Spend most of your time on high-yield subjects.
Unfortunately, you can no longer solely rely on good test-taking skills. Most of the clues that helped identify the correct answer in the past are now closely watched for by test-writing groups and corrected before approval. For example, the longest answer choice used to be a clue that it was the right option. Now, it is likely not the correct answer, because test-question writers actively avoid this phenomenon. In general, reliance on testwiseness (the skill that allows a student to choose the correct answer on an item without knowing the correct answer based on mistakes in test construction) is not a good strategy on the Rheumatology Boards. Every question is well vetted for such mistakes prior to utilization on the exam.
Tip 5: Get a Board Review Book
By general consensus, the best book for board prep is Rheumatology Secrets. Now in its third edition and available on Amazon.com, this masterful work by Sterling West, Jason Kolfenbach and colleagues provides high-yield information on an incredibly broad array of topics.5 Read every page of this book—twice, if you have the time.
Other review materials are also available, including the Rheumatology Board Review by Karen Law and colleagues out of Emory.6 Recognize, however, that although these books cover a breadth of rheumatology, for some of the bigger topics you will need to turn to the larger, traditional textbooks. Use these resources instead to reinforce high-yield tidbits of knowledge, especially for the more esoteric topics, for which more in-depth knowledge has little benefit for the board exam.
Tip 6: Review the ACR Image Library
If an image is used in a question on the Rheumatology Boards, chances are it was pulled from the ACR’s Rheumatology Image Library.7 Question writers are encouraged to use only images that have been vetted for accuracy and demonstrate classic characteristics for a given disease, and the ACR’s Rheumatology Image Library is recognized as the go-to resource for this material. It takes only about a week to go through the images carefully, and the dividends are huge.
Tip 7: Spend Most of Your Time on High-Yield Subjects
The first step is to become familiar with the ABIM Rheumatology Certification Examination Blueprint.8 This document can be found on the ABIM website and basically breaks down the exam by topic and the relative percent that each area represents on the test. For example, rheumatoid arthritis accounts for 13% of the exam, whereas infection and related arthropathies are only 6%.
For more common subjects, I recommend reviewing the major textbook chapters related to them. This actually yields multiple returns, and I point to the chapters on RA as a prime example. Not only is RA the highest percent-tested single disease, many of the questions related to DMARD mechanisms of action, potential side effects and medication interactions are covered in the RA section. Additionally, many basic science questions, especially about cytokines and pathways relevant to current therapeutics, are also covered in these chapters.
This is not to say you shouldn’t try to review as many different topics as you can, just don’t give the same amount of attention to rare metabolic myopathies as you would to osteoporosis. Guess which of these topics I didn’t see a single question on during my own recent exam.
