I'm still a little in shock honestly. Got my results this morning and I passed with a 680. After failing by 11 points last October, I genuinely wasn't sure I had it in me to go through the whole process again. But here I am, and I want to share what made the difference this second time around.
The biggest change was being way more systematic about my weak areas. First attempt I just read through the ONS Core Curriculum and called it a day. This time I used a structured CPHON study guide approach — broke everything into domains, tracked where I kept getting questions wrong, and drilled those topics hard. I spent about 8 weeks, roughly 90 minutes most evenings. The pharmacology section nearly broke me, but I found that doing a CPHON practice test every weekend (timed, no interruptions) helped me get comfortable with how the questions are phrased, not just the content itself.
A few exam tips that genuinely helped: prioritize pediatric-specific dosing considerations over adult oncology content, and don't skip the psychosocial domain — I underestimated it both times and it's a bigger chunk than you'd expect. Happy to answer questions if anyone's prepping right now.