I'm going for the final exam of the Saudi board of internal medicine that  will be held in 5/11/2009 , thats awful and Im totally  freaking out  .during the last 4 years of misery  I spend in the board I read  every MCQS book out there ,I read Harrison's textbook and Cecel textbook but still it feel that I'm no where near ready for this exam.

I feel like  nothing out there can prepare you as our examiners try to be very creative during putting there quetions , I really beleive that :) despite what our RTP ( residency training director) is telling us .   Though 75% of exam questions apply to traditional internal medicine and internal medicine subspecialties, a number of questions on the exam don't directly pertain to internal medicine. Our examiner  thinks that internists need to master broad medical knowledge, so you can expect about one-fourth of the questions to cover fields like  biostatistics allergy/immunology, dermatology, ophthalmology  evedence based medicine and psychiatry . You can also expect to see at least a few questions on ethics.

When I'm nervous about something I search it out. I read some of previous years exam and I  noticed that they focus more  on  on cardiology, gastroenterology nephrology and pulmonology.


Three-quarters of exam questions are based on scenarios that take place in offices or emergency rooms. Many require to look at information from several sources and reach a conclusion using your clinical judgment. Most of them ask you to pick the right diagnostic test, choose the right therapy or identify risk factors.

When you're reading through a scenario, remember that the question may not always be about diagnosis just answer the quetion and do not over think it.

X-rays or photos of rashes and lesions ,EKGs are common  on the exam, so be prepared to diagnose problems based on visual as well as written information. The best way to target this kind of question is to pay attention to how the lesion looks (color, size, clusters, etc.) and where it is located on the body.


also I've been asking few of those who passed This exam and they all recommended looking at the College's Medical Knowledge Self-Assessment Program (MKSAP), which has "the best source of questions written in a similar  style as those on the exam." as said by our residency director.


Some MCQs strategies:

After reading through a question, try to come up with the answer on your own before reviewing the choices. For long clinical senarios, glance at the last line of the scenario and the question first so you know whether to look for a diagnosis, course of treatment or appropriate testing procedure. On the test, you're not going to have every piece of information that you would want. "Just go with what's given.

 Stay alert for  "magic words" those words that specific for certain conditions .Phrases (tearing pain, for instance) that can clue you in to key epidemiologic or physical exam data. Ethnicity, age, geography, gender and occupation can all be magic words. For example men over 50 have a higher incidence of temporal arteritis.

 your first choice is usually the best one, so if you go back to look over your answers, change something only if you are sure you made a mistake or misread the question.

Studies of people who see themselves as "poor test-takers" show that they often don't understand the question being asked. As you read, circle the negative words (least likely, the following are true except) to highlight key phrases. This reduces your chances of becoming confused by the wording.


My RTP keep on saying that The writers of the exam are not trying to trick you, yeh right! :) . "If the answer seems obvious, it probably is right" he says . The object is to get residents to think systematically, to logically use the information to come up with a diagnosis, a plan, and what you're really going to do with a patient. I'm not sure about that but I just to think positively :S.

Finally good luck to every one and to me in trying stay calm and positive.