Tulane’s overall board pass rate is 90%. Year-in and year-out, categorical residents have a 100% board pass rate. The discrepancy between the two numbers is explained by the number of combined programs (Med Psych, Med Neuro, Med Peds, Med Prevent.) in the Tulane program. While we have very talented combined residents, the nature of combined training (splitting time between the two specialties, doing overall less internal medicine training than a categorical resident), and the challenge of trying to study simultaneously for both board exams (e.g., pediatrics and internal medicine), occasionally leads to a board failure.

What explains the dramatic increase in board pass rate from 5 years ago? When I came to Tulane five years ago, I immediately re-focused the curriculum on the ABIM objectives that appear on the In-Service Training Examinations (ITE) hat each Tulane resident takes each year. Once I had those in hand, I set out to build a curriculum around these objectives. The result was the MEDICAL MATRIX.

Each year, each resident takes the In-Service Training Examination (ITE). This is not used for promotion nor to determine favor. Rather, it is simply used to give each resident an idea of his or her greatest area of weakness (e.g., infectious disease or rheumatology or whatever), and to focus subsequent reading and/or electives on these high-yield areas. In addition, each ITE report has a listing (by code) of the learning objectives that the resident missed on the examination. By plugging these objectives into the MEDICAL MATRIX, the resident is taken to the learning objective so that he knows exactly what he missed. For each of these learning objectives, there is a high-yield review article (selected by the program director and other residents) to efficiently and quickly remediate the gap in the resident’s knowledge. This is important, because while you want to read every day, you do not want to waste your precious time trying to find a high-yield article to read. And nothing is worse that wasting an evening on a low-yield article or chapter. This level of filtering (finding the high yield articles for you, and making them readily accessible to you) is that a program should do for you. This is what Tulane will do for you.

In addition to the MATRIX, the Friday School schedule is organized around the ABIM learning objectives. Tulane has great faculty, and the re-birth of several sections has lead to an explosion of medical research. The faculty who lecture in the Friday School schedule are drawn from this faculty base.

So, how do you get 100% board pass rate? Simple, you attend the Friday School series (your time will be protected each and every week to do so), and over three years (and three ITE’s to guide your studying) you complete the MEDICAL MATRIX question book. If you do this, I guarantee 100% board pass rate.