Issue 76 - September 12, 2025

Sole Purpose 76
Studying for 3rd Year
Boards and In-Training Exams

Print

One of the questions I’m frequently asked is how I plan to study for my final board exams before graduating from residency. While my testing anxiety and desire to be thoroughly prepared might be higher than average, the truth is—as a rising second-year resident—I haven’t officially started studying for my third-year boards. That said, I’ve already taken both the ABFAS and ABPM in-training exams (ITE) and can reflect on how those initial experiences went. Recognizing my limited experience and barely PGY-2 status, I reached out to a few trusted third-year residents (who will remain anonymous) and asked them to share their advice on board exam preparation. Here's what I learned.

What is Board Certification?

As residents, we all complete a CPME-accredited three-year minimum residency program. Toward the end—typically during third year—we take board exams to become board certified. Preparation for these exams begins during residency with the ABFAS and ABPM In-Training Exams (ITE), which are completely separate from the APMLE exams taken during podiatry school.

The ABFAS board exams are typically administered in the fall (around September), while the ABPM exam usually takes place at the very start of the calendar year. The first step in the board certification process is taking the fall ITE exams, which serve as practice tests to assess your progress throughout residency. For first- and second-year residents, these exams are formative—your scores don’t count toward board qualification. However, as a third-year resident, a passing score on any individual ITE exam can be used toward board qualification.

While that might sound minor, passing the ITE in your final year can save you significant time and money—especially when you’re preparing to graduate, move, and start a new job. In that context, studying isn't just about doing well—it’s about setting yourself up for success during a very busy transition period.

My First In-Training Exam

As a first-year, I was explicitly told not to study for my ITE exam. My chief, knowing my tendency to overprepare, made a point of this. So, I treated it as a baseline—a chance to see the exam format, assess my comfort level, and understand the test’s structure.

At Ascension St. Vincent Indianapolis, we review cases from Board Wizards once a month. This helped me become familiar with how to approach a case, what the exam expected, and how to avoid wasting clicks. I went into the ITE with a rough idea of how to navigate a case and focus on what mattered most.

If I could go back and do one thing differently, I’d change the timing. I had scheduled the didactic portion for 9 PM on a busy podiatric surgery week, and I was completely fried. It had slipped my mind just how mentally draining it is to work through that many questions after a long day in the OR and clinic. Next time, I’d take the didactic section at a testing center on a fresh day—definitely not after a full surgical load.

So that’s my two cents on the ITE. Now, let’s hear what the third year residents had to say about how they studied for boards.

When did you start studying for 3rd year boards?

I started studying in June.
For the fall boards, I started studying in the summer around June. During the summer, I was not studying everyday/consistently for a few hours. However, I started to study more consistently around July/August.
For the spring retake, I started studying in January and was consistent during that time.
Maybe I will start a little earlier for my spring retake.
I’d recommend doing practice questions as much as possible and paying attention to the “explanation” part of the questions to understand why the “most correct” answer is the “most correct” and reading those resources ie McGlamery’s. I took notes on questions/topics I got wrong and tried to study those topics more.

How much were you studying each night?

Depending on the workday I was having, ie How many cases labs/clinic/other things I had to do directed how many hours I studied. I would aim for at least 2 hours nightly.
On days I had more free time, I could study for 5 hours +.
I tried to study for at least 1 hour every night and more on the weekend. I considered myself working as an approach to studying.

What resources did you use to study?

My program pays for Board Wizards, and I started using it 6 months before the exam.
First time around, I used Board Wizards, practice exams from ABFAS, study notes/materials I already had to refresh on specific topics as necessary. For the second time around, I did the same thing but added in McGlamery’s as well.
I’d recommend doing practice questions as much as possible and paying attention to the “explanation” part of the questions to understand why the “most correct” answer is the “most correct” and reading those resources ie McGlamery’s. I took notes on questions/topics I got wrong and tried to study those topics more. I used Board Wizards.
Boards Wizards is plenty in terms of practice, talk to people about what topics were high yield on their exams.
Waterhouse resource is cross-referenced with McGlamry's. Great for perioperative management. Don't just read McGlamry though. Use if for reference.

Register Here for the 2025 Superbones Superwounds Virtual Fall Conference

General recommendations for the test itself:

Imaging - you don't get dinged unless there's contraindications to the imaging.
No true trick - you must study and really PRACTICE doing well. Studying for ITE 2nd year for 6 weeks before helped a lot when real board time came around. Practice for the real thing. Treat it like the real thing. Break down your exam scores from ITEs, see where you need work/focus.
This year there were lots of tumors. Always check the lymph nodes! All the way up to inguinal! Node bx for plantar fibroma - we wouldn't do it in real life....but for boards might be legit. Refer to oncology!
Talk to previous grads of your program and see what resources they have made to study.
Pregnancy on every woman. Make your own system for what you're going to check.
Infection markers - doing more than you would IRL is ok - also order lactic acid, urine cx, blood cx, procalcitonin, whatever you can. Labs you can be generous with.
Diagnostic injections can be important to order. Can tell you exactly where the pathology is. More common on boards for arthritis - find which joint the pain is coming from, then fuse it!
Checking pulses could be a waste of an exam on a 20-yr old presenting for bunion. You can do it if you need something to fill your exams but be careful not to get stuff you might not need when there's more important points to get.
Smoker - yeah, check pulses every time. Also smoking cessation! Easy points! Drug screen for any suspician - even EtOH history.
Don't overthink it. Usually, first answer you think is the right one. This is back to basics - don't worry about small things like one attendings specific preferences on certain things - ex leaving the CC joint out of a triple - the classic answer is to do the entire triple arthrodesis.
Fracture - CT Gas - CT. Soft tissue - MRI. Bone infection - MRI. And x-rays on everyone.
Match everything - if you have positive Silfverskiöld’s, then you need to treat it, and diagnose it!
Boards are 10-15 yrs behind in "new data". Stick to basics. ex Bone scans, we don't do anymore, you may have to order because they used to.
Sections are weighted - treatmentplan is more important.
Trying to get as many points as possible per section.
Do not have to use up all of the given tests, imaging, exam points.
Do gait exams for biomechanical problems (flatfoot, cavus)
Do not do anything that harms a patient
- Ex Renal issues and MRI contrast
- Ex Pregnant and XR
Use ABFAS site to review cases.
CBPS Review = Use Board Masters, Boards By Numbers, Board Wizards
Review drop downs!!! KNOW what is in the lists for easy recall.
CBPS
- Start with imaging (XR foot/ankle) and pathology noted will help focus the physical exam. Often the prompt/clinical image and then XR/MRI will get you the answer.
Do not get discouraged if 2 part question and they did not choose the same procedure as you, not necessarily wrong.

Register Here for the October 18, 2025 DEA Mate Training

What was the most difficult part of the exam?

The most difficult part for me was between didactic and case-based questions. The most difficult part for didactics was trying to figure out what the “best” answer would be for treatment options, or more so what answer they were looking for as more than one option was viable and what would be the “best” option based on who you ask.
It is just a hard test, and you need to do as many practice scenarios as you can.
Diverse case load and just overall preparing for everything, I think preparing for our cases helped the most but there is some weird stuff you just don’t commonly see which is why it is so important to do practice questions.

Conclusion

Studying for third-year board exams and navigating the in-training exams can feel overwhelming, especially when balanced with the demands of residency. What I’ve learned—from my own experience and from speaking with upper-level residents—is that success doesn’t come from a single strategy or perfect timeline. It comes from consistency, thoughtful practice, and tailoring your approach to what works best for you.

Start early if you can. Use the ITEs not only to assess your knowledge but to guide your studying. Focus on high-yield topics, lean into the explanations behind practice questions, and take advantage of the resources your program provides. And just as importantly, talk to those who’ve gone through it before—mentorship and peer advice are invaluable.

This process isn’t just about passing a test—it’s about becoming a thoughtful, prepared, and confident physician as you transition into independent practice. Whether you're a first-year taking your first ITE or a third-year gearing up for boards, remember: every bit of preparation adds up.

And finally, thank you to the third-year residents who generously shared their time and insights. Wishing the best of luck to everyone studying—you’ve got this.

Until next time!