I know this is blasphemy, but is FA overkill?

[swtiepie711]

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So my test is rapidly approaching, and I decided to run through some path section of FA and my confidence totally got crushed. I mean, I know of all the dz in there, but holy crap there is so much detail in there (and lots of lists, top6 of this, top 4 of that). I know it's wayyy less detail than, say, Robbins 😉 but I keep hearing "you have to AT LEAST memorize FA" or "FA alone isn't enough" - I'm like, holy crud I don't even know what's in FA?!?!?

BUT I'm doing ok on UW. So what gives? Is FA overkill?

I had a lecturer argue that most of this test is "basic concepts" - like even if you think a question is detail oriented, you can use basic concepts to work through it. The fact that I don't know FA and yet am doing ok on UW argues that this might be true.

Or that my UW performance is completely bogus and I'm going to eat it on the exam next week!!! Ahhhhhhh! Anyways, thoughts always appreciated (hopefully not ones that will say I'm screwed cuz there's not much I can do at this point )

 

[psychforme]

i dont think FA would have given me a single point on Usmle world assessment. were doomed.

 

[Depakote]

Reviewing first aid has helped me remember details, but the majority of my points in UWorld comes from applying the details conceptually.

I would say that reviewing first aid is helpful and high yield, but attempting to memorize it is probably not the best course.

Approach it and ensure you understand the concepts presented. If something is discussed, see if you know why different things are associated with it.

But don't prepare to regurgitate. There's way too much application and volume on this test for that to work...

^my take

 

[swtiepie711]

But don't prepare to regurgitate. There's way too much application and volume on this test for that to work...

Maybe that's my problem. I tend to be the kind of student who wants to be able to have everything in my head - able to tell you everything about a drug, for example, just off the top of my head. It's not working now, which is why I get overwhelmed & disheartened by FA. I just honestly can't know everything in that book - at least not in the regurgitate it type of way.

But my UW's going fine (at least I think it's fine...?) even tho I'm just not able to recall on my own the 700 details about a given disease...? Just got my confidence shaken by FA cuz I just don't remember all the details - I feel like I know nothing next to FA, which I hope isn't true based on the ok UW scores... ::hoping:: I'm not gunning for a top score - I just want to pass this beast & move on with my life...

 

[Slide]

If anything FA isn't enough, there's not enough pathophys to explain certain diseases, and are horribly lacking in some departments (like neuropath). The details are good but I often find myself needing to supplement with BRS phrs and RR Path.

 

[swtiepie711]

If anything FA isn't enough, there's not enough pathophys to explain certain diseases, and are horribly lacking in some departments (like neuropath). The details are good but I often find myself needing to supplement with BRS phrs and RR Path.

No, I know FA isn't enough b/c it lacks the explanations - but I mean - all the lists! All the mnemonics! Just not sure it's all really necessary...
I guess I'm wondering if someone could know this stuff but not be able to spout it off the top of their head? Like, if you asked me to explain XYZ disease, I'd certainly forget things, but when prompted by a question? Oy... I'm rambling. Just shaken by FA and wondering if it's all really necessary - again, not much I can do - test in <1 week. Hopefully UW scores are more accurate reflection than my feeling about how little I can remember from FA...

 

[Law2Doc]

If anything FA isn't enough, ...

Agreed -- it's underkill. You can do well on world but miss a ton of points because the overlap between what you've done on world and the real test may not be as total as you'd like. It very definitely needs to be supplemented with other resources. FA might not be the best text resource, but you need something else besides world or you are taking a huge risk. It's not uncommon for folks to get out of the test and realize that much of what they saw wasn't on world. World does a good job of approximating what will be there based on history, but it's not perfect, and you don't want to get that one test full of non-world things that you could have been prepared for if you broadened your resources. I'm just saying.

 

[gsmithers68]

So my test is rapidly approaching, and I decided to run through some path section of FA and my confidence totally got crushed. I mean, I know of all the dz in there, but holy crap there is so much detail in there (and lots of lists, top6 of this, top 4 of that). I know it's wayyy less detail than, say, Robbins 😉 but I keep hearing "you have to AT LEAST memorize FA" or "FA alone isn't enough" - I'm like, holy crud I don't even know what's in FA?!?!?

BUT I'm doing ok on UW. So what gives? Is FA overkill?

I had a lecturer argue that most of this test is "basic concepts" - like even if you think a question is detail oriented, you can use basic concepts to work through it. The fact that I don't know FA and yet am doing ok on UW argues that this might be true.

Or that my UW performance is completely bogus and I'm going to eat it on the exam next week!!! Ahhhhhhh! Anyways, thoughts always appreciated (hopefully not ones that will say I'm screwed cuz there's not much I can do at this point )

IMHO FA is the primary source in which to build your studying around... and it depends on what kind of score you are looking to get... yes there are about 50 pages in FA that you can look over, memorize, and maybe regurgitate and get a few points on your test... translocations, chromosomes for mutations, etc. But all in all, FA is a foundation for the conceptual knowledge that will be tested. And by foundation I mean, it is the high yield base of information for which 60-70% of the questions are going to be geared towards on your test. There will be 20-30% of the q's that are random, applied knowledge, or beyond the scope of the FA that can be found in other low yield sources.

On your UW performance. No, you are probably doing well because you are good at applying and problem-solving just as much as you know the material which is a plus. So, just keep trying to retain as much information as possible and learn from your UW and FA.

FA is not overkill... it is just right truthfully.. I had questions on minutia found in a single sentence from that book. On the other hand you are right about being able to use basic high yield concepts to figure out questions rather than dissect the entire clinical presentation and then find an answer, that is totally true and held true on my test. But I still think you should prepare for questions where they give you the concept and then ask an association or a specific side effect, etc. You've gotta be ready for those questions to do well on this test. I would try and say just try and look through the FA on your last pass over 5 days, marking pages you want to look over (including exact specifics to memorize) and split those between your last 2 days. That's the best thing to do... memorize what you don't know or the advanced associations of diseases with a 5 day reinforcement period on what you already know. You can also do it where you do 3 days, 1 day of memorizing, 2 days of your worst subjects, then last day of route memorization. That's my 0.02.

 

[swtiepie711]

IMHO FA is the primary source in which to build your studying around... and it depends on what kind of score you are looking to get... yes there are about 50 pages in FA that you can look over, memorize, and maybe regurgitate and get a few points on your test... translocations, chromosomes for mutations, etc. But all in all, FA is a foundation for the conceptual knowledge that will be tested. And by foundation I mean, it is the high yield base of information for which 60-70% of the questions are going to be geared towards on your test. There will be 20-30% of the q's that are random, applied knowledge, or beyond the scope of the FA that can be found in other low yield sources.

On your UW performance. No, you are probably doing well because you are good at applying and problem-solving just as much as you know the material which is a plus. So, just keep trying to retain as much information as possible and learn from your UW and FA.

FA is not overkill... it is just right truthfully.. I had questions on minutia found in a single sentence from that book. On the other hand you are right about being able to use basic high yield concepts to figure out questions rather than dissect the entire clinical presentation and then find an answer, that is totally true and held true on my test. But I still think you should prepare for questions where they give you the concept and then ask an association or a specific side effect, etc. You've gotta be ready for those questions to do well on this test. I would try and say just try and look through the FA on your last pass over 5 days, marking pages you want to look over (including exact specifics to memorize) and split those between your last 2 days. That's the best thing to do... memorize what you don't know or the advanced associations of diseases with a 5 day reinforcement period on what you already know. You can also do it where you do 3 days, 1 day of memorizing, 2 days of your worst subjects, then last day of route memorization. That's my 0.02.

Thanks for the thoughts. I guess I'm just confused b/c I look at FA and, yes, I know certain things - random facts from UW & FA - but I'm not like I normally am - normally I like to be able to spout off all the detail abotu somehting and I just can't with all these diseases. But my UW's are good - like overall 78% (46% complete), last few blocks 81%, 89%, 77%, 79%, 81%.

My goal is to pass. I don't care above that. I don't know what I want to do with my career (not gunning for a top specialty at this point) and don't want to add stress to myself.

I guess I'm just worried b/c I feel like I don't know much, I look in FA and am like "jeez! all these details" but then... the UW performance? I guess I'm afraid of what someone said above - relying on UW and getting rocked on the real thing when it isn't like UW....

And with <1 week left, I'm not sure what I can do about the stuff in FA I don't know. I'm trying to debate about spending more time with FA and less time doing questions or continue to spend most of my time on UW. Currently spending 8-5 UW, 6-10 on FA (obv w/ breaks, etc)... like should I just throw the q's out & dedicate the next few days to reading & re-reading FA?

I guess my concern is - can a person be averaging well on UW and then actually fail Step1 (this fear is compounded by the feeling I know a small fraction of whats in FA)? I know is possible (anything is) but considering my goal is to pass? Probably just need to take a chill pill, relax, focus on FA & UW and this will all be over soon enough....

Sorry to be blasphemous or to be annoying - I just honestly got really shaken up and my confidence plummeted - anxiety's sinking in I guess

 

[Pinkertinkle]

Memorize it cause its points points points

 

[AllUpOnYoMama]

you should be all good dude. You might not be able to regurgitate every detail from FA but I bet you are doing great at making connections..... your scores on WORLD show. I haven't taken the test yet so I dont know much. But with those WORLD scores...average 78%? Shiiiiiiiiii... your sitting pretty. Why not take today off and write NBME #5 and see what you get? Then you'll really really know where you stand.

 

[Slide]

Thanks for the thoughts. I guess I'm just confused b/c I look at FA and, yes, I know certain things - random facts from UW & FA - but I'm not like I normally am - normally I like to be able to spout off all the detail abotu somehting and I just can't with all these diseases. But my UW's are good - like overall 78% (46% complete), last few blocks 81%, 89%, 77%, 79%, 81%.

My goal is to pass. I don't care above that. I don't know what I want to do with my career (not gunning for a top specialty at this point) and don't want to add stress to myself.

I guess I'm just worried b/c I feel like I don't know much, I look in FA and am like "jeez! all these details" but then... the UW performance? I guess I'm afraid of what someone said above - relying on UW and getting rocked on the real thing when it isn't like UW....

And with <1 week left, I'm not sure what I can do about the stuff in FA I don't know. I'm trying to debate about spending more time with FA and less time doing questions or continue to spend most of my time on UW. Currently spending 8-5 UW, 6-10 on FA (obv w/ breaks, etc)... like should I just throw the q's out & dedicate the next few days to reading & re-reading FA?

I guess my concern is - can a person be averaging well on UW and then actually fail Step1 (this fear is compounded by the feeling I know a small fraction of whats in FA)? I know is possible (anything is) but considering my goal is to pass? Probably just need to take a chill pill, relax, focus on FA & UW and this will all be over soon enough....

Sorry to be blasphemous or to be annoying - I just honestly got really shaken up and my confidence plummeted - anxiety's sinking in I guess

It's understandable, I think everyone goes through a panic phase midway through their studying when they start plateauing and realizing they need to know a lot more than they thought they would need to. I went through this too half a week ago, but after a while you calm down and realize if there's anytime to plateau and realize you're weaker than you think, it's in the middle of your study period; that way you have impetus to finish strong and boost your confidence near the end.

BTW, with a UWorld score of over 70%, I think you're doing very well overall.

 

[defcon8]

you should be all good dude. You might not be able to regurgitate every detail from FA but I bet you are doing great at making connections..... your scores on WORLD show. I haven't taken the test yet so I dont know much. But with those WORLD scores...average 78%? Shiiiiiiiiii... your sitting pretty. Why not take today off and write NBME #5 and see what you get? Then you'll really really know where you stand.

I agree. If you really want peace of mind at this point, considering you are still a week out, you should take an NBME. At the very least, it might point out a weakness that you didn't pick up while doing UW and can at least focus on that aspect in FA. I predict your score will be within a very safe range 🙂

 

[confuse]

FA is the foundation that you use other sources like UW to build on. With < 1 wk left, I think you should take NBME/Kaplan to get a different perspective. Although I think UW is the best question bank out there, I don't really trust its percentage score because there are so many repeats or questions that are similar to each other. This is the same with other question banks but at least by doing several Qbanks, you'll get to see the entire spectrum of questions.

 

[kdburton]

I'm more or less using FA as a checklist to make sure I know all the stuff in there at the end of reading through a review book (besides Pharm, which I'll be using FA as my primary source and supplementing with a review book). Although it lists a lot of HY facts in there i think the point is to just make sure that you know the concepts behind everything and not so much memorize the top 6 cuases of X (since they will most likely present questions in a way that the top of your DDx will be the #1 cause in that situation)

 

[ENThopeful]

Maybe that's my problem. I tend to be the kind of student who wants to be able to have everything in my head - able to tell you everything about a drug, for example, just off the top of my head. It's not working now, which is why I get overwhelmed & disheartened by FA. I just honestly can't know everything in that book - at least not in the regurgitate it type of way.

But my UW's going fine (at least I think it's fine...?) even tho I'm just not able to recall on my own the 700 details about a given disease...? Just got my confidence shaken by FA cuz I just don't remember all the details - I feel like I know nothing next to FA, which I hope isn't true based on the ok UW scores... ::hoping:: I'm not gunning for a top score - I just want to pass this beast & move on with my life...

I know where you are coming from. Sometimes I feel like my scores have been due to test taking ability. I can pick out the right answer but not necessarily rattle off everything I know about a disease.

Anyone know the solution for this? Should I just begin memorizing FA?

 

[Cliff Huxtable]

Does the actual step 1 have questions that require rote memorization?

Like will they ask, "Patient is experiencing blah blah blah, what chromosome is the defected gene located on?"

 

[Depakote]

Does the actual step 1 have questions that require rote memorization?

Like will they ask, "Patient is experiencing blah blah blah, what chromosome is the defected gene located on?"

I could easily see something like that popping up. I know I've seen things like that in UWorld.

 

[ENThopeful]

Does the actual step 1 have questions that require rote memorization?

Like will they ask, "Patient is experiencing blah blah blah, what chromosome is the defected gene located on?"

I see your point, there of course will be questions like that, and of course there isnt anyway around those sort of questions but memorization. My question is the benefit of being able to recant the pathology of diseases instead of being able to recognizing it, which is where I am mostly confused.

Say sarcoidosis, is it beneficial to be able to fire off the top of your head
- Skin lesions, erythema nodosum
- Eye lesions, produce uveitis,
- Liver lesions - granulomatous hepatitis

etc etc or just be able to identify the disease

because the method of studying would be different in my opinion. Rote memorization involves sitting there and staring at the page like you would powerpoints, but understanding means just reading it and making sure it make sense...


and to drive the point home, I think this is what swtpie was talking about when she said she doesnt feel like she knows anything. Im sure she knows that m3 aml is 15,17, but like me never sat in front of first aid, covered the headings of each pathology and made sure they were able to recant all thats under there. this is why when i do questions or do a practice test, I have to reason my way into answers and not go bam thats the answer

 

[Cirrus83]

No, I know FA isn't enough b/c it lacks the explanations - but I mean - all the lists! All the mnemonics! Just not sure it's all really necessary...

I gotta agree with the mnemonics being largely silly. There's a few good ones but a lot of them aren't helpful at all and I wouldn't bother using them (plus a lot are totally incomplete).

 

[fruitloops]

I gotta agree with the mnemonics being largely silly. There's a few good ones but a lot of them aren't helpful at all and I wouldn't bother using them (plus a lot are totally incomplete).

Those mnemonics are useful; ignore them at your own peril. If you don't like some of them and find them too hard to remember, make up your own. My bonus mnemonic for p450 inhibitors: IC KEGS as in "icy kegs of beer" and remember that beer is an antidepressant, thus these are p450 inhibitors. And, for the p450 inducers, like Goljan says, the other one's the other one: Randy's Black Car Goes Putt Putt And Smokes.