How best to study Preventative Medicine and Health Management

[NewYorkDoctors]

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This routinely ends up my worst section on NBME.

I know about vaccinations and appropriate screening intervals.

Rather, what always gets me are the questions that ask how to prevent infection in a certain setting.

Moreover, the geriatric questions also usually confuse the living daylights out of me.

Any suggestions on sources I can read?

Thanks

 

[Valadi]

Can you be more specific?

 

[NewYorkDoctors]

Certainly:

On some of the Clinical Science NBME, there were a few questions of the variety of how to prevent infection in certain circumstances

For example:

A patient has peritoneal dialysis installed, which of the following is the best way to prevent infection. Each of the answers seems reasonable, but the only way to know for certain seems to be if the test taker had a lot of hands on experience on the wards or if he/she read the exact protocol.

Another one is regarding how best to prevent infection in an elderly individual who was catheterized for urinary incontinence. For those without a lot of hands on clinical experience, the easy out was to choose "intermittently remove catheter." However, the correct answer is because catheterization is not an indication for incontinence, the best choice to prevent infection is to use adult diapers.

or another case about the details of hospice care. Can an individual receive hospice care at home only to be shuttled off to another site during the event of death?

These kind of things seem like something a practicing physician would have lots of experience with. However, I have not come onto these kinds of things too often during my clinical rotations. I have seen these things but I do not know the subtleties.

Therefore, I am just wondering how best to approach studying these topics.

 

[Valadi]

So you're asking, "How do I prepared to the mixed bag of random stuff the NBME might throw at me?" 😛

Slightly facetious, but I empathize. I had some major ???!(*#&(#! moments taking and studying for Step II.

Deductive reason will be your only hope in 50% of these questions and there will be no way to prepare for them because these types of questions are low-yield and not emphasized in review material. For the other 50%, UWorld will be your best friend and I would encourage you to go through it thoroughly.

Luckily, these types of right-field questions are not common on the exam. Focus on the big picture stuff in the review books and you will be fine.

 

[NewYorkDoctors]

Well fair enough

I'm just at the end of my board review and I've gone through many of the high yield materials already. Short of moving the test date up (costs $$ and no spots available), I'd figure I'll go do some low yield hunting in some tome of a textbook then.

 

[Valadi]

Well fair enough

I'm just at the end of my board review and I've gone through many of the high yield materials already. Short of moving the test date up (costs $$ and no spots available), I'd figure I'll go do some low yield hunting in some tome of a textbook then.

FWIW, I heard from one of my MS1 mentors that used to write questions for the NBME that in order for them to accept them you had to provide something like 4-5 publications which support reasoning why the right answer is correct. If there is something you want to learn more about, pubmed'ing a review article is likely to contain testable information. Might be easier that sneaking into the restricted section at Hogwarts for a medical tome.

 

[MossPoh]

Also, keep in mind that while two or three answers may be right in some capacity, they tend to have something contraindicated in the stem for all but one of the answers. Sometimes it is about which answers are less right.