Every year radiology residents have to study a large amount of material on imaging physics, pathophysiology, anatomy, special procedures, alternate imaging modalities, and radiation biology in preparation for the written board exams. Itâ€™s a stressful time for residents in terms of deciding what materials to use and how to divide their time between subjects. Last year I interviewed three residents who completed the written boards, and got great feedback from those who were preparing to do the same thing.Â You can read the 2007 interviews here:
2008 was the first year that the written exam was taken at the end of the second year, rather than in the third year of the residency. This meant that everyone had to be that much more organized in their strategy early on in the residency program. I interviewed two residents who successfully completed the written exam in 2008; Matt Cannon from UC Davis, and Sophie Dennison from the University of Wisconsin, Madison. Randi Drees from the University of Wisconsin, Madison, wrote the exam in 2007 and was kind enough to contribute her advice as well.
This week Iâ€™m publishing part I of the interview for you. Matt, Sophie and Randi share their timelines for studying and their approach to reviewing the literature. Next week youâ€™ll be able to read part II, including the residentsâ€™ top three tips for preparing for the written board exam and their favorite study resources.
If other residents have tips for the exam, please post them in the comments section! You canâ€™t have enough good advice from people who have been through the process, so I welcome your contributions to the conversation.
AZ:How many months ahead of the exam did you start preparing?
I started studying lightly after Christmas during my first year. I also had several weeks off in the spring and summer of my first year that I used to organize material and begin studying. However, I also made it a point to read recent VRU and other classic articles from the beginning so that I did not have to cram too much in at the last minute. I found this practice really helpful from a clinical perspective as well. I began more focused studying of the exam objectives 4-5 months before the exam. I had 5 weeks off before the exam that I used primarily to review material and fill in any holes in my knowledge.
Actually I worked pretty much from the start of the residency to get up to date with literature and get back in the swing of pathophysiology, but 5 months before was the hard core summarizing notes and learning period.
January 1st thorugh May 2nd, that makes 4 months.
During the Residency I had gone through some what I thought would be pertinent books such as Bushberg, Thrall, Butler, Zagzebski, Nyland/ Matoon, etc. And tried to read through the previously written objectives. And read some papers.
AZ:What did you start with and how much time did you study per week?
I began by reading certain foundation textbooks and taking some notes on pertinent sections. I did this to get an overall understanding of the material, especially physics. The second time around I read with an eye toward answering individual objectives. Initially I studied for several hours in the mornings on weekends when I wasnâ€™t busy or on-call. I treated off-clinics time like workdays for the most part, studying from about 9-5 with a lunch break. About 4-5 months before the exam, I began studying about 10-15 hours per week, in the evenings and on the weekends. During the 5 weeks before the exam, I spent each day as a full workday, studying from about 8-5. I then would typically take a break for dinner and then spend an hour or two in the evening reviewing the dayâ€™s material or studying anatomy ( I didnâ€™t actually allot any days of studying for anatomy, as I figured this section would take the least amount of time and doesnâ€™t require a lot of thought). During this review period, I spent 1 week each on pathophysiology, alternate imaging, physics, special procedures, and radiation biology. I had several days left over at the end for last minute review and memorization.
Pathophys, physics and literature; 1-2 hours a night of objectives study regardless of what other work needed to be done. Once within 5 months of the exam, minimum of 3 hours a night plus 4-6 hours each weekend day.
I tried starting to just work down the objective list but there is repetition and not the chronology I liked, I figured that won’t work. I tried reading though the notes written up by previous residents, that is excellent supply, but I could not study directly from that.
Study time: I had 4 weeks off clinics before the exam.
- reading papers and supplying with Guyton / Ettinger / etc.: good 3 Month with ~3 hrs Mo-Fri, up to 10hrs on Sat / Sun during clinics time
- All physics including alternate imaging: 2 weeks in the off time (off time study time ~ 4-12hrs / day, depending on mood)
- Rad Bio: 2 days in off time
- Specials: 2 days in off time
- Anatomy: 2 days in off time
- Melt down: 2 days in off time.
AZ:What was your approach to reviewing the literature? (which journals, which years, any software, etc)
As mentioned above, I tried to read VRU and other classic articles throughout my residency instead of cramming at the last minute. After reading each article I would write several sentences at the top of the article summarizing the basic gist and any essential points to remember. Therefore when I went back through the articles later I could quickly get a feel for the important points of the paper. When reviewing in the last several weeks I spent the vast majority of time reading the last 8 years of VRU. I did skim other journals including JVIM, JAVMA, AJVR, and Vet Surgery and read pertinent articles but I did not find this particularly helpful. Overall, I did not spend that much time reviewing literature and instead spent the majority of time reviewing the individual objectives.
I searched the last five years of JAVMA, JAAHA, JSAP and last 8 years of Vet Rad. If something sparked an interest then I looked up other refs using pubmed or google scholar search engines. I copied and pasted the title, ref and abstract plus any images which would spark memory onto a word doc page, printed the page and added hand written notes about the article to the sheet. This ensured I read the article, proved to me at a later date I had read the article and provided something for my mind to go back to when trying to recall information.
During the residency I had started to collect interesting articles in a simple windows file system, pdfâ€™s filed by organ system. I additionally downloaded the last ~ 5 yrs of VRU, and imaging related things out of JVIM, JVS, JAAHA, JSAP, JAVMA, JVR and added that to the files. Then I started reading by organ system. With Adobe I copied title, abstract and pictures that I thought would help onto a single page per article and printed that and summarized on this page what I thought was important in handwriting. That way the highlights are on the pdf and I know where to find it, but I don’t have that overwhelming amount of papers to print out. Those summary pages made up about 4 folders in the end and are organized the same way as the pdf-files on my computer. Nice and handy. Reading the papers I covered a lot of relevant physiology, pathophysiology, anatomy and physics. Areas I felt weak on or couldnt answer an objective after doing this I supplied mostly with Guyton and Ettinger for pathophys. Doing all this took the longest time.
Physics: I had fought my way through Bushberg before, and that went very much faster for the real preparation as I anticipated. Same for NucMed, I used the handbook and papers. For US Physics Zagzebski, for MRI physics I read also books for technicians, they break things down a little more user friendly and applicable.
Special procedures: very good whatâ€™s written up in the previous residents notes, papers and books like Thrall.
Anatomy: looking at pictures in Miller and other Anatomy books and normal Radiographs in Thrall, papers.
I then I got some summarized notes (pretty and colorized, very soothing to the eye, and very good for memorizing) from one of my fellow residents. I took additionally about 3 days to write a short answer to all the objectives to make sure I know at least something for every one on the list and don’t miss anything.It is great if you manage to compile this huge amount of information into some smaller format, such as 2-3 folders. Otherwise I felt I sit in front of â€œextraordinary large pilesâ€ and can’t look up things fast or can’t even transport all that to where I was supposed to take the exam.