Intern year? Ha!
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Aug 15, 2003
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Judging by the sheer volume of review textbooks out there and all the question books and online Qbanks available to direct your studies, I'm curious why people in general don't always do as well as they had expected to. My question is this:

Are these review books really representative of a huge majority of the information on the Step 1, or are there still 50 or so questions out of the 350 that cover random information (like some obscure disease or treatment that no one's expecting to be asked about).

Another, and perhaps better, way of asking my question is what exactly makes the difficult questions on Step 1, "difficult"? Is it because they expect you to know some random small detail, or some obscure disease or graphical presentation, or is it because they are really involved and require you to stop and really work through them? From my experience of working review questions, it seems that most of the difficult ones involve the most RANDOM information I've ever seen and never would've thought to be important.

Any help would be appreciated..


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To answer your question, from my experience, the difficult questions arise from the way in which the question is presented rather than the actual disease etc. i can remember only a few zebras on my exam, which i didnt think were impossible, but the hardest questions involve interpreting an experiment, or knowing some obscure fact about a common disease. with that said, i think the most underrated aspect of the exam are the answer choices which include multiple well written distractors.


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The "difficulty" arises with, say, 15 questions that you have NO idea what they are talking about -- this might be because they are zebras or because you've understandibly forgotten something. Then there's the 30 questions that you know what the question is asking about, but you've not been able to make the second step in the logic to get to an answer. Plus another 30 you have narrowed down to two possible answers and you can't decide because of disctractors.

I would say that if you really KNOW First Aid and Step-Up you can have the potential of doing quiet well. However, given the sheer about of information that can be tested, the odds are against you and some people are bound to not do as well as they'd hope (but still pass).
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