A class divided

[coldcase331]

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So as the title says, my class (M2) is essentially divided into 2 camps. The first camp studies lectures, reads Robbins, and uses FA/pathoma/sketchy (essentially worrying about H/HP/P along with Step 1). The second camp uses FA/pathoma/sketchy almost exclusively (essentially worrying about Step 1).

Personally, I've been jumping back and forth in regards to which study approach I want to use. Up until now, I've been in the camp that reads robbins and studies lectures for the most part, and I've been doing better on the exams. However, part of me feels that because I'm taking on a lot more information, my long-term retention of the high yield concepts is lower than those that focus their time memorizing the high yield resources. In addition, I feel that the time required to focus on reading a source like robbins is much higher than just focusing on high yield resources. Could anyone comment on which study method they used and how it panned out for them?

 

[watermelon master]

It's going to be different for everybody. What I've heard is that if you are in a P/NP school is that it's important to stay on top of the material, understand it, pass obviously, all while simultaneously preparing for the boards. Try to do a combination of both strategies. Good luck.

 

[Redpancreas]

Congratulations, you've found a way to make the most frequently asked question on SDN sound epic.

 

[Goro]

So as the title says, my class (M2) is essentially divided into 2 camps. The first camp studies lectures, reads Robbins, and uses FA/pathoma/sketchy (essentially worrying about H/HP/P along with Step 1). The second camp uses FA/pathoma/sketchy almost exclusively (essentially worrying about Step 1).

Personally, I've been jumping back and forth in regards to which study approach I want to use. Up until now, I've been in the camp that reads robbins and studies lectures for the most part, and I've been doing better on the exams. However, part of me feels that because I'm taking on a lot more information, my long-term retention of the high yield concepts is lower than those that focus their time memorizing the high yield resources. In addition, I feel that the time required to focus on reading a source like robbins is much higher than just focusing on high yield resources. Could anyone comment on which study method they used and how it panned out for them?

You have to use what works for you, and you alone.

 

[Foot Fetish]

It depends what your goals are. I think true mastery of UFAP + Sketchy would guarantee a ~250. Obviously few people reach that stage of mastery, as evidenced by the national average. If you want to score in the 260s and 270s, those resources are probably not enough. There are lots of experience reports where people claim to have gotten questions that were nowhere to be found in UFAP/Sketchy and which they only knew from Goljan, Robbins, class, or clinical experiences. Granted, you may only have a very small handful of this type of question on your exam, but it is what separates the good scores from the jaw-dropping scores. Of course, this all presupposes that you have the fundamentals down pat. Knowledge of obscure pathologies from the depths of big Robbins is worthless if you don't know the bread and butter diseases backwards and forwards.

 

[coldcase331]

It depends what your goals are. I think true mastery of UFAP + Sketchy would guarantee a ~250. Obviously few people reach that stage of mastery, as evidenced by the national average. If you want to score in the 260s and 270s, those resources are probably not enough. There are lots of experience reports where people claim to have gotten questions that were nowhere to be found in UFAP/Sketchy and which they only knew from Goljan, Robbins, class, or clinical experiences. Granted, you may only have a very small handful of this type of question on your exam, but it is what separates the good scores from the jaw-dropping scores. Of course, this all presupposes that you have the fundamentals down pat. Knowledge of obscure pathologies from the depths of big Robbins is worthless if you don't know the bread and butter diseases backwards and forwards.

Woah dude, I don't think I'm shooting for the 260-270 range, although it would be nice to have a score like that. Since I'm looking at cards or heme/onc right now, my goal is in the 240-250 range. Don't really have a desire to do surgery or any of the top specialties at the present time (derm/plastic/uro/ortho/neurosurg)

 

[Jojos]

do what works for you. i personally stopped using robbins at some point just because of how much time it took me to wade out the unnecessary details. by sticking to the fundamental i felt that i mastered the details that matter.

 

[Drrrrrr. Celty]

It depends what your goals are. I think true mastery of UFAP + Sketchy would guarantee a ~250. Obviously few people reach that stage of mastery, as evidenced by the national average. If you want to score in the 260s and 270s, those resources are probably not enough. There are lots of experience reports where people claim to have gotten questions that were nowhere to be found in UFAP/Sketchy and which they only knew from Goljan, Robbins, class, or clinical experiences. Granted, you may only have a very small handful of this type of question on your exam, but it is what separates the good scores from the jaw-dropping scores. Of course, this all presupposes that you have the fundamentals down pat. Knowledge of obscure pathologies from the depths of big Robbins is worthless if you don't know the bread and butter diseases backwards and forwards.

I don't think you're guaranteed much anything on step regardless of knowledge base. I also genuinely think that once you break the 240s it all starts to become entirely luck based.

 

[kb1900]

I don't think you're guaranteed much anything on step regardless of knowledge base. I also genuinely think that once you break the 240s it all starts to become entirely luck based.

How can you even say that? “Entirely luck based” is ridiculous.
You really think that a person at a 240 has the same level of knowledge as someone at 270?

 

[Matthew9Thirtyfive]

How can you even say that? “Entirely luck based” is ridiculous.
You really think that a person at a 240 has the same level of knowledge as someone at 270?

I think he just means on most standardized exams, above a certain threshold, the difference between scores is often dependent on luck--i.e., what day you take the test giving you that extra question you know versus not.

I don't think that threshold is 240 though.

 

[kb1900]

I think he just means on most standardized exams, above a certain threshold, the difference between scores is often dependent on luck--i.e., what day you take the test giving you that extra question you know versus not.

I don't think that threshold is 240 though.

True. But even at the upper portion of the curve, on average, those scoring higher have a better fund than those scoring lower, even if the significance is smaller. Luck and random variation certainly plays a factor on an individual level here, but less so when considering a the population of scores

 

[Matthew9Thirtyfive]

True. But even at the upper portion of the curve, on average, those scoring higher have a better fund than those scoring lower, even if the significance is smaller. Luck and random variation certainly plays a factor on an individual level here, but less so when considering a the population of scores

When you get really far to the right, the likelihood that one tester had significantly more knowledge is a lot lower than the likelihood that random variation just made it so one tester had a question he knew versus another who didn't. It easily could be the other way around, which is the point.

But regardless, I agree that the threshold for that is definitely not 240.

 

[Dr.J.D]

 

[Drrrrrr. Celty]

How can you even say that? “Entirely luck based” is ridiculous.
You really think that a person at a 240 has the same level of knowledge as someone at 270?

I'd wager that the difference isn't all that great compared to the difference between a 240 and numbers below it.

2017's 240 isn't 2010's 240 anymore guys. It's merely a few points above average for most academic mid tier IM/GS programs and below average for any surgical subspecialty or Derm.

It doesn't change that a 240 is still 70th percentile among US MDs. This is not even considering USDOs, IMGs, FMGs, or Canadian schools.

 

[Newyawk]

In my experience (n=1 school) the students who did poorly on exams, irrespective of what sources they used, also bombed the boards. However, our M2 exams tended to be a little easy. I found that those students who did exceptionally well on step 1 pushed themselves far past what was required for exams.

For me that meant doing all 3 major Qbanks and robbins review questions every module and essentially cutting class to make more time for my personal study (lectures were podcasted). I still used lecture notes to do well on exams and to pick up on things that may not have been taught in pathoma/goljan etc. I remember one specific Uworld Q during GI that I had done immediately before a lecture by coincidence (after finishing pathoma etc) and the lecturer taught the exact concept that I had just gotten wrong. No other source taught that concept aside from UW. I also got a pretty easy path Q on my real step 1 wrong bc i didnt learn it well enough when my path lecturer taught it. I thought it was too low-yield to pay any mind. My classmate who scored <210 claimed to have remembered it from lecture.

It's also important to point out that many classmates who were straight A students just werent the greatest standardized test preparers/takers so they didnt do as well as some of their peers despite working hard. Some people call this the "IQ factor" of the exam. Idk how much i believe that.

 

[AshNiffler]

In my experience (n=1 school) the students who did poorly on exams, irrespective of what sources they used, also bombed the boards. However, our M2 exams tended to be a little easy. I found that those students who did exceptionally well on step 1 pushed themselves far past what was required for exams.

For me that meant doing all 3 major Qbanks and robbins review questions every module and essentially cutting class to make more time for my personal study (lectures were podcasted). I still used lecture notes to do well on exams and to pick up on things that may not have been taught in pathoma/goljan etc. I remember one specific Uworld Q during GI that I had done immediately before a lecture by coincidence (after finishing pathoma etc) and the lecturer taught the exact concept that I had just gotten wrong. No other source taught that concept aside from UW. I also got a pretty easy path Q on my real step 1 wrong bc i didnt learn it well enough when my path lecturer taught it. I thought it was too low-yield to pay any mind. My classmate who scored <210 claimed to have remembered it from lecture.

It's also important to point out that many classmates who were straight A students just werent the greatest standardized test preparers/takers so they didnt do as well as some of their peers despite working hard. Some people call this the "IQ factor" of the exam. Idk how much i believe that.

True

 

[JamesPotterMS-3]

In my experience (n=1 school) the students who did poorly on exams, irrespective of what sources they used, also bombed the boards.

YESSSS 100% accurate.
There were a TON of students in my class who would say "My grade on the exam doesn't matter because boards are more important" or "I'm studying for boards, not Dr. X,Y,Z's exam" etc. These are all defense mechanisms. The reality is that it is impossible to re-learn everything during dedicated. You learn everything once or twice during the school year and then review during dedicated. Some stuff (for boards and exams) is pure memorization (like IHC markers for certain cancers, chromosome mutations, etc.). But you should be very familiar with the general disease processes before dedicated. If you sit down during dedicated and don't know basic medical micro/biochem or what Sarcoidosis looks like or the clinical presentation for various vitamin deficiencies, you won't be able to catch up in time.

 

[libertyyne]

YESSSS 100% accurate.
There were a TON of students in my class who would say "My grade on the exam doesn't matter because boards are more important" or "I'm studying for boards, not Dr. X,Y,Z's exam" etc. These are all defense mechanisms. The reality is that it is impossible to re-learn everything during dedicated. You learn everything once or twice during the school year and then review during dedicated. Some stuff (for boards and exams) is pure memorization (like IHC markers for certain cancers, chromosome mutations, etc.). But you should be very familiar with the general disease processes before dedicated. If you sit down during dedicated and don't know basic medical micro/biochem or what Sarcoidosis looks like or the clinical presentation for various vitamin deficiencies, you won't be able to catch up in time.

So here might be an odd question. Even though I am doing well in my exams that are instructor written , I feel like I am brain dumping after each exam and on to the next exam. Do you actually retain the stuff? Will it come back to me in dedicated?

 

[JamesPotterMS-3]

So here might be an odd question. Even though I am doing well in my exams that are instructor written , I feel like I am brain dumping after each exam and on to the next exam. Do you actually retain the stuff? Will it come back to me in dedicated?

It comes back. Trust me.
Quick example: I remember it took me about a week to study the brachial plexus during MS1. During dedicated, I think it took me maybe 2-3 hours to study it again.
During dedicated, I would go through my old lecture powerpoints and seeing my symbols and highlights and circles, etc. would "jog my memory." (I didn't use FA too much; found it to be too disorganized; used it more as a checklist than learning resource).
That's why I'm not a big fan of the idea of doing giant Bros/Zanki decks during the year. It's probably very helpful and I do not doubt the evidence behind spaced repetition. But the reality is most MS1-MS2 students don't know what a "board-style" question looks like until they do UWorld questions around dedicated time. I made my own anki deck while doing UWorld and wrote the cards to reflect the style of clinical/pathological reasoning that UWorld tries to train you.

 

[Freeinfinity]

So here might be an odd question. Even though I am doing well in my exams that are instructor written , I feel like I am brain dumping after each exam and on to the next exam. Do you actually retain the stuff? Will it come back to me in dedicated?

You retain about 20% of all information delivered to you throughout your 4 yrs of med school. It has been argued that students therefore should pay only 20% of medical school tuition.

 

[libertyyne]

You retain about 20% of all information delivered to you throughout your 4 yrs of med school. It has been argued that students therefore should pay only 20% of medical school tuition.

It doesnt feel like i am learning anything except regurgitation.

 

[Iz_FtB]

It comes back. Trust me.
Quick example: I remember it took me about a week to study the brachial plexus during MS1. During dedicated, I think it took me maybe 2-3 hours to study it again.
During dedicated, I would go through my old lecture powerpoints and seeing my symbols and highlights and circles, etc. would "jog my memory." (I didn't use FA too much; found it to be too disorganized; used it more as a checklist than learning resource).
That's why I'm not a big fan of the idea of doing giant Bros/Zanki decks during the year. It's probably very helpful and I do not doubt the evidence behind spaced repetition. But the reality is most MS1-MS2 students don't know what a "board-style" question looks like until they do UWorld questions around dedicated time. I made my own anki deck while doing UWorld and wrote the cards to reflect the style of clinical/pathological reasoning that UWorld tries to train you.

There's no reason for anki cards to be formated in a board style manner. That would probably only limit their usefulness. Brief, to the point cards capturing a single idea is what works best.

If retention is the goal, get on the bros/zanki train asap.

 

[Frogger27]

There's no reason for anki cards to be formated in a board style manner. That would probably only limit their usefulness. Brief, to the point cards capturing a single idea is what works best.

If retention is the goal, get on the bros/zanki train asap.

Do you start Bros/Zanki once systems start or would there by any point to do it during biochemistry/immunology classes? (M1 Systems based)

 

[Iz_FtB]

Do you start Bros/Zanki once systems start or would there by any point to do it during biochemistry/immunology classes? (M1 Systems based)

Currently doing 18 month systems based pre clinical. Started with zanki more or less immediately in conjunction with our biochem block. Lecture material and zanki aren't always 100% in sync, but in a pass/fail system that doesn't matter. Doing the cards consistently actually improved my understanding and retention of lecture material.

Look up reddit posts on bros/zanki strategies and give it a shot to see if it works for you. First few months of med school are all about figuring out how best to get all the material in your head, anyway.

 

[kb1900]

Do you start Bros/Zanki once systems start or would there by any point to do it during biochemistry/immunology classes? (M1 Systems based)

my biochem starts next week and I plan on doing the cards alongside class. I used anki for anatomy and had like 4K cards after 9 weeks. So doing 50 cards of Zanki per day during biochem doesn’t really phase me. I have a strong biochem background so I plan on finding a biochem qbank as well to use to supplement.

It helps that from what I can tell, the deck lines up with my lecture material fairly well and I’ll just have to add cards for each lecture as needed.

 

[Newyawk]

So here might be an odd question. Even though I am doing well in my exams that are instructor written , I feel like I am brain dumping after each exam and on to the next exam. Do you actually retain the stuff? Will it come back to me in dedicated?

Cant say i agree with jamespotter completely. I had several students in my classbwho literally aced exams but didnt do well on the boards. True, anyone who said "boards are more important" and didnt do well on exams also probably didnt do well on the boards bc most of them dont learn the material properly. As i said previously, many people would quote some upper year and say "oh doing uworld is useless right now, im just gonna focus on class". Some of those people ended up doing ok on the boards, but i dont know a single one that did exceptionally well ( 250s or above).
everyone forgets things they learned for a module. Does a doctor remember the specific side effects of every drug? Of course not. But there are principles that are simply too difficult and too time consuming to learn for the first time during dedicated. In my opinion, it is those concepts (frank-starling, for example) that cannot be "dumped" bc those arent random details that can be relearned. The example of the brachial plexus is a poor one in my opinion because anatomy in general isnt a conceptual subject. Of course its easier to rememorize something than it is to memorize it for the first time.

Also there are certain concepts that you need to have learned in order to learn new things. Theres a reason most schools teach either physio or cardio before pharm or renal. If you didnt learn cardio or physio well, you also probably wont learn renal or pharm well.

 

[NotYou20]

Do you start Bros/Zanki once systems start or would there by any point to do it during biochemistry/immunology classes? (M1 Systems based)

I started bros about halfway through the summer before m2. Doing the biochem cards doing with the class would've helped, but there's some stuff we didn't cover so I would've had to read more about it along with the cards. During the summer I just did the biochem deck because biochem and phys were the only things we covered that are in bros. I feel like I have a decent grasp on it and I'll be able to build from it. Still, people that did it during first yeah have like 5 biochem cards to review each day whereas I have 30 or so.

So if you have the time and motivation, go for it. It's a lot easier doing cards that are relevant to what you're learning.
As a side note, these days I pretty much search through the main bros deck using keywords like "tay-sachs" and move all of those into the deck I'm actively using. This avoids having to go through cards that you haven't seen in class, which isn't helpful imo.

 

[JamesPotterMS-3]

Cant say i agree with jamespotter completely. I had several students in my classbwho literally aced exams but didnt do well on the boards. True, anyone who said "boards are more important" and didnt do well on exams also probably didnt do well on the boards bc most of them dont learn the material properly. As i said previously, many people would quote some upper year and say "oh doing uworld is useless right now, im just gonna focus on class". Some of those people ended up doing ok on the boards, but i dont know a single one that did exceptionally well ( 250s or above).
everyone forgets things they learned for a module. Does a doctor remember the specific side effects of every drug? Of course not. But there are principles that are simply too difficult and too time consuming to learn for the first time during dedicated. In my opinion, it is those concepts (frank-starling, for example) that cannot be "dumped" bc those arent random details that can be relearned. The example of the brachial plexus is a poor one in my opinion because anatomy in general isnt a conceptual subject. Of course its easier to rememorize something than it is to memorize it for the first time.

I agree with this. Maybe I didn't articulate it as well in my post. But I completely agree that you don't have the time to restudy everything during dedicated. You should just be brushing up and reviewing weak areas and memorizing dumb things that the test requires (like specific HLA subtypes or mutations, etc.).