How Am I Supposed to Study for Boards on Inpatient Nights?

Though I committed to a few multi-hour study sessions each week, I struggled to be mentally present enough to do more. Either I was too tired, too busy or too aware of my own procrastination habits. By spreading my studying throughout the day and engaging in short sessions (along with the longer ones I did have time for), I knew that my mental health and future board score would benefit.

Teach the Masses

The first time I was on inpatient nights, I was terrified. How someone trusted me to run an entire service at 3 a.m., I couldn’t understand.

I quickly realized that nights were an excellent time to not only practice my independent medical thinking (with my attending’s cell number handy if needed) but to study for boards as well. Inpatient nights provided some precious quiet time to read and do practice questions. When I was able to get in a good study session on nights, the same as on inpatient days, I felt pretty good about my progress. But it was the morning time at the end of my shift that I most enjoyed utilizing.

At my residency, the night seniors were responsible for a key portion of the teaching that interns received. With only six residents per class, New York-Presbyterian/Columbia University Medical Center Family Medicine Residency is a small program that thrives on developing a sense of community, so many of our seniors took pride in planning and providing that early morning teaching. We’d select a teaching topic applicable to the night before and engage in either didactic, case, or lecture-style teaching.

When I started studying for my boards, I often realized that one or two of the practice questions were relevant to my planned teaching topic, so I’d include them in my teaching. I’d read the question, let everyone select their answer (including the attendings, whose participation made the exercise a lot of fun), and then share the answer and explanation. Suddenly, the whole team was engaged. I loved it because I felt less alone in my studying but I also enjoyed everyone’s responses. On extra engaging mornings, the team might spend a few minutes arguing about the best answer. The team also loved it because any study help was always a plus — this was even true for the interns who want to feel prepared throughout residency and not just at the end when preparing for their own boards.  

Download the AAFP Mobile App

Using the AAFP mobile app made studying easier and more efficient. On the app, I was able to listen to the AFP Podcast for clinical highlights, read the AFP and FMP journals to refresh specific topics, and practice board review study questions. I realized early on that though the podcast episodes are high yield, I need music when I study. (I like to think my Spotify playlists need me, too). Plus, I prefer questions to articles, so I spent most of my time doing practice questions.

Whatever your approach to studying, it’s important to realize that it can change. What worked for you during your COMLEX or U.S. Medical Licensing Examination might not work for boards, even if it took you until that third exam to feel like you finally got your study strategy right.

You might prefer studying with others, but your schedule might force you to study alone this time. You might usually study during the daytime, but you now might find that you have to add in some night-shift sessions, too. The most important thing is to be ready to adapt to your environment, be honest about what you need for a successful study experience, and give yourself the time and grace needed to make that happen.

Finally, don’t procrastinate.