I Failed the Pediatric Boards: Now What?

It’s the second week of December and you check your email to find the long-awaited email from the American Board of Pediatrics with your board results. You open up the email to find out that you failed the pediatric boards.

While this is both disheartening and devastating, remind yourself of this: failing the boards does not make you a bad pediatrician. There are still plenty of options and strategies to ensure that you pass your retake!

First things first, it’s ok to be upset if you failed your board exam. You worked hard in residency and studied hard for the exam. The pediatric boards are a very difficult exam. Second, passing the pediatric boards is more about having a comprehensive and effective strategy than anything. And third, you can still continue on in your fellowship or your job. 

Here are the next steps to make sure you pass the pediatric boards next time.

1. Figure out what this means for you

Each fellowship or job has different requirements. Most fellowships require you to pass the boards by the time you graduate from the fellowship. Ask your fellowship program director how your program handles failed boards.

If you just graduated from residency and have a job lined up or recently started a new job, talk to your boss and see how your institution or workplace handles failed boards. You can still work at your job as you have a full unrestricted license to practice medicine in that state. Most jobs require you to pass the boards within three years of completing your residency. 

2. Talk to your residency program director

Your program director is an abundance of resources. This is not the first time that they’ve had a resident fail the boards! They can help guide you on where you need to improve your studying, when to retake the exam, and put you in touch with past residents who have also failed the boards. 

3. Decide when to retake the exam

The pediatric board exam is offered every October. If you just started a fellowship, you may not have the time to devote to studying for the rest of the year. The first year of fellowship is notoriously rough and it can be difficult to juggle other academic responsibilities. If you just started a new job, it might take you some time to get settled and used to your new setting. You might decide that you want to wait a year and give yourself time to get acclimated to your new environment before re-taking the boards.

On the other hand, you may want to retake the boards the following year to minimize having to study from scratch again. You may worry that you will forget everything you studied. There is no right or wrong answer, there is only what is best for you. Just make sure your fellowship or job does not have any specific requirements about when you need to pass the boards before making your decision.

If you are going to retake the exam next October, make sure to register before April 1st. Nobody wants to pay the late registration fee!

4. Identify your weaknesses in studying

This is important the second time around, as you do not want to repeat your mistakes. Were you not able to devote enough time to study because you started a fellowship or a new job? Did you have any personal stressors in your life at the time? 

Look at the breakdown of topics on your board results. This will tell you if you have a weakness in certain topics. Did you struggle with timing? Did the question stem trip you up? Think back to taking the USMLE exams and if you struggled with test-taking strategies then. Identifying your weaknesses will set you up for success when you retake the exam.

5. Change your study approach

Now, consider your previous study approach—were you focused on memorizing the material or applying it in a scenario? When you learn a new concept, try thinking about it in various contexts to solidify your knowledge.

Hear more from Adam Rosh, MD, about the #1 reason for failing an exam:

Other questions to ask yourself: did you not devote enough time to practice questions, or did you use too many resources? Were you prepared with enough knowledge, but on exam day found your test-taking skills were lacking? Was the exam structure unfamiliar to you and made it difficult to truly perform your best?

Once you have the answer to these questions, you can build your study strategy around closing any knowledge gaps and focusing on the strategies that worked while studying the first time.

6. Create a study schedule

Once you’ve decided to retake the exam and have identified your weaknesses, plan out a study schedule. This will keep you on track. The ABP adheres to a content outline of topics. Use this to create a study schedule where you can devote a week to each topic. Some topics are lighter than others and may not need a whole week. This will help you plan out how far in advance you need to start studying. I would recommend starting to study at least 4-5 months before the exam. This way you can cover all the topics at least twice. Start with your weakest topics so you don’t neglect them.

Hear from Adam Rosh, MD, on how to craft your study schedule (9-minute clip from the Rosh Peak Performance course):

7. Decide whether you need extra help

Your study resources are your building blocks for success. If you need someone to keep you accountable for your studying, decide whether you need a tutor. There are organizations and courses that offer group tutoring or one-on-one tutoring. If you need a resource for a knowledge base, ask your coresidents and new colleagues about the resources they recommend. Stick to only one or two resources to avoid being overwhelmed. You may even consider studying with a resource that comes with a Pass Guarantee to boost your confidence on your retake.

Another way to boost your confidence is by taking a mock exam. While a Qbank is a great way to create custom practice exams and learn with answer explanations, mock exams are precreated assessments that replicate the board exam as closely as possible. Try simulating your test conditions while taking the mock exam for the most accurate projected score.

Learn more about the power of simulating your test conditions before exam day:

8. Consider using a Qbank

Pediatrics Qbank questions are a great resource to use and are representative of the actual exam. I recommend doing two passes through the last 5 years of PREP. You may also consider the Rosh Review Pediatrics Board Exam Qbank including 2,000 ABP-formatted questions and a personal analytics dashboard to identify any areas of weakness and view your projected score. You can even earn 100 AMA PRA Cat 1 CME credits with your Qbank subscription!

It is helpful to do at least 20 questions daily, write down the key points from each explanation, and make flashcards out of your most difficult topics. At the end of each week, go over your key points and flashcards to reinforce concepts. 

9. Most importantly, be kind to yourself

This setback does not mean you are not a good pediatrician. The pediatrics boards are difficult, to say the least. But you are stronger than that! You survived medical school, the USMLE exams, and residency. Now that you know what to do the next time around, feel confident that you will pass!

Rosh Review is a board review company with Qbanks and mock exams for your pediatrics board exam, pediatric hospital medicine board review and beyond. Get started with a free trial today!

By Tanya Masand, MD

Tanya Masand graduated summa cum laude from the Albert Dorman Honors College at The New Jersey Institute of Technology with a degree in biology and is currently a pediatric critical care medicine fellow at Virginia Commonwealth University. She attended medical school at St. George's University and completed a pediatrics residency at Rutgers New Jersey Medical School. Her professional interests include health disparities, traumatic brain injury, and status asthmaticus.

Tanya is passionate about medical education and mentorship and is actively involved in her fellowship's education for residents and medical students. She has tutored throughout high school and college. She feels there is nothing more satisfying than helping others understand physiologic concepts and helping others achieve their goals and dreams. Tanya is excited to help future pediatricians achieve their academic and personal goals. In her free time Tanya enjoys baking, kickboxing, running, and spending time with her puppy.