Struggling with ITE

[Ketafol123]

Hi all,

Hoping to get some help in terms of doing well on standardized exams. I'm currently a CA3 and recently received the ITE score. To say the least, it was abysmal. I was always a decent student and did above average on most the exams but for some reason, I'm not doing well on my ITEs. I somehow passed the BASIC exam after scoring 20% percentile on my CA1 ITE and did ok on CA2 ITE (50% percentile). I spent about 2 months doing Truelearn questions this time and was scoring in the 70% and felt pretty good leading up to the ITE. I recently got the score and I ended up being in the bottom 10th percentile. I thought about what my problem is for the last a few days and I am not really sure why I am struggling. I am sure there is a component of knowledge deficit, but I think it's mostly related to my test taking skills. I feel like I will usually come down to 2 answers and somehow picks the wrong answer most of the time. I've asked around other residents who do exceptionally well on these exams and most of them just tells me there is no real tips/tricks. I am terrified that I may not pass the Advanced exam as the passing rate has been going down recently and its previous passing rate was already 12% lower than the Basic exam. I am coming up with the study plan but I wanted to ask the group if there is any suggestion on how to prep for the Advanced exam. Any input or suggestion is greatly appreciated. Thank you in advance.

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[ucladoc2b]

Question banks. Lots of them.

Was 70% your raw score on TrueLearn, or was that your percentile?

Everyone uses True Learn. It’s probably the most solid bank for sure. However, I would consider adding 1-2 more banks (PassMachine, Hall, OpenAnesthesia). You will see the same concepts over and over again. I think that will help shore up your knowledge and weak points. I’m confident your score will improve.

 

[Ketafol123]

Question banks. Lots of them.

Was 70% your raw score on TrueLearn, or was that your percentile?

Everyone uses True Learn. It’s probably the most solid bank for sure. However, I would consider adding 1-2 more banks (PassMachine, Hall, OpenAnesthesia). You will see the same concepts over and over again. I think that will help shore up your knowledge and weak points. I’m confident your score will improve.

Thanks for the response.
Regarding your question, 70% was the overall % correct. Percentile was 65th percentile.

I did use the PassMachine for the Basic and I am wondering if that is what I am missing. I went through the video lectures x 2 but didn't do many questions as I ran out of time. After taking the Basic, I didn't think that PM helped much tbh, so I did not consider buying it for Advanced exam. Also, I don't think I studied much for the CA2 ITE and scored much better and now, I am wondering if it's because of PM.

 

[Iso4ane]

Sometimes it's not only knowing the correct answer but why it's correct as well. (Or at least why the wrong answers are the wrong answers). Plus is that 70% (65th percentile) only 1st pass or did that include repeats questions.

In the end it does sound like there is a component where you need to shore up your knowledge, and if put in the work now, it should also help you for your APPLIED exam as well.

 

[ucladoc2b]

Thanks for the response.
Regarding your question, 70% was the overall % correct. Percentile was 65th percentile.

I did use the PassMachine for the Basic and I am wondering if that is what I am missing. I went through the video lectures x 2 but didn't do many questions as I ran out of time. After taking the Basic, I didn't think that PM helped much tbh, so I did not consider buying it for Advanced exam. Also, I don't think I studied much for the CA2 ITE and scored much better and now, I am wondering if it's because of PM.

If that’s a single pass, that’s ok.

However, you’ll probably want to make a few passes of a couple of banks. You’ll pick up more and more with repetition. PM and TrueLearn should cover almost everything on it.

 

[abolt18]

How's your testing strategy? People don't talk often enough about strategy, but I think it's nearly as important as knowledge.

Couple of things I do that helped me do very well on tests:
- Trust your gut! (I mean the INITIAL gut feeling, not the creeping thoughts later that talk you into changing your answer)
- Answer a question and move on. Push previous questions out of your mind. The only question of importance is the one you're looking at currently. I literally cannot remember what was asked 5 questions ago usually.
- Rule out the things you can first, then if you just don't know, have a system for guessing (for me I guess A. If A has already been ruled out, then B, and so on). This allows you to not waste a lot of time on questions to which you don't know the answer.
- ONLY go back and change your answer on a question if you've had some big epiphany that made you remember a fact that you answered another question wrong, or another question give you the correct information.

 

[Iso4ane]

How's your testing strategy? People don't talk often enough about strategy, but I think it's nearly as important as knowledge.

Couple of things I do that helped me do very well on tests:
- Trust your gut! (I mean the INITIAL gut feeling, not the creeping thoughts later that talk you into changing your answer)
- Answer a question and move on. Push previous questions out of your mind. The only question of importance is the one you're looking at currently. I literally cannot remember what was asked 5 questions ago usually.
- Rule out the things you can first, then if you just don't know, have a system for guessing (for me I guess A. If A has already been ruled out, then B, and so on). This allows you to not waste a lot of time on questions to which you don't know the answer.
- ONLY go back and change your answer on a question if you've had some big epiphany that made you remember a fact that you answered another question wrong, or another question give you the correct information.

Yeah, this is a very individualized question., But, being a little ADHD, back when I would take the the ITE, I would go through the test at least four times (and I never had issues with time; never the first one done, but probably within the first handful.)

Pass 1: Were questions that I could answer in a seconds without heavy thinking/questions I could answer without looking at the answer choices. (What is your name? Which one is stored as a liquid in a gas cylinder? etc,). If i couldn't answer it in t hat time frame, then onto the next question. This means the first pass I only answered maybe 10-20% of questions, but I've seen all 200 questions in about 15mins-20mins.

Pass 2: Answer question that I knew I could answer from the first pass but either required a calculation or just some extra thinking/seeing what the answer choices were? (How long does it take for a 3/4 tank of oxygen to run out a 4LPM? Which of the following increases risk of complications in myasthenia gravis? )

Subsequent passes are just more of the same but longer time frames/praying for epiphanies/arguing with myself. (What drug is most abused by anesthesiologists ? Propofol/Fentanyl/Midaz/Volatile are not answer choices; Whats the the ideal RSI agent for some with ESRD on dialysis with a K of X for a short 30min procedure?)

Point is, you need to have a plan that works for you.

 

[Ketafol123]

Thank you all for taking your time to put in good recommendation. I truly appreciate it.

Those numbers were based on the first pass on tutor mode in a selected topic. This is how I studied for my STEP 1/2/3 which I did well, so I didn’t bother changing my approach. I know some people think it’s better to do it in a timed mode with random questions to mimic the real situation. Maybe I will try that now for the advanced question set.

I usually have the similar approach as some of you mentioned. Go through the easy ones first and trusting my gut when picking between last 2 choices, but for some reason, its obviously not working well. In hindsight, I’m wondering if it because we as a resident don’t get dedicated time off for these exams and maybe I’m just not taking them seriously unconsciously. Also, I realize that I get pretty annoyed when TL explanations don’t explain the logic like UWorld but just repeats what’s written in the answer choices or give somewhat different explanation from each other as the questions are written by different people with different resource. This is why I’m considering other QBanks as some of you suggested but I do keep hearing TL is the best prep course, so I’m little worried.

I will bump the thread hoping that I can get some more feedback/suggestion on test taking strategy/tips. Once again, thank you all for taking your time to respond.

 

[ucladoc2b]

Thank you all for taking your time to put in good recommendation. I truly appreciate it.

Those numbers were based on the first pass on tutor mode in a selected topic. This is how I studied for my STEP 1/2/3 which I did well, so I didn’t bother changing my approach. I know some people think it’s better to do it in a timed mode with random questions to mimic the real situation. Maybe I will try that now for the advanced question set.

I usually have the similar approach as some of you mentioned. Go through the easy ones first and trusting my gut when picking between last 2 choices, but for some reason, its obviously not working well. In hindsight, I’m wondering if it because we as a resident don’t get dedicated time off for these exams and maybe I’m just not taking them seriously unconsciously. Also, I realize that I get pretty annoyed when TL explanations don’t explain the logic like UWorld but just repeats what’s written in the answer choices or give somewhat different explanation from each other as the questions are written by different people with different resource. This is why I’m considering other QBanks as some of you suggested but I do keep hearing TL is the best prep course, so I’m little worried.

I will bump the thread hoping that I can get some more feedback/suggestion on test taking strategy/tips. Once again, thank you all for taking your time to respond.

Your percentile and percent on TL will be grossly inflated when you use the database like that. I would do True Learn on timed mode in small chunks (10-25 questions). It’s ok to go by subject for a first pass. However, I would do at least second pass on timed random and be sure to review the questions.

I still suggest adding a second qbank and doing it the same way. TL for the Advanced is not comprehensive enough for that exam.

 

[teacher2md]

I think you need more than 1 pass with TrueLearn. You need to actually use it as an e-textbook; make notes about every single question that you missed, and those that you got correct but weren’t 100% sure on. Make Anki flash cards from your notes and drill in the information every day.

The benefit of using a question bank this way is that you’re not only learning relevant information, but you’re also seeing how it will be tested.

 

[Ketafol123]

I think you need more than 1 pass with TrueLearn. You need to actually use it as an e-textbook; make notes about every single question that you missed, and those that you got correct but weren’t 100% sure on. Make Anki flash cards from your notes and drill in the information every day.

The benefit of using a question bank this way is that you’re not only learning relevant information, but you’re also seeing how it will be tested.

I’ve used the anki previously (for med school exams and boards) and it didn’t go well with me. I think I didn’t do it right as I often didn’t have time to commit (I tried doing it after I review my note that day and I simply ran out of time pretty much every day). I basically made a review book based on TL and read it several times before (I know it’s a passive learning but it kinda worked except ITEs).

I’m little hesitant to change up too many pattern and I think I’ll stay with adding one more Qbank. Can I get some feedback on PM vs Hall to start with? Once again, I’ve used the PM before but didn’t find it to be particularly effective tbh. I have the Hall Qbank book but I would like to add the more effective Qbank initially to supplement TL. If I have time, I may add the 3rd Qbank but definitely don’t want to overload from the beginning. Thank you all again for all the responses.

 

[ucladoc2b]

I’ve used the anki previously (for med school exams and boards) and it didn’t go well with me. I think I didn’t do it right as I often didn’t have time to commit (I tried doing it after I review my note that day and I simply ran out of time pretty much every day). I basically made a review book based on TL and read it several times before (I know it’s a passive learning but it kinda worked except ITEs).

I’m little hesitant to change up too many pattern and I think I’ll stay with adding one more Qbank. Can I get some feedback on PM vs Hall to start with? Once again, I’ve used the PM before but didn’t find it to be particularly effective tbh. I have the Hall Qbank book but I would like to add the more effective Qbank initially to supplement TL. If I have time, I may add the 3rd Qbank but definitely don’t want to overload from the beginning. Thank you all again for all the responses.

PM was good for advanced. Hall is ok but more limited. Also, the TL ITE bank is useful for advanced as well.

 

[repititionition]

If M5 is still around, was absolutely the best qbank for people with substantial knowledge gaps when I trained (recently). I recommend it highly for everyone, not just those struggling.

 

[kb1900]

Incoming rant because I miss the sdn mcat/step1/2/3 experience threads. So I’m only a ca1 but got my result back and was >90th %ile and I did;
- TL 1 pass by subject and scoring initially mid 60s and ultimately closer to 75-80% correct towards the end of each subject. I recommend by subject when your knowledge deficits are an issue
- I did not finish my first pass of TL (250q left) but did also do 200q from the aba exams (which are excellent btw, better than TL for their explanations but expensive)
- anki self made based on M&M selected chapters based on weak subjects and for pure number things from TL (eg vapor pressure of sevo?). About 2.5k cloze deletion cards.
- Google doc with notes from TL explanations from any question I wasn’t 1000% confident on. Memorized this backwards and forwards 50 pages or so
- I did not feel bad whatsoever not finishing TL because I knew that I probably got more out of 1 pass 80% complete than most would get out of 3 passes


I think the biggest thing is realizing that the ITE only has THREE answer choices per question. If you are narrowing it down to 2 that’s pretty much meaningless and indicating a large knowledge deficit IMO. I marked every question I wasn’t 100% sure about (even if I narrowed it down to 1 answer) on the ITE and that ended up being only 35% of questions, which is a lot lower % than I end up marking on step1/2/3. For every non marked question i would say 50% was a you know it or you don’t question (trivia style) and the other 50% was, can you apply this common principle of anesthesia question testing that you could logic through to one answer. Im not the fastest test taker in the world but the questions stems are very short and I went through the entire exam 3-4 times and was the last one done. Lots of practice having 110% focus doing questions for 3+ hours at a time goes a long way imo. I was not fatigued by the end thankfully as I took it precall

Test taking skills and using TL as a textbook to memorize like the back of your hand > anything else you can do. I was a tutor for 10+ years prior to residency and I attribute a lot of my performance on this exam to standardized TESTING and STUDYING strategy/skills more so than my efforts rushing through M&M and TL in 2 months. I have approached every exam the exact same since high school


We’re a workhorse program where we sit at 65-70 hours / week due to a lot of call but I managed to study 3 -4 hours at a timeon post 24s after a 4 hour nap and up to 8 (4+long break+4) on my weekend free days. Probably more than most other ca1s in my class in terms of effort but less in terms of months/questions. I’ve always believed that if you aren’t at minimum at 90%ile for how hard you push yourself for quality of study time then there is no reason to believe you deserve a 90%ile score. Working harder than others is the bare minimum if your goal is high imo and doubly so if lack of confidence in strategy/skills/prior performance. I never did a question in the OR because I deemed questions as precious but did read over my Google doc and anki over and over when I could. I often found ways to connect small parts of my studying to experiences in the OR as well. E.g I love those double lumen bronchoscope questions with images asking you what is going on. I haven’t done thoracic but did have an intern year scope where I missed an anomalous RUL take off and thus mis-identified the carina.


I would recommend a tutor or sitting down with a “good test taker” in your class to see how they approach questions and the overall exam in regards to time management etc.


I know nothing about advanced materials or strategies and am only a ca1 so big grain of salt with everything I said. Just wanted to throw in my .02c about quality over quantity.

 

[ace_inhibitor111]

Anyone have the percent correct to scaled score conversion? Or scaled score to percentile? My program still hasn’t released scores and I‘m getting angsty lol

 

[neutro]

Seems like test taking anxiety/confidence on game day issue to me. Try to relax and meditate or walk weeks and day before your exams.
Ensure good sleep.
Build stamina. Go for morning and night walks and listen to music when you're prepping. Drink plenty of water.
Essentially self care days leading up to the exam.

Everyone on this forum including you has taken enough exams by now to know that the above is probably at least 20-30% of game- like professional sports at highest level, its all psychological when the stakes are high. Little to do with skill/training on game day.

Try not to stress too much about failure on your exams. I know its hard, but if you are doing well on practice exams then the knowledge is there - you need to consider other issues.

Good luck,