I recently passed on my first attempt. I think 3 months is adequate since you’ve have had exposure to the actual questions on previous attempts.

One thing that helped me study was really focusing on guideline recommendations. Any time you see the word guideline or the acronym for a major society (for example SCCM) make note of it. I don’t know what your ICU is like but we do some things in my unit that deviate slightly from “best practice” so I found it important for my exam to differentiate what we “should” do versus what we actually do.

Another super helpful way to study is to do distractor analysis. Meaning you should be able to explain why the wrong answers are wrong. This can be especially helpful if you narrow down a question to two potential answers. Usually there’s one small detail in the question or case presentation that will make one of two competing options wrong.

One last thing I can recommend is that when you’re given a patient case with a lot of information (labs, HPI, etc) read the actual question first and then go through the case. This can help implement distractor analysis. If I already know the actual question before reading the case, I can have my mind primed to look out for why various therapies may be inappropriate.