How To Prepare For The Upcoming ABFAS Exam

It is mid-February now and board preparation season is picking up steam. As a podiatric resident or board-qualified practitioner, not keeping the New Year’s resolution of creating and sticking with a study plan would be a grave mistake. For third- and fourth-year residents, March 12, 2019 is a date circled on the calendar for the American Board of Foot and Ankle Surgery (ABFAS) board qualification exam. The same can be said for those (such as myself) who are board-qualified and looking to sit for the board certification exam in May.

Often the hardest part about preparing is knowing where to begin. The most common question residents ask me is “What was your study plan?” We must properly manage our time as time mismanagement is a common reason for failing parts of the exam. Unfortunately, failure rates are high. According to the most recent ABFAS release, in the spring of 2018, the reconstructive rearfoot/ankle (RRA) didactic pass rate was 54 percent and only 55 percent for the computer-based patient simulation (CBPS) portion.¹ (Figure 1) Additionally, pass rates are consistently lower in the fall as test takers tend to be those who previously failed the qualification exam in the spring.  

The CBPS portion of the examination is the easier half of the test in my opinion. One might consider it the more intimidating section but not after you have mastered the method of this portion, most notably the software. You must familiarize yourself with the most pertinent options and be able to track them down quickly. For example, when requesting an ESR, do not simply enter ESR. You must search the “erythrocyte sedimentation rate.” Some of the answers are worded in a way different than you would initially think, creating angst as you sit there scrolling up and down the list looking for the response you want.

There are many nuances such as this and these can be time-killers during the real exam, compounding the stress at test time. The ABFAS has five practice cases available on its site. Use them and go through them multiple times. Study each portion’s list of “prompts” to know what is located where and how the prompts are worded. Know what each of these words means and how you could potentially implement them during a podiatric patient evaluation. This way, you are not looking for the prompt you want but are looking with intention and directly scrolling to the word’s location on the list. This cuts down on both time and frustration, which can throw off some test-takers.

Funny enough, while writing this blog, I received an email from the ABFAS recommending the strategies I mentioned above.² (Figure 2)

Still nervous about the exam? There are a few print resources. Besides the standard textbooks, the only high-yield book I am aware of is Orthopaedic Knowledge Update: Foot and Ankle 5 published by the American Academy of Orthopaedic Surgery (AAOS) and probably some old podiatry “pearls” textbooks that may have been passed down as PDFs while in school.

I personally pooled resources and made my own “binder study textbook,” which I one day hope to publish in some fashion, but anyone can do this themselves. I would pick a topic (I used a board review course syllabus as my table of contents for subjects to study and in creating a worksheet) and open to sections of McGlamry’s (or Mann’s) textbook, some manual textbooks (The Penn Presbyterian Manual, The P.I. Manual, Pocket Podiatrics, P.R.I.S.M., etc.) or resources on the Internet (Orthobullets.com, Wheeless’ Textbook of Orthopaedics by Duke Ortho, eORIF.com). I would write out on plain white paper all the key points to that subject, inserting figures, tables and pictures from the Internet to supplement the information as necessary (Figure 3). Building the content was based on what I felt was either high yield or what I needed to learn/remember, etc. This method is really what you make of it.

My website has a section with resources that I found helpful in studying for boards, both the qualifying exam and now again for my certification exam. Preparing for the didactic portion requires covering a great deal of content. McGlamry’s Comprehensive Textbook of Foot and Ankle Surgery remains the consistent go-to resource in preparing for this portion. Many work through the whole textbook, but given the length, a better strategy is to focus on the chapters you are least comfortable with.

Regarding the CBPS section, there are many more online resources that you utilize, especially since it is difficult to recreate the CBPS portion as a study aid in comparison to the vast multiple-choice question banks one can find online.

There are multiple companies offering questions and CBPS patient scenarios with a similar interface as the real exam. I performed an online search and found the following programs …

• BoardVitals (boardvitals.com). No CBPS cases, over 700 multiple-choice questions, three price tiers, free trial available.
• Board-Master (board-master.com). Six foot/two RRA CBPS cases, no multiple-choice questions, three price options, no free trial.
• Boards by the Numbers (certifiable.com). Seventeen foot CBPS cases, 825 multiple-choice questions, one price tier, no free trial.
• Board Wizards (boardwizards.com). This is a new resource that was not around when I first took the qualifying exam.

I had used the first three programs for my ABFAS board-qualifying exam as I wanted to use any/every resource possible and they each offered different advantageous features. Further, both BoardVitals and Board Wizards services are timed and provide an excellent alternative to complement your textbook. While the first three websites have the edge in longevity, the recently released Board Wizards offers the greatest number of CBPS case examples (46 combined for Foot and RRA with a layout seemingly identical to simulate the real exam, over 1,000 multiple choice questions, three price tiers, free trial available) by far. In a situation in which repetition and more exposure are keys in passing, it is definitely an excellent new source for board prep.

There is no excuse to be caught unprepared for the CBPS. If you are unprepared, expect to take the exam again (one thing I am hoping not to have to do). Further, when the certification exam is CBPS-only and costs over $1,000 each time, I want to do everything in my power (and use everything at my disposal) to make it a one-time event.

The ABFAS qualification examination is supposed to be a rigorous exam. It tests on the knowledge that began in podiatry school and information you have learned throughout your residency training. The best way to pass is to create a daily schedule and study consistently between now and exam day. Then sit back and relax while taking the test, knowing you have done everything in your power to be as prepared as possible (especially with the limited resources available and using everything at your disposal) to come out ahead. Hopefully, some of this information can be a springboard to preparing successfully for your next exam.

References

1. ABFAS board exam result/passing rate data from fall 2017 and spring 2018. Available at https://issuu.com/abfas1/docs/abfas_fall_2018_newsletter> . Published Fall 2018.
2. ABFAS email. Available at https://elink.clickdimensions.com/m/1/86112449/02-b19018-1dbad48d9ad8410b8b9fa6ca5c8c16b2/1/111/0d7f9be8-ad4c-4400-b53a-7c30d2733d42 .

Additional Reading

1. Niehaus S. How to prepare for the ABFAS and ABPM board qualification exams. Podiatry Today DPM Blog. Available at https://www.podiatrytoday.com/blogged/how-prepare-abfas-and-abpm-board-qualification-exams . Published June 9, 2017.

Questions for Discussion:

• Has anyone found another online study resource they thought was helpful and wish to share with the public?
• What methods of studying for boards exams did you find most helpful? A favorite resource? A technique?

Disclaimer: Dr. Hood has no business or financial ties with any of aforementioned resources in this entry or links provided on his personal educational website. He wishes to present all the known boards resource options to prospective test-takers in order to give them the best chance in passing. He does not stand by any claims each of the resources may make on their websites. The views, thoughts and opinions expressed in the text and website belong solely to Dr. Hood, and not the author’s employer, the aforementioned resources, or Podiatry Today. Dr. Hood has no board affiliation with the American Board of Foot and Ankle Surgery (ABFAS), other than he is currently board-qualified under the ABFAS.

Dr. Hood is a fellowship-trained foot and ankle surgeon. Follow him on Twitter at @crhoodjrdpm or check out his website www.footankleresource.com, which contains information on student/resident/new practitioner transitioning as well as links to academic and educations resources found throughout the internet.