Your Ultimate Guide to the Pediatric In-Training Exam

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Each year during your pediatrics residency, you’ll take the pediatric in-training exam (ITE). This gauges your preparedness to take the pediatric board exam. The pediatric ITE allows you to see how you’re doing compared to national peer groups, so it can be an invaluable tool to tailor and guide your studying as a resident. Furthermore, it helps program directors identify where there’s room for growth, and how they can lend extra support, guidance, and mentorship when you need it.

In this guide, we’ll break down what you need to know for the pediatric ITE, including what it is, why it matters, and how to prepare for it!

What is the pediatric in-training exam?

According to the American Board of Pediatrics (ABP), the pediatric in-training exam is a three-hour exam consisting of 150 multiple-choice questions that’s administered in July.

The exam is designed as an abbreviated version of the General Pediatrics Certifying Examination and is based on the same content outline. It’s an incredibly useful tool, as you can use it to track your progress and target areas that need improvement.

Why should I take the pediatric in-training exam seriously?

While it’s tempting to think the exam is just practice and isn’t that important, I would caution against that mindset.

Here are three reasons you should take the exam seriously:

1. It helps you identify your strengths and weaknesses early on.

By identifying weak subjects, you can tailor your studying as a resident early on. You can see where you need help and utilize additional resources, such as question banks, to boost your knowledge and get a better score the next time you take it.

2. You can track your progress and seek additional support as needed.

Each year, you can compare your performance on the pediatric in-training exam with residents nationwide. It can be a useful tool to gauge your progress as a resident. You can then determine the type and level of support you need to be ready for the boards.

3. It’s valuable practice for the pediatric board exam.

By taking the pediatric in-training exam under test-like conditions, you can determine if you have any issues with test anxiety, timing, or test-taking skills, and seek support early on. You may be able to work closely with a residency mentor or even a tutor. If you identify any weaknesses, receiving extra support early can help you pass the notoriously difficult pediatric board exam.

How should I prepare for the pediatric in-training exam?

Now let’s review some tips to help you prepare for the in-training exam. In the end, you need to do what works for you, but I recommend the following:

1. Start early and study daily.

It’s incredibly important to start studying for the ITE at the beginning of your intern year. Making studying a habit is instrumental to the expansion of your knowledge base. And there are many ways to do it. Listening to podcasts on the way to work or reading UpToDate articles on your patients can really add up over time.

Furthermore, staying up-to-date on “Pediatrics in Review” articles can help build your knowledge. (Pro tip: Many people believe that some content on the pediatrics board exam is derived from Pediatrics in Review articles published in the last three years!)

2. Utilize question banks.

The more practice questions, the better. Given the enormity and volume of material you’ll have to know for the boards, doing practice questions is just a good habit to get into.

I’d recommend utilizing study tools that can be accessed on your phone, so you can incorporate studying during lulls in your day as a resident, or during lunch. Some great options include Anki for flashcards, or Rosh Review for pediatric practice questions with detailed explanations:

3. Take practice exams.

Taking sets of 100 or more practice questions under timed, real test-taking conditions will be instrumental to your success on the pediatric in-training exam. It can help identify any issues with timing, exam anxiety, testing skills, or your knowledge base. Start doing timed sets early on so you can identify any issues and seek additional support ASAP.

Check out the Rosh Review Pediatrics Resident Qbank and complete practice sets with questions specific to your in-training exam!

You’ll find…
❓1,900 practice questions aligned with the ABP content outline
💡Detailed explanations for correct and incorrect answers
🫀Teaching illustrations to reinforce concepts
📈 Performance analytics to identify knowledge gaps
💪 “One Step Further” questions and a Rapid Review with each question

What are some test-taking strategies for the pediatric in-training exam?

1. Read the question first, then the multiple-choice answers, then the stem.

This is one test-taking strategy that’s worked well for me. By priming yourself with the question asked and the answer choice options, you can then return to the question stem and more easily identify the right answer.

Try this method a few times and, if it doesn’t work for you, switch back to the more traditional approach to answering questions.

2. Take breaks, eat nutritious snacks, get good sleep, and exercise.

Taking care of your physical and mental health will optimize your performance. Treat yourself as if you’re approaching boards to get in the right mindset.

Final Thoughts

The pediatric in-training exam is an incredibly valuable tool that helps you gauge your strengths and weaknesses early on during residency. Remember, it’s important to start studying early and make it a habit! Identify room for growth and seek out additional resources, including practice question banks, mentors, and/or tutors. Best of luck!

By Sonia Pothraj, MD

Sonia is a board certified general pediatrician and pediatric urgent care physician. She is a passionate tutor and mentor. She has tutored doctors for the General Pediatrics Board Certifying Exam starting in January 2023.

She received the merit-based Rice Trustee Distinguished Scholarship to attend Rice University where she graduated in three years with numerous grants and the Spanish and Portuguese Cervantes Award for outstanding seniors. Sonia was an SAT tutor and college and medical school admissions counselor for a private company for four years, where she enjoyed guiding students. Over 95% of her students received admission to their top choice schools. Sonia received her MD from Rutgers Robert Wood Johnson Medical School where she graduated with numerous clinical honors distinctions as well as nominations for Gold Humanism Honor Society and house officer.

Sonia graduated pediatrics residency from Rutgers Robert Wood Johnson Medical School. She received nominations for resident of the month as a senior resident by the Divisions of Hospitalist Medicine, the Chief of the Division of Emergency Medicine, the Medical Student Clerkship Director, and the class of interns she supervised for her professionalism, leadership skills, and teaching. She also received the David H. Carver Teaching Award upon her residency graduation. In her current role as a general pediatrician, she precepts medical students from Touro College of Middletown and New York Medical College and has a teaching role at New York Medical College. As a pediatric urgent care physician, she also sees patients in a fast-paced setting, and stabilizes acutely ill children. Finally, she volunteers with Breakthrough Collaborative, a program for gifted, underserved students where she mentors pre-med students and keeps in touch with old students she taught years ago as well.