“If you’re going through hell, keep going.”
– Winston Churchill
This quote comes to mind when I look back at board prep and all the times I sat for those inhumanely long exams. You might be an early-career physician in the midst of prepping for boards following residency or fellowship at this very moment.
You might have just started a new job, in a new city, and have not yet established your favorite study spot. You might have failed in your previous attempt and doubted your worthiness and capabilities.
Wherever you find yourself, I do not want you to feel alone. As a collective, prepping and sitting for boards is one of the most anxiety-provoking times in most physicians’ lives. You are vulnerable, and your inner critic yells louder than ever. It is also physically taxing as you sit for long hours, forget you even need sleep, and disconnect from your body’s needs.
Here are seven strategies that you might find helpful at this time:
Don’t delay the celebration. This very stage of life, the fact that you are even board eligible, that you got this far, deserves a celebratory pause.
Self-compassion baths. Yes, you heard me correctly. Surround yourself with self-compassion. Instead of beating yourself up every time you get an MCQ wrong or just cannot get another hour of studying in, treat yourself with the same decency you would show to a friend in a similar situation. This is a research-proven strategy to increase your internal motivation and will set you up for long-term success.
“What can I do right now?” Remember all the times you keep going back to the questions you got wrong or the hours you should have been studying but wasted. Self-criticism is a distractor. Instead, take a pause and a literal deep breath when this cycle is happening, and ask yourself this question: “What can I do right now?”
“Don’t let what you cannot do interfere with what you can do.”
– John Wooden
Do not disconnect physically. Your body has taken a beating with every medical test and exam when you did not honor its needs. When I was studying for my fellowship boards a few years ago, I did what I had done for every preceding exam: sleep poorly, eat poorly, and largely forget to hydrate. Come exam day, it was extremely challenging to sit while severe exam-prep-induced sciatica was wreaking havoc on my lower body. This is your reminder to sleep, stretch, move, eat nutritiously, and hydrate.
Comparing your prep to others will not make it better. Comparing ourselves to others is the most unhelpful sport we play. This is the fastest road to misery. Draw attention to your personal journey. How far have you come from the first day you started this process?
Worrying does not change test scores. You have done your best. Before you start self-flagellating and arguing with me that you have not, that there is more you could or should have done, stop. You are exactly where you were meant to be, and you did your best.
“Worry pretends to be necessary but serves no useful purpose.”
― Eckhart Tolle
Even if you fail, you are a good doctor and a worthy human. I have seen brilliant and compassionate physicians fail tests. That is a fact. Tests are tests; they are not the supreme indicator of your clinical skills, bedside manner, and ability to provide compassionate care to your patients. Tests are tests. Becoming board-certified does not mean you are more worthy as a human.
I want to validate all the emotions and doubts this stressful time is bringing up for you. They do not mean you are “weaker” than your colleagues. They only indicate you are human.
Try these seven strategies and thoughts as you prepare yourself for this season of your life. All seasons pass. Just like all the other exams that brought you to this point, you will handle this one well.
“It is not the mountain we conquer, but ourselves.”
– Sir Edmund Hillary
Amna Shabbir is an internal medicine physician.
