Medical How to Pass the USMLE and the COMLEX [Episode 172]

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The goal of this podcast is to help you get accepted to your top choice program. If that is medical school, one of your next steps will be preparing for the challenging USMLE or COMLEX exams. Today’s guest, Dr. Marcel Brus-Ramer, is joining us for a discussion about how to prepare for the USMLE.

As an undergrad, Dr. Brus-Ramer studied economics at Rutgers. He completed his MD/PhD at Columbia, then did a residency in radiology and biomedical imaging at UCSF, and a fellowship in neuroradiology, also at UCSF. He began tutoring in 2009, and helped launch Elite Medical Prep about a year ago, in August 2015. He’s here to share his advice for success in med school and the Step exams.

What were some decision-points in your own career? [2:03]

I knew I wanted to go to med school and that I wanted to do a year of research. When I looked into it, I decided to do the MD/PhD.

While doing my PhD research after the first two years of medical school, I worked with neurosurgeons, and realized that the lifestyle didn’t fit with my family life and goals. So I decided to pursue radiology: I was attracted to the Sherlock-Holmesian aspect of the diagnostic process. People don’t realize how much treatment you get to do in radiology – you’re not just working in a room by yourself.

How did you get involved in tutoring and test prep? [4:20]

I finished school a little off-cycle, and I was looking for opportunities. I had a family. And I didn’t want to do more research. I saw a flier for a small test prep company – ultimately, I helped them grow their business, and I started spending a lot of time thinking about medical education.

In 2015, Dr. Rubin asked me if I would join his venture – and we launched Elite Medical Prep.

What services do you offer for pre-meds? [6:11]

We offer some strategy and advising – guidance on course selection, etc. And we do some MCAT prep and science tutoring. We’re both MDs, and we bring that experience.

MCAT prep isn’t our main focus at this point, because there’s a relatively greater need for tutoring at the medical level (ie USMLE tutoring) – but some of our clients need MCAT tutoring, and we work with them.

All of our tutors are MDs.

What services does Elite provide for MDs and DOs? [8:20]

Osteopathic schools have a different test (COMLEX). But the USMLE and COMLEX are very similar, and DO students often also take the USMLE. Most of our tutoring is for the USMLE.

What does Elite Medical Prep do differently from other services? [10:15]

Both Dr. Rubin and I started at Med School Tutors, and have years of tutoring experience.

There are couple of fundamental differences. One is that the company is run by (and all the decisions are made by) MDs. Everything is designed from the perspective that we were once medical students.

We give our tutors extensive training. They’re excellent to start with (and have records of high achievement), but that’s just the beginning: we really focus on teaching/tutoring skills.

We always emphasize hospital terminology.

And we recognize that tutoring is a major decision, and an expensive one. Because of that, any unused time is refundable. We stand behind the quality of our product.

Your website mentions “evidence based” tutoring. What does that mean? [14:15]

We were really affected by the book Tutoring Revolution. Tutoring is a major part of our modern world.

From the book, we distilled 6 important things for our practice:

– All our tutors are to be professionally prepared in order to improve student achievement

– Tutors use a developmental template to structure their approach

– We coach students on how to learn, and promote optimal study habits

– We track the session-by-session progress of all students

– We operate by continuous feedback: we help students develop a positive self-image as a learner

– We formally and informally assess students.​

Does your medical background play a role? [17:50]

The thought process from radiology and neuroradiology helps – seeing a situation and playing out the differential diagnosis.

Do you have any prep tips for the USMLE? [18:52]

Follow a structural plan – don’t jump around. Pick a resource that focuses your attention.

The most important advice is to practice questions and review them. Put yourself in a testing situation and assess appropriately – review practice tests fully. You learn from questions you get wrong.

How would you advise a premed student who is confident she’ll get in somewhere, plans to take a gap year, and wants advice on how to ease her way into med school? [21:43]

The very first thing that comes to mind is to enjoy your time off! Once you start med school, summer vacations are over, for the rest of your working life. So enjoy it.

When school starts, adopt professional habits of studying. If you try to study ahead of time, you’re likely to forget it. But if you’re adamant about reviewing before med school starts, review biochem and anatomy. Don’t use your college texts – get a book at the USMLE prep reference level.

Students who’ve struggled with the MCAT are often concerned they’ll struggle with the USMLE. Is there a correlation? [25:05]

It’s definitely a valid concern. There’s a strong link between MCAT scores and the USMLE, partly because there’s an overlap between the type of preparation and general testing ability/aptitude. This is one reason why we always ask people about their testing history.

These are exams where just working harder doesn’t cut it: you have to work smarter. A lot of physicians consider USMLE Step 1 the hardest exam they’ll ever take in their careers. There’s just so much information.

What skills or traits should premeds develop if they want to be great physicians? [29:05]

One of the most important things you can do is to develop your writing skills. Modern medicine is about documenting what happened, formulating a plan to respond…and doing it all again the next day. One of the most valuable things is a well-written note. Poorly written notes can impact medical care.

And read widely. You’ll learn geographical, historical, and zoological information, from a variety of genres.

At a relational level – when you make a patient feel comfortable (it can just come from finding common ground), it makes the interaction much more positive.

Are you happy with the decision to be a doctor, and would you do it again? [32:00]

Yes, but it was not an easy process.

I enjoyed the process, not just the result. If you’re only about the title or the paycheck, it might be tough for you.

There are a lot of personal sacrifices involved with medical training. But treating patients is really rewarding – it feels really great.

And just because you get an MD, you don’t necessarily need to practice medicine. There are other things you can do in the healthcare field.


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