we feel less confident in, perhaps because we don’t see that type of pathology or think about those questions as frequently in our practice environment,” said Meredith Pugh, MD, MSCI, Critical Care Board Review Vice-Chair.
Take an inventory of which topics you’re most familiar with and which ones you don’t have as much experience with. Use these questions to guide you:
- Which disease states or topics do I typically see in clinic?
- Which disease states or topics do I rarely or never see?
- Which disease states or topics have I seen previously but don’t encounter anymore?
- Which disease states or topics do I see routinely but don’t feel as confident with?
Since your day-to-day clinical experiences will make you more familiar with certain concepts, you may have different knowledge gaps from your colleagues and friends.
“There may be disease pathologies or topics like circulatory support for cardiogenic shock that, working in a medical intensive care unit, I don’t see nearly as commonly as my colleagues working in the cardiovascular intensive care unit. Brushing up on those topics is always helpful.”
– Meredith Pugh, MD, MSCI
Review your in-training exam scores
If you’re a graduating fellow, your in-training exam scores will likely point to areas you should focus on. Başak Çoruh, MD, Critical Care Board Review Chair, said fellows’ performance on those exams is highly predictive of their performance on the board exam.
“It’s helpful to look at your in-training exam results and say, ‘It looks like I missed a bunch of questions around management of obstructive lung disease on the ventilator, for example, or identifying ventilator dyssynchrony.’ That’s one way to be strategic about how you’re going to study.”
– Başak Çoruh, MD
Create a strategy based on your knowledge gaps
Once you’ve identified what your gaps are, prioritize your weakest areas and bring them to the forefront. Invest more time in studying those concepts compared with other ones you’re more comfortable with.
Another tool is breaking down your priority topics into smaller chunks. Reviewing the concepts in bite-sized pieces will make them easier to digest. If you identify more gaps than you were expecting, it’ll also help the process feel less overwhelming.
Dr. Pugh also noted that while identifying your unique knowledge gaps is critical, certain topics tend to challenge clinicians more frequently than others.
“There are some topics that people commonly struggle with or have to spend more time relearning,” she said. “Statistics is one example. I think all of us can benefit from a refresher in that area.”
For clinicians taking the critical care medicine board exam, Dr. Pugh said other commonly challenging topics are electrolyte disturbances, rare endocrine pathologies, unusual arrhythmias, and extracorporeal membrane oxygenation, particularly if you don’t see it in your unit every day.
Get expert feedback as you prepare
If you’re looking for more expert advice on studying for boards, CHEST Board Review courses on critical care, pulmonary, and sleep medicine provide live in-person instruction and individualized feedback as you study for the exam.
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