I used this to study for the boards along with ACCSAP. The ACCSAP practice exams were overall better, probably because more of them were of the long clinical vignette style that the exam has adopted and they were more current. The questions here have some of that and some of the longer questions. Overall it's not a bad thing to do to run through several hundred questions right before the boards, although I wouldn't rely on this as your only source of questions. Unfortunately it's a bit dated so it doesn't incorporate some of the latest stuff (last few years) but some things haven't changed much in cardiology (e.g. congenital) where others have.