How to Select the Best Med-Peds Board Review in 2024

December 1, 2023
Every day, customers ask us the same question in several variations: What is the best internal medicine & pediatric board review? Is my only option to purchase two separate Qbanks from different companies? Why is your Qbank the top board review for internal medicine & pediatrics? How does Rosh Review compare vs PREP, MKSAP, Pediatrics Board Review (PBR), UWorld, BoardVitals…?”

We understand the importance of the question. Now that the focus has been on self-directed learning due to coronavirus (COVID-19), purchasing Qbanks for your certification exams or in-training exams costs more than money. Depending on the quality of the Qbanks and your exam results, it will save or cost you time. And time is the limited resource. You may still have time to choose a Qbank, though—here’s a reminder of the 2024 exam dates:

Internal Medicine:

  • IM-ITE: August 15–September 4, 2024 (except September 2)
  • Certification exam: August 15, 20, 26, 28, 29, 2024


  • In-training exam: July 10–24, 2024
  • Pediatrics board exam: October 15–17, 2024

Let’s state the obvious: we sell Rosh Review Qbanks to use during Internal Medicine and Pediatrics (Med-Peds) residency, and Rosh Review might not be the best fit for you. Separate internal medicine & pediatric Qbanks from BoardVitals, NEJM Knowledge+, MKSAP, or UWorld might be a better fit. In fact, you might not even need Qbanks and would benefit more from live courses such as the American College of Physicians (ACP) Internal Medicine Board Review (IMBR), Cleveland Clinic Children’s Annual Pediatric Board Review course, or a do-it-yourself program. This article will discuss the key decision criteria that will help you answer your most important question: Which board review resources are right for me during my Med-Peds residency?

Do you really need a Qbank to pass your exam?

Some individuals do not use a Qbank for their board preparation. Consider these questions if you think you may be able to forgo a Qbank:

  • Do you have the self-discipline to study on your own?
  • Do you like curating your own curriculum around the American Board of Internal Medicine (ABIM) and American Board of Pediatrics (ABP) content outlines by reading journals and using review books, listening to podcasts, or free content available on the web?
  • Can you make the content relatable enough without a Qbank to remember it out of context for questions on the real exam?
  • How much time can you invest in preparing, and how much time will you invest?
  • How much money can you invest in this tool?
  • Are you using this Qbank as your only exam preparation tool? Are you using it to supplement a live course, self-study, or another Qbank?

As you answer these questions, consider the many options available to you along the spectrum of your investment of time and money, such as the following:

  • Live courses or “boot camps,” which offer peer-to-peer interaction and “force” you to make exam preparation a priority over a two- to four-day period (when there’s not a global pandemic). As a side benefit, you get to focus on studying with little distraction. Check out the ACP IMBR courses, the annual Mayo Clinic Internal Medicine Board Review course, the Children’s National–George Washington University Pediatric Board Review course, or the University of Michigan Annual Pediatric Board Review course.
  • AAP PREP® questions, which you might access free of charge if you are a resident.
  • Free Open Access to Medical Education, which offers quality content at no cost. As a side benefit, you can learn from your home, favorite coffee shop, or the beach on your time. Check out Life in the Fast Lane, Louisville Lectures, or CHOP Open-Access Medical Education.

Picture yourself in each of these settings: Sitting at your desk, googling “duodenal atresia” on your computer as you self-study. Or booking flights, flying to a popular city, spending two to four days in a conference room with your peers and some big screens (when there’s not a global pandemic). Or watching lectures online and reviewing questions during a live course. Or answering hundreds of curated questions from your smartphone between shifts or at a cafe. You might picture yourself in all of these scenarios. You need to be ruthlessly honest with yourself about what is best for you as you consider these options.

If you believe you still need a Qbank during Med-Peds residency, read on. If not, you can save time and click to another board review article on the web.

Content, Content, Content

Now that you’ve determined you need a Qbank, you have many options. You need selection criteria that provide the best outcome for you, not the marketer.

Hint: It’s all about the content.

High-quality content should be the primary decision criteria (nobody selects low-quality content, at least not intentionally). Your challenge begins here. Every Qbank company makes the claim of offering high-quality content in different forms such as “closest to the boards,” “meticulously crafted,” and “high yield.” What is the definition of high-quality content that suits your needs?

Every Qbank you consider should provide content around these building blocks:

  1. Authored and peer-reviewed by internal medicine & pediatric faculty, clinicians, and program directors.
  2. Created to align with the ABIM & ABP formats. There should be no “negatively phrased” questions, no “all of the following except,” no “A and B”…you know what we mean.
  3. Addresses the right content and is well structured. These two basic criteria are imperative in order for a test question to be high quality.
  4. Explains why an answer is correct or incorrect. Understanding why an answer choice is incorrect is just as important as knowing why it is correct.

If the Qbanks you’re considering for your ABIM and ABP exams don’t meet these basic requirements, you should quickly eliminate them.

Basic or Comprehensive Content

Fortunately, most internal medicine & pediatric Qbanks create questions around these building blocks, but that may not help you to make your selection. You need to dig deeper to determine which type of content works best for you by asking the following questions:

  • How strong are the distractors in the answers? The difficulty of a question is defined by the choice of distractors. Good distractors determine the difficulty level of a question.
  • How detailed are the explanations? Too much and you feel like you’re reading a medical journal. Too little and you’re not getting enough supporting content to learn the topic well.
  • Is there additional content to enhance your learning such as images, tables, video clips, teaching aids, or condensed bullet points? Are they memorable enough to stick with you on exam day?
  • Do they offer multiple paths to understand and solidify your knowledge of the topic with additional questions on the topic?
  • Do they offer multiple references and hyperlinks to those references if you want to dive deeper into the subject?

Again, you are in the best position to determine what you need from the content—something that just scratches the surface or something more comprehensive that provides multiple viewpoints. This is analogous to assessing a newborn using NRP criteria. Can you decide on the next steps in resuscitation for the newborn by considering only the clinical appearance, or would more information such as vital signs be helpful? If you only need the clinical appearance, consider a basic Qbank. If you need the vital signs along with the clinical appearance, select a comprehensive Qbank that provides context and reinforcement to gain a deeper understanding of each topic.

Where the Rubber Meets the Road

You’re making a big investment in time and money, which impacts your career, your patients, and your livelihood. The only way to assess the content is to experience it yourself. Sign up for a free trial for each Qbank that you’re considering. Yes, you’ll probably get a few extra emails now that you shared your contact info, but the hassle of unsubscribing from the companies you don’t select will be outweighed by the confidence you gain by making the right decision.  

If you want to evaluate separate internal medicine & pediatric Qbanks, here are the ones we recommend you check out for internal medicine (listed in alphabetical order to avoid bias):

  • BoardVitals
  • MedStudy
  • NEJM Knowledge+
  • Rosh Review
  • TrueLearn
  • UWorld

And these are the pediatric Qbanks you might want to review:

  • BoardVitals
  • Hippo Education
  • MedStudy
  • NEJM Knowledge+
  • Rosh Review
  • TrueLearn

Keep an open mind during the evaluation. Your due diligence will pay off. Once you get into study mode, you want to eliminate the time, energy, and distraction of questioning your decision.

Internal Medicine & Pediatric Qbank Free Trial Evaluation

You’ve signed up for one or more free trials and are evaluating content based on what you need for a successful outcome. What else might you consider as you interact with the content? These attributes will enhance or detract from your preparation, providing a “Wow” experience or an “Ugh” experience. Remember: you’ll be viewing hundreds of questions, if not thousands. Small details matter when you repeat something over and over.

Software Design and Technology

Do you mind using two separate Qbanks to study for internal medicine versus pediatrics? If not, finding the best Qbank for you in each specialty might make sense. Or would you prefer to study both subjects from the same platform rather than having to learn a new system? You’ll want to look for a combo internal medicine & pediatrics Qbank.

Do you like the way you experience the content? As you answer questions and read the explanations, take time to look at the buttons, fonts, colors, white space, and page layout. The software doesn’t need to be flashy. Rather, it needs to be highly functional so it doesn’t distract you from the content. The interface should be seamless and intuitive. After taking 10 or 20 questions, the software should become “invisible” so you can focus on learning.

Are time-saving features built into the platform? See if you can name your exams for better organization and retrieval. Check if you have the ability to search your answered questions. You can save precious time by being able to search your questions, answers, explanations, and images.

Does the application function quickly? A three-second improvement in performance might not seem like a big deal, but when you multiply that by thousands of questions answered and explanations reviewed, that can add up.

View the questions on the devices you plan to use to study on. If the Qbank offers an iPhone or Android app, take the time to download it to your phone or tablet. Will you be studying when you are not able to connect with Wi-Fi (e.g., on a clinical shift with tight IT firewalls or on the subway)? If so, make sure the Qbank you use has an “offline” mode. You want to prepare for all the situations and slices of time that you’re able to study.

Customer Support

You need to evaluate customer support in the same way you evaluate the content. Internal medicine & pediatric Qbanks offer a wide spectrum of support options:

  • Basic: account administration and technical support
  • Medium: content correction and updates
  • Enhanced: clinicians available to clarify questions, discuss conflicting evidence, and suggest strategies to understand the topic

Test them out by sending a support ticket. Do you receive a response? Do they publish customer support feedback? You will find varying levels of support and can determine whether their support model suits your needs.

Learning Technologies

Learning technologies continue to emerge, advance, and disappear. They all center around learning and test theories combined with high volumes of data and vast computational power.

Here are the classic learning techniques:

  • Retrieval practice: recalling facts, concepts, or events from memory
  • Spaced repetition: studying information more than once but leaving considerable time between practice sessions
  • Interleaving: studying two or more topics at a time
  • Elaboration: finding additional layers of meaning in new material
  • Generation: attempting to answer a question or solve a problem before being shown the answer

Test theories:

  • Classical Test Theory (CTT): Your goal with exams (and question banks) is to get the most correct answers. Exam providers report percent correct, and exam takers strive to score 100%. Scores are evaluated independently.
  • Item Response Theory (IRT): Assumes that questions measure some underlying latent trait. Exam providers view responses simultaneously, looking at thousands of test takers and thousands of questions.

While reviewing Qbanks, you might find the term “adaptive learning.” You’ll see it in other forms such as smartbank or prescriptive learning, and it can be defined in many ways. Adaptive learning originated in the K12 market. Companies are testing this technology in the graduate medical education (GME) market to determine whether these concepts can improve outcomes. If you value this feature, ask more questions about the underlying technology and algorithms incorporated into the product.

As you review the learning and testing theories, you’ll see that many of these concepts can be applied to your exam preparation with or without a technology assist. Technology can be helpful, but it also can be a distraction. Good practice will always beat theory.

Predictive Analytics, Peer Comparison, Performance Analysis

Qbanks can offer lots of data to help you identify your weak areas, self-remediate, and predict your score. Check out their performance dashboards to see what tools you might use to streamline your preparation time.

Basic information should include the following:

  • Number of questions (total, used, unused)
  • Performance based on the ABIM & ABP content outlines

Enhanced information includes additional data:

  • Projected exam score
  • Probability of passing
  • ABIM & ABP content outline subcategories
  • Performance breakdown based on age, acuity, type (e.g., first order, second order), and Bloom’s Taxonomy
  • Options to count skipped and unanswered questions

How are you doing relative to your peers who are preparing for the same exam? Did the majority of examinees miss the same question? Or are you in the minority that missed this particular question? Many individuals find this data motivational. Others find it a distraction.

The Med-Peds Qbank Comparison Matrix

Now that we’ve covered the major factors to consider during your free trials, it’s time to create your grid. This decision needs to be right for you, not a marketer.

Med-Peds Qbank comparison matrix

Download the Med-Peds Qbank Comparison Matrix

Here are the steps we recommend taking to complete an effective evaluation using the Med-Peds Qbank Comparison Matrix:

  1. Narrow the Qbanks you want to compare to three. The incremental benefit of adding additional Qbanks to the evaluation is low.
  2. Rank the Qbanks using the criteria: 3 = excellent, 2 = average, 1 = poor.
  3. Add up the points in each column.

You will note that we included cost and company culture at the bottom of the matrix. You can use these as tiebreakers.

Comparing the Costs of Qbanks

We rarely complain about paying too much for something that is high quality—a product that delivers on its promises. We also know what it feels like when we purchase something cheap that disappoints. That’s why we place cost near the bottom of the criteria list.

Are CME credits included? Is there group pricing or military discounts? Do a web search with the product name plus “discount” to see what’s available so you save money where you can. If price is the most important criterion for you, calculate the cost per question and skip the evaluation.

Company Culture and Values

Do a web search on the company. Who leads it—a physician or business operator? Does leadership include experienced educators, faculty, and former program directors? Individuals who have dedicated their lives to fostering the success of others on their medical education journey? Or is the company led by venture-funded marketing gurus?

When you purchase a Qbank, you not only invest in your personal success but also in the success of others. Your money goes towards the cost of producing and supporting the product, the livelihood of the company’s employees, and the company’s profits. Does the organization align with your values? Where do the profits flow—to shareholders with dividends, to customers through more innovation, to the medical community with scholarships and grants, to programs that eliminate disparity in education, to initiatives to help eliminate the world’s most pressing health crises?

Decide and Act

Now it’s time to make your decision. At this stage, your head and heart (some say gut) should be aligned. Enjoy the purchase of your Qbank(s) and prepare to conquer this next milestone in your career. We’re cheering for you.

By Mike Sanders

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