I’m taking my family medicine board exams one last time. This is not entirely sensible. It’s been 21 years since I did family medicine, and 17 since I last saw a patient. I’m unlikely to practice again. The exam will be difficult; my brain is old and cruddy. (Long ago I did rather well on these, but it does help to actually practice medicine.)
Still, for one reason or another, I’m committed to doing the exam this November. I’ve slogged my way through the ABFM’s intricate preparations, including, for the non-practicing candidate, 6 self-assessment modules (SAMs) and one “alternative” module (which was quite awful and may have been since withdrawn). I even managed to meet the under-documented CME requirements . The expensive Self-Assessment Modules varied from quite good to rather poor; alas the simulations are not worth continued investment .
When I’m done I’ll revise this post with what I end up with. By far the best guide I’ve found for someone like me was something written in 2008 (*cough*). I’m basically following my old recommendations (including ignoring audio CME/podcasts). For example:
- ABFM | Exam Preparation: look for the tiny links at bottom to Study Tips and 2-week checklist. Some of this advice is wrong for me - and probably for most people. Still worth a read.
- ABFM | Exam Content: this page hard for me to find - maybe my problem. I focus on topics with 5% and above.
- I have old online medical notes written back when we thought HTML would be a good format for knowledge sharing and documentation. How naive we were! My medical notes started out in pen, moved to Symantec MORE 3.1, then FrontPage/HTML and now they’re back to an outliner (OmniOutliner 3). I have to write to learn. When I’m done I’ll attach a version of my notes here, but they’re really only going to be useful for me.
- SAM Module Review: The SAM modules were a mixed bag, but the question explanations are superb summaries of current/expected knowledge. I’m mining those for my notes.
- ABFM in training exam: The ABFM provides 3 years of teams. I’m studying these in depth, identifying any areas of strength, guiding my study, and generally awakening old memories.
- Online references: this has changed, and not for the better. There’s much less available for “free” online than there was in 2008 . Only Scott Moses’ self-funded hobby/obsession remains - the FP Notebook. So I’m buying selected paper references  like the venerable Washington Manual and Sanford Antimicrobial therapy. Some of my old textbooks (EKG interpretation) still work.
- Monthly Prescribing Reference (print version): still evil (drug money funded), still remarkably useful. Trick is to know what drugs are actually used vs. what are legacy — would be nice to have a version filtered by popularity.
- AAFP Board Review prep: skip over the expensive and inefficient modules and find the free (38 credit!) Board Review Questions. I think this is what the ABFM “exam prep” document was warning against. Needless to say, I’ll be sampling these, though Emily recollects they’re less useful than the ABFM in training exam materials.
I’m alternating topical work (reviewing Sanford, relearning EKG interpretation) with review designed to rebuild old memories. My medical knowledge network is frayed and fragmented, but there’s a lot of it. Much of my preparation is really resurrection. I've brute memorization ahead - reading, closing eyes, regurgitating. Then exam-guided note review and expansion.
It will be interesting to see how it all goes. Failure is certainly an option.
- fn -
 Dear ABFM: Please note the current cycle progress tracker omits CME requirements but the future cycle includes CME requirements. Could be fixed.
 In the late 80s through early 90s we used to get 360K floppy disks each month with a unique DOS based medical simulation. I cannot, just now, remember what medical publisher did them (something Cardinal?). I remember them as quite excellent, I featured them in our residency computer-based training program. Several clinicians, likely retired now, did some serious work on those. There really is no modern equivalent. Which is a kind of interesting.
 UpToDate is by far the dominant online resource for medical information — and it’s very expensive. (Priced for organizations.)
 See . Also the movie Groundhog Day.