Medical School and Multiple Choice exams

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Dr Dazzle

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Hi guys,

What's your advice regarding improving test taking skills for med school? I realize majority of exams are multiple choice including the boards. What do you do during your studying to become better at taking these tests? Do specific q banks or other questions while reviewing content in slides? What do most students do to improve their retention of material and performance on MC tests? Of course this helps for boards.

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Answer by the clock.

If you read a question and you have no clue to the answer, look at an old analog clock. If the second hand is in between the 12 and the 3 (the first 15 seconds), the answer is A. Between 3 and 6 is B. 6 to 9 is C, and 9 to 12 is D. This can be modified for a 5 answer multiple choice fairly easily by cutting the time into 12 second blocks.

It works better if you can eliminate some of the distractions and modify the time to fit the number of choices left.

I knew someone that took a practice exam this way and score 85%.

Seriously, get past the MCAT first.

*note- I have not started med school yet, but I have spent the last 19 years as a high school teacher giving exams. I think I know a little about pulling out important information and asking questions about it. My favorite strategy is to eliminate bad answers and you are left with the correct answer. (Paraphrase of Sherlock Holmes).

dsoz
 
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Hi guys,

What's your advice regarding improving test taking skills for med school? I realize majority of exams are multiple choice including the boards. What do you do during your studying to become better at taking these tests? Do specific q banks or other questions while reviewing content in slides? What do most students do to improve their retention of material and performance on MC tests? Of course this helps for boards.

What has worked for me so far is to not dwell to much into the details when you study. Sure, knowing in depth is important, but it is not necessarily good for getting high scores on MC exams. I just try to associate key terms with certain conditions/ pathologies.
 
I recommend finding a lecture on test taking strategies but some of my go to strategies are

1) First, rule out the distractors and plain wrong choices. I cross them out on every question for every test and it helps one focus on differentiating the remaining answers.

2) Figure out what the examiner wants you to know They asked that question for a reason. Why?

3) Often you can group a few or all but one of the answer choices together by some concept, leaving the lone answer choice as the outlier and the correct answer

4) Pay attention to seemingly superfluous info in the question stem you might otherwise simply glance over. Often age, or gender, or job description, or geographic info from the patient is the key to answering the question.

5) Realize for med school you'll be given basic and classic presentations of diseases. Know these classic presentations.

6) Always pick the best answer choice. On harder questions people often do worse than random by getting fooled by a distractor or by picking an answer that sort of fits but not really. If your answer fits poorly, it's probably wrong.

7) Random stuff we've been taught from test taking lectures; if an answer is more detailed than the others, there's a good chance it is right, if the answer has two aspects to it, usually the second part is wrong so stay away from those, and in the event of a total guess, pick the earliest answer choice you haven't ruled out.

As far as overall study skills go, active learning is the way to go. And go into a lecture with some sort of basic background of the material. You'll retain more.
 
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I recommend finding a lecture on test taking strategies but some of my go to strategies are

1) First, rule out the distractors and plain wrong choices. I cross them out on every question for every test and it helps one focus on differentiating the remaining answers.

2) Figure out what the examiner wants you to know They asked that question for a reason. Why?

3) Often you can group a few or all but one of the answer choices together by some concept, leaving the lone answer choice as the outlier and the correct answer

4) Pay attention to seemingly superfluous info in the question stem you might otherwise simply glance over. Often age, or gender, or job description, or geographic info from the patient is the key to answering the question.

5) Realize for med school you'll be given basic and classic presentations of diseases. Know these classic presentations.

6) Always pick the best answer choice. On harder questions people often do worse than random by getting fooled by a distractor or by picking an answer that sort of fits but not really. If your answer fits poorly, it's probably wrong.

7) Random stuff we've been taught from test taking lectures; if an answer is more detailed than the others, there's a good chance it is right, if the answer has two aspects to it, usually the second part is wrong so stay away from those, and in the event of a total guess, pick the earliest answer choice you haven't ruled out.

As far as overall study skills go, active learning is the way to go. And go into a lecture with some sort of basic background of the material. You'll retain more.

Good stuff! Keep em coming!
 
Any blatantly obvious distractor can be crossed out. Don't even think twice about it.

Then, you can just parse through each of the remaining answer choices by deciding what makes each choice wrong. When I'm studying, I like to write the reason why it's wrong, and what the correct answer is. This always helps me get through the answer choices faster during the real exam.
 
I feel that you could know all the content and info and still miss the questions you should have gotten because its applied. How do you guys develop these skills? Do practice questions for the specific material? I've noticed some med students annotate first aid and answer some q-banks with their courses. Recommended? What else can someone do to improve performance?
 
Does anybody find anki useful??

I feel that would be way too time consuming to maintain with the amount of material. Most time I would have would be to annotate the slides and do some textbook reading. Do people use it?
 
Does anybody find anki useful??

I've used anki all throughout first year. It is amazing! Sure, it takes some extra time up front, but once you've made the cards, you can drill 200+ pages worth of facts into your head in a day or two. I honestly could not imagine studying without anki. Simply rereading material over and over again is totally inefficient. Anki gives you the ability to isolate the details you're having trouble remembering and really nail them down, without having to waste a bunch of time rereading things you already know.

I should add that we have syllabi, so the information is relatively condensed to begin with, at least compared to textbooks. In other words, our material is very anki-friendly. If your school uses textbooks then perhaps anki isn't the best way to go, as that would probably get a bit overwhelming. Regardless, if you want to score consistently high grades on the exams, you're going to have to find an efficient way of picking up a lot of the details. Anki has worked like a champ for me. I prepare the same way for each exam, and my results are very consistent. As long as I put in the work, I know what I'm going to get out of it.

Just to give you an idea, I typically have anywhere from 400-600 cards per test. It generally takes me a solid day to really nail them down, but once I do, it's like I've memorized the entire syllabus. I usually reread the syllabus once after reviewing the cards, mainly for context and to pick up on the occasional nuance that didn't translate well onto a card. Like I said, it takes some time up front, but you end up spending a lot less time on the back end (near the exam), and your studying is extremely focused and efficient.
 
And I was one of those people that didn't use a single flashcard as an undergraduate. I used to hate on flashcards all the time, but after taking my first medical school exam, I realized I was going to need to do something different if I wanted to do well. I got destroyed by the details. You simply cannot read 200-400 pages worth of material and retain everything. Some things I pick up on right away, and I only need to cover that particular flashcard once, but then there are other details that just refuse to get into my head, and that's where anki becomes an awesome tool.
 
Members don't see this ad :)
Answer by the clock.

If you read a question and you have no clue to the answer, look at an old analog clock. If the second hand is in between the 12 and the 3 (the first 15 seconds), the answer is A. Between 3 and 6 is B. 6 to 9 is C, and 9 to 12 is D. This can be modified for a 5 answer multiple choice fairly easily by cutting the time into 12 second blocks.

It works better if you can eliminate some of the distractions and modify the time to fit the number of choices left.

I knew someone that took a practice exam this way and score 85%.

Seriously, get past the MCAT first.

*note- I have not started med school yet, but I have spent the last 19 years as a high school teacher giving exams. I think I know a little about pulling out important information and asking questions about it. My favorite strategy is to eliminate bad answers and you are left with the correct answer. (Paraphrase of Sherlock Holmes).

dsoz

You say, "I think I know a little about pulling out important information and asking questions about it," but offer no insight and nothing to back up your statement. After 19 years of teaching the only advice you have is "...eliminate bad answers and you are left with the correct answer"? Well, you really found the trick, didn't you? What was the point of your post?

Thanks to those actually posting useful content!
 
Hi guys,

What's your advice regarding improving test taking skills for med school? I realize majority of exams are multiple choice including the boards. What do you do during your studying to become better at taking these tests? Do specific q banks or other questions while reviewing content in slides? What do most students do to improve their retention of material and performance on MC tests? Of course this helps for boards.

Read, read, read

As I have gotten older through the years, my reading has picked up significantly. I am a writer so I am fluid with words. When I took the SAT (number 2 pencil days), I could not finish the tests. Ditto for PSAT. When I took the MCAT 20 years ago, I could not finish the exams. I scored poorly because of not finishing the exams. The ones I did complete I did well.

I finished my MCAT 2 years ago with time to spare for all sections. Today I fly through my computer based exams in medical school. The kids in my class struggle. They are poor readers. When the professors ask them to read outloud, I am stunned as to how badly they read: mispronounce words, ignore punctuation, stop mid-sentence and complain (imagine that, a 20 something year old complaining)

"Christ, I miss the Cold War"
M (Judi Dench) in James Bond "Casino Royale"

Kids can't read well today compared to when my parents were in their 20s because kids today don't read much...other than Twitter, Face(less)book and other mind numbing media. When I fly on airplanes, it's the kids on electronic games and the "adults" (over 40) reading books (hardcover or Kindle).

So here is my suggestion to pick up your pace to finish your exams:
Read books, long articles in periodicals (NY Times "Well" Column rocks!), and other pieces of literature where your brain is required to engage for long periods of time. Part of the hassle of computer based exams in medical school is that the questions are clinical cases and reading 130 of these for 3 hours is enough to give you headaches and mental fatigue...just after one hour.

Twitter makes your brain rot.

Reading "War and Peace" makes your Cerebral Cortex more plastic.

This is really a no-brainer

pun intended
 
Read, read, read

As I have gotten older through the years, my reading has picked up significantly. I am a writer so I am fluid with words. When I took the SAT (number 2 pencil days), I could not finish the tests. Ditto for PSAT. When I took the MCAT 20 years ago, I could not finish the exams. I scored poorly because of not finishing the exams. The ones I did complete I did well.

I finished my MCAT 2 years ago with time to spare for all sections. Today I fly through my computer based exams in medical school. The kids in my class struggle. They are poor readers. When the professors ask them to read outloud, I am stunned as to how badly they read: mispronounce words, ignore punctuation, stop mid-sentence and complain (imagine that, a 20 something year old complaining)

"Christ, I miss the Cold War"
M (Judi Dench) in James Bond "Casino Royale"

Kids can't read well today compared to when my parents were in their 20s because kids today don't read much...other than Twitter, Face(less)book and other mind numbing media. When I fly on airplanes, it's the kids on electronic games and the "adults" (over 40) reading books (hardcover or Kindle).

So here is my suggestion to pick up your pace to finish your exams:
Read books, long articles in periodicals (NY Times "Well" Column rocks!), and other pieces of literature where your brain is required to engage for long periods of time. Part of the hassle of computer based exams in medical school is that the questions are clinical cases and reading 130 of these for 3 hours is enough to give you headaches and mental fatigue...just after one hour.

Twitter makes your brain rot.

Reading "War and Peace" makes your Cerebral Cortex more plastic.

This is really a no-brainer

pun intended

Nice! Any other advice for extracting info from clinical vignettes?
Additionally how do you apply info from slides and content to the actual exam?
 
Nice! Any other advice for extracting info from clinical vignettes?
Additionally how do you apply info from slides and content to the actual exam?

It's kind of hard to describe how one gets trained to extract information from clinical vignettes, but after having just finished Step 1, I can tell you that a lot of it is learned by practice. In a lot of MS1, you don't have enough context or knowledge to be able to narrow down what the stem of the question is asking about without seeing the actual question or reading the answer choices, especially if you weren't told what specific organ system the test was on. Once you get through a lot more material toward the end of MS2, your pattern recognition gets better and you can see what diagnosis/objective the question is going to be about in the first sentence or two of the stem.

I find that pattern recognition also applies to what you apply from slides/syllabus on an exam. You'll learn pretty quickly what is testable and what is probably not testable and start triaging information that way. If you have a reasonable memory, you can tell as you go through a course what information is new to you versus what you've seen before. If the information on a particular topic is presented more than once, you'd better know it for the exam. Also, there is no shortage of lecturers who put happy red stars next to things on their slides/use special hand signs/say "hint: this is important" to let you know what might be tested.
 
It's kind of hard to describe how one gets trained to extract information from clinical vignettes, but after having just finished Step 1, I can tell you that a lot of it is learned by practice. In a lot of MS1, you don't have enough context or knowledge to be able to narrow down what the stem of the question is asking about without seeing the actual question or reading the answer choices, especially if you weren't told what specific organ system the test was on. Once you get through a lot more material toward the end of MS2, your pattern recognition gets better and you can see what diagnosis/objective the question is going to be about in the first sentence or two of the stem.

As a first year, Im definitely having some trouble coming up with differential diagnosis and the correct answer from the clinical vignettes in my microbio class. Everyone else in my small group seems to do just fine except for me, which is frustrating.
 
It's kind of hard to describe how one gets trained to extract information from clinical vignettes, but after having just finished Step 1, I can tell you that a lot of it is learned by practice. In a lot of MS1, you don't have enough context or knowledge to be able to narrow down what the stem of the question is asking about without seeing the actual question or reading the answer choices, especially if you weren't told what specific organ system the test was on. Once you get through a lot more material toward the end of MS2, your pattern recognition gets better and you can see what diagnosis/objective the question is going to be about in the first sentence or two of the stem.

I find that pattern recognition also applies to what you apply from slides/syllabus on an exam. You'll learn pretty quickly what is testable and what is probably not testable and start triaging information that way. If you have a reasonable memory, you can tell as you go through a course what information is new to you versus what you've seen before. If the information on a particular topic is presented more than once, you'd better know it for the exam. Also, there is no shortage of lecturers who put happy red stars next to things on their slides/use special hand signs/say "hint: this is important" to let you know what might be tested.

Yes, those pointers are definitely helpful! One thing I need to do is become more used to utilizing starred topics and using those to answer the question that seems vague, but actually is put that way to test that starred point in the notes.
 
Nice! Any other advice for extracting info from clinical vignettes?
Additionally how do you apply info from slides and content to the actual exam?

I realize you want an easy answer. I would invite you to approach this from a different angle.
Reading quickly and efficiently are skills to be acquired over time. Drop the "cliff notes" mindset and dig deep. You will be doing alot of reading in medicine. Adopt the necessary skills now instead of looking for easy answers.

When I was a teenager, I read the paperback books that were assigned to us in high school. Classics such as "Catcher in the Rye" (JD Salinger), "A Chocolate War" (Robert Cormier), "Brave New world" (Aldous Huxley), "1984" (George Orwell), etc, were required reading. I did not go to a special school and I did "alright" academically. But I did not have, like kids do today, all of the distractions that serve as obstacles to developing critical thinking and interpersonal skills. Heck, we played kick ball in the streets, hung from trees, played freeze tag, and childhood obesity was non-existent. We had fun as kids and we interacted with each other. Our parents had to hunt for us in the neighborhoods and drag us back home kicking and screaming because we wanted to be with our friends. Today you have to PUSH the young kids off the couch and pry out of their hands "their" cell phones! Crazy!!!

I rarely reply to SDN Pre-Med students. What does a pre-med under 21 year old know?
I replied to you only b/c you got this thread going.

Kids today just don't have the interpersonal skills necessary for relating to adults (like Attendings, Residents and Patients in hospitals) and they prefer to whine, play the martyr role and bitch about how unfair people are to them. I have zero patience for them. If you see the computer exams are really difficult for you, then there is something about you that you are lacking. You are missing some necessary skills. So what should you do?

Adopt those missing skills.

Simple! It costs nothing. But it does mean spending less time on Youtube and Facebook and, um, reading.

I enjoy reading The Wall Street Journal, The New York Times, books on my iPad, and I listen to audio books when I drive for long periods (30 minutes). The critical thinking skills one develops when adopting these undertakings can not be exaggerated. It goes without saying that the computer based question exams are all about critical thinking. There are alot of facts thrown at us in the medical school exams that are extraneous. They are not relevant and are placed in the exams on purpose to make you stumble. Look out for them. Expect them. Get ready for them. Be aggressive. The test authors are NOT your friend. They are TRYING to make you stumble. So what do you do? Beat them at their own game.

When you read for a lifetime, whether you are my age, or as a late teen, early 20 something year old, you should have adopted decent reading comprehension skills and, of course, critical analysis skills. Facebook, Twitter, and SDN posts where ANYONE CAN POST ANYTHING WITHOUT REPRISAL, do not help you for much in life, other than satisfy immediate gratification and down time.

Read.
Practice questions 50% of the time while the other 50% of your study time should be course material.

But you're just a pre-med student, so you don't have to worry about this yet. But adopt healthy reading skills now. When you get into medical school, you should tackle these things seriously

And for God's sake, if you get into medical school, and the professors call on you to read cases outloud, read with confidence, authority and not stumbling on pronunciation. Laughing at these foibles in class only make you look unreliable and immature. Who would want you as a doctor?

Medical schools are too soft on applicants as to qualifying issues other than MCAT and GPA

They need to do a better job of screening applicants to see if they have the wherewithhall of having the right stuff (Tom Wolfe!!! ha!)

Now there's a great book! Tom Wolfe's The Right Stuff. Oooorrraaaahhhh!!!

Off we go into the wild blue yonder.....
 
I realize you want an easy answer. I would invite you to approach this from a different angle.
Reading quickly and efficiently are skills to be acquired over time. Drop the "cliff notes" mindset and dig deep. You will be doing alot of reading in medicine. Adopt the necessary skills now instead of looking for easy answers.

When I was a teenager, I read the paperback books that were assigned to us in high school. Classics such as "Catcher in the Rye" (JD Salinger), "A Chocolate War" (Robert Cormier), "Brave New world" (Aldous Huxley), "1984" (George Orwell), etc, were required reading. I did not go to a special school and I did "alright" academically. But I did not have, like kids do today, all of the distractions that serve as obstacles to developing critical thinking and interpersonal skills. Heck, we played kick ball in the streets, hung from trees, played freeze tag, and childhood obesity was non-existent. We had fun as kids and we interacted with each other. Our parents had to hunt for us in the neighborhoods and drag us back home kicking and screaming because we wanted to be with our friends. Today you have to PUSH the young kids off the couch and pry out of their hands "their" cell phones! Crazy!!!

I rarely reply to SDN Pre-Med students. What does a pre-med under 21 year old know?
I replied to you only b/c you got this thread going.

Kids today just don't have the interpersonal skills necessary for relating to adults (like Attendings, Residents and Patients in hospitals) and they prefer to whine, play the martyr role and bitch about how unfair people are to them. I have zero patience for them. If you see the computer exams are really difficult for you, then there is something about you that you are lacking. You are missing some necessary skills. So what should you do?

Adopt those missing skills.

Simple! It costs nothing. But it does mean spending less time on Youtube and Facebook and, um, reading.

I enjoy reading The Wall Street Journal, The New York Times, books on my iPad, and I listen to audio books when I drive for long periods (30 minutes). The critical thinking skills one develops when adopting these undertakings can not be exaggerated. It goes without saying that the computer based question exams are all about critical thinking. There are alot of facts thrown at us in the medical school exams that are extraneous. They are not relevant and are placed in the exams on purpose to make you stumble. Look out for them. Expect them. Get ready for them. Be aggressive. The test authors are NOT your friend. They are TRYING to make you stumble. So what do you do? Beat them at their own game.

When you read for a lifetime, whether you are my age, or as a late teen, early 20 something year old, you should have adopted decent reading comprehension skills and, of course, critical analysis skills. Facebook, Twitter, and SDN posts where ANYONE CAN POST ANYTHING WITHOUT REPRISAL, do not help you for much in life, other than satisfy immediate gratification and down time.

Read.
Practice questions 50% of the time while the other 50% of your study time should be course material.

But you're just a pre-med student, so you don't have to worry about this yet. But adopt healthy reading skills now. When you get into medical school, you should tackle these things seriously

And for God's sake, if you get into medical school, and the professors call on you to read cases outloud, read with confidence, authority and not stumbling on pronunciation. Laughing at these foibles in class only make you look unreliable and immature. Who would want you as a doctor?

Medical schools are too soft on applicants as to qualifying issues other than MCAT and GPA

They need to do a better job of screening applicants to see if they have the wherewithhall of having the right stuff (Tom Wolfe!!! ha!)

Now there's a great book! Tom Wolfe's The Right Stuff. Oooorrraaaahhhh!!!

Off we go into the wild blue yonder.....

Starting med school in the fall.
 
I realize you want an easy answer. I would invite you to approach this from a different angle.
Reading quickly and efficiently are skills to be acquired over time. Drop the "cliff notes" mindset and dig deep. You will be doing alot of reading in medicine. Adopt the necessary skills now instead of looking for easy answers.

When I was a teenager, I read the paperback books that were assigned to us in high school. Classics such as "Catcher in the Rye" (JD Salinger), "A Chocolate War" (Robert Cormier), "Brave New world" (Aldous Huxley), "1984" (George Orwell), etc, were required reading. I did not go to a special school and I did "alright" academically. But I did not have, like kids do today, all of the distractions that serve as obstacles to developing critical thinking and interpersonal skills. Heck, we played kick ball in the streets, hung from trees, played freeze tag, and childhood obesity was non-existent. We had fun as kids and we interacted with each other. Our parents had to hunt for us in the neighborhoods and drag us back home kicking and screaming because we wanted to be with our friends. Today you have to PUSH the young kids off the couch and pry out of their hands "their" cell phones! Crazy!!!

I rarely reply to SDN Pre-Med students. What does a pre-med under 21 year old know?
I replied to you only b/c you got this thread going.

Kids today just don't have the interpersonal skills necessary for relating to adults (like Attendings, Residents and Patients in hospitals) and they prefer to whine, play the martyr role and bitch about how unfair people are to them. I have zero patience for them. If you see the computer exams are really difficult for you, then there is something about you that you are lacking. You are missing some necessary skills. So what should you do?

Adopt those missing skills.

Simple! It costs nothing. But it does mean spending less time on Youtube and Facebook and, um, reading.

I enjoy reading The Wall Street Journal, The New York Times, books on my iPad, and I listen to audio books when I drive for long periods (30 minutes). The critical thinking skills one develops when adopting these undertakings can not be exaggerated. It goes without saying that the computer based question exams are all about critical thinking. There are alot of facts thrown at us in the medical school exams that are extraneous. They are not relevant and are placed in the exams on purpose to make you stumble. Look out for them. Expect them. Get ready for them. Be aggressive. The test authors are NOT your friend. They are TRYING to make you stumble. So what do you do? Beat them at their own game.

When you read for a lifetime, whether you are my age, or as a late teen, early 20 something year old, you should have adopted decent reading comprehension skills and, of course, critical analysis skills. Facebook, Twitter, and SDN posts where ANYONE CAN POST ANYTHING WITHOUT REPRISAL, do not help you for much in life, other than satisfy immediate gratification and down time.

Read.
Practice questions 50% of the time while the other 50% of your study time should be course material.

But you're just a pre-med student, so you don't have to worry about this yet. But adopt healthy reading skills now. When you get into medical school, you should tackle these things seriously

And for God's sake, if you get into medical school, and the professors call on you to read cases outloud, read with confidence, authority and not stumbling on pronunciation. Laughing at these foibles in class only make you look unreliable and immature. Who would want you as a doctor?

Medical schools are too soft on applicants as to qualifying issues other than MCAT and GPA

They need to do a better job of screening applicants to see if they have the wherewithhall of having the right stuff (Tom Wolfe!!! ha!)

Now there's a great book! Tom Wolfe's The Right Stuff. Oooorrraaaahhhh!!!

Off we go into the wild blue yonder.....


It does not "go without saying" that these MC test questions are all about "critical thinking". in fact, quite the opposite. they are all about memorizing all the details and then answering the questions when the details show up in the questions. Med School FACT #1: THE MORE YOU MEMORIZE, THE HIGHER YOUR TEST SCORES WILL BE. Always. same goes for step 1, 2, 3 etc. Having taken all of the above, I can tell you that the more time you spend memorizing, the higher your scores will be. "Critical thinking" is a lovely concept, but not a reality when it comes to taking these tests. Sorry to burst your bubble...
 
It does not "go without saying" that these MC test questions are all about "critical thinking". in fact, quite the opposite. they are all about memorizing all the details and then answering the questions when the details show up in the questions. Med School FACT #1: THE MORE YOU MEMORIZE, THE HIGHER YOUR TEST SCORES WILL BE. Always. same goes for step 1, 2, 3 etc. Having taken all of the above, I can tell you that the more time you spend memorizing, the higher your scores will be. "Critical thinking" is a lovely concept, but not a reality when it comes to taking these tests. Sorry to burst your bubble...

How does step 1 thinking compare to the MCAT?
 
It does not "go without saying" that these MC test questions are all about "critical thinking". in fact, quite the opposite. they are all about memorizing all the details and then answering the questions when the details show up in the questions. Med School FACT #1: THE MORE YOU MEMORIZE, THE HIGHER YOUR TEST SCORES WILL BE. Always. same goes for step 1, 2, 3 etc. Having taken all of the above, I can tell you that the more time you spend memorizing, the higher your scores will be. "Critical thinking" is a lovely concept, but not a reality when it comes to taking these tests. Sorry to burst your bubble...

Totally true. It's the sad reality of medical school.

Being only an MS1, I am interested to know if step 1 is like this as well. The MCAT seemed to be much more about critical thinking. How would you compare Step 1 to the MCAT?

Edit: Sorry to reiterate Dr. Dazzle's question.
 
Totally true. It's the sad reality of medical school.

Being only an MS1, I am interested to know if step 1 is like this as well. The MCAT seemed to be much more about critical thinking. How would you compare Step 1 to the MCAT?

Edit: Sorry to reiterate Dr. Dazzle's question.

nothing alike in any way, shape or form. fortunately (for some i suppose, less so for others) the steps directly correlate with how much minutia you have memorized. that said, you have to be able to apply it of course, but you study so much for step 1, that come test time there is zero critical thinking...you automatically recognize what they are going for and then just have to recall a fact that they want you to remember. each test question is the same: they present a classic clinical scenario say for...i dunno...sickle cell anemia. you immediately recognize the kid has sickle cell. then the question will be basically what is the mechanism of the drug you use to prevent sickle crises with? so it's a three step process...1) recognize sickle cell, 2) remember that you prevent sickle crises with hydroxyurea and 3) hydroxyurea increases fetal hemoglobin (this is the answer). So, there's really no critical thinking. The presentation will be so friggin classic, and you just need to quickly recall you prevent crisis with hydroxyurea, and what it's mechanism is. Absolutely nothing like MCAT. Forget that test. It's over, stupid, and has no more bearing on your life ever again.
 
nothing alike in any way, shape or form. fortunately (for some i suppose, less so for others) the steps directly correlate with how much minutia you have memorized. that said, you have to be able to apply it of course, but you study so much for step 1, that come test time there is zero critical thinking...you automatically recognize what they are going for and then just have to recall a fact that they want you to remember. each test question is the same: they present a classic clinical scenario say for...i dunno...sickle cell anemia. you immediately recognize the kid has sickle cell. then the question will be basically what is the mechanism of the drug you use to prevent sickle crises with? so it's a three step process...1) recognize sickle cell, 2) remember that you prevent sickle crises with hydroxyurea and 3) hydroxyurea increases fetal hemoglobin (this is the answer). So, there's really no critical thinking. The presentation will be so friggin classic, and you just need to quickly recall you prevent crisis with hydroxyurea, and what it's mechanism is. Absolutely nothing like MCAT. Forget that test. It's over, stupid, and has no more bearing on your life ever again.

Thanks for the response. I guess the nature of Step 1 can be both a good and bad thing. In one sense, you are much more likely to get a particular score, given a certain amount of preparation. In other words, there is less variability in the ultimate outcome. However, you have to spend a ton of time memorizing all the minutiae.

The MCAT was always sort of a double-edged sword for me. I liked that it was more about critical thinking, but it always scared me that I wouldn't be able to think something through when it came time for the real deal. With all of the nerves and everything surrounding actually taking the exam, you're not exactly in the ideal mental state to perform your best on an exam like the MCAT. Basic recall, on the other hand, doesn't seem to be as susceptible to external factors, at least in my experience.
 
I agree with you. The critical thinking aspect was fantastic, but the structure, concepts, and overall feel of the exam was pretty numbing. It literally felt like a flaming hoop was presented for me to jump through.
 
Wow, roadlesstravel.... you are going to be bitter as hell when you see that any of the young 20 somethings doing better than you in school, considering how much you generalize the entire generation and say that they basically can't read. lol, enjoy that.

To OP: If it's a long vignette, read the question first. Sometimes I'll read the entire vignette and focus on figuring out the diagnosis, then in the question line or the last 2 lines of the vignette, they give me the diagnosis and ask for some 3rd or 4th order question.

Step 1 is exactly as billybob stated in his previous post. It's 3rd (at least) or 4th order questions. You figuring out the diagnosis (unless it's a very obscure one where there's one detail that separates it from another answer choice) will almost never get you to the right answer. For example, differentiating between Tay-Sachs and Niemann-Pick is likely going to be a one-symptom difference. However, to answer the question (since this is a hard one to differentiate between two similar diseases) you'll have to go 2nd order and say what enzyme is affected by the disease (one of them will be Hex A for tay-sachs, and whatever the enzyme for Niemann-Pick is).

Never be happy with a question asking 1st order stuff. If a question asks you to diagnose sickle cell only, think about the complications (like encapsulated organism infections [N. Meningitis, H. Influenza, S. Pneumo] due to functional asplenia), or the treatment+mechanism like billybob mentioned above, or other important facts (ilke sickle cell trait --> malaria resistance, thus SCA is most common in African-Americans).
 
Read, read, read

As I have gotten older through the years, my reading has picked up significantly. I am a writer so I am fluid with words. When I took the SAT (number 2 pencil days), I could not finish the tests. Ditto for PSAT. When I took the MCAT 20 years ago, I could not finish the exams. I scored poorly because of not finishing the exams. The ones I did complete I did well.

I finished my MCAT 2 years ago with time to spare for all sections. Today I fly through my computer based exams in medical school. The kids in my class struggle. They are poor readers. When the professors ask them to read outloud, I am stunned as to how badly they read: mispronounce words, ignore punctuation, stop mid-sentence and complain (imagine that, a 20 something year old complaining)

"Christ, I miss the Cold War"
M (Judi Dench) in James Bond "Casino Royale"

Kids can't read well today compared to when my parents were in their 20s because kids today don't read much...other than Twitter, Face(less)book and other mind numbing media. When I fly on airplanes, it's the kids on electronic games and the "adults" (over 40) reading books (hardcover or Kindle).

So here is my suggestion to pick up your pace to finish your exams:
Read books, long articles in periodicals (NY Times "Well" Column rocks!), and other pieces of literature where your brain is required to engage for long periods of time. Part of the hassle of computer based exams in medical school is that the questions are clinical cases and reading 130 of these for 3 hours is enough to give you headaches and mental fatigue...just after one hour.

Twitter makes your brain rot.

Reading "War and Peace" makes your Cerebral Cortex more plastic.

This is really a no-brainer

pun intended

Reading Tom Wolfe makes you better at interpersonal skills?
 
nothing alike in any way, shape or form. Fortunately (for some i suppose, less so for others) the steps directly correlate with how much minutia you have memorized. That said, you have to be able to apply it of course, but you study so much for step 1, that come test time there is zero critical thinking...you automatically recognize what they are going for and then just have to recall a fact that they want you to remember. Each test question is the same: They present a classic clinical scenario say for...i dunno...sickle cell anemia. You immediately recognize the kid has sickle cell. Then the question will be basically what is the mechanism of the drug you use to prevent sickle crises with? So it's a three step process...1) recognize sickle cell, 2) remember that you prevent sickle crises with hydroxyurea and 3) hydroxyurea increases fetal hemoglobin (this is the answer). So, there's really no critical thinking. The presentation will be so friggin classic, and you just need to quickly recall you prevent crisis with hydroxyurea, and what it's mechanism is. Absolutely nothing like mcat. Forget that test. It's over, stupid, and has no more bearing on your life ever again.

+10
 
nothing alike in any way, shape or form. fortunately (for some i suppose, less so for others) the steps directly correlate with how much minutia you have memorized. that said, you have to be able to apply it of course, but you study so much for step 1, that come test time there is zero critical thinking...you automatically recognize what they are going for and then just have to recall a fact that they want you to remember. each test question is the same: they present a classic clinical scenario say for...i dunno...sickle cell anemia. you immediately recognize the kid has sickle cell. then the question will be basically what is the mechanism of the drug you use to prevent sickle crises with? so it's a three step process...1) recognize sickle cell, 2) remember that you prevent sickle crises with hydroxyurea and 3) hydroxyurea increases fetal hemoglobin (this is the answer). So, there's really no critical thinking. The presentation will be so friggin classic, and you just need to quickly recall you prevent crisis with hydroxyurea, and what it's mechanism is. Absolutely nothing like MCAT. Forget that test. It's over, stupid, and has no more bearing on your life ever again.

Exactly.
 
It does not "go without saying" that these MC test questions are all about "critical thinking". in fact, quite the opposite. they are all about memorizing all the details and then answering the questions when the details show up in the questions. Med School FACT #1: THE MORE YOU MEMORIZE, THE HIGHER YOUR TEST SCORES WILL BE. Always. same goes for step 1, 2, 3 etc. Having taken all of the above, I can tell you that the more time you spend memorizing, the higher your scores will be. "Critical thinking" is a lovely concept, but not a reality when it comes to taking these tests. Sorry to burst your bubble...

It's unfortunate that memorization >>> critical thinking for MC tests. When I took physio, I was expected more critical thinking and it gave me a mental hard-on because I come from an engineering background. However, the same strategy applied for physio like for any other class: memorize, memorize, memorize.

Good advice in this thread, some of which I haven't heard/used before. A few more pointers:

  • Time management: be aware of how many questions there will be on the exam and how much time for a given set of questions. Usually, I will plan to hit half the questions of the exam by 1/3 of the alloted time. Time management was especially useful for me during shelf exams because I would know whether my pace was appropriate or not. For example, I paced myself on the anatomy shelf and was able to finish on time, yet many of my classmates ran out of time.
  • Skip Around: this should be fairly obvious if you've taken MCAT, but I'm surprised to still here about students who get fixated on difficult questions. Don't waste time on them and save them for last. Maximize your points. Sometimes you just need a break for a question only to have an epiphany when you look at the same question the second time around.
  • Water: water keeps me calm. I take regular sips during my exams. After finishing half the questions, I take a long drink, stretch, and move on to the second half. It's like tension release for me.
  • Double-Check Your Answers: if you have time to spare, double-check. I find it funny that I come across a handful of dumb mistakes on every exam. At this point, practically all the questions I get wrong are simply from a lack of knowledge.

That's all I can think of for now.
 
It's unfortunate that memorization >>> critical thinking for MC tests. When I took physio, I was expected more critical thinking and it gave me a mental hard-on because I come from an engineering background. However, the same strategy applied for physio like for any other class: memorize, memorize, memorize.

Good advice in this thread, some of which I haven't heard/used before. A few more pointers:

  • Time management: be aware of how many questions there will be on the exam and how much time for a given set of questions. Usually, I will plan to hit half the questions of the exam by 1/3 of the alloted time. Time management was especially useful for me during shelf exams because I would know whether my pace was appropriate or not. For example, I paced myself on the anatomy shelf and was able to finish on time, yet many of my classmates ran out of time.
  • Skip Around: this should be fairly obvious if you've taken MCAT, but I'm surprised to still here about students who get fixated on difficult questions. Don't waste time on them and save them for last. Maximize your points. Sometimes you just need a break for a question only to have an epiphany when you look at the same question the second time around.
  • Water: water keeps me calm. I take regular sips during my exams. After finishing half the questions, I take a long drink, stretch, and move on to the second half. It's like tension release for me.
  • Double-Check Your Answers: if you have time to spare, double-check. I find it funny that I come across a handful of dumb mistakes on every exam. At this point, practically all the questions I get wrong are simply from a lack of knowledge.

That's all I can think of for now.

With all this emphasis on memorization, how does one make sure that they retain info for the boards? I feel all that hardwork is lost if you don't retain info from classes. Perhaps do the review books along with courses? But is there enough time for that? That way boards would require just doing q-banks.
 
With all this emphasis on memorization, how does one make sure that they retain info for the boards? I feel all that hardwork is lost if you don't retain info from classes. Perhaps do the review books along with courses? But is there enough time for that? That way boards would require just doing q-banks.

Step 2 basically just requires using a qbank to smash it.

Step 1 has way more minutia so you actually need review books and qbank. The detail in class was way more detail than the step 1. So no you don't need to use review books during class. You use them to review in the coming months before. Hence a "review book." ;) If you use them during class you'll actually see how inadequate they are for your lecture tests.
 
Medical school is about plain old rote memorization. There is nothing fancy about it. Use flashcards to get the information into your head. My favorite program is called "CueCard" (you can find it on download.com) I have used it since undergraduate and have yet to find a better alternative.

Survivor DO
 
Step 1:
Do Qbank questions til you're numb
Look over FA til you go blind
 
Step 2 basically just requires using a qbank to smash it.

Step 1 has way more minutia so you actually need review books and qbank. The detail in class was way more detail than the step 1. So no you don't need to use review books during class. You use them to review in the coming months before. Hence a "review book." ;) If you use them during class you'll actually see how inadequate they are for your lecture tests.

I was thinking using the books to have gone through them once with classes. Comparing to MCAT, I wouldn't have needed any review, if I just used a set of books and annotated with each class. Then just do practice exams before the exam. You get a month to study for steps, so this way you could focus more on just the q-banks I would think.
 
Medical school is about plain old rote memorization. There is nothing fancy about it. Use flashcards to get the information into your head. My favorite program is called "CueCard" (you can find it on download.com) I have used it since undergraduate and have yet to find a better alternative.

Survivor DO

What about Anki?
 
I'm an M1 and have been using anki throughout the year. The times when I didn't use Anki, I scored lower than usual. I've always been a flashcard person, ever since high school. I flashcarded my way through college, and now I'm flashcarding my way through med school. It takes up a lot of time, but it works...perhaps not so much for long term knowledge, but at this point, I'm just trying to survive and hope that I at least remember basic concepts so that it's not so hard to relearn the second time.

Anki is good in that it solves the problem of studying things you already know. The cards are also searchable, which is great when you want to find something fast and can't remember which lecture it's from.
 
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