What to Do if You Fail Your Board Exam

Last updated on August 9th, 2023

I’m here to talk about a difficult topic with you today. What do you do if you fail your board exam?

Below is a transcript of the video:

Well, the first thing you should if you fail your board exam do is to take some time to come to terms with what has happened.  When you first open up that envelope and you see that you failed the exam, it will hit you like a ton of bricks.  You don’t need to do anything. You do not need to start studying. Just take it easy, sleep on it. Give yourself a few days, a week or two.    Your next exam is six months to a year away.  After a while you will see that no one will love you any less because you failed the exam or that failing the exam will not materially hurt your career.  It doesn’t seem that way in the short term, but after you have a few days of perspective, I think you will be ready to move forward.

The second thing to do is not beat yourself up.  Sometimes it’s easy to just want to be angry at oneself.  But if you are beating  yourself up, that means you are getting beaten up, and you can’t afford to be beaten up because you are your own resource. You have to do well. You have to be in good shape in order to go forward, to conquer this exam. Then when you’re ready, assess what went wrong and where you can make changes.  For example, if you ran out of time, although not very common, going forward in your studies for the next exam you should take a lot of practice tests and time your pacing.  Most exams have about a minute per question.  If you’re off that pace, then you could practice speeding up. Take note of which type of questions really slow you down.  There are a lot of questions on exams where you will not be certain about the answers.  Some individuals have a hard time with that uncertainty and they almost freeze up. Pay attention to that. You’re going to have to, in a way, desensitize that feeling because the time is ticking, and you need to move onto the next question. You’re just going to have to take your best guess and move on. Also, as you’re taking your practice tests, you can practice to speed things up if you need to.  If you didn’t do well, but you took a very short amount of time, maybe you would do better if took some more time and slowed down.  Maybe you were rushing through reading the question and you never fully understood what you were being asked.

Next, go ahead and review your exam performance report. I want to give you a tip that may seem counter-intuitive.  On every exam, there are a certain number of topics, maybe 4, 6, or 7 at the most, that are very large topics, close to 10%, sometimes over 10% of the exam.  For example, on the Psychiatry board exam, the big topics are psychotic disorders, mood disorders, substance use disorders, cognitive disorders, and so forth.  In neurology it’s going to be vascular disease, epilepsy, neuromuscular diseases, among others.  So even if you passed that big section, there are still a large number of questions that you got wrong, just because the percentage is so high.  The total number of questions in that section is so high that even if you pass, the number of wrong questions is still substantial. Also, on every exam there are going to be a dozen or maybe two dozen topics that have very few questions associated with them.  For example, on psychiatry, sleep disorders, it’s 2% of the exam.  There might be 3, 4, or maybe 5 questions at most.  But sleep disorders, there are many of them, and they’re pretty complicated.  It could take a long time to really master that area that really has very few questions associated with it.  It makes more sense to focus on the big topic areas even if you passed them.  If you did not pass them, then that’s a no brainer.  That’s really where you need to spend the time.

Now, there’s one last thing I wanted to talk with you about.  I want to say this gently.  I don’t want you to throw rotten tomatoes at my head.  I don’t want to upset you, but this is what I want to say.  Sometimes there is a silver lining to failing an exam.  As physicians we are all high performers.  We’ve all worked hard, spent hours and hours, years, decades, studying.  Some of us don’t really have a history of failing much of anything.  Then when we fail something, like a board exam, we can take it hard, really, really hard. It may undermine our self-concept, our sense of selves and who we are. That sounds pretty negative, but there is a silver lining there because we are more than passing or failing an exam. Maybe it’s time to really rethink about what makes us who we are.  If we’ve never failed, then maybe we’re not taking enough risks in our life.  Failure has to be part of the things that we do.  If we’re always passing everything, succeeding at everything, maybe we are playing it just a little bit too safe.

In my own case, in psychiatry, I’m a psychiatrist, at the time we had written boards and oral boards, and I took and failed my psychiatry oral boards twice.  I choked.  Lo and behold, it turned out to be one of the best experiences of my life.  Not at the time, it felt horrible, but it let me to really understand what I was doing wrong.  I was a junior faculty member at my university, and I started training my residents about how to better interview patients and present cases.  Then that led me through a series of steps of starting American Physician Institute which is now my fulltime job.  It was my failure that ironically led to my greatest success.  If it wasn’t for my failure, I wouldn’t be talking to you right now in this capacity. Again, I don’t want to stress this too much. You may not be ready to hear this. But I do think it is an important part of the message to share with you.

If you need help preparing to re-take the boards you can access our board reviews for psychiatry and neurology at Beat the Boards, and all other medical specialities at The Pass Machine.

In any case, if there’s anything I can do to help, certainly reach out to me DrJack@AmericanPhysician.com.  Take care of yourself.

Signing off,

Dr. Jack

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