Focused practice in Hospital Medicine Maintenance of Certification Examination

I recently took hospital medicine focused board exam. I want to share my experience with you. This exam is an alternative to the regular ABIM exam that everyone takes. Not everyone is eligible for this exam. Please go through the above link once you read this entire page to know more details of this exam eligibility.


The exam had 4 blocks of 55 questions each. We get 2 hrs for each block. We have access to UpToDate to look for answers. We can take a maximum of 3 breaks. Total break time is close to 1hr 20min if I remember correctly. There is a nice partition between each examinee as you have seen during all other previous exams we took. I did not notice any kind of disturbance from any other examinee.

FOCUSED PRACTICE IN HOSPITAL MEDICINE Maintenance of Certification (MOC) Examination Blueprint

Before Exam:

Exam starts at 8am. You take a token and wait after 730am when they allow you inside. They call you as per your token number and take your vein printing of your hand. They need 2 forms for identification from you. This is a must, so don’t forget to take two IDs. One Driver’s license and the other can be even your debit card or hospital badge.

During the Exam:

The hall is quite as you already know. You get noise cancelling headphones if you want. You also get a scribble pad and that you will need to answer Acid base questions.

If you want to take a break, you choose break time after your block of questions and rise your hand and turn backwards to look at the staff and they waive their hand to allow you to walk out. They take your right hand vein printing each time you come out and enter the exam hall.

Preparing for the exam:

I did the 450 questions that are there in SPARK 2 from SHM. I did them 3 times. Only a very few questions are directly from those questions.

I read Medstudy Hospital Medicine Basics 2nd edition which focuses only on Hospital Medicine. It is a small book with 44 pages and a quick read. It focuses on certain important topics in hospital medicine.

I also read Awesome review material and took their online awesome review course for 5 days. I read that material 3 times too. I could answer some questions based on this material.

No single material is enough to prepare for the hospital medicine focused board exam. The questions are directly based on what we do in the hospital. You have to come up with answers based on the knowledge you gained so far. No amount of preparation will make you prepare yourself thoroughly for this test.

I ended up opening UpToDate a lot more times than I imagined.

There is plenty of time to answer questions if you do not open UpToDate that much. But, due to time availability and due to our desire to do well, we end up opening it more than we want to. That will make your time tight.

I answered all the questions as there is no penalty for wrong answers.

I studied for 6 months. I studied several hours a day. I studied for 10hrs a day in the last one month before my exam. Boy, it was tough. lol.

How to prepare to do well in Hospital Medicine Focused Board Exam:

Definitely do SPARK 2 question bank from SHM. While preparing for exam, I used to first read the answer choice and then see how a question is framed to arrive at that answer. That helped me remember all the questions given in SPARK by the time of exam. If you tell me the answer given for a particular question in SPARK 2 question bank, I can recollect the entire question asked to arrive at that answer.

Read regular ABIM exam material too from any source of your choice if you have time. I don’t know if Medstudy or MKSAP would have been more helpful than Awesome review. I did not do MKSAP or MedStudy Internal Medicine Board material. I only read Medstudy Hospital Medicine Basics 2nd edition which focuses only on Hospital Medicine. This book is a companion to the video lectures with the same name. It has info on Clinical quality Measurements, Consultative Co-management, Hospital based prevention strategies, and ethics and palliative care scenarios. It was somewhat helpful for the test.

Keep yourself relaxed during the exam. Be prepared to spend the whole day in the exam center. Don’t be anxious and in a rush to finish the exam early and run home. Just utilize the full time calmly and in a relaxed manner.

Take break after every block so refresh your body and mind. You have plenty of time.

Familiarize yourself well with using and searching in UpToDate. This is crucial as it will save time. I used to look at Summary at the end of the topic to look for answers. We may find answers in the body of the topic too. So play with UpToDate several days in advance and familiarize with it.

Start your preparation in advance. Don’t read from too many sources as it causes confusion and preparation takes longer time.

I always read the final question asked for each question and the choices before I read the body of the question. I think this technique helps me focus on relevant points while I read the long question. Some questions are very short and some are very long in the exam.

To minimize anxiety during preparation, keep a target for each day as how many pages you have to read to finish the preparation and try to reach that target daily. This helped me some.

Cut down social media presence during exam preparation time.

I used ‘white noise’ from YouTube if I am getting disturbed while reading due to kids running around the house. This helped me focus better. Some videos on Youtube have more than 10hrs of white noise recorded without ads in the middle so you can focus once you start the video. Also, explain to your kids and spouse to make minimal sounds and explain how being silent helps you read well and do well in the exam.

Choose and keep ready most comfortable dress and shoes for your exam day in advance.

Visit the exam center at least once before the day of the examination.

Prepare thoroughly as to how to do Acid base questions. At least, you can answer 3-4 questions right.

Be thorough in Perioperative management of insulin and blood thinners.

Basically, expect a question on everything we encounter in the hospital medicine. I don’t think any single resource will make us prepare well for this exam.

I took Tylenol 500mg on the morning of the exam as I was anticipating headache or neck pain doing so many questions. I don’t know if it helped or not but I did not have any pain during my exam.

Which exam is better: IM or Hospital Medicine?

The first impression I got after coming out of exam center is that I should have opted to take IM exam rather than Hospital medicine exam. The main reason is that there is comprehensive material prepared for IM exam as this exam format is in existence from a long time. Hospital medicine being new does not have enough and comprehensive material made yet to help make the exam easier to tackle.


My Impression changes after My Exam Results: I got my exam results approximately 6 weeks [1/6/22] after I took the exam [11/18/21]. Now, I feel very happy that I got really good score. Probably I would take this exam next time when I have to do it after 10 years.

You can join “Medicine Board Review” discussions on Clubhouse if interested.


Leave a Comment

This site uses Akismet to reduce spam. Learn how your comment data is processed.