Preparing for the Pulmonary Medicine Board Examination

By: Deepak Chandra, MD

July 30, 2018

This post is a part of our Life as a Fellow blog post series. This series includes "fellow life lessons" from current trainees in leadership with CHEST.

It was a nice sunny day on October 18, 2017, but I was unable to enjoy it because of a constant gnawing in my stomach. I dreaded the thought of taking the pulmonary boards the next day. I had started my preparations early and felt like I made some progress. What worried me was the ABIM Pulmonary Board exam has historically been very tough. The first-time test-taker pass rate was only 86% in 2014 and 87% in 2013. Fortunately, in 2017, my stars aligned perfectly and I passed. The first-timer pass rate was 99% in 2017!!

There is a huge, confusing universe of resources available to prepare for the board exams. I won’t go through the relative merits and problems of each but will try to break down how I prepared and what else one could do.

• I encourage constant reading about the cases that you encounter daily. Additional board-specific reading is necessary as the boards test you heavily on obscure material that is not encountered in routine pulmonary practice. The ATS pulmonary board review book, available for free for members to download is a great resource. It is an easy-to-read book with high-yield pointers and buzzwords marked out.
• The only way to ace the boards is to practice doing more questions. Performance in multiple-choice questions is a skill that will improve with deliberate practice. CHEST SEEK™ education includes a large repository of well-written questions and covers high-yield topics. I used the CHEST SEEK Library on the CHEST App™ on my phone/tablet; you get hundreds of questions in each library with more than 1,500 questions in the full library. I found noting down the high-level points while answering questions is a great last-minute review. In retrospect, it would have been more value if I had neatly arranged the notes instead of scribbling on scrap paper!
• Histopathology images are tested in good measure. Be sure to review images of the lung malignancies and pathologic hallmarks of major lung diseases. This is not a pathology exam, so tested images are classic findings. Google is an excellent resource to find them.    
• There are several board review courses available. The most popular and my recommended one is the CHEST Pulmonary Board Review course. This is an intense, 4-day review, which is highly recommended and endorsed by several of my colleagues and seniors. This premier course comprehensively covers high-yield topics and questions. The recorded audio and videos of the previous year’s course is available for on-demand viewing. This is available with member discounts on the CHEST website.

Most importantly, for efficient brain functioning, you have to be calm and stress-free on exam day. It is a long day with a lot of screen time, so planning your breaks to give some rest to your eyes and brain is paramount.

Deepak Chandra is currently in his final year of pulmonary-critical care fellowship at the University of Nebraska Medical Center, Omaha. He attended medical school in Kerala, India, and completed his internal medicine residency from University of Arkansas in Little Rock. His interests are critical care ultrasound and improving medical education in the clinical environment.