If you engage in the behaviors below, you are in danger of losing your mind in the process of preparing for your board exam.
- You spend more time worrying about the exam than studying for it
- You keep buying more and more prep resources when you’ve barely made a dent in the materials you already have
In this post my goal is to help you not lose your mind, that is, to keep your stress under control and instead expend your time and mental focus resources productively.
Worry Vs. Study
A common way to define worry is as a state of anxiety. This is true but misses the core meaning. Foundationally, worry is thought and, more specifically, ruminative thought about actual and potential problems that are thought about in such a way that results in anxiety.
Why is worry so ruminative? The answer is that the focus of worry thoughts is not on coming up with a realistic solution to the problem which is their focus. Instead, worry thoughts focus on aspects of the problem which are not amenable to a solution. Consider this example: if a clinician has a board exam coming up and is worried about passing – who isn’t? – then developing and sticking to a study plan is a productive strategy. Once the plan is in place and the exam candidate gets in the groove of studying, worry ruminations often lessen or disappear. If, on the other hand, the exam candidate thinks about all the negative fallout that will occur if they fail or about how bad they did on some previous exam, those thoughts can continue to circle in awareness, leading to anxiety but not necessarily to a viable solution. Thoughts about the past or the future are productive only if they increase motivation to engage in the behaviors – like study – that will minimize some future aversive consequence. In our case, thoughts are not productive if they don’t lead to increased study, and they are actually counterproductive if they lead to decreased study. And chronic worry often leads to the latter, becoming so stress-inducing and demoralizing that the sufferer is less able to focus and study productively.
My motto is: Worry is the enemy of study and study is the enemy of worry. Studying more leads to a greater sense of mastery of the material and confidence in being prepared for the exam. Thus, when the thoughts that lead to worry are starved of attention, they begin to lose their malign power over a person. Conversely, worrying more leads to less study or less effective study for the reasons I explained above.
If the solution to worry is so simple, why is it then so hard to stop worrying? Why would a person continue to focus on unresolvable aspects of their problem rather than come up with a viable plan and deploy it? It is because there is a magical-thinking aspect to worry ruminations: during the act of ruminating on the problem and the danger it poses, the worrier feels safer. Worry keeps the danger visible, which feels better than letting the danger remain hidden, waiting to pounce at any moment. The problem is that continuing to ruminate about the danger can lead to less of the behavior that would actually minimize that danger. So, overcoming worry requires discipline: as soon as you catch yourself worrying, do the thing that is the enemy of worry: immediately start studying.
Buying More Study Resources Vs. Completing What You Already Have
This is a common problem. One could argue that if an exam candidate wants to buy more study resources and has the funds to do so, then this is not a problem. This is true up to a point. However, the buying of more and more resources both indicates an underlying problem and can worsen it. The buying of more and more resources may indicate an out-of-control worry, with a solution that can exacerbate that worry. A person buys additional study resources because they must feel what they have is not sufficient, but what they have done is make their preparation hole feel deeper. Rather than having already gotten through, let’s say, 50% of their prep course, they are now only through, let’s say, 20% of all of their combined study material. Thus, the huge amount of unstudied prep material, perhaps an amount that no one could realistically get through in the remaining time to the exam, looms over them and leads to more stress and worry. That person will likely continually feel they are falling short and lacking enough time.
My recommendation is to get a good comprehensive course or other resource, develop a study plan, and study what you have. If you find you can do more than what you had planned, then certainly add additional resources. But remember that you will NEVER be as prepared as you want to be. You will NEVER know everything there is to know. You will ALWAYS get some exam questions wrong. And that is all ok. You don’t get gold stars for a high grade on your ABPN exam. Board exams are pass or fail only. Study in a way and to the degree that when you enter the exam you can hold your head high, knowing you were a disciplined and conscientious studier. The rest is out of your hands. Say a prayer. Focus on the exam question in front of you. Answer it to the best of your ability. Take a breath. Move to the next one. Repeat. All will be ok.
I end with good news. We have launched BERACUDa, which is the acronym for Board Exam Review Assessment and Curriculum Design. Rather than me explaining it here, take a look yourself. Click here. It is free and open to all. It may be extremely useful to you.
Thanks and all the best on your exam,
“It’s not the will to win that matters—everyone has that. It’s the will to prepare to win that matters.” – Paul Bryant
“By failing to prepare you are preparing to fail.” – Ben Franklin
“We try too hard to know the exact future and do too little to be ready for its many possibilities.” – Bina Venkataraman