Thanks to Bina Jangda of TCM Review for contributing this article!

Acupuncture school is a grueling experience. Students begin programs with a fresh passion to learn a new medical paradigm. By the time they reach 3rd or 4th year of school, they find themselves exhausted and sometimes lacking inspiration, relieved to see an end in sight. Of course, the studying doesn’t end once the diploma is in hand: there is still the daunting task of sitting AND passing the CALE and/or NCCAOM exam!

The anxiety produced by this last barrier is tremendous. I’ve witnessed students physically make themselves sick with worry and stress. Fortunately, it doesn’t have to be this way.

Having taught students to pass their licensing exams for the past 15 years, I’ve observed the habits of the most successful students. It’s not just luck that helps students pass their licensing exams. Instead, there’s a formulaic approach, and it can be applied to preparation for any big exam – whether it’s school comp exams or a licensing exam.

This success formula can be broken down into the following 8 steps:

  1. Consistency

Successful students create a consistent schedule for their board study and stick to it.

TCM theory tells us the digestive system likes regularity. Having meals at the same time of day, not too much, not too little, with a mix of all the five flavors brings strength and harmony to the Middle Jiao. This signals our body to secrete enzymes and promotes more efficient digestion.

Similarly, studying at the same time daily signals the brain and body that it’s time to learn. It works even better if you can study in the same place. This doesn’t necessarily mean that you must study each day at your desk in your room. You can switch it up as long as there is regularity and consistency in your approach. For example, on Mondays, you might study at the library in the mornings, Tuesdays at a café in the evenings, Wednesdays with your study partner at their house, etc. Creating a daily, weekly, and monthly schedule gives you short-term and long-term goals to work toward. 

While it’s important to have a schedule, it’s just as important to have some flexibility in your schedule – especially in the beginning as you start your study journey. We humans tend to overestimate what we can get done in a day, and underestimate what we can get done in a week. Create your schedule, then follow rule number 2:

  1. Repetition Repetition Repetition

Successful students spend part of each study session reviewing what they have already learned.

I often see students spend a week focusing on theory and diagnosis. The next week they focus on acupuncture point prescriptions. After point prescriptions, they study other topics like laws and regulations. When they go back to review theory and diagnosis 3-4 weeks later, they find that they don’t remember anything. How frustrating! The key to studying for your board exams is spaced repetition and regular review of everything you learned previously. This is one of the biggest ways that board exams differ from school exams.  There is no way you can cram for your licensing exams. 

Successful students approach board study slowly and steadily, with a lot of review, review, review. Once you learn a subject, you want to make sure you are reviewing it regularly. At first, that might be daily until it sinks into your long-term memory. Then review it every second or third day.

I had a good friend during acupuncture school that was a year or so ahead of me. She entered all the information she was learning into a quiz program on her smartphone. She’d then review everything nightly and again first thing in the morning. It was amazing to see how much information she could rattle off the top of her head. – Bina Jangda

Studies show that in order to memorize quickly and effectively, look at what you want to learn the last thing before going to bed, and the first thing upon rising. This helps to assimilate new information quickly into your long-term memory. New research shows that the brain is like any other muscle in your body. The more you use it the stronger it becomes and the stronger your memory becomes. 

  1. Take Breaks

Successful students take regular breaks.

It’s impossible to spend all day studying without taking breaks. The brain is like a muscle in that it tires from stress. So take breaks regularly. We recommend our TCM Review students take a 10-minute break after every 50 minutes of study time. Stretch, drink water, or have a protein snack during your break time. If you are blood deficient, a quick 5-minute sprint, 10 sun salutations, or another high-intensity aerobic exercise will increase blood circulation and increase oxygen to the brain. In TCM, we know that when blood is deficient, the areas that suffer the most are the limbs and the head. Think about the symptoms that manifest like poor memory, focus issues, and anxiety. Activating blood flow – especially if you are tired – can help get an extra hour of focused study time in. 

If you are feeling depleted, realize that you don’t have to study a full 3, 4, or 5 hours in one stretch. You can study in smaller chunks throughout the day. For example: studying an hour in the morning, an hour in the afternoon, and an hour in the evening still achieves 3 hours a day of study time. Sometimes it’s better to do smaller study sessions with longer breaks between those sessions. 

  1. Blocking

Successful students break up big subjects into small, digestible blocks.

Successful students block what they need to learn in smaller, digestible sections that are not going to overwhelm them. Often, I hear of students who sit down in an 8-hour study session and learn 60 CAM point prescriptions. Yes, they’ve learned them that day. But do they still know them the next day? Most likely not. What’s in the middle of a longer study session is hardest to retain. We remember best what is at the beginning and end of a study session.

Successful students learn 4-5 CAM point prescriptions a day during a 15-minute period. By studying smaller blocks of information, you’ve shrunk the middle of your subject matter from 60 CAM prescriptions to 2-3 CAM prescriptions. This technique guarantees better results.

  1. Switch It Up

Successful students change subjects often.

The brain, like any muscle, fatigues with overuse. You wouldn’t go to the gym and only do biceps curls. You switch it up to target all the muscles. It’s the same with the brain. The parts of the brain activated while learning diagnosis are different from those memorizing point prescriptions, and further still, different from what is activated working through case studies.

Switch subjects often to keep the mind fresh and attentive. We tell our students to switch subjects after every 30-50 minutes. The harder a subject is for you, the less time you want to spend on it. Repeated short bursts of study time (10-15 minutes a day) over a few months is most effective for learning difficult material.

  1. Get Out of Your Comfort Zone

Successful students spend most of their study time with material they are less confident with.

Successful students push their limits and do not shy away from the task at hand. A mistake I see students make is reviewing a subject that they are good at, and then under-studying or avoiding subjects that are difficult for them.

Successful students spend the bulk of their study time learning what they don’t know or are less secure with. Yes, it can be uncomfortable. For many of you those weak spots are what you’ve been avoiding for the last 3 years of school. There is no skating by with the board exams. Roll up your sleeves and dive in!

  1. Manage Stress

Successful students know how to manage their stress.

This is a big part of studying for the boards. I know that many of our students are still in school when they begin our review course. Between finishing school, work and family life, and keeping up with our course, they are already maxed out. Make sure you are taking care of yourself. Here are a few suggestions:

  • Eat foods that will help keep you nourished and focused. High protein/low carb meals will keep your B vitamin levels high and prevent blood-sugar spikes. This is essential to help you process your stress.
  • Get plenty of sleep. Sleep deprivation won’t help you focus during this time, and it will weaken your memory.
  • Exercise at least a few times a week. Take walks, get outdoors. In a study done at the UBC, researchers found that regular aerobic exercise boosts the size of the hippocampus, the brain area involved in verbal memory and learning. Additionally, exercise improves mood and sleep, and reduces stress.
  • Clear your plate enough to have the bandwidth to focus on the task at hand. For three months before the exam, minimize your commitments and make studying your #1 priority. A couple of years ago, we had a really smart student who was already running an integrative practice. She had a full clinic load and a new relationship. She couldn’t even make it to half the review classes and she definitely couldn’t carve out three hours to study. She had already taken the exam and not passed, and she didn’t pass again. When she finally hired someone to cover her patients and locked herself in her house for 3 months to study, she finally passed, and with 92%! That was a very expensive lesson to learn, mentally, emotionally and financially.
  • Start studying early, even if this means that all you are doing is assembling your study material. Procrastination and stress create a negative feed-back loop. Starting early, on the other hand, helps you to have enough time to implement the tips above and enjoy studying.

The best way to manage stress is to be organized, devote enough time, and put in the work so you are confident with the information.

  1. Positive Visualization

Successful students imagine how it feels to have already passed.

Successful students see themselves succeeding. I know that the thought of studying and writing your exam may sound overwhelming and scary. Imagine instead how it feels to receive the letter in the mail that you have already passed, to have your license framed and hanging on the wall of your clinic. Imagine that you confident and relaxed while taking your exams.

You should know that the worst thing about the board exam is that you have no clue what to expect the day of the big exam. Of course, all those urban myths that shroud the test in secrecy and fear, making it loom like a Goliath don’t exactly bring confidence to the test taker. Unlike classes at school, you only have one shot at it. There is no mid-term before this final so you can get a sense of how it might be.

All of this is simply the fear of the unknown, and nothing more than that. The mind loves to project and create a future when faced with the unknown. So you might as well create a positive one! See yourself sitting there with a nice, healthy posture, breathing fully with a smile on your face, feeling calm and confident, knowing in your heart that you will pass. The reality is, if you take a good review class and really putting in the hours, the knowledge will be there, and you will pass.

Follow these images with an image of you receiving a parcel in the mail shortly after your exam with a big “Congratulations!” and your license certificate ready to display on your new clinic wall.

Student Resources Bina’s Success Formula for Passing the CALE & NCCAOM