The Hell of Waiting for Board Results – Use This Mindset to Avoid Driving Yourself Crazy

Nearly every board exam candidate feels unnerved by their exam. Many physicians feel despondent, remembering how many questions they were either ‘clueless’ or ‘really unsure’ about. This experience of deep uncertainty continues for the entire period of waiting, often 4 to 6 weeks, until results arrive.

The reason for this despondency is that a large – usually the largest – percentage of questions on the exam are those that the candidate is less than 100% certain of having gotten right. On either end of this spectrum lie questions that the candidate is certain either of having gotten right or of having gotten wrong. Therefore, a high level of uncertainty about one’s results is common.

Interestingly enough, in my experience of nearly 25 years of involvement in board exam preparation, it does not appear that the candidate’s self-assessment of having passed vs. having failed is valid. I’ve had dozens, if not hundreds, of physicians reach out to me to tell me how horrible they did, asking me beforehand how they should activate their course guarantee, only to find out that they passed. I’ve had fewer but still a sizeable number tell me they did ‘ok’ only to find out they failed.

How could such a poor track record of judging one’s board exam performance occur? The answer lies in the following reasons, which often interact to compound the level of uncertainty:

• As mentioned, most questions are written in such a way that the candidate cannot clearly say afterward whether they answered correctly or incorrectly. These are often questions that assess clinical judgement. They are often based on a case vignette and ask the candidate, “What is your most likely next management step?” The problem is that more than one of the response options often seem like viable “next possible steps”, while only a single “best response” is permitted. Thus, the clinician feels flummoxed that he or she can only choose one response option when they would like to choose two, three, or even four. Sometimes, candidates even freeze up at these questions, unable to just choose the most reasonable response option and move on. After all, there’s still the entire rest of the exam to be completed!
• An exam candidate can get about one quarter of their board questions wrong and still pass. It is hard to judge whether one got more or fewer than about a quarter of the questions right.
• Complicating one’s exam self-assessment is the fact that every board exam includes a sizeable number of ‘test questions.’ These are questions that are included in the exam for purposes of validation but are not counted in candidates’ scores. When a candidate leaves the exam flabbergasted by some “really crazy questions” being on their exam, it is likely these questions were in that “being assessed” category and were eventually eliminated.

With that as background, what mindset do I recommend you maintain following your exam?

Well, based on the way I described the problem and the multiple contributors to it, the answer seems clear: You, as the exam candidate, cannot know whether or not you passed. Your exam self-assessment is likely to be wrong. There is no way around this problem, no matter how hard you think about it. By continuing to think about it, your only accomplishment is to drive yourself crazy. Whether you drive yourself crazy or let it go changes nothing in terms of exam results.

So, if there is no earthly reason to continue to dwell on the exam results, let them go! You have – I’m sure – important things to do, like take care of your patients, family, and yourself. You have decades of a career ahead of you, and you would be foolish to burn yourself out for no good reason. I know it’s sometimes hard to let it go. But knowing that you should let it go can motivate you to not give in to these empty ruminations. It is more than OK to distract yourself with other thoughts and activities.

Last point: it is likely you’re reading this before your exam and not afterwards. If so, then you are in a position to face the exam with “your head held high.” What do I mean by this? If you’ve made a good faith effort to prepare for your exam, given your constraints of time and energy, then you can go into the exam, thinking, “Pass or fail, I did my best in preparing for it. I rose to this important career challenge. I will now take my exam, respond to the exam questions with thoughtfulness, and then I will let it go afterwards. At that point, it is out of my hands. I will await results with whatever equanimity I can muster, given the difficult circumstances of a long wait time for results.”

Of course, if you are not yet in a position of facing the exam with your “head held high,” then I suggest you do what you have to do to turn it around right now! It is never too late to get your “S in gear.” Every 5 minutes of prep time improves your odds. So, go ahead and start improving your odds and stop beating yourself up over not starting sooner. Beating yourself up is both a waste of time and you end up beating up the ‘person’ who will be taking your exam – and that person is you, of course.

Let me suggest The Pass Machine family of courses to get yourself up to speed, as fully prepared as you’re able to do in the given amount of time left. The Pass Machine courses have large board-reflective QBanks, and most have a large number of high-yield board preparatory lectures. Check out the selection of courses and options for each one.

Here’s the link to the home page.

I’ve been doing this a long time. We’ve had over 70,000 physician customers. The Pass Machine courses all have better-than-money-back guarantees attached. Why? Because I want to lose money if you fail your exam. Why would I want to lose money if you fail your exam? Karma maybe. And because I want to always be sure that we at API are doing our best. I want to continue to run my business with my “head held high.” If only results matter to you, then only results must matter to me, too.

Here’s the link again.

You can always email me at drjack ‘at’ americanphysician ‘dot’ com if we can help you with anything exam-related. Take care of yourself and remember to be well rested for your exam – they are taxing. 

Yours in Exam Success!

Jack Krasuski, MD
Founder
American Physician Institute