P/F and no internal rank-should I focus more on boards?

[intubesteak]

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I know this has been discussed in a few older threads but I wanted to hopefully get input from people who have tried this and taken step1. My school has decided to drop preclinical ranking completely and go strictly pass/fail without internal rank. I feel like our tests are VERY lecture specific-I have been doing well on them, but have felt like I am neglecting more generalizable step1 material for the sake of doing well on exams. For example, on our last test (just started systems), I did 500 Qbank questions while studying for the test. I felt like this helped on maybe 1/3 of the questions-the rest was very lecture specific and seemed a little obscure. In general it seems like we hit about 60% of what's in first aid in each section, which worries me a little. I don't want to get into dedicated study time and feel like I've never even seen stuff before.

So instead of studying out of the lectures, I would do 1) Pathoma 2) read Robbins and do Robbins questions 3) Qbank questions 4) Actually keep up with firecracker 5) Look through FA to become familiar and make sure I'm not leaving out anything major.

I'm thinking a week or so before the exam I could read through the lectures/powerpoints to pick up some of the lecture specific stuff in order to pass the test.

Anybody tried this or something similar?

 

[mcloaf]

Are you and M1 or an M2?

 

[WheezyBaby]

I think in general preclinical students underestimate the importance of information in classes. I'll be the first to say that preclinical years are bloated, but there's a lot of valuable information in there as well. Med school isn't just a game where you max your stats for residency, it's the foundation you build your practical knowledge on. Beyond that, board prep materials are limited with regard to the boards as well. In my experience, step was about 80% stuff I had reviewed. The remainder seemed like it was either low yield information not in any board prep material or questions attempting to get your to extrapolate things you should know to new situations. If you're true pass fail, that's wonderful, you don't have to min/max for class tests by cramming genetic markers associated with 20 different types of intracranial neoplasms, but I wouldn't cast classes aside quite to the extent you're suggesting

 

[intubesteak]

I'm an M1. I totally agree that blowing off preclinical stuff is a bad idea. My goal in doing this would be to actually study the material more in depth and increase the breadth of my knowledge--both to do well on step1 and because there are quite a few things that are really interesting to me that I don't get to learn much about. A doctor I worked for before med school sort of inspired me to get the most out of preclinical. He caught some insanely rare disease presentation in the ED, had never seen of or heard of a case presenting, but remembered reading about it in med school. I feel like our curriculum is designed to make sure everyone passes, and not to help more dedicated students achieve their full potential. I would like to tap into my full potential-actually read the textbooks, do more Qbank questions, review old material, etc etc. And I would still listen to or read our class lectures, but instead of going through powerpoints 8-10 times, I would go through them maybe twice. Part of the issue is that I learn SOO much better reading out of a textbook than listening to lecture or reading a powerpoint. But I digress...

 

[Psai]

I think in general preclinical students underestimate the importance of information in classes. I'll be the first to say that preclinical years are bloated, but there's a lot of valuable information in there as well. Med school isn't just a game where you max your stats for residency, it's the foundation you build your practical knowledge on. Beyond that, board prep materials are limited with regard to the boards as well. In my experience, step was about 80% stuff I had reviewed. The remainder seemed like it was either low yield information not in any board prep material or questions attempting to get your to extrapolate things you should know to new situations. If you're true pass fail, that's wonderful, you don't have to min/max for class tests by cramming genetic markers associated with 20 different types of intracranial neoplasms, but I wouldn't cast classes aside quite to the extent you're suggesting

Yeah but it's hard to understand the utility of what you're learning until later. I thought that anatomy wasn't as important as it wasn't really tested heavily on step 1 and I regret it now. Having a better understanding of anatomy would really help when looking at imaging but now I just go back and try to refresh my memory on what's there.

Getting a good step score is important to getting where you want but having a broad based knowledge in all areas of medicine is even more important. It seems like it's really easy to get super focused on your little area of medicine and forget about the big picture.

The only problem is that there's so much to learn and never enough time.

 

[intubesteak]

Anatomy is a great example for this. We dissected and learned about the hip and femur this week and had a "clinical" lecture. Any mention of hip fractures? How about sciatic nerve pain? Nope-instead the PhD basically reviewed and went over the structures we were supposed to see in lab. Its just not doing it for me.

Time is another big reason for me to consider this. For instance--we are required to attend epidemiology class which is 2 hrs per week. I can read the same chapter in Jekels epidemiology, do a set of practice questions, and review/re-read as needed in about an hour. Half the time for twice the understanding/knowledge. That is a pretty extreme example but I think it translates overall.

I think what I'm hearing and what I would agree with is not to blow off the lectures completely. I think I'll try waiting until the week before the test to start watching the recorded lectures so that I can still have time to appreciate the unique perspective that each professor provides. What will (hopefully) save me time and energy will be learning the bulk of the pathophysiology from the text and from doing Qbank questions, instead of struggling to pay attention in class and reading powerpoint slides. Ideally I would just pre-read before each lecture, but the timing of this has just not worked for me. I'll probably try this out in our next block (GI) and see how it goes.

 

[padfoot777]

I crammed for class exams and pretty much only studied the board prep material during preclinical years. I did really well on boards and found that I still had a very strong knowledge base for my third year clinical clerkships and step 2. You need to understand the board prep material inside and out and do a lot of practice questions to do very well on boards. For class exams, most of the time, you could just regurgitate the material from the ppt slides somebody presented. Given you have practically zero incentive to prioritize course work vs boards, I would say prioritize boards.

 

[EmergDoc2B]

Do you just get a trophy when you graduate? 😉

 

[WheezyBaby]

Anatomy is a great example for this. We dissected and learned about the hip and femur this week and had a "clinical" lecture. Any mention of hip fractures? How about sciatic nerve pain? Nope-instead the PhD basically reviewed and went over the structures we were supposed to see in lab. Its just not doing it for me.

Time is another big reason for me to consider this. For instance--we are required to attend epidemiology class which is 2 hrs per week. I can read the same chapter in Jekels epidemiology, do a set of practice questions, and review/re-read as needed in about an hour. Half the time for twice the understanding/knowledge. That is a pretty extreme example but I think it translates overall.

I think what I'm hearing and what I would agree with is not to blow off the lectures completely. I think I'll try waiting until the week before the test to start watching the recorded lectures so that I can still have time to appreciate the unique perspective that each professor provides. What will (hopefully) save me time and energy will be learning the bulk of the pathophysiology from the text and from doing Qbank questions, instead of struggling to pay attention in class and reading powerpoint slides. Ideally I would just pre-read before each lecture, but the timing of this has just not worked for me. I'll probably try this out in our next block (GI) and see how it goes.

I think attending lecture is a horrendous waste of time, but this is personal preference; some people seem to like it. The point is the breadth of the knowledge. As long as you're getting it from somewhere, you shouldn't be selling yourself short

 

[Redpancreas]

Med school isn't just a game where you max your stats for residency, it's the foundation you build your practical knowledge on.

This. Lectures are for third years as well.




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[intubesteak]

Do you just get a trophy when you graduate? 😉

Unfortunately this was not in the budget. We did however, all get a nice pat on the back just for showing up.

 

[mik30102]

My school has a similar curriculum. My opinion is that boards do not equal being a physician, so simply learning from prep material is not enough to be knowledgeable. I also think you get a better understanding of the material going through non board prep materials sometimes. I think its wise to do both. With that said I ignore unicorn diseases that sometimes come up in our classes where it happens to be that lectures research topic for example. No one has time for that.

 

[failedatlife]

No matter what your school does, all your effort should be focused on step 1. That test matters more than anything you can quite possibly do in your 4 years of medical school. It is more important than your wedding day, the birth of your first child, etc.

 

[WheezyBaby]

My school has a similar curriculum. My opinion is that boards do not equal being a physician, so simply learning from prep material is not enough to be knowledgeable. I also think you get a better understanding of the material going through non board prep materials sometimes. I think its wise to do both. With that said I ignore unicorn diseases that sometimes come up in our classes where it happens to be that lectures research topic for example. No one has time for that.

What do you call a unicorn disease? Off the top of my head I've seen 3 cases of hlh, 2 cases of bpcdn, pulmonary lymphangiectasia, a variety of glycogen storage / mitochondrial / etc disorders, a variety of rare neuro dz. You do actually come across unicorn diseases. They're also often good fodder from a test taking standpoint for highlighting certain concepts

 

[intubesteak]

What do you call a unicorn disease? Off the top of my head I've seen 3 cases of hlh, 2 cases of bpcdn, pulmonary lymphangiectasia, a variety of glycogen storage / mitochondrial / etc disorders, a variety of rare neuro dz. You do actually come across unicorn diseases. They're also often good fodder from a test taking standpoint for highlighting certain concepts

This is exactly why I want to study more on my own.

Some of you have curriculum that brings up the rare diseases and gives too much information, my curriculum would err on the side of "lets not bring that up and confuse too many kids." Its like they stick to the high yield stuff too much, but still go off on random PhD tangents. Wayyy too often they say "this list of drugs will not be on the test, but you will need to know them for the boards..."

 

[Amba]

No matter what your school does, all your effort should be focused on step 1. That test matters more than anything you can quite possibly do in your 4 years of medical school. It is more important than your wedding day, the birth of your first child, etc.

Lol your posts crack me up. Never change.

 

[Azete]

What do you call a unicorn disease? Off the top of my head I've seen 3 cases of hlh, 2 cases of bpcdn, pulmonary lymphangiectasia, a variety of glycogen storage / mitochondrial / etc disorders, a variety of rare neuro dz. You do actually come across unicorn diseases. They're also often good fodder from a test taking standpoint for highlighting certain concepts

My problem with learning a lot of the "unicorn" diseases is in many cases there's very little we can do in terms of treatment to improve outcomes, and nobody is working on a treatment because the rarity makes research an unprofitable venture. So outside of being able to beat our chest and say we diagnosed it, what's the point? I think med schools would be better off spending more time teaching physiology so that we're better equipped to think outside the box when we see a patient that doesn't match the buzzwords we've memorized.

 

[intubesteak]

My problem with learning a lot of the "unicorn" diseases is in many cases there's very little we can do in terms of treatment to improve outcomes, and nobody is working on a treatment because the rarity makes research an unprofitable venture. So outside of being able to beat our chest and say we diagnosed it, what's the point? I think med schools would be better off spending more time teaching physiology so that we're better equipped to think outside the box when we see a patient that doesn't match the buzzwords we've memorized.

That's why I like reading Robbins. Instead of giving one or two buzzwords, you read an entire page about variations in presentation and severity, and come away with a more global view of the disease (in addition to buzzwords/minutiae). And who knows, by the time were in practice and definitely in the scope of our careers some of these untreatable diseases will be treatable.