Tag Archive for: board prep

Clinical Vignettes and How to Ace Them

tangled rope representing vignettes

What are clinical vignettes?

Clinical vignettes are a huge portion of most board exams. They present a scenario to the reader which includes key information they will need to answer a series of questions.

These questions may be syndrome related to identify a condition the case patient is being presented with; they may be symptom related to determine a symptom of a given condition based on the patient’s given history; or they may be treatment related to decide the best course of action for treatment of a given condition. Really, the sky is the limit when it comes to these tricky questions.

Vignettes are helpful learning tools. They hone in on your critical thinking, they test your attention to detail, and they provide a more realistic experience of how to discern information you’re given from a patient to make the best choices. Sometimes they can seem like a giant, tangled mess. Here’s how to untangle it and get started!

Where to start?

Let’s use an example (straight from our question banks!):

Matt is a 13-year-old patient who is brought to see you because of behavioral problems. His parents report that in the last year Matt has had four separate occasions of intense aggression resulting in physical violence. The outbursts do not last long, typically abating within 20 minutes. The behavior is not in character for Matt and do not seem precipitated by a specifically intense trigger. In one instance he was unable to go to a friend’s house; he began screaming and hitting walls which lead to his hands becoming badly bruised. His outbursts are causing significant distress to his family, who are becoming more and more apprehensive of him harming them or himself. There have not been any major life events in the last year, and he is not diagnosed with any existing medical or mental conditions.

Following this, you are presented with question such as: “What is the likely diagnosis?” or “What prognostic factors could have increased the likelihood of Matt developing this condition?

Break it down

The first thing to do is look for key demographic and symptom information. In this vignette, we have an adolescent patient who is male. The vignette also tells us right away that he has behavioral issues. Knowing this narrows down the possibilities. Occam’s razor is true for most cases; you wouldn’t assume a 13-year-old is dealing with frontotemporal dementia for his behavior problems!

Next, look for symptoms ranges. This vignette tells us he’s been experiencing issues for the last year. This is important to know if the symptoms are a new, acute experience or something that has been persisting. It also helps as most diagnoses have requirements on how long symptoms must be present for.

Then, look for the 4 D’s: deviance, distress, dysfunction, and danger. Do the behaviors being presented fit into these criteria? Or is the patient experiencing sub-clinical symptoms with poor coping skills?

Process of Elimination, Vignettes style

Clinical vignettes are almost always multiple choice questions. You’ll be given five or more answer choices with each question and must choose the best option(s). Sometimes there’s more than one answer! Using our example above of “What is the likely diagnosis?“, you may be given answer options of:

A Oppositional defiant disorder
B Intermittent Explosive disorder
C Conduct disorder
D Disruptive Mood Dysregulation disorder
E Antisocial personality disorder

Least likely choices:

Now we need to look at each answer, and applying Occam’s razor, eliminate the least likely choices. Conduct disorder (choice C) does not match the presenting case as Matt does not show persistent disregard for other people or animals, deceitfulness or theft, or serious violation of rules. He does show intense aggression and destruction of property, but these are in brief occurrences and not a chronic issue.

Moving on to Disruptive mood dysregulation disorder (choice D), it also does not fit this scenario as it also requires the patient to have a persistent, irritable, negative mood most of the day every day; further, it cannot be diagnosed unless the behavior began before the age of 10. Matt’s parents have reported that this behavior has only been present for the last year in isolated incidents starting when Matt was 12.

Let’s look at Antisocial personality disorder (choice E). This condition cannot be diagnosed until the patient is 18, with specific disregard for the rights of others being present from the age of 15. Kick that one out.

And Oppositional defiant disorder (choice A). This is recognizable by persistent angry, irritable, vindictive, and argumentative behavior that is noticeable at least once a week for at least six months for Matt’s current age (attention to detail!).

Most likely choice:

Matt is presenting with symptoms that best match intermittent explosive disorder (choice B). His behavioral problems have only arisen in the last year with isolated incidents of intense, aggressive outbursts. The events are not precipitated by major life events or stressors, and the reaction is grossly disproportionate to the triggering incident.

Timing is Everything

The hardest part of mastering vignettes is being able to do them within time constraints. Generally, a board exam allows about 1 minute per question on the exam. 60 seconds is not a lot of time to gather all the information, discern what is valid or not, and eliminate the least likely options.

So what is the secret? The true key is practice, practice, practice. You know your DSM conditions, you know their criteria. You just have to practice the mechanics of gathering information and making critical choices from it. And what better way to do that than to give our clinical vignettes a try- totally FREE? – using our Free Trial!

We tailor each bank to the type of test you’re taking, whether that is Nurse Practitioner Mental Health Certification, ABPN, USMLE, or PRITE. You can take these practice exams over and over again until you get the hang of it. You can use a practice mode that doesn’t penalize for time, or you can use the timed mode that mimics the actual exam.

We want to help you MASTER clinical vignettes. They’re the part of exams most people do the worst on. Let’s tackle this and make it your strongest section! If you like what you see on the trial, check out our Question Banks and find the best option for you! Or, contact us with any questions you have so we can get you on the right path today!

Test Anxiety and How to Manage It!

Test Anxiety and Performance

Most people know that chronic or acute anxiety has negative impacts on performance. This is particularly true for academic performance in the form of test anxiety. But, what is more stressful than going in to take an exam that will determine the rest of your career? Obviously this goes without saying that exams and anxiety go hand in hand.

However, some people are impacted by this more than others. There are a few factors that influence this, and if you fall into one of these categories, we hope we can offer some help to get you through your next exam with flying colors!

Glasses on notebook from test anxiety

Working memory can amplify the effects of test anxiety

Everyone feels the effects of anxiety. It makes it harder to concentrate, bring information to mind, and sucks your motivation. But there are some lucky individuals that feel these effects harder than others.

Working memory (WM) capacity, or the amount of information you’re able to hold in mind at a given time, differs across individuals. The more WM capacity you have, the more easily you can hold bits of information at the front of your mind and retrieve that information for a task at hand. The lower your WM capacity, the harder this is. This capacity varies from person to person.

People with low WM have increased effects of anxiety on test performance. The relationship seems to be: anxiety interrupts WM (which is already having a hard time), which in turn effects retrieval of additional information. Further, the anxiety the person is feeling diverts attention from the task at hand to worrying about their performance. This results in reduced performance which is not reflective of the person’s true ability!

Distress load

Another factor that can make test anxiety worse some compared to others is total distress their experiencing. Regardless of their working memory, if a person is experiencing high levels of distress, they will under perform on academic tests. High stress shuts down your prefrontal cortex which interrupts executive functioning and critical thinking. This leads to higher anxiety, reduced attention, and thus lower scores.

If you’re experiencing extraneous factors in your life that are causing you significant distress, this may have detrimental effects on your academic strivings.

So we know these different things hurt some people more than others, but what can we do about it?

Social Support

As we all know, people are social creatures. Studies have shown that increases in social support negatively predict test anxiety. So what does this mean? Stop studying for a hot minute and go chill with your friends! (What, a test prep site is telling me to NOT study??- yes!) The more we experience social support, the less likely we are to experience test anxiety. Does this mean it magically disappears? Unfortunately, no. But, it can help mitigate the amount you experience!

Self-Esteem

Self-concept, self-esteem, call it what you want. Individuals that have a greater capacity for self-esteem or self-care tend to have greater academic achievement, and this can reduce the effects of anxiety you experience. This isn’t a one size fits all concept. Some people come in knowing they’re the cat’s pajamas (and let’s be real, you really are 😉 ), but others need some help seeing the value they bring to the table just by being themselves.

Not to be repetitive, but if you fall into the second category, try getting around some people that help boost you up! If this isn’t a friend or other trusted person, sometimes seeing a counselor can help shift our perspectives on ourselves just a bit. And clearly the implications of doing this will reap reward!

Studying skills…what about those?

One last interesting thing about those of us that experience higher levels of test anxiety is we generally have GOOD study skills! So know that you have the tools to accomplish what you’re aiming for. You aren’t less intelligent even if your test scores come out lower than you know you can do. We know that, too.

At the end of the day, text anxiety can’t be totally dispersed as much as we’d like it to be. But, if you know you’re someone prone to experiencing it, we hope we dropped a few tidbits to help you get through your next round of exams with a little less stress! Want some extra practice? Try our question banks – FREE- using our Free Trial! Or if you’re ready to take the plunge, check out our Question Banks and find the best option for you! Or, contact us with any questions you have so we can get you on the right path today!

REFERENCES: Hyseni Duraku, Z., & Hoxha, L. (2018). Self-esteem, study skills, self-concept, social support, psychological distress, and coping mechanism effects on test anxiety and academic performance. Health psychology open5(2), 2055102918799963.

Matthews, G., Wohleber, R. W., & Lin, J. (2020). Stress, skilled performance, and expertise: Overload and beyond.

Studying Tips Broken Down: Set yourself up for success!

Time to get back to studying… wow… it seems like just yesterday the summer was just kicking off!

Now it’s time to head back to school, so naturally, we’ve received some DMs asking “How can I make the most of the upcoming school year?”.

Going back to school can seem like an overwhelming time and it can be, but we’ve put together a few studying tips that should help you excel in your learning.

Our Top Five Tips!

1️⃣ Get Organized…

Get all your study materials together, ensure you know your new schedule, and plan your time properly. Take a look at each class; What do you need? What do you already have?

2️⃣ Be Active In Your Learning.

Don’t just follow your current curriculum. Seek out other experiences and knowledge whether you’re in a group studying, participating in volunteer labs/programs/research groups, and much more. You can gain more knowledge and experience this way!

3️⃣ Study, Study, Study — but with others!

Studying with others can improve your memory recall, provide other points of view, and give you a great trusted group whom you can make memories with outside of just staying. Since you’re all going through the same experiences together it can help ease the stress. You could even utilize various question banks and tools to make the most of the study sessions!

4️⃣ Use Your Time Wisely

Just because others are going out every night doesn’t mean you need to… you can still have a solid social life AND go to school. Write down and prioritize everything you need to do. Ensure you have built a solid routine, and get what you need to do, but also make sure you are taking time to have fun too (which brings us to our next section.)

5️⃣ Take Care Of Your Mental Health!!!

This is last but certainly NOT least. We’ve said it before and we will keep saying it. Take care of yourself and your mental health. You need to ensure you aren’t pushing yourself too far. Find things and activities which help you relax. School is not forever so take everything one step at a time. Use your support group/study group we mentioned in point 3.

Need some additional tips or a tutor? Contact us today!

Who is My Psych Board?

My Psych Board is a board review website created by Dr. Abdel, MD, MBB. CH., founder and CEO of Westlake Brain Health clinic in Cleveland, OH. This program offers access to unique courses and question banks to prepare residents and medical students for the American Board of Psychiatry and Neurology (ABPN) Psychiatry Certification Exam, Psychiatry Resident In-Training Examination, United States Medical Licensing board examination, and Nurse Practitioner examination. Each question bank is specifically tailored to the required difficulty and type of questions expected for the different board exams. New questions are continually being added to the question banks, ensuring the most current and up-to-date information is being made available.

My Psych Board is created by experts in the field and covers all the topics you need to master in order to pass your board-certifying exams. Feedback is given immediately in Practice Mode as questions are answered, including in-depth explanations that accompany each question for both correct and incorrect answer options. Additionally, students have the option of accessing a one-time phone call with Dr. Abdel to discuss their best studying strategies and one-on-one tutoring to help them gain maximum preparation. My Psych Board is customer oriented; we take your feedback seriously and are always looking for ways to improve the user experience! 

Failed Your Psychiatric Board Exams? What should you do now?

Failed Your Psychiatric Board Exams? What should you do now?

So let’s say you’ve taken round one and failed… what now?⁠

Firstly, it’s ok! You’re human, breathe. Take a break and avoid freaking out. Take a moment to step away and have some much-needed “you time”. You’ll want to clear your head and get a new perspective, if you need a week or more…take it!

Now that you’ve taken time for yourself, it’s time to jump back in. Create a realistic timeline and schedule that will work for you. Cover the big areas and focus on where you were unsure.⁠

Don’t be afraid to change your studying routine. Ask yourself — Are there issues with your previous method? Do you have all the right/up-to-date resources? Are you staying away from distractions?⁠

Finally, when you’re going back in keep it focused on the questions and stay out of your head. We know it’s easier said than done but everyone goes through ups and downs. Check out our post on what to do differently when retaking the boards for more inspiration!

You may learn something from this experience!

Did you know we offer a FREE trial for our question banks? Just head over to our website (exams.mypsychboard.com) to get started today risk-free (with no Credit Card required!)

Feeling like you need a bit of extra help?

Contact us OR sign up for our tutoring!

How to make the most of DOWNTIME while in school

Text reads "How to make the most of DOWNTIME while in school!" it shows 2 students walking into a beautiful school and then a desk inside with a green chalk board.

Are you feeling overwhelmed with school or maybe you feel as if you’re not doing enough..?⁠

Here are our top 3 tips on how YOU can make the most of your downtime while in school.. it’s not all books and tests, you can have fun too!⁠

Stay Active!

Exercise is crucial to your mental health, not just physical! Getting up and being active can help by reducing anxiety and depression, improving your mood and self esteem! Studies show it also alleviates social withdrawal and improves your ability to study and learn!

Be Social!

Talk to your fellow students and friends! It will break up the monotony of your classes. Go do something you enjoy, join a club, or just go grab coffee. Being social ALSO has positive effects on your study routines!

Study Study Study!

This should go without saying…make sure you use your time wisely! Although the other topics are essential to your mental health…so is studying!


📲 SHARE this with someone who could use the help! Are you enjoying these tips? Check out our previous post on how you can get the most out of studying. It’s a lifesaver…

Did you know we offer a FREE trial for our question banks? Just head over to our website (exams.mypsychboard.com) to get started today risk-free (with no Credit Card required!)

Feeling like you need a bit of extra help?

Contact us OR sign up for our tutoring!

Introducing: My Psych Board, pass your boards with ease!

Welcome to My Psych Board!

We are a board review and question bank website which gives you access to unique courses and question banks tailored to your needs. Our program offers access to unique courses and question banks to prepare residents and medical students for the American Board of Psychiatry and Neurology (ABPN) Psychiatry Certification Exam, Psychiatry Resident In-Training Examination, United States Medical Licensing board examination, and Nurse Practitioner examination. The world is always changing, so what do we do? New questions are continually being added to the question banks, ensuring the most current and up to date information is being made available!

The world of Psychiatry can be confusing, but don’t get a headache over it! We want to help — call us ANYTIME and we will get YOU moving in the right direction.

My Psych Board offers multiple modes to try: Practice, Timed, and Custom. In Practice mode, we focus on feedback, one of the most important things when learning new materials. We give feedback immediately as questions are answered, including in-depth explanations that accompany each question for both correct and incorrect answer options. There’s no time limit so you can take as long as you need to really dive into the questions and topics. Jump over to Timed Mode where the amount of time mimics the real tests and skips the explanations to see how far you can get before the time runs out. Or, zero in on your weakest areas of study by creating custom tests made from your most missed questions across dozens of topics.

Our goal is to make your test preparation as smooth and easy as possible. We’re constantly innovating and making this experience better so you can pass your board with ease! Our only goal is to see you succeed! 

#dontfailyourboards


Utilize our question banks here! Have any questions? Contact us for in-depth information + help.

Study Styles for Psychiatric Residents

With the impending standardized exam, you may be asking “how the heck should I study?” Here are our top tips to help you pass your boards with ease!

As a senior psychiatry resident, recent graduate or even junior resident, this is a question that may cross your mind when the term ABPN initial certification is mentioned.  But as someone who has taken my fair share of medically geared standardized tests- i.e. MCAT, USMLE, PRITE, as well as too many medical school exams to count, teaching for the Princeton review, teaching gymnastics, and the occasional residency didactic topic, the best method to study and retain information may not come into focus until one takes a step back to do some self-assessment.  Sometimes you (meaning me) even forget what got you over that what once seemingly insurmountable conglomerate of material until a new challenge presents itself.  It is only then can one get refreshed insight on how to approach the material before you, by looking at what worked and did not work before.

I’m a firm believer that the more you hear or see something, the more you retain it.  I don’t hesitate to review and re-review the basics.  This is true whether you are an athlete preparing for a big event or a chief resident reviewing the DSM V for diagnostic criteria for Major depressive disorder with psychotic features vs schizoaffective disorder. The foundations allow us to build and retain our skills and knowledge, and yes they can sometimes be more palatable to review. With that I must remind myself of what my old gymnastics coach used to say every time I wanted to practice balance beam instead of bars, “To be great, one must practice what they hate not what they love.” So I would begrudgingly trade my beam shoes for my hand grips and chalk up. A medical school or USMLE equivalent could be me tucking away neuroanatomy and forcibly pulling out lung volumes.  A PRITE example could be me tip toeing to get to biostats once all my other studying is done, But I digress.

I would argue you need to make time for that which comes easier, and that which you might just slightly avoid. One way I like to go about this is what I call mixing it up. I am also a believer in learning via multiple pathways and methods.  I have always found, when the brain processes data from multiple sources, the more likely you are to retain this material. Now I realize we all have our personal preferences and we do not all learn the same way.  For example, some of us like to read, while others may like to listen. Some of us never showed up to lectures, and some were front and center. However, I’ve found the material I have retained the greatest, or exams I have done the best on, I was using several of my available senses. This included, reading, watching lectures online on core material, listening to recordings at the gym or while traveling throughout the day, and rewriting key material. The more pathways I used, the better I retained and understood the material. I find this to be key in studying for standardized exams, where the amount of material can seem insurmountable. We will get to this, but this can also come in handy when you are having an off day, a too busy to do much day, a I am over this day.

We all get overwhelmed, me included. The vast amount of material for anything before us can seem daunting and overwhelming. This is when I like to take a deep breath, take a step back and write out a plan. Most importantly, this plan must be unique to you and both your long-term and short-term study goals, and how you will accomplish them. Remember to be kind but firm with yourself.  Offer motivational tips and rewards while holding yourself accountable to some sort of framework.

Break it up and use your senses.

Try and study in small, consistent blocks of time and take advantage of hands-on learning.  Learning while providing patient care (reading up, reviewing their diagnoses, meds) can go a long way when it comes time to study and sit for a big exam. Just like an athlete who keeps the foundation fresh and well maintained, when time to throw the bigger skill those foundations will allow an easier transition.  

Break the material/subject down into systems using several sources of information stimulating different ways of learning. Some examples of systems are reading review, videos, questions. 

How I approach each topic, no matter if medical school, USMLE, PRITE, or psychiatry board review:

  • Core material/ foundation and concepts-does not matter if I already know it or think I know it. I start here
  • Case study-reviewing sample cases and how they present with review of material. That helps with retention and “real world,” understanding. It Is often how tests present material.
  • Esoteric details-Put off sometimes until the core and concepts are re-reviewed
  • Question banks-for understanding; then for simulated test taking via a buildup (start with 5 questions at a time, to ten, to 20 etc)

This brings us to the topic of question banks. A question bank serves several different purposes, again taking what I say with a grain of salt in case that is not your style. Here goes, I initially use question banks for learning the raw material. I don’t time myself and I’m not trying to do a full block, and I’m definitely not worried about timing myself. I take my time, use tutor mode and read everything; I mean EVERYTHING thoroughly. Things I got wrong and things I got right. Test bank explanations can be a gold mine of information for the questions I’m both sure and unsure of. This knowledge is important and allows you to brush up on topics you thought you knew once upon a time, and gives you a feel for the level of material and depth you should know for that exam. Once I personally feel “ready” and comfortable, (although full disclosure I have never been one to feel fully ready for any test), then I start to incorporate the questions slowly into timed and simulated experiences.

As a firm believer of understanding the material from the ground up, I don’t ever recommend going into a standardized examination without using a question bank. There are however people that do just fine using question banks purely as simulated examination situations and to get a feel for the test and types of questions you will see. This is of course fine, as that is a vital part of preparation, but for me, question banks can be used in different ways as described above, depending upon your personality and comfort with learning styles.

Good luck as you start your preparation. You got this! Remember, it is easy to get discouraged or feel like the massive mountain of study material before you can be insurmountable, but remind yourself that even small study sessions will take you one step closer to your goal, and things that you are remote and you think you forgot often come back easier the next time you review them.  P.S. I speak from experience 😉

– Dr. J

Are you utilizing the correct tools to make the most of your studying?

Thankfully, our question banks are formatted to get the most out of your learning experience. Studies have proven members who use formatted practice q-banks have a much higher score/pass rate!

Still feeling overwhelmed? Contact us today! We can help build a study plan tailored for your needs.