Preparing for CORE Radiology Exam

The CORE is a beast of a test. Like any obstacle, it can be tamed with the right schedule, training, and focus. I wanted to share what worked for me with a timeline to help lay things out mentally for someone from 1st year to 3rd year of residency. I needed to create a materials and time management formula to get through the CORE. Disclaimer: any good things I say are not meant to brag and any shortfalls I share are simply meant to make you feel better about yourself. The point is, that with enough work anyone can beat the CORE regardless of how things have gone so far. If my experience can help even 1 person have an easier time with the CORE, then it was worth sharing. With a test like the CORE, we need as much help as we can get. So here is my story.

I'm in my last year of residency at Hahnemann in Philly. I just got my results back Tues July 12th 2016 at 1:30 PM, yea you'll remember the exact time too. Seeing that "PASS" was such a relief. I still don't quite know what my score means or how it measures against other people, but the max you can get is 800 and passing is 350. The ABR has a whole convoluted algorithm to figure out what to do with you if you don't pass. None of it matters anymore, it's done! So how did I get here?

While I've gone straight through with schooling, life outside of work hasn't slowed either. I got married at 19 (we recently celebrated 10 years of marriage) and we have three kids. The two oldest are girls and biologically ours; the younger is a boy who we adopted from North Philly. We adopted him during intern year, because that's when everyone has the most free time (sarcasm). The point is that for anyone with families or any other responsibilities outside of work, it doesn't have to work against you for getting through the CORE. Throughout residency (including the CORE), I haven't studied at home in the evenings or weekends once. The other important point I'd like to make is that I'm not what you would call a "good test taker". I got 217 on Step I, yea not so great for trying to get into Radiology. For the inservice exam each year, let's just say I've never gotten the highest score award (it makes me laugh every time I think about how badly I did). So, the plan.

1st year ( YAY! No more intern year): Up at 6AM and read Brant and Helms (CORE radiology is probably a more applicable substitute with the new boards). I would read for about 1/2 hour, get breakfast, and then read until 7AM with breakfast. At 7AM kids got up, hungout with them, and headed to work around 7:30AM. At work, I would fill anytime I had reading Brant and Helms (only added up to about an hour over the day).

2nd year (Call SUCKS!): Up at 6AM and do about 15-20 questions from Rad Primer's basic section. The rest of the day stayed the same doing questions and reading throughout the day as I had time. If I was coming off call or just exhausted, I would sleep in a little and just daydream at work. This whole thing is a marathon; taking breaks is important.

3rd year (Oh crap, it's here): I broke the year into 3 parts. The first 6 months: continue with Basic Radprimer, read  the textbook CORE Radiology twice, and build a binder. Getting through the CORE was about my mental game. Having this binder and a detailed study schedule (discussed below) were the two things that put my mind at ease through the whole process. Everything I needed to know was in 1 place and I knew where I needed to be to fit everything in. Part 2 of the 3rd year was months 6-9 (up to 1st week of March). I read Crack the Core once through and then went back over the higher yield topics twice (physics, nucs, mammo, cards), each time adding to the Binder with new information and rapid recall. In months 6-9 of 3rd year I finished up RadPrimer's basic questions (about 3500 total). The 3rd part of 3rd year was the 13 weeks leading up to the CORE exam.

BINDER: I bought a 3", 3 ring binder that I could add pages to and created a section for each area of radiology (mammo, chest, cardiac, physics, nucs, etc.), about 13 total. I hole punched a bunch of plain white printer paper and drew a line down the middle of each page, front and back. On the left side of each page I created an area for each topic and wrote all the important points from CORE Radiology. The right side of the page was blank to add info I came across on each topic later in studying. At the end of each section I created a rapid recall section where I would put a buzzword or topic on the left side and an explanation on the right side. I filled the rapid recall part with anything I came across that would make a good question. This rapid recall idea became the most useful part of the entire binder. The last week of board studying was spent going through the rapid recall sections, marking things I got wrong, and repeatedly cycling through until I got everything right. 

SCHEDULE: I always do better with a detailed plan. So I made a list of all the resources I wanted to use and laid out every hour of Mon-Fri for 13 weeks leading up to the boards. My basic day was studying from 6AM-4PM Mon-Fri, no evenings or weekends. That 6-4 included time for breakfast (1/2hr), lunch (1/2hr), working out (1hr), and an afternoon break (45min). So each day, I'd study for maybe 6-7 hours total. I would keep track of my progress and make changes to fit everything in. I was able to pin down how long it took to read a set number of pages or do 60 questions. It was just a reassurance knowing if I stayed on track, I would fit in what I needed and reach the end.

SOURCES:

CORE Radiology: Good for building a foundation of Radiology

Crack the Core: Good for learning how to take the CORE

Textbooks: HUDA, Metler, Requisites, etc are all too detailed and not efficient enough to justify the time is takes to get through them for the CORE.

RadPrimer: 7200 questions. Very Helpful

Qevlar: 2100 questions: Very Helpful

Face the Core: 2600 questions: Good for learning information. Not good for giving you an idea how you'll do on the CORE. You have to answer a question before moving onto the next (really screwed up my rhythm). The questions are really tricky, but the explanations are good. So if you're score isn't so good it doesn't reflect how you'll do on the CORE; you'll still learn the info from Face the Core and be able to apply it later.

Random Board Prep Cases and Physics Questions: Totaled about another 2500 questions. 

BENCHMARKS: How do you know if you're doing enough well enough? One measure I've heard is getting a 60% or higher on ABR's 111 question practice test (save this until a month before the test). Another is doing at least 5000 questions in the 3 months leading up to the exam.

METHODOLOGY: For lack of a better term, I guess. I approached studying as a repeating consolidating cycle. I used multiple sources covering all of radiology between CORE, Crack the Core, various Case Review Powerpoints, etc. I didn't focus 1 week on each section at a time and get to the end with no time to go back over what I started 13 weeks earlier. I just kept cycling through all areas of radiology in the order the source I was using at the time happened to organize them. When I was doing questions, it was always a shotgun approach where it could have been anything from chest to physics to non-interpretive. It helped keep everything in the short term memory through the whole process.

APPROACHING QUESTIONS: It may seem too detailed, but how I did questions played a big part on the mental game. Controlling the mental part of this was almost as difficult as learning the information. Each day of the 13 weeks, I would do 2 sets of 100 questions on RadPrimer, Qevlar, FacetheCore, or some other Q-Bank. I would read the question, the answers, look at the pictures, and then pick an answer. I would go through the questions and answer any I knew. If I didn't know them after 15 secs of reading the question and options, I would mark them, and move on. I noticed the second time I came around and read the question, my mind had cleared out all the fuzz and I was able to just pick what I thought it was. Getting a rhythm down, so you're not thinking about how much you hate doing the questions was really helpful. On test day, it's 350 questions the first day and 300 the second. I set up a game plan ahead of time. Day 1, I did 50 questions, break, 100 questions, break, 100 questions, break, 50 questions, break, 50 questions, done. Day 2, I did the same thing, minus the last set of 50 and I was DONE!.

TEST DAY: I went to Chicago and stayed at the ABR's hotel Renaissance, definitely the easiest way to go. My plane out of Philly was impressively delayed, no pilot and all. I didn't get to sleep in Chicago until 2AM the day to the test, sweet! The hotel lobby in the morning looks like a cult convention. Everyone is the same age group and carrying around a clear plastic gallon size bag. The ABR is very particular about the CLEAR bag to hold everything you need for the day of testing. I had to use the ice bag from my room. I finished with about 1.5 hrs to spare each day. At the end of day 1 I think I spent about 3-4 hours between the pool, hot tub, and working out just to do anything except sit around and study or think about studying. 

SHARING: All of the work I've put into preparing for the boards has already served it's purpose to me. So, I am happy to pass along my schedule, electronic board prep materials, and any other advice anyone might want regarding the CORE.