20 Things I Wish I’d Known When I Took the Board Exam

by M. Rachadian Ramadan, M.D.
Chief Plastic Surgery Resident, University of Indonesia,
Ciptomangunkusumo National Hospital, Jakarta, Indonesia

For many plastic surgery residents, taking the board examination can be a nightmare. It is like facing the final boss in an adventure game. Years of training and studying would lead to this examination with only two outcomes: pass or retake. Here, I’ve made my personal list of tips to help co-residents facing their board examination.

The Preparation:

  1. Rome was not built in one day—It’s a common phrase you’ve heard, but it’s true. Cramming a week or two before the exam will only send all those bits of knowledge of anatomy, classification, and surgery techniques to the short-term memory realm, which will eventually evaporate when you get tense, especially on the exam day.
  2. Decide your study goals and begin studying early; there is a lot to go through. Make a plan, use a plastic surgery textbook, syllabus or modules (like PSEN resident curriculum) as a base and go over all topics. Your study goals can change later, but a clear plan will help you to maintain focus.
  3. You can’t build a great building on a weak foundation. The same goes with your prep: start from anatomy and spend most of your time on things you don’t know.
  4. Take a trip down memory lane. Check with your senior colleagues about the types of question, topics and tips from previous board exam. Chances are, they will repeat, or if it doesn’t, most of the questions will not be too different from previous exams.
  5. “If I don’t write it down immediately, I forget it right away. If I put it into a sketchbook, I never forget it and I never have to look it up again.”—If the previous sentence worked for Beethoven, so it does for you. Make notes: write them down, separate what is “must know” from “nice to know”, and put a label on them so it is easier for you to trace back. 
  6. “Alone we can do so little; together we can do so much.” Hey, you are not alone. Try to get a colleague to study together with you. This way you can discuss topics, practice the oral exam, and get advice on your performance. Just remember, don’t compare yourself with others; everyone has their weakness and strength. All you need to do is work on what’s best for you and your study.
  7. Just like speed running, speed writing needs practice too. Most of the plastic surgery board examination will require a written test (or drawing test). Practice on this, so on the actual exam, you can finish the question quickly and precisely.
  8. Ask and discuss previous exam questions with your consultant. Chances are, they are also a board examiner (or was one). You will find many useful tips and “lingo” that examiners use. You need to realize that the board examiner and resident have lived in different eras (10-20 years), so it is important to capture what kind of answer they actually want in the exam.
  9. Board examiners are nice people that want you to pass. When studying gets tough just remember the previous sentence.
  10. Stop studying—seriously. I mean, you should maintain a healthy life-study equilibrium by creating study habits that are comfortable for you. Have a life, look after yourself, eat and rest well. A steady and balanced study habit is better than an intensive study in the last days, which will burn you out.

The Day of the Exam:

  1. Be confident on the day of your exam; know that you will pass. 
  2. Take a quick moment to meditate or pray before the exam. Take a deep breath, control your breath, calm down.
  3. Get a clear view of the exam format, exam marking, time allocated, and how many questions there are. 
  4. READ the questions. Careless reading leads to mistakes and eventually failure to pass.
  5. The clock is ticking. On the written examination if you cannot answer a question, skip it and come back later. Finally, just write anything on the exam paper, because an educated guess is better than leaving it blank.
  6. In the oral exam, your responses should show your understanding of the problem presented, not what you think examiners would do. You should demonstrate your competence and the mastery of problems.
  7. Answer oral question systematically: history, physical examination, diagnosis, treatment option, after treatment.
  8. Defend yourself and your answer. Prepare to treat complications by providing “life-boat” procedures.
  9. It’s okay to be wrong; the exam is intended to explore the limit of your knowledge, and it’s all right to have a basic limit.
  10. Failure is not the end. If you failed to pass, don’t get demotivated—come back next year!

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