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How to prepare for the ABMM examination.

How to Prepare for the ABMM Examination

Don't waste your time studying for the certification exam of the American Board of Medical Management. IF! If your knowledge of health economics and finance is comprehensive and current; if you have retained a basic understanding of statistical methods and decision-making theory; if you have mastered the elements of organizational behavior and general management; and if you are readily conversant regarding health policy and law, you need no further preparation. These and a modicum of common sense, some test-taking savvy, and a little luck will take you through without difficulty.

The ABMM exam is a serious hurdle for the physician wishing to acquire medical management credentials. It is not a mere formality and should not be taken lightly. Only about 80 percent of candidates pass on their first attempts. The exam is designed to challenge one's knowledge of the field of medical management as well as one's managerial judgment and decision-making ability. Neither common sense (alone) nor a surface knowledge of a discipline will suffice. For most, preparation will consume several months of weekend study.

I did not find it easy or simple to prepare for the exam. The role of physician executive is seeking definition, and the field of study is undergoing dynamic development. The requisite body of knowledge is changing with the profession. There is no single definitive text, no residency program, no formalized course of study, and no easy opportunity to seek the counsel of others who have successfully completed the exam. The material to be mastered is predominantly conceptual rather than factual, requiring more "thinking" than memorization. And most of us find it necessary to study for this test while maintaining fulltime jobs, taking additional time away from relaxation and family life.

So how does one approach it? In a word, Read! Reading widely in the subject areas covered by the test will provide a comprehensive review of your knowledge. It will help to fill in "data gaps" and add to your reserve of retrievable facts. A substantive reading-based review will sharpen your cognitive skills and bolster your confidence.

Upon reviewing your application and approving your candidacy for the exam, ABMM will provide you with a packet of materials designed to assist in your preparation. This includes a series of sample questions, a brief outline of topics covered, and a recommended bibliography of relevant articles and texts. I had two immediate and paradoxical reactions upon my initial review of the bibliography. "Is this all the help I get?" and "How am I ever coing to get through all this stuff?" The sheer volume of suggested reading is intimidating. You may find the following suggestions helpful.

If you have the good fortune to live near a medical library, you will find it of inestimable value. A well-managed medical library will have most of the journals and books from which referenced articles are drawn. For unavailable materials, the librarian can usually obtain needed articles through an interlibrary loan. In addition, most libraries provide a "search and copy" service for a reasonable fee, allowing you to maximize the productivity of your time for study.

I found the recommended articles sufficiently helpful that the investment of time and effort is justified to review most or all of them, depending on availability. It is more difficult to characterize the textbooks in terms of their quality, readability, and applicability to the exam. And there is insufficient time to read all the texts one might wish. It is necessary, therefore, to assess your own knowledge and experience and to focus your reading in areas of perceived weakness. Second, evaluate the available texts, not limiting your selection to the recommended bibliography. You may find a more concise, more understandable, or more current text on a particular subject.

Obtain a loose-leaf ring-binder notebook as you begin your reading, and arrange it by topic--health policy, law, economics, etc. After reading and highlighting articles, place them in your notebook under the appropriate subject area. As you read textbooks, take notes regarding pertinent facts, dates, cases, lists, concepts, etc., and add them to your notebook, including source and page number for future reference. You will probably wish to copy an occasional chart or graph from a text to supplement your notes. You should plan to have your basic reading completed by two weeks prior to the exam to allow time for review and specific attention to areas of particular concern.

I found two books from the bibliography especially helpful, although others may have other choices based on their individual needs:

The Physician Executive, edited by Wesley Curry, published by the College, 1988. This book provides a fairly comprehensive overview of the discipline and is written in a most readable manner.

The Law of Hospital and Health Care Administration, Second Edition, by Southwick and Slee, published by Health Administration Press, 1978. Although this book is somewhat dated, it provides a basic understanding of the development of health-related law and illustrates the impact of relevant case law. At 500 plus pages, is seems long, but it is well worth more than cursory review.

Two other good books, not listed in the bibliography, are:

Bioethics Today: A New Ethical Vision, adited by J. Walters, published by Loma Linda University Press, 1988. This concise, readable text discusses briefly the historical development of health care ethics, and deals in a readily understandable manner with current major ethical dilemmas in health care.

Essentials of Health Care Finance, Second Edition, by William O. Cleverly, PhD, published by Aspen Publishers, Inc., 1986. This is a good, basic primer on health care finance. It is well-illustrated, highly informative, and as readable as a book of this nature can be.

The exam in 1989 consisted of approximately 150 multiple choice questions and four to six essay questions. There was a time limit of five hours for completing the exam. I found my time about equally divided between the two parts. It is important to keep moving, not becoming bogged down in the multiple choice section, thus leaving inadequate time for the essay portion. Be mentally prepared for the transition--don't allow yourself to be intimidated by the essay questions. Start writing, even if the answer is not entirely clear, and you will find that your thoughts will begin to flow.

What would I do differently to more effectively prepare for the exam? Specifically, I would learn more about data management systems and mini-and microcomputers and their capabilities and limitations. I would spend considerably less time familiarizing myself with "Robert's Rules of Order" and more time reviewing quantitative and statistical methods. I would become knowledgeable regarding the elements of interinstitutional contracts and be less concerned about relatively sophisticated aspects of health care accounting.

Was the experience worth it? Would I do it again? Yes and yes. The preparation was an invigorating learning experience, and the test was an engaging challenge. The entire process provides an opportunity to measure oneself, to acquire new knowledge and skills, and to achieve the recognition of one's peers within the profession. I recommend it to you as an experience well worth the undertaking.

Ted Hamilton, MD, MBA, FACPE, is Medical Director, College Square Urgent Care Center, Oakwood, Ga.
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No portion of this article can be reproduced without the express written permission from the copyright holder.
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Title Annotation:American Board of Medical Management
Author:Hamilton, Ted
Publication:Physician Executive
Date:Jul 1, 1990
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