How is this possible????

[nofear]

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A friend of mine got his scores back a few days ago and he got a 239 which is pretty good. Now the crazy thing is he did NOT read a single review book and all he did for 2 months were Qbank questions and other questions. Only questions and I know he is not lying about his study methodes and I saw his score so how the hell is that possible? He was an average student in his class so I cant understand it.

 

[me454555]

b/c you can learn alot from just doing questions if you do them the right way.

 

[doc05]

b/c you can learn alot from just doing questions if you do them the right way.

right. Questions are possibly the best way to prepare for the exam -- if you do TONS.

 

[Pox in a box]

What are the chances that he failed a course too? My guess is your friend honored nearly every course and the ones he didn't, he didn't do an extra assignment. Sounds like he had raw, natural talent. As you can find all over this board, Step 1 prep is a longer process than the weeks after 2nd year is over. It takes 2 years or even more for some if you include the cell biology and other helpful courses in undergrad.

 

[nofear]

What are the chances that he failed a course too? My guess is your friend honored nearly every course and the ones he didn't, he didn't do an extra assignment. Sounds like he had raw, natural talent. As you can find all over this board, Step 1 prep is a longer process than the weeks after 2nd year is over. It takes 2 years or even more for some if you include the cell biology and other helpful courses in undergrad.

Yeah that could be true he might have lied to me about his grades but from what i know he is just an average student who went to attended most of his classes..i just think its amazing because he achieved that score while having the same amount of time as most others after 2nd year (about 2months) and while we all read all these various books he only did questions...I know he wants to do family practice and so maybe he was not concerned about getting a high grade so he decided to go this route I dont know it just doesnt make sense?

 

[Mumpu]

For Step 1, I did a ton of Qbank (for a total of about 2500 questions... yes, some more than once) and read Step-Up and Buzzwords over the course of my 2nd year. Got 242/98 and kicked butt on IM rotation and shelf in the 6 weeks following the test.

The exam is computer-based multiple choice. Studying anything other than computer-based multilpe choice is therefore inefficient. I used books only as a break from staring at the monitor.

 

[Stinger86]

Your friend is probably relatively bright too. People seem to forget that counts for something


Or perhaps there was no pressure on his shoulders (family practice) so he was able to relax and clear his head for the exam. I still think the number one obstacle to making a great score is stress

 

[nofear]

Your friend is probably relatively bright too. People seem to forget that counts for something


Or perhaps there was no pressure on his shoulders (family practice) so he was able to relax and clear his head for the exam. I still think the number one obstacle to making a great score is stress

I agree stess is the best...

 

[nofear]

Your friend is probably relatively bright too. People seem to forget that counts for something


Or perhaps there was no pressure on his shoulders (family practice) so he was able to relax and clear his head for the exam. I still think the number one obstacle to making a great score is stress

I agree stress is the best...

 

[Pox in a box]

Yeah that could be true he might have lied to me about his grades but from what i know he is just an average student who went to attended most of his classes..i just think its amazing because he achieved that score while having the same amount of time as most others after 2nd year (about 2months) and while we all read all these various books he only did questions...I know he wants to do family practice and so maybe he was not concerned about getting a high grade so he decided to go this route I dont know it just doesnt make sense?

Don't you realize that "I didn't study at all for the quiz" means "I fell asleep with a book in my face last night"?

 

[nofear]

Don't you realize that "I didn't study at all for the quiz" means "I fell asleep with a book in my face last night"?

lol...yeah good point...

 

[Ramoray]

I know step is diff but i would buy it as i completely rocked my path shelf and did not do an OUNCE of review but i did study very intensly all year long and i was surprised at the amt of stuff i remembered, stuff i didnt even konw that i ever knew. I mean i am betting how you do on step 1 is mainly due to how you study over the course of 2nd year esp, and also first year so i think its totally buyable

 

[HiddenTruth]

I know step is diff but i would buy it as i completely rocked my path shelf and did not do an OUNCE of review but i did study very intensly all year long and i was surprised at the amt of stuff i remembered, stuff i didnt even konw that i ever knew. I mean i am betting how you do on step 1 is mainly due to how you study over the course of 2nd year esp, and also first year so i think its totally buyable

i always hear this, and i don't necessarily agree with this. Bottom line is you have to know your stuff, regardless of how and when you aquire it. Our 2nd year is really poorly taught, such that most people know a fraction of the path you are required to know for the step--it's no more than 4 months, and we have people study their tails off (3-4 months) and do really well. So, I guess you would have to know your stuff well (meaning having done well in year 2) if you were only allotted the typical 6 weeks or so.

 

[LukeWhite]

While the proof is in the yet-to-be-taken-COMLEX pudding, I'm having good luck with a strategy similar to your friend's:

1. Do 20 question Qbank chunks (conveniently about 1% of QBank each time)
2. Review, writing down every association on notecards, both for right and wrong answers.
3. Hit the books for those points that keep popping up or need more elucidation.

From what I've seen of the test, even a non-med student could pass the boards if they spent enough time memorizing the associations between typical presentations, signs, diagnoses, etc. Qbank is particularly helpful in that it isolates the most common of these, and catalyzes the efficient lumping of concepts. When I study from a book, on the other hand, it's nearly impossible to know (even with HY like First Aid or Step Up) what's *really* important, and what format it will be presented in.

 

[kpax18]

While the proof is in the yet-to-be-taken-COMLEX pudding, I'm having good luck with a strategy similar to your friend's:

1. Do 20 question Qbank chunks (conveniently about 1% of QBank each time)
2. Review, writing down every association on notecards, both for right and wrong answers.
3. Hit the books for those points that keep popping up or need more elucidation.

From what I've seen of the test, even a non-med student could pass the boards if they spent enough time memorizing the associations between typical presentations, signs, diagnoses, etc. Qbank is particularly helpful in that it isolates the most common of these, and catalyzes the efficient lumping of concepts. When I study from a book, on the other hand, it's nearly impossible to know (even with HY like First Aid or Step Up) what's *really* important, and what format it will be presented in.

that sounds pretty good. but my question is, given what many have said about qbank comlex are not in par with the real one (assuming the real comlex is even more poorly written), would it b worthwhile to rely heavily on qbank during the last week of study?

 

[LukeWhite]

that sounds pretty good. but my question is, given what many have said about qbank comlex are not in par with the real one (assuming the real comlex is even more poorly written), would it b worthwhile to rely heavily on qbank during the last week of study?

A good point that others would be able to answer better. As I work for Kaplan I won't say too much one way or the other about the COMLEX stuff, but it's my impression that the OMM stuff could be written better, and if anything the COMLEX questions they do write aren't written poorly enough, given COMLEX's notorious quality control issues.

With that said, I think it's all about hierarchizing data, especially on the COMLEX, which is known to repeat Concept X over and over between the two days. What's important, what does it look like, what's everything that's associated with it, how is its presentation phrased? I find that hard to absorb from review books, but if each question is used as a template for learning the concept instead of just testing one's level of knowledge, it seems to go more quickly.

But we'll see on June 7!

 

[Long Dong]

Don't you realize that "I didn't study at all for the quiz" means "I fell asleep with a book in my face last night"?

I totally agree with this one, one of my classmates even made me promise not to tell the others in our class that he/she studied for boards during christmas brake.

 

[Stinger86]

it's no more than 4 months, and we have people study their tails off (3-4 months) and do really well.

Are you saying that your path course is only 4 months long??

That's really unfortunate.

 

[Pox in a box]

From what I've seen of the test, even a non-med student could pass the boards if they spent enough time memorizing the associations between typical presentations, signs, diagnoses, etc.

Not a chance. There's no way this would happen.

 

[nofear]

Not a chance. There's no way this would happen.


I wish i didnt pay all this stupid money then...i could have gone straight from junior high although i think it is an interesting idea becasue if what he says does come true and say someone like a high school student gets a 240 on the exam would that make every admin in every school look like an ass for making us go through the first two years of medical school? hmmm...

 

[smgilles]

I wish i didnt pay all this stupid money then...i could have gone straight from junior high although i think it is an interesting idea becasue if what he says does come true and say someone like a high school student gets a 240 on the exam would that make every admin in every school look like an ass for making us go through the first two years of medical school? hmmm...[/QUOTE]


I say we grab a random sample of High School kids and let them take the NBME exams. That way when they get a higher score than me I can go throw myself off of a bridge 👍 !

 

[nofear]

I wish i didnt pay all this stupid money then...i could have gone straight from junior high although i think it is an interesting idea becasue if what he says does come true and say someone like a high school student gets a 240 on the exam would that make every admin in every school look like an ass for making us go through the first two years of medical school? hmmm...

I say we grab a random sample of High School kids and let them take the NBME exams. That way when they get a higher score than me I can go throw myself off of a bridge 👍 ![/QUOTE]


lollllllllllllllllllllllllllllllllllllllllllllll.....yeah they will beat me as well......that would be awesome and ill bet you if some of our prof had to retake the exam the high school kids would kick their ass as well......how sad would that be...say you are a heart surgeon with 20 years of experience and you get killed by a high school kid on retaking step 1.......

 

[HiddenTruth]

Are you saying that your path course is only 4 months long??

That's really unfortunate.

yup, starts mid jan, ends first wk of may (but this was last yr, we finish basic sci in 1.4 years), and this includes like 2 weeks off they give to do some autopsy crap (which is absolutely worthless, and a wk to study for the shelf). I literally felt like I knew NOTHING comming out of the course, and i even tried readnig robbins. I spent nearly 5-6 weeks on my own full time to learn/re-learn it. Of course, all my bitter comments on the evals mean nothing, because the students end up doing well with the extra time we have for boards. And, most kids in my class (who have no clue) loved the course, because the lecturer lectured a 70 pg ch in robbins in 90 minutes and said "that's all u have to know for the exam", which is about 40-50% of the material, and people just study that. Since the boards are a year away, no one even think about boards. Mind you, we also have 4-5 professors (MD path's), who are all foreigners (no offense meant), who work om the path dept in the hosp, and are really not academicians. I think they just have to "teach" as part of their job, and they are just horrible. One guy is sched 3-4 usually, and he wraps it up in 60-90 mins, with "that's all u have to know for the exam", and i'm sure he goes and sits in his comfy chair at the 4 top notch rest he owns around town. Absolutely worthless.

 

[LukeWhite]

Not a chance. There's no way this would happen.

Medicine's not rocket science...if one has a large enough web of associations, a huge chunk of USMLE/COMLEX is trivial. The percentage of questions that actually *require* critical reasoning of the sort unique to a medical education seem rather small indeed, particularly relative to the enormous number of questions that can be missed while still passing.

 

[Pox in a box]

Medicine's not rocket science...if one has a large enough web of associations, a huge chunk of USMLE/COMLEX is trivial. The percentage of questions that actually *require* critical reasoning of the sort unique to a medical education seem rather small indeed, particularly relative to the enormous number of questions that can be missed while still passing.

Give the material to 99+% of America and they'd bomb the exam.

 

[me454555]

Give the material to 99+% of America and they'd bomb the exam.

While this is true, it still doesn't mean the material is conceptually difficult to master. I think anyone w/a high school diploma and desire to learn, if taught correctly and given enough time could probobly pass the boards and be a doctor. I don't think the actual material presented in medical school is tough, its the sheer volume and amt of details that get you. There's no secret to knowing that sjogren's syndrome is dry eyes, dry mouth, and another autoimmune disorder or that lupus endocarditis presents w/lesions on both sides of the valves. Those are just memorized facts that anyone could do. Even the physio and stuff is intuitive enough that almost anyone could learn it. I don't think it takes a genius to do well in medical school, only someone who is willing to work his/her a$$ off

 

[nofear]

While this is true, it still doesn't mean the material is conceptually difficult to master. I think anyone w/a high school diploma and desire to learn, if taught correctly and given enough time could probobly pass the boards and be a doctor. I don't think the actual material presented in medical school is tough, its the sheer volume and amt of details that get you. There's no secret to knowing that sjogren's syndrome is dry eyes, dry mouth, and another autoimmune disorder or that lupus endocarditis presents w/lesions on both sides of the valves. Those are just memorized facts that anyone could do. Even the physio and stuff is intuitive enough that almost anyone could learn it. I don't think it takes a genius to do well in medical school, only someone who is willing to work his/her a$$ off

agree 110%

 

[Pox in a box]

While this is true, it still doesn't mean the material is conceptually difficult to master. I think anyone w/a high school diploma and desire to learn, if taught correctly and given enough time could probobly pass the boards and be a doctor. I don't think the actual material presented in medical school is tough, its the sheer volume and amt of details that get you. There's no secret to knowing that sjogren's syndrome is dry eyes, dry mouth, and another autoimmune disorder or that lupus endocarditis presents w/lesions on both sides of the valves. Those are just memorized facts that anyone could do. Even the physio and stuff is intuitive enough that almost anyone could learn it. I don't think it takes a genius to do well in medical school, only someone who is willing to work his/her a$$ off

Anyone can say the "what" of Sjogren's but even most med students can't tell you why. Explain the immunology, histology, pathology, and biochemical processes. I doubt even most college graduates could do it, in fact. If it's so manageable, why is it so hard to study for the exam and do well?

 

[automaton]

i disagree very strongly. let us not overestimate the value of a high school degree, or the average intelligence of the american public. while i agree that a lot of people can master simple word associations, i very much doubt that the average american can be able to do well on the USMLE. the USMLE isn't about simple word association. you are taught one way, with eponyms and buzzwords, and tested in another, with clinical descriptions and subtle re-phrasing of what is familiar to us. it takes a fair amount of intelligence to de-code all the test-writer verbiage into something we're familiar with. it takes yet more intelligence to associate this with something else that has to do with one of the answers. and then re-encode that answer into yet more test-writer verbiage.

to do this with a time restraint is difficult even for medical students, who are on average much smarter than someone with just a high school degree. it's true that the medical school curriculum is more about facts than difficult concepts, and while it may be easier than theoretical physics, it is much more difficult than the art of burger flipping. let's face it, the average high school graduate can barely multiply. ask them to do 350 questions on 3 digit multiplication and most would probably quit after 20 questions and hump each other in the bathroom or plant a severed finger in the floppy drive.

 

[LukeWhite]

Anyone can say the "what" of Sjogren's but even most med students can't tell you why. Explain the immunology, histology, pathology, and biochemical processes. I doubt even most college graduates could do it, in fact. If it's so manageable, why is it so hard to study for the exam and do well?

The only correlation I've observed in my class among top scorers is how much time they study...the correlation between raw logical power or intelligence and rank in class is very tenuous. It's hard to study for exam and do well because it's a lot to remember! Explaining the immunology, histology, etc is, like the rest, 90% a matter of spitting back the arbitrary numbers, acronyms, and sequelae.

 

[Bounty]

ask them to do 350 questions on 3 digit multiplication and most would probably quit after 20 questions and hump each other in the bathroom or plant a severed finger in the floppy drive.

 

[LukeWhite]

i disagree very strongly. let us not overestimate the value of a high school degree, or the average intelligence of the american public. while i agree that a lot of people can master simple word associations, i very much doubt that the average american can be able to do well on the USMLE.

I don't think anyone's arguing that the average person could do *well* on the USMLE, only that plenty of people with no medical education could pass given a not-exceptionally-long period of traning. While doing well on the USMLE does require some exceptional skills, not least among them a prodigious memory and some logical capacity, it seems like there's a high enough percentage of simple-association questions that passing's not unlikely in the scenarios we mentioned.

 

[automaton]

well if you're making the "1000 monkeys on a typewriter for an infinite amount of time writing hamlet" argument, then yes, it's in the realm of possibility. mind you, i'm not saying that medical students are exceptionally smart; but merely that the average american is exceptionally stupid.

 

[LukeWhite]

well if you're making the "1000 monkeys on a typewriter for an infinite amount of time writing hamlet" argument, then yes, it's in the realm of possibility. mind you, i'm not saying that medical students are exceptionally smart; but merely that the average american is exceptionally stupid.

Perhaps helpful to go back to the original claim at this point:

From what I've seen of the test, even a non-med student could pass the boards if they spent enough time memorizing the associations between typical presentations, signs, diagnoses, etc.

That's all! I'm surprised people disagree with this. There's nothing so magical that happens in two years of med school that a non-med student with a little drive and intelligence couldn't accomplish the same thing. The point was meant to illustrate that studying by association is probably pretty efficient (as opposed, say, to reading Robbins). No one's agitating for opening the USMLE to the great unwashed masses.

 

[automaton]

i'm not sure where you're going with this. you say people with no medical training can memorize crap and do well on the test... which makes me wonder, isn't that what medical training is to begin with? what's the difference between someone who goes to medical school for 2 years and studies one month for USMLE and someone who reads board review books for 2 years? that's pretty much the same thing.

i realize now that i really have no idea what this whole conversation is about. not that i care anymore. good luck to everyone still studying. i'm just procrastinating and waiting for my score.

 

[Mumpu]

A fair percentage of med students get smart quick and stop going to lectures. Thus, they basically learn on their own for the first two years from books, notes, etc. How is that different from Joe Shmoe picking up First Aid and cramming the bejesus out of it?

Anyone with decent memory can hit QBank hard for 6 months and pass the boards. The questions do not require clinical reasoning or any sort of insight -- merely buzzword associations and common presentations.

Anyone with semi-decent analytical skills can go on UpToDate and come up with the correct diagnosis and treatment. What used to set physicans apart was their physical exam skills because that's the only part of medicine you cannot learn without actually taking care of many patients. Now most people can't tell S4 from their arse, so that's going away too.

 

[automaton]

hmmm i don't really agree mumpu. first obvious point - emergent things can't be taken care of by reading uptodate. second, joe schmoe reading uptodate doesn't have the vocabulary to understand what it means. they can use a medical dictionary and spend hours and hours, reference netter, and read up on various other things, but that's very inefficient. third, joe schmoe doesn't have the fund of knowledge necessary to know what to look for. while it's true that he can type in "chest pain" and get a good idea of what's going on, i'd like to see him look at lab results, pick out what's pertinent, and then search for wiskott-aldrich out of the blue to look for prognosis and treatment. ain't gonna happen.

physical exam skills aren't really what sets us apart. it's the very wide fund of knowledge that is able to place things in proper context. you can't get that by reading uptodate without any prior knowledge.

 

[me454555]

The key phrases in my original post is "desire to learn" and "Work his/her a$$ off". Those are the 2 key things a person needs to do well on this exam. Most people don't go to medical school b/c it requires too much of a time committment and sacrifice of their lives that you must really like this stuff to be willing to put yourself through hell for it.

Yeah I know they don't test buzzwords and you have to make associations but thats not really THAT tough if you've learned the material well the first time. Last night I saw a picture of an eye with a blueish tinge and a vignette that had a bunch of neurological signs like tremors. They wanted the molecule that was high. Not a far jump to say hmmm....eyes + tremors is probobly Wilson's. Wilson's has high copper so I'll pick that one. Again, something that 2 years ago, I had no clue but something that I was able to learn. I don't think there was any trick to learning that association, nor do I believe I was supersmart for making it.

If you take anyone with the desire and work ethic to do it, I think they can pass almost regardless of their intellect.

 

[zeloc]

What are the chances that he failed a course too? My guess is your friend honored nearly every course and the ones he didn't, he didn't do an extra assignment. Sounds like he had raw, natural talent. As you can find all over this board, Step 1 prep is a longer process than the weeks after 2nd year is over. It takes 2 years or even more for some if you include the cell biology and other helpful courses in undergrad.

What does raw natural talent mean? I don't know anyone in my class who has natural talent, everyone who does well studies really hard, although some students conceal their studying. This applies to all the people who honor everything/nearly everything. Like someone else said, any relationship with intelligence is tenuous. I also think that anyone who did enough questions would start to remember stuff no matter how much talent or knowledge that person had originally, and this could explain the person's 239.

 

[Pox in a box]

What does raw natural talent mean? I don't know anyone in my class who has natural talent, everyone who does well studies really hard, although some students conceal their studying. This applies to all the people who honor everything/nearly everything. Like someone else said, any relationship with intelligence is tenuous. I also think that anyone who did enough questions would start to remember stuff no matter how much talent or knowledge that person had originally, and this could explain the person's 239.

Perhaps "raw natural talent" could be replaced with "increased synapse-forming capacity." Some people can hear or see something and recite it back verbatim. Others can stare at it for days and not even remember the first word.

I totally disagree with the argument that any street person could pass the USMLE. I think it would be tough to find 100 people in a city of 1,000,000 that could come close. First, who has the drive to learn that much material? Not many. If it's not that big of a challenge, are you saying that the 7% of America that doesn't pass Step 1 the first time (assuming only allopathic institutions) are complete boneheads and simply didn't study? I find that hard to believe.

 

[LukeWhite]

I totally disagree with the argument that any street person could pass the USMLE. I think it would be tough to find 100 people in a city of 1,000,000 that could come close. First, who has the drive to learn that much material? Not many. If it's not that big of a challenge, are you saying that the 7% of America that doesn't pass Step 1 the first time (assuming only allopathic institutions) are complete boneheads and simply didn't study? I find that hard to believe.

I think you're missing the point..."drive" doesn't factor into it, as no one's talking about actually pulling some hapless pededestrian and sitting them for USMLE prep. The point is that the stuff does not require any exceptional level of critical reasoning, which is where I'd say your hundred-in-a-million goes astray. You really think that the lower-tier med students (remember, we're just talking about passing here) are in the 99.99th percentile of whatever ability you're purporting to measure? That seems to me quite the stretch.

 

[Pox in a box]

I think you're missing the point..."drive" doesn't factor into it, as no one's talking about actually pulling some hapless pededestrian and sitting them for USMLE prep. The point is that the stuff does not require any exceptional level of critical reasoning, which is where I'd say your hundred-in-a-million goes astray. You really think that the lower-tier med students (remember, we're just talking about passing here) are in the 99.99th percentile of whatever ability you're purporting to measure? That seems to me quite the stretch.

No, I'm exactly on point. You can't seriously believe that the USMLE does not test critical reasoning. If it did, then people would keep telling us how easy the exam was with all of its single jump questions or buzzwords. Some people study for Step 1 like it's their life (all day every day for the last two years) and I'm sure if it were as easy as you're making it out to be, they'd crush the exam with ease. I've never heard anyone say the exam was easy. You won't even hear the people that got the 265+ scores say that it was not a challenge. No, I don't think that the lower-tier med students are even close to the 99.99% of all humans. Probably 99.99% of all med students aren't even in the top 5-10%. I'm just saying that you are giving the exam too little credit in terms of its testing power (1-Beta for all you biostats junkies reading still) and giving Joe Blow off the street too much credit. I don't remember the stats exactly but the number is pretty staggering. I'm thinking only 10% of all applicants even get into medical school so to assume that Mr. or Ms. GED can just strut into the library and pull off a 182 is a near-impossible feat in my book.

 

[LukeWhite]

No, I'm exactly on point. You can't seriously believe that the USMLE does not test critical reasoning. If it did, then people would keep telling us how easy the exam was with all of its single jump questions or buzzwords. Some people study for Step 1 like it's their life (all day every day for the last two years) and I'm sure if it were as easy as you're making it out to be, they'd crush the exam with ease. I've never heard anyone say the exam was easy. You won't even hear the people that got the 265+ scores say that it was not a challenge. No, I don't think that the lower-tier med students are even close to the 99.99% of all humans. Probably 99.99% of all med students aren't even in the top 5-10%. I'm just saying that you are giving the exam too little credit in terms of its testing power (1-Beta for all you biostats junkies reading still) and giving Joe Blow off the street too much credit. I don't remember the stats exactly but the number is pretty staggering. I'm thinking only 10% of all applicants even get into medical school so to assume that Mr. or Ms. GED can just strut into the library and pull off a 182 is a near-impossible feat in my book.

Again: My point is merely that a sufficient proportion of the USMLE tests mere association that it can be passed with someone of average reasoning ability. The fact that some people never pass the USMLE would be a valid argument *if* the least adept med student were generally smarter than the average person. This is not the case, or at the very least is begging the question.

As for the 99.99% figure, that's (if I'm not mistaken) what your hundred-in-a-million translates to. I think you're giving the average medical student far too much credit; my sample of med students, at least, is distinguished primarily by the quality of hard work rather than exceptional intelligence.

 

[Pox in a box]

As for the 99.99% figure, that's (if I'm not mistaken) what your hundred-in-a-million translates to. I think you're giving the average medical student far too much credit; my sample of med students, at least, is distinguished primarily by the quality of hard work rather than exceptional intelligence.

I'll repeat:

No, I don't think that the lower-tier med students are even close to the 99.99% of all humans. Probably 99.99% of all med students aren't even in the top 5-10%.