get the soul of the exam - talatum

[ArchivalUser]

Just givng my two cents worth. I believe we can use the skills we learned as physicians in any aspect of our life including preparing for an exam. If a treatment strategy is not working (in this case 3 times already), the problem lies either in the treatment or in the diagnosis.

I took the exam on april 24,2006 and as per OASIS trick last May 17, I have passed it. Just tweedling my fingers waiting for the postman. I went into this exam with the following statistic.

NBME form 1: 740 (3 weeks before exam) (1 hour timed per block)

Kaplan QBank: 84% (all random, timed blocks no repeat. Answered 1250 questions in groups of 2 to 4 blocks/day over 9 days.)

USMLE CD : 46, 44, 48 (2 months before exam)

I reviewed for 7 months ( 4 months seriously) for this exam. I am an IMG. A very, very old IMG. so that you'll have an IDEA, when I was studying

1. DOC for Typhoid Fever was Chloramphenicol.

2. when I first encountered the word 'p53' all I could think of was that he was senior member of this forum.

3. There was no treatment for AIDS.

4. 50% of our graduating class who went to the US after graduation are now practicing physicians in the US and most have already finished their J1 Waivers and some are already citizens.

I've used this framework for analyzing my weak points throughout my review.

We can divide our whole preparation into 3 parts,

1. Knowledge Acquisition(KA) - This is where you put information into your Knowledge Bank(KB) Most new graduates are extremely fine here (Except if you're one of those who barely made it. Crammed for every test and promptly forgot everything afterwards. Most Old graduates and some IMG graduates usually have problems here. If your deficiency is primarily here (like me both old and IMG), I'm sorry, I don't think there can be any successful prescription but to hit the books.

2. Knowledge Recall or Review(KR) - This is how well you extract information from your KB. Most new graduates have some problem only here. FA and the QBank makes a fantastic tool for improving Recall. So people with problems here usually give fantastic ratings to FA and Qbank.

3. Test Preparedness (TestPrep) - If you are not familiar with CBT, MCQ or clinical slant to questions, this is where your problem is. Problems with sitting for 8 hour exam is also classified here. Difficulty in answereing 2 to 3 step thinking questions also fall here. This is where QBanks are the most effective.

If the problem is primarily in KA, answering 100 thousand Q's will not help, IF your KB is full and you have problems only with KR and TP, hitting the books will be a waste of time. QBank, FA, HY and Flashcards should be the way to go.

How do I know where my primary problem is?

Well a quick way to know is to use an evaluation examination, preferably one that's very near like to the actual exam. (The Kaplan CD examination comes to mind)

If you find while answering the questions that either the choices, the question itself or the pictures makes you think out loud "What the Heck is this?" You have a KA problem.

If most of the time it is, "I know this, but I can't recall how you differentiate between drug A and drug B (or symptoms, presentation, treatment, mechanisms,etc.)" You're having a KR problem.

If you thought you had the answer, then find out it's wrong, but after reading the explanation, you are surprised that you had misunderstood the question, It's a TP problem. Running out of time answering questions is also a TP problem.

As the medical adage goes, from the Diagnosis all things flow. After you've correctly diagnosed your problem, then the treatment is routine.

I'll discuss the solution to each identified problems in my next post and particular strategies you can use to improve your TestPrep ability.

[ArchivalUser]

Thanks for reading my post and your kind comments. To continue.

As we all know, Medicine is a very broad subject, so broad that we are divided into specialties. However, for the purpose of the board we are required to know a little of everything. So for the purpose of the board, What you need to know is divided into 3 parts.

1. Knowledge that need to be mastered. - The so called HY materials that are almost always tested.

2. Knowledge that need to be known. - you must know enough so that they are taken into consideration in your decision making.

3. Knowledge that you need only to be familiar - aware that it exists.

Subsequently our own knowledge bank is divided into 3 parts

1. What we have mastered -we can recall this information at any time in whatever way it is twisted in whatever condition we are in.
2. What we know - we can recall this information only when condition is optimum. We may need some time to think about it.
3. what is familiar- we can recall this information only with some clues and enough time to think about them.

The more closely the component of our knowledge bank conforms to what is expected of us by the board, the higher the probability of acing the exam.

Why is this important? Because of the way the examination is structured. The concepts that you are required to master are usually presented in 2 to 3 step thinking format. Physio and Pharma concepts requiring calculations usually include not only irrelevant numbers but also may need multiple calculations to come up with the answer. The exam is extremely fair in this regard. I'll give 2 examples in my exams (without giving away the actual question since this is prohibited)

I had a question involving p21 Cyclin D and Cyclin E2. Now I had mastered the p53 and Rb concept since I had expected this to be one of those that should be mastered. As you all know p21 and cyclin D are two components that mediate between p53 and Rb. I had also read about cyclin E2, which is the component that normally initiate the process that pushes cyclin D and Rb into allowing the cell to proceed to the S Phase. The function of p53 if you would recall is merely to act as a gatekeeper and does not initiate the process. However, I did not memorize in detail the whole process, ie. I was familiar with the role of cyclin E2 but did not master it. (Good thing the question popped up in the 4th block when my mind was still functioning). Any way they were good enough to give details in the question stem on cyclin E2 (instead of presuming you know it) Giving me a reasonably good chance of answering the question.

Another example is on transcription factors. They gave a drawing of the chemical formula of a transcription factor (believe me it was fairly obvious which transcription factor it was if you are even just vaguely familiar with it) and asked its function. If you know it, you can answer it. If you are familiar with it, it gives you a reasonable chance to get the answer.

So if you mastered what needs to be mastered and so on, you'll probably ace the exam. Except that that is impossible. Kaplan and all those in the prep-review business will give an arm and a leg to be able to do that. If you mastered what they want you to master, you'll say that was fair. If you mastered what they expected you to know, you'll say that's easy. If you know what they expect you to master, you'll say that's hard, If you are only familiar with or don't know what they expect you to master, you'll probably curse and call it experimental questions.

In reality experimental questions can be easy or hard. They're called experimental questions since not enough statistics have been gathered on the question to rate them as hard or easy for the purpose of grading the block.

Now going back to the quick and dirty method of analyzing your weak point. If the QBank you used does not reflect the emphasis of the board (Master what needs to be mastered, etc.) What you thought is a KR problem may be a KA problem after all. The Qbank may have presented that concept in a straightforward manner (ie, you know the concept) and you readily got it, but the Board will present it in a 2 to 3 step thinking manner (expecting you to have mastered it which you didn't) Another disconnect, hence the danger of relying only on Qbanks for review.

So what concepts should I master? Well, that maybe impossible to answer for certain, but there can be reasonable ways to arrive at what are the most probable ones. You may think FA. But FA includes all concepts tested on the exam, whether you are expected to master it, know it or be familiar with it. If you have the time to master all the concepts in FA fine, but that would probably be more time-consuming than reading entire texts. Remember memorizing is not mastering. Mastering for example the Brachial Plexus requires not only knowing the anatomy, but also what they innervate, pattern of denervation or injury, etc. Reading one line in FA should bring back a dozen or so paragraphs that represent the concept that that one line in FA represents.

A more reasonable way is to use HY books like HY and BRS. For example, you've decided to use Big Robbins as your main text for pathology because like me you've forgotten half of what you know about pathology and the other half is obsolete. You need BRS Patho because it is practically impossible to master everything in big Robbin's. A reasonable strategy is to master and know most information in Big Robbin's that are also found in BRS and just be familiar with the rest. If you are a more recent graduate, you could start with BRS and reference to Big Robbin's for concepts to master.

Another good example is Micro and Immuno by Levinson and Jawetz. Master all Organisms contained in its "Brief Summaries of Medically important organism". Know what is discussed in the text and be familiar with organisms in the minor pathogen sections. Exception is of course Immunology which you should probably master.

I think this is a reasonable place to end this post. I'll continue with the rest next time.


___________________

[ArchivalUser]

The original poster was writing a Thesis about " How to conquer USMLE" . He is genius ("askdoc")

I learned from these posts which were very long about KA, KR and TP hehehe and was so surprised about his knowledge as well as his way of explanation that was not so different with a Prof's in educational research.


Anyway, good reading friends!

I think this is not yours, right? tatalum. If so, please post the source

[ArchivalUser]

are u askdoc?why are u posting his posts ...dont do this ..if u want for benefit of others do mention his name

[ArchivalUser]

askdoc rulez.....he is the best.....

[ArchivalUser]

dont take his credit

[ArchivalUser]

I 1ST TRIED TO GIVE THE LINK SO THAT U PEOPLE CAN SEARCH N READ IT THOROUGHLY BUT BUT IT DID NOT APPEAR AFTER MANY TRIES SO THEN I DECIDED TO POST HIS COMPLETE POST U PEOPLE DID NOT GIVE ME A CHANCE TO SAY THAT THESE ARE NOT MINE . I HONOUR HIS WORK AND LEARDNED MUCH FROM IT AND FOLLOWING HIM IN MY STEP 2CK AS WELL

[ArchivalUser]

MY INTENT WAS TO TELL U PEOPLE WHAT IS THE SOUL OF ANY EXAM. I WAS A SILENT OBSERVER HERE . AND I NOTICED THAT THIS FORUM IS LOSING ITS PURPOSE FOR YHE LAST FEW MONTHS , IT WAS AN ATTEMPT TO LET THOSE NOT FAMILIAR WITH SUCH A GREAT WORK AND THE EFFORT ASK DOC PUT. ANY WAY HIS POSTS R LEFT I WILL PASTE IF U PEOPLE REQUIRE THOSE