I promised myself that I would post a review of the PBR book after my results came out. Admittedly I knew that the results would color the review, but then again, the results are also the most objective evaluation of the course. In my case, I passed the course.
For one thing, before I bought the book, I had searched these forums and found only a few mentions of the PBR course. The poster above (jennsmithmd) has posted about PBR in a couple of places, but her wording almost sounded like one of those fake paid reviews. I was already somewhat skeptical because the PBR website is kind of sleazy-looking, in the same way that, say, advertisements for an 'As-seen-on-TV' product look. Also it really tries hard to 'upsell' you from the book to a course or some kind of bundle deals. Also, it charges you something like 20 dollars just for very slow shipping (took me about 2 weeks to receive the book). This immediately put me off, but the reason I ended up pulling the trigger is because the two chapters that are provided for free (GI and Derm) were actually very readable, far more than MedStudy. Also they were far less annoying than LYW, which, for me, was infuriating to read, because there's so much time wasted reading not only stupid jokes, but footnotes whose sole purpose might or might not be a stupid joke. MedStudy is a dense, intractable, unreadable piece of crap written by people who have no ability to synthesize material. In contrast, often PBR provides very straightforward, simple reasoning for the etiology and pathology associated with a certain disease. At other times a few complicated steps are summed up by the author stating: 'just assume that the low calcium is because bones are using it up' or something like that. This is preferable to 1. no reasoning or 2. many convoluted steps.
So I bought a physical copy of the book which comes with a Q&A book (which only has 50 Qs in it), which I think is the most basic 'bundle'.
Additionally, what I liked about PBR was that the guy had already put together a review schedule for me. Not only that, but it looked very doable. I'm one of those people who puts together a meticulous schedule, then fails completely at keeping up with it. In this light, the instructions to read x amount of (very readable) pages per day and do y number of PREP Qs per week was like a godsend: I didn't have to worry about any other material or making a schedule I would not keep. Basically you read the book three times, and do three years of PREP Qs, stepping up your speed as you go. That's it.
The material flows together pretty well, high-yield stuff is repeated 2, 3 or perhaps even 4 times throughout the book. The mnemonics are a little 'out there' but actually the way he comes up with them remind me of my own methods in the past, using striking visual images and resemblances between words, letters and symbols (e.g. ALL looks like 4:11; a common translocation). They actually work.
By the time I got the book I had already been reading the online version, and I had 12 weeks (rather than his recommended 14) to read through the book 3 times and do 3 years of PREP. I actually ended up a little short on time at the end because I hit a wall after the second time through (not because of the material but just because I was tired of sustained study) and probably did not study at all about 1 week out of the total of 12 weeks.
So I went through the book 2.5 times (skipped a few chapters the last time through), did 3 years of PREP, and also, since I had LYW, read through those special boxes in LYW where they talk about what answer you think its going to be and what answer it actually ends up being.
...And I passed, with a score about half a standard deviation below the mean. I did not expect to, for several reasons:
1. Everyone keeps talking about how hard it is.
2. I was projected to fail based on the in-service exams, and I never cracked a book during residency
3. I have always done quite well on standardized tests (>97%ile in SATs, ACT, MCAT, IQ tests etc) but below average on tests that require recall of trivial details, which this test is supposed to have in spades, moreso than the Steps, I think.
I cannot imagine that this test correlates at all to being a good doctor; the PPV is probably even lower than the NPV. This test is not that difficult, when it is approached from the same angle in which it was written, which is regurgitation via word association and the intentional obfuscation of certain stereotyped scenarios. There were several questions straight out of PBR and the 2011 edition of LYW. It's just disappointing that this is the preferred method of evaluation of a doctor, and a sad testament to modern science's obsession with measurement and its inability to recognize quality except in terms of quantification.
