pediatrics board review

Quince De Mayo

Written by Stuart Silverstein on Monday, 01 May 2017. Posted in pediatrics board review

If you have a calendar provided by Anheuser Busch or Corona Beer then Cinco De Mayo is a holiday celebrated in US bars everywhere. Cinco De Mayo or as it is known in Mexico, May 5th is an insignificant day outside the State of Puebla and border town Bars catering to Americans on spring break (

However, if you have a calendar provided by the American Board of Pediatrics, then the important date on this calendar is “Quince de Mayo”. This is a date that should be circled in green and red. Quince de Mayo or May 15th as it is known in Chapel Hill, North Carolina is your last chance to sign up for the General Pediatric General Certification exam.

Remember to check your clocks because the day ends early at the American Board of Pediatrics headquarters in Chapel Hill. The deadline is actually at 3:00PM and not midnight on Quince de Mayo.

We do not suggest you wait until the last minute to register for the exam. Murphy’s Cinco De Mayo law suggests that there will always be last minute glitches that can arise. The American Board of Pediatrics warns that these glitches can include incorrect spelling of names and password resets which can take up to 48 hours to fix.

We strongly urge you to also circle Cinco de Mayo on your calendars, and complete your registration before that date (May 5th). Once you have this off your list you will be free to celebrate Cinco De Mayo and raise a toast to your compatriots in the Mexican State of Puebla in an American bar of your choice.

Go ahead what are you waiting for?

Brand New Basket of Adorables: Volume 2 Set of Pediatric Questions and Answers

Written by Stuart Silverstein on Monday, 21 November 2016. Posted in Maintenance of Certification (MOC), pediatrics board review

For those of you who must complete your Cognitive Expertise Secure Exam Part 3 MOC before the end of this year we have some good news.  We will be releasing a brand new set of questions to replace our current Volume 2 Questions and answers. 

This set is completely updated to reflect the content specifications for the Pediatric Boards and Part 3 MOC exam.  We have once again included over 400 multiple-choice questions broken down by specialty to help you focus on specific areas. We have added a section on Patient Safety and Ethics for the Primary Care Pediatrician. 

You should have already registered for the exam but in case you haven’t or need to confirm your registration the following link should be helpful:

As you get closer, our PDF download “Down the Wire Guide to Completing the Pediatric MOC 2016 Cycle" is an excellent guide and resource at $15, what do you have to lose?

To get you started and to help take the holiday stress off this process we will be running a sale from Black Friday through Cyber Monday on all Medhumor/Laughing Your Way study guides including this newly released set of questions.

The MOC PDF download and our brand new Volume 2 question set are the perfect “basket of adorables” to get the holidays going so that you end and begin the new year on a good note. 


Nominate Yourself!

Written by Stuart Silverstein on Friday, 02 September 2016. Posted in pediatrics board review

With the RNC convention DNC convention over, did you ever wish you could just nominate yourself? Well it turns out that you CAN nominate yourself .  Well….you can’t just nominate yourself to be president, although I am not sure who would want to anyway!

You can however, nominate yourself to be on the General Pediatrics Examination Committee. If you are board certified in a pediatric subspecialty you can even nominate yourself to one the subspecialty board exam committees.

If you are selected you will have plenty of power without having to go through debates and public scrutiny of your dress and whether your hair is real or a variation on marsupial fur. You would be involved in reviewing and even writing questions for the in-training exam (ITE), initial certification and maintenance of certification exams. You might even be asked to determine the passing standards for each exam.  Remember no good deed goes unpunished, so when the crowd boos the exam, you will be on stage instead of being in the crowd joining the boo birds in the cheap seats.

For more information on how you can nominate yourself or nominate a friend (or enemy) you can get additional information through this link

ITE Makes Might

Written by Stuart Silverstein on Thursday, 28 July 2016. Posted in pediatrics board review

Depending upon your residency program, you will have already taken or will be taking the In-Training Examination. This is a trial run for the actual Pediatric Boards you will be taking eventually.  If you are the Chief Resident you can also take this trial run if you are listed in their pediatric residency tracking roster. 

pediatric test in progress

This is an excellent way to see which areas you are weak in and which you are strong in. It will be very tempting to focus on the areas you are strong in but it will not help you get a better score on next year’s ITE exam or on the boards itself. This exam consists of 150 multiple choice questions that are based the same content specifications used for the boards. Diligently using this exam will enable you to continue to get stronger in previously weak areas. In that case ITE does make might! 

pass pediatric boards


Program by Program Passing Rate: Does it Matter?

Written by Stuart Silverstein on Friday, 15 April 2016. Posted in pediatrics board review

The American Board of Pediatrics has a report that includes the pass rates for residents taking the General Pediatric Certification Exam for the first time. The report included the same pass rate for Pediatric Residency Programs both in the US and Canada.  An important stat included in the report was the confidence interval.


They emphasize that the confidence interval is important when interpreting the data. The reason for this is, .. uh , um …. actually at this point I am not sure, since my mind kept wandering as I read the gruesome explanation.  We have included a link to the information which you can read on your own. However, does it really matter?

If you are going to learn about nuanced statistical analysis regarding confidence intervals, you are better off spending your energy studying the statistics topics you are responsible for on the pediatric certification exam.


While this information might be useful on an aggregate level it is not really relevant on an individual basis. In fact, the analysis and explanation of the report focuses primarily on the limitation of the statistics.  They note that the confidence interval varies by the number of trainees, especially those with fewer than 25 trainees (is that your program?). They also note that if there were significant changes in the program during the period of time studied then the data is no longer accurate.

Therefore, we are presenting this information to you, but our take home message is that in your case there is only one trainee you should be interested in regardless of where you are training or trained.  If you prepare and study effectively you should be among the residents who pass the first time around. 

Additionally, if you are taking the exam for the 2nd time, then you can and should implement changes in the way you prepare for the exam.  Remember, the statistics don’t take into consideration those from residency programs that implemented improvements.


It certainly won’t factor in effective exam preparation strategies you will implement regardless of where you trained. In fact, the 6th Edition of our Laughing Your Way to Passing the Pediatric Boards has a chapter on this topic

Remember, the pass rate in this study only includes those who pass the first time they take the exam. If you are among those who successfully pass with flying colors after failing the first time, you aren’t even being factored into this study. As a result, the study has no relevance for anyone taking the board exam for the 2nd time.

Therefore, after a casual glance you can skip this statistical study of the pass rate for pediatric residency programs. The only study you should be interested in is the study that you are participating in with a pass rate of 100% as your goal. 

Mime is Money

Written by Stuart Silverstein on Wednesday, 16 March 2016. Posted in pediatrics board review

One of my favorite lines in the movie This Is Spinal Tap involves Billy Crystal, who is the supervisor of a group of mimes serving food at a party. The company is called "shut up and eat" and while one of the waiters is complaining, Crystal says "don't talk back mime is money".

While that may be true, it is clearly a play on the expression “Time is Money” since a talking mime hired to serve food isn’t doing what he's paid for.

For those of you planning on taking the General Pediatric Certification exam, time is definitely money ($345 to be exact). Why $345!? That is the late fee for those registering after March 31st for the next exam. The dates of the exam is between October 18th and 20th at a Prometrics ® test center near you. This may seem like a long time from now, but March 31st is right around the corner!

Just change the above caption to "if you don't stop and look around, the price of the Pediatric General Certifying exam goes up because the ABP thinks we have a ton of money to blow"

Just to clarify, this $345 late fee is already on top of the $2,265 it costs to register for the exam before the March 31st deadline.

Above: The guy on the ladder looks an awful lot like the ABP!

Inevitably, there will be glitches in the registration process. Therefore, you should register right now while it's on your mind! $345 is enough to even make a mime talk back!

So don’t talk back, just click this link and register for the exam.  In fact, for those of you who register before the deadline you can use the following code: REGISTER2016 to get 10% off on our board review books. That, combined with the $345 late fee you will avoid, will go a long way to passing the exam this October, which isn't as far in the distance as you think.

Say No To Despair and Fear and Yes to Steps to Just Persevere

on Tuesday, 01 December 2015. Posted in failed pediatrics board exam, pediatrics board review

In past years you had to wait until the most wonderful time of year was done before you

received that letter from the American Board of Pediatrics either congratulating you on

successfully passing the exam or a letter regretting to inform you that you unfortunately, didn't

pass the Boards. Well, it seems like now that the exam is electronically graded those letters

come before the holidays even have a chance to get rolling. We have heard those whoo hoo

celebratory shouts and those sighs of despair which means the results were sent out just before

the most wonderful time of the year.

For those of you who were congratulated we would like to second that. We want to especially

congratulate those who didn't pass the first time around, how much sweeter it must be to get

that letter.

For those of you who didn't pass, this is certainly not the time of the year to despair. It's the

most wonderful time of the year to persevere. However, persevere doesn't mean studying the

same way you did the first time. You must do something different.

If you are one of those who passed after taking the exam the second time around, you very

likely tried a new approach. Feel free to share your experience with those who are in the

position you were a year ago.

In fact, the 6th edition of Laughing Your Way to Passing the Pediatric Boards released last

October not only contains completely updated material, but we've also included a chapter

devoted to those of you taking the exam for the 2nd time. If you want to get started right now

you can start the most wonderful time of the year and not despair. Use the code persevere2015

to get an 20% discount to take the sting out.

Because the Mets are Really SOCKING the Ball Hitting those Home Runs Over the WALL

on Sunday, 25 October 2015. Posted in pediatrics board review

We want to apologize to our readers who are avid New York Mets Fans apologizing for an egregious error on P 828 that unfortunately was not noted or corrected in our original printing of the 6th edition of Laughing Your Way to Passing the Pediatric boards.

This is especially embarrassing since author, Dr. Stu Silverstein has been a Mets fan dating back to 1969 and has the saved headlines to prove it. 

Specifically, footnote number 6 on that page (shown below) incorrectly states in reference to the criteria for meta analysis., “Or it can be discussing the New York Mets rapid decline and subsequent elimination from the playoffs prior to the start of the season for the next 200 years.”

We are correcting this mistake effective today for all future printings to now read “ Or it can be discussing the New York Mets rapid success in 2015 following their being prematurely written off by Yankee fans and other scientists who prematurely wrote them off before the season even started”

We do not know where this will go from her, but the Mets ARE in the World Series and clearly did not miss the playoffs this year as predicted by so many before the season started. Had they used proper Meta-analysis techniques or shall we say “Mets” analysis techniques they would not have made this error and we would not have included this.

Please except our apologies and “ Let’s go Mets” 

Is the 2013 Pediatrics board exam going to be harder than the 2012 board exam?

Written by Stuart Silverstein on Monday, 15 July 2013. Posted in pediatrics board review

180 is the New 410

Up until this past October you were graded strictly on a curve. That means, if you looked around the room and you sensed the group was smarter than usual you were in trouble. Theoretically at least, the same raw score one year could have been a passing grade and a failing grade the following year.

That is because the previous passing grade was 410 (based on a 0-800 scale ). This 410 benchmark was based on a raw score that was 0.9 standard deviations below the mean.  This meant that in practical terms that you needed to answer 70-75% of the questions correctly to pass the exam.  As a result 75-85 % of first time test takers pass the exam. The American Board of Pediatrics does not make available the pass rate for those taking the exam for the 2nd , or nth time, but it is believed that the passing rate for this group is lower. (see our blog for 2nd time test takers)

Therefore, by definition a set number of first time test takers (and probably a higher number overall when factoring in repeat test takers) will be failing the exam.

A lot changed in October 2012.  One change, is 180 is the new 410.  The passing grade for the American Board of Pediatrics Certification exam is now 180 (on scale of 0-300). The big change is your score is not curved. Your fellow test takers can be whiz kids from prep school or cyanotic mouth breathers from Brooklyn like myself, and it will have no bearing on your ability to pass.

This past year, according to the American Board of Pediatrics, more than 85% passed. However, they maintain that the same number of test takers would have passed even under the old system. Yet, still more people passed percentage wise than in previous years.

We do know that, whereas in the past the percentage that passed was controlled via a set curve. Now, the only way to control this is via the difficulty of the questions themselves. Again, if they are looking to return to the 80-85% pass rate that they have in the past, it is likely that the questions for October 2013 might be more challenging.


Therefore, it will become more important to be very prepared for this exam.  In addition to using pediatric board study guides and books, the American Board of Pediatrics suggests you review the pediatric in house training exams available to residency programs. The board notes that these consist of retired board questions that are reflective of what you might encounter on the exam regarding degree of difficulty. Knowing how to approach questions methodically and being familiar with the material so that it is impossible to forget will likely become more crucial now. 

Just answer the questions, you’ll get the points

Written by Stuart Silverstein on Friday, 21 June 2013. Posted in Maintenance of Certification (MOC), Pediatric recertification, pediatrics board review

As of the previous blog, I obtained a total of 30 Part 2 points.  These were achieved relatively painlessly

10 Points: General Knowledge 2013 General Pediatrics Comprehensive Knowledge Self-assessment 

For this activity there was no minimum score required and was very painless 

20 Points: 2013 General Pediatrics Decision Skills Self-assessment 

In this activity there was a minimum number of points that WAS required. However, this activity contained sections that were relevant to clinical practice AND appears to be helpful in preparing for the Part 3 Prometric Exam. I would go ahead an classify this as relatively painless, especially since as noted in our previous blog you can take your time to search the interweb for the answers. I will note here that after going through this process the ABP really designed this portion to help you out.

A minimum of 40 Part 2 points is needed to meet the requirement and completing these activities brought me to 30 points. So, I needed 10 more points. Be careful though, many of the Part 2 activities are not so painless since you are required to get a minimal number correct to get your points. 

You are permitted to retake any one of these tests but be warned, you only get one shot at retaking it. And for these activities, you have to actually know the subject well or be willing to read the material that accompanies these activities. Most of the self-assessment topics are subspecialty based, and quite esoteric for those who are not in that field, and possibly esoteric and boring even to those in that subspecialty. This wasn't going to work for me! I don't mind earning my points and learning but I want it to be material that is relevant to the work I do as a General Pediatrician. 

So there I was in search of user friendly and hopefully relevant activities where I could either get the answers based on my current fund of knowledge and/or would find it easy to read up on the correct answers (which of course is the goal of the Pediatric MOC / recertification process anyway).  

So I decided to check out the American Academy of Pediatrics PREP Self Assessment Questions that are also approved for MOC as well as CME credit.   

First you have to get there though the following link and assuming you are a member of the American Academy of Pediatrics and registered with the PREP program, you log in under your username and password. 

You should click onto the "CME tab" rather than the "MOC tab".

Now you will be faced with 2 radio button "Mode" options 

1) Learning

2) Exam

Fortunately, the correct mode is the one that is also the default mode: LEARNING

This is the mode that must be selected and submitted in order to get the MOC Credit

Sometimes it pays to be paranoid. I did call and confirm that "learning mode" was the correct mode. I also wanted to confirm that the minimal score required was 80%.

While they did confirm that 80% correct was required to be eligible for MOC Credit this requirement did not apply to the 2011 PREP Self-Assessment.

Therefore, completion of the 2011 AAP: Prep Self Assessment Questions does not require a minimal number correct to get MOC or CME credit. 

You can get 0% correct or 100% correct and this is not reported to the ABP. The AAP only reports that you have completed the activity. (Of course this means anyone can fulfill this obligation, even Hodor from HBO's "Game of Thrones" could complete this activity if placed in front of the keyboard.) 


I would like to point out that this is not consistent with the spirit of this MOC activity and we are in no way encouraging it. Such a casual and meaningless approach is not the intended goal of the ABP.  However, it is refreshing and less stressful to know that you can go through this exercise and actually learn without worrying if you will get the MOC / CME points. 

Since there is no minimum, this was an excellent painless method to obtain 20 Part 2 Points 

Although, as they say on TV, this offer is for a limited time only. This gift, (20 Part 2 points, regardless of the number you answer correctly) must be completed before December 31, 2013. 

Choice c pediatrics

I personally recommend the 2011 PREP Pediatric Self Assessment as one of the activities for your 20 points and that is exactly what I did, and am now the proud owner of 20 additional points.. 

My total Part 2 Points is now : 50  

10 Points : General Knowledge : 2013 General Pediatrics Comprehensive Knowledge Self-assessment 

20 Points : 2013 General Pediatrics Decision Skills Self-assessment 


20 Points 2011 PREP Self-Assessment

Thankfully, I have fulfilled my Part 2 Point requirement with 10 points to spare. Now, the 20 additional points out of the 100 total can come from Part 2. So I have 10 points toward this flexible requirement. 

My new search is to find an additional painless way to obtain 10 more Part 2 Credits.  At this point I have decided to go with Part 2 points since Part 4 Performance in Practice is still an unknown process.  So my search for continues. 

I also have to enroll and register for my Cognitive Expertise - Secure Exam (Part 3) exam at a local Prometics (R) center . I wish to take this exam before July 1, since you cannot take the exam during the months of July and August and I wish to have a margin of error in case I have to take the exam again, in the fall i.e. I don't pass the first time. 

Next blog I will have an update on my search for 10 more Part 2 points. Also, I will update all of you on the process of registering for the Prometrics test and the real rate limiting step which is actually committing to an exam date. I hope you find this blog series helpful. Feel free to contact me with any questions via email or commenting below.

Be Decisive With Pediatric Decision Making Self Assessment Part 2

Written by Stuart Silverstein on Monday, 10 June 2013. Posted in Pediatrics MOC , Pediatrics Recertification, Pediatric recertification, pediatrics board review

I am happy to report that I did reach the 80% mark and am now the proud owner of 20 more Part 2 Pediatric MOC points. This brings my total up to 30 Part 2 Pediatric MOC points.

How did I approach it differently this time? 

1)    For one thing I made sure I was very certain I had the correct answer (should be obvious).

2)    If it seemed to be challenging I held off on answering it.

3)    Free throws  - I went through the ones that to me were pretty easy to figure out fairly quickly.

4)    Challenging Layups - If I still wasn’t sure I went back and made notes on the information that was being presented and often this was enough to make the answer apparent.

5)    Needs some time - In some cases this was not enough and the obvious answers didn’t seem to be correct.

6)    All along the way I kept track of the percentage correct, with each correct answer I got closer and closer to the 80% number.

7)    I also tracked the number of incorrect answers I was getting and yes even despite this approach I still answered questions incorrectly.

8)    Since this is an open book, which is now an outdated term; more like an open google test. I used google for the “ needs some time” category. The way I did it was by simply searching for the clinical descriptions and lab findings .

9)    More often than not this helped me discover the correct answer and I actually found myself learning along the process.

10)  Once I reached the magical number 0f 80% I still had a couple more questions to go but the pressure was off.

11)  But I and you should still want to get as high a score as possible. After all, this is a really good opportunity to learn. Although the process is challenging the American Board of Pediatrics (ABP) really set it up so you review a lot of material.

12)  So I took a different approach this time and reached 84% and now am the proud owner of 20 points toward fulfilling my Part 2 Pediatric MOC requirement.

13) Yes that means I got 8 wrong, which is quite close to comfort, in missing out on an opportunity to get 20 points on what I believe is one of the more useful, and least painful ways to get your Part 2 Pediatric MOC points.

Be decisive with Pediatrics Certification Review


Recall that I already got 10 points on the dashboard for completing 2013 General Pediatrics Comprehensive Knowledge Self- Assessment and now have 30 Points.

Therefore, I suggest you go through this process the way you would approach anything that required concentration. If this means putting on your thinking caps and playing ocean sounds then do it. (see previous blog)

Remember to be methodical; they are presenting material in broad strokes. The question consisted of a history, physical and lab / imaging studies.  I made a list of all the pertinent positive findings and pertinent negative findings. This allowed me to filter out irrelevant negatives.

I noted when something had “quotes” around it, it meant that things weren’t necessarily what the patient was describing, and I made a “beware” notation on my notes.

One of the benefits of this section is once you have “committed to an answer” you can print out the case summary which helps outline fine points of difference in differential diagnosis which is sure to be helpful in preparing for the secured Part 3: Pediatric MOC exam.

So my scorecard so far is

Part 2 Points:

2013 General Pediatrics Comprehensive Knowledge Self-Assessment: 10

2013 General Pediatrics Decision Skills Self-Assessment:  20

Still need 10 more to meet the minimum of 40 Part 2 points. I will need 30 more points if I want to use Part 2 points for the 20 “either Part 2 or Part 4 “ category toward the total 100 points needed for Parts 2 and Parts 4. Wow, I think I just confused myself.

I will let you know in the next blog where my search for the most useful and least difficult to pass MOC Part 2 activities 

Jumping into the Part 2 MOC Pool

on Wednesday, 01 May 2013. Posted in Maintenance of Certification (MOC), Pediatrics MOC , Pediatrics Recertification, Pediatric recertification, pediatrics board review, Pediatric Maintenance of Certification

Well it is now May and more than ¼ into the calendar year. The deadline for completing the Pediatrics MOC (Maintenance of Certification) cycle including the exam is looming. Since I do need to leave a margin of error, I have decided now is the time to get through Part 2 of the MOC cycle and begin thinking about Part 4. Recall, I already completed Part 1 by having a medical license.

Pediatrics Recertification

I discovered that Parts 2 and Parts 4 are intimately linked like Heckle and Jeckle

Between Parts 2 and Parts 4, I must complete 100 points divided as follows:

  -Part 2 – Lifelong Learning Cognitive Expertise: 40 Points

  -Part 4 - Performance in Practice: 40 Points


Therefore, I must get at least 40 points through Part 2 Activities.  There is an additional 20 points that I can decide between Part 2 and Part 4 Activities.  At this point I am not sure which way I will go with this.  This is because Part 4 Performance in Practice is a large unknown. 


This still begs the question, if Parts 2 and 4 are activities done in concert with each other, why aren’t these PARTs 2 and 3 with the exam being Part 4.  As if the process isn’t convoluted enough.


This is like Billy Crystal inAnalyze This asking ”How can we talk about the first thing without discussing the 2nd thing first???”


Part 2 is primarily questions and answers on relatively known territory. In a previous blog I noted that there are 3 options for Part 2.

At the time of that writing I didn’t pay any particular attention to the details of these 3 options. That was because I wasn’t personally going through the process.  I now have learned more and will share that with you now..  Boy this has more subplots and number patterns than an episode of Touch.

The components are as follows with my analysis of each:


            Knowledge Self Assessment- While there are a variety of options which you can search for the one I suggest as a no–brainer is the “American Board of Pediatrics General Pediatrics Comprehensive Knowledge Self- assessment, 2013” which consists of 200 multiple choice questions selected from the secure exam (aka Part 3) pool. You get to kill 2 MOC birds with 1 stone. You get 10 “Part 2 points” while practicing for the test and assessing your areas of strength and weaknesses.

You are also told that your chances of passing the secure exam can be predicted based on how you do on this set of questions as follows:


Your score

Likelihood of passing the Secure Part 3 Exam

80% or greater


66% -79%


65% or less



Pediatric Recertification


The best part of all is there is no minimal number correct to pass.  You can also take this as many times as you want and essentially know these questions cold.  You get “immediate feedback“ which simply means you will be told either you answered the question correctly or you answered it incorrectly. In addition, you will be told which answer was correct.

However, you will not be provided with detailed answers. This is where a good review book will come in handy. You can take notes or study in real time regarding the details of the topic being questioned and learn it for the next time the concept is tested or when you come across it clinically, which is supposedly the point of all this.

I was so excited about this that I re-enrolled for another set of questions. After answering the questions again, I got a confirmation of completion email from the ABP which stated that I can check my dashboard to see how it was applied. I assumed I would be getting 10 more points. WRONG! You only get credit for this set of questions once and once only.


I really do suggest you take the time to write down the specific topics you do not do well on and START with those topics when reviewing for the Part 3 recertification exam requirement. There are also a limited number of images you have to click on for some of the questions, much like you will have to do on the actual exam.

There are other sets of questions you can choose from.  To my own peril I thought the same rules applied that no passing grade was required.  At this point it appears, that for the other options you need to get 80% correct. Unlike other CME question sets, you do NOT get to answer them over and over until you get them right. Here you only get ONE more opportunity to answer the questions you got wrong.  If you still don’t reach the 80% threshold, that module is not available for you this year.

So I decided to try my hand at the next  option which are:

Subspecialty Questions

Well here again, you have to get at least 80% correct and do not have unlimited attempts to answer the questions you got wrong. After a humiliating attempt to answer subspecialty questions I decided to try my hand at the 3rd Part 2 activity, which is:

Decision Self Assessment Skills

This is worth 20 Part 2 points and is more in line with General Pediatrics. Interestingly, it actually is fun.

Here you are given a patient brief history and are provided with a medical history , physical findings and diagnostic studies. There are 50 such questions.

You then have to either pick a diagnosis, or decide what study to do next etc. There are more than 4 choices here. After going through all this, you are either right or wrong.

Here you also have to get 80% correct which means you can only get 10 wrong in order to hit the bell and get your 20 points.

If you do not get 80% you get to take it again. However if you still get less than 80% on your second chance, you are done and will have to find other activities to get your Part 2 card punched.

In this case you ARE given detailed explanation and summary but only after you have committed to an answer.

I am currently in the middle of this and will update my status with the next blog. If I successfully complete this activity I will have 30 total points (20 here and 10 from the General Pediatric Knowledge Self Assessment)

I will still have to choose another activity worth 10 points to get my 40 Part 2 points.

I will need another 20 Part 2 points if I choose my combination points to be Part 2 rather than Part 4.

Once I complete the Decision Skills section… hopefully successfully I will write about my next steps on the road to MOC.

By the way we invite you to discuss your experiences and if you found any relatively painless approved activities for completing the Part 2 requirement.

[1] Outside of Brooklyn the phrasing is different. 


The Sounds of Studying for the Board Review Thinking Cap!

Written by Stuart Silverstein on Wednesday, 20 March 2013. Posted in USMLE review, Neonatology review, board review, Pediatric recertification, Neurology Board Review, pediatrics board review, Pediatric Maintenance of Certification

One of the most important steps in setting aside time to study is to actually set aside the time to study.

It can be challenging to separate regular (aka more enjoyable comfort zone time) from the time you must set aside to study for whichever board exam you are preparing for.

We suggest studying in a specific place or even engaging in a certain action that puts you in the mindset that this is the time I will be reviewing for the pediatrics, neurology or neonatology boards.  This was probably the origin of the “thinking cap” where one put on a special cap when one had to do serious thinking. I know of someone that does not need to wear glasses but puts on plain glass frames when they sit down to study (sounds crazy, but works for him!)

Pediatrics Board Review Thinking Cap

Consider this a reset button, which puts the brain and body on notice that this is time to get down to business and do some serious board review studying. Call it “board review conditioning”.

Well, once you have put your brain on notice, where will you do the studying? We suggest picking a place that is specifically designated as “the” board review location.  This can be a room in your home, a conference room in your office, or perhaps a conference room in the public library. This should be a place that has as few physical distractions as possible.

Now that you have separated the time and space, how do you filter out the distraction of sound and in some cases the distraction of silence?

neurology board review too quiet

Everyone is different.  Some people study better with total silence, some like white noise, and some even like a lot of noise.  Any of these sounds is difficult to reproduce in the setting you have selected as the ideal location to focus on pediatrics board review questions, for example:

While we usually recommend resisting temptation to be distracted by the Internet in general when blocking out time to study, one important exception could be logging into one of the many websites that provides ambient sound.

One of the websites we have found most useful is nature sounds for me which is a free online tool to play nature sounds on your headphones to help provide the ambient sounds you work best with. There are 4 channels that allow for 4 separate sounds to be played at once (i.e. birds, river etc.)

We have found this to be an excellent tool to filter out or even filter IN noise. For example, let’s say you study best with ambient background conversations, the kind you would get at a local café. However, you prefer a location where you won’t meet anyone who might start talking to you and pull you away from the important pediatrics board review material you wish to focus on? This tool will provide you with “ambient conversations“ so you can have your café cake and eat board review questions in an environment without actual people.

The sounds range from ambient ocean waves to kitchen sounds, seagulls, owls, and even wolves. If you find sustained sounds distracting you can even vary the sounds so the conversations come and go, the same for the seagulls and rain.

We suggest you try this wonderful and free tool, and consider the headphone to be the noise cancelling thinking cap you need to put on when you have set aside time to do serious board review thinking.

If at First you Don’t succeed Try Try ….Something New ( Part 3 )

Written by Stuart Silverstein on Wednesday, 06 March 2013. Posted in failed pediatrics board exam, pediatrics board review, pediatric board certification review, Pediatric Maintenance of Certification

Of Course a Course?

Even if you are an auditory learner, attending a pediatric board review course is often not enough.  Live board review courses are primarily a good way to preview what you should be studying and/or serve as a review to reinforce the material you have already studied in board review books and questions. Even within a board review course one will find wide variation in the lectures. Some lecturers are very good at providing high yield pearls and focus their lecture on the board exam. Other lecturers just give their standard lecture on their area that includes clinical information and research that is not helpful to those of us who are only interested in passing the exam at this point in your career. 

Less is More

Often out of desperation, after failing the boards there is a tendency to buy every book written and attend every course you “ heard” was good.  It is better to focus in on a limited number or resources and really work with them than to surround yourself with a forest of books and material. 20% of the material out there will give you 80% of the results. Focus on the 20% that will work for you. There is nothing wrong with using the same resources as before or updated editions, as long as you take a new approach.

Pediatric Studying

Content Specifications

The American Academy of Pediatrics publishes the Content Specifications of topics you need to focus on in preparing for the pediatric board exam, which is similar to the content specifications for the Pediatric Maintenance of Certification/ Recertification exam published by the American Board of Pediatrics. It can be found here


Included in the content specifications are important images and illustrations you must be familiar with. Therefore you will need a good access and/or material that will help you distinguish between similar looking illustrations, tables and photos.


There is very little variation from year to year regarding the topics emphasized in the content specifications. The core material needed to pass the boards is fairly static.

Reinforce with Review

Remember to review the material you studied the previous study session. With each progressive week the sections you have reviewed more than 3 times will become less and less time consuming. At the end you will be studying the areas you were stronger in to begin with.

In fact each study session you should begin my answering board review questions from the material you studied the previous week to gauge how well you actually mastered the material and to identify any gaps.

Missed it by That Much

Of course most pediatricians who failed the exam tell us they failed by only a few points. In the past the curve has been set up so that everyone who fails the exam misses it by a small margin, which often comes down to 10-15 questions. We have heard that the grading system has changed somewhat and that instead of a curve, passing is based on answering a minimum number or percentage of questions correctly.  This will be the subject of a future blog.  In the meantime we still suspect that passing and failing will still come down to 10 -15 questions making the difference between passing and failing the boards.

We have outlined some important steps you can take that will help you answer the 10-15 that make the difference between failing and passing the boards successfully.

We have heard from some of you who are taking the exam again and wish to hear from more of you. This will enable us to help share, anonymously of course, the experience of others. This pooled information can further help repeat board takers finally get it done.

Finally, we know you may feel like this now:

You may feel like this

But once you outline a study schedule and strategy you should and need to feel like this:

You need to feel like this 


If at First You Don't Succeed Try...Something New (part 2)

Written by Stuart Silverstein on Friday, 15 February 2013. Posted in failed pediatrics board exam, pediatrics board review, pediatric board certification review

pediatric board review (night before)

Above image: Night before the board exam

The 7 Year Itch

In Part 1 of our blog for those taking the pediatric board exam for the 2nd or nth, we left off by noting the importance of a fresh start and a new approach. We have heard from many readers in other specialties since publishing Part 1, noting that we seem to be focusing on the pediatric board exam.  We want to point out that the same exact principles apply to the Neurology Board Exam as well as other medical specialty exams.

This becomes particularly important now that you must take the exam within 7 years of completing residency. That means you get 7 tries before being sent to the penalty box. The penalty box is having to complete another year of Internship.  Not to offend anyone who has had to do this[1], but this cannot be pleasant.

Know What you Know

When we are stressed the first thing we do is reach for comfort food, but the comfort is of course only temporary and empty of any nutritional value. Many of us after failing the boards feel empty and need validation and we reach for the equivalent of comfort food. That is we study the areas that we know well, to make ourselves feel good.  While this might help in the very short run, it should be done only to help you get back in the saddle

Part of doing something new must consist of studying and working on the areas you are weakest and sections you have done poorly on. The challenging part is working on areas that you are not only weak in but areas you find mind numbingly boring. For me, remembering and studying developmental milestones was particularly challenging. You must identify those areas for yourself. Start your road back to passing the pediatric boards (or any boards), with the material you are weak in and find most boring while your energy level is up and you are eager to get it right this time.

You might consider differentiating the material you know well from those you do not know well with a color-coded spreadsheet. For example material you know well can be highlighted in green, the material you know fairly well, but needs additional work can be yellow, and the material you find most boring and need to work on a lot can be highlighted in red. As you learn the material and become more comfortable with it, you move it to the yellow column and finally the green column. Once you have honestly moved all of the material to the green side, you can see visually that you are on your way to passing the pediatric board exam. As an aside, you may pick your own colors from the rainbow for your spreadsheet.

Know Your Own Way

An often-overlooked step is recognizing how you study best. Different approaches work for different people and you must determine what will work for you. You can begin by determining if you are primarily an auditory or visual learner. As a general rule, most of us are better visual learners.  If you are primarily a visual learner, and find that you get very little out of live lectures, why would you now consider attending a live board review course?  Your focus should remain visual learning through books, but focusing on different books than before.

If you are primarily an auditory learner, you don’t necessarily have to attend a live board review course. Another alternative might be dictating and playing back the file in your car, while you are working out at the gym, or even during sex if that works for you [2]

If have any artistic talent, drawing a picture to help remember the characteristics of a disorder might help, for example drawing a child on a motorcycle might help you remember the characteristics associated with Kawasaki Disease.

In the final section of this blog we will go through some of the pros and cons of courses and putting together a study plan and outline to better streamline your next attempt to pass the exam.

 pediatrics board exam prep

Above image: When you block out time to study, it's important to actually study 


[1] Feel free to contact us if you had. We would like to know what this process was like/ Clearly you are not the only one your experience can be helpful to others.

[2]  and the person you are having sex with assuming there is an actual partner involved


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