Studying for boards and lecture

[DaktaD]

Just finished 1st semester MS1 at a school with a systems based 18 month preclinical curriculum, and was planning on starting Zanki this coming semester. I was wondering how to go about balancing boards studying and lecture. I would still like to do decently on in-house exams, but do recognize that school lectures don’t always line up with board content. Should I completely forsake lecture in favor of Zanki, first aid, pathoma, and sketchy?

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[FalconSlice]

As you said, unfortunately, there are things that you need to know to be a good student and eventual doctor (i.e. part of them being your med school lectures/exams) and there are things you need to know to score high on standardized exams (i.e. memorizing FA, etc.) and these two things overlap but there are significant portions of each that don't.

My advice is to have priorities regarding what to focus on. I encourage prioritizing your school studies/assignments and fill in any free time you are willing to volitionally do the other stuff. Over the course of M2, these priorities may shift and you might be doing the bare-minimum for school and spending more time on board-specific stuff. At the end of the day, this time (pre-clinical years) is the time to build a good medical knowledge foundation... and you will not have time to do this again (unless you take time off or something which you shouldn't do just to "restudy" stuff...) so keep that in mind.

I will leave you with two anecdotes that I will have you analyze instead of me putting my thoughts in your head:

1. There was this below average med student in my class and he completely disregarded school stuff during M1 and M2 year and solely focused on Step I. If something wasn't related to step I, he didn't care. He ended up killing Step I, but marginally passed M1 and M2 year--consistently being on prohibitionary status. He tanked M3 year because he didn't like the real world and his same "if it's not on exams, I don't care" attitude carried over. He ended up almost not matching.

2. There are always several students that fail the last M2 exam because they spent too little time actually learning the material (which also is on Step I) and only focused on boards. They had to do a make-up exam before they took their board exam...not good.

All in all, do what you want, but please remember the utility of what you're doing and what you want to get out of it. This has been said many times, but the first thing to do to do your best on Step I is to grasp the material and do well in your first and second year. It is an investment (in many ways) that will pay out--not only for Step I--but for the rest of your career.

FS

 

[OrgoCoop]

Step 1 is the single most important component of your medical school career. Nothing else will open (or shut) doors quite as convincingly as step 1.

 

[slowthai]

Just finished 1st semester MS1 at a school with a systems based 18 month preclinical curriculum, and was planning on starting Zanki this coming semester. I was wondering how to go about balancing boards studying and lecture. I would still like to do decently on in-house exams, but do recognize that school lectures don’t always line up with board content. Should I completely forsake lecture in favor of Zanki, first aid, pathoma, and sketchy?

Almost none of us that are given mainly in house exams completely forsake lecture. We just focus on step stuff 90% of the time and then cram slides at the end of the block. It works beautifully for me because there's good enough overlap such that cramming really isn't as stressful as you'd think. I imagine this differs curriculum to curriculum though.

 

[Deecee2DO]

As you said, unfortunately, there are things that you need to know to be a good student and eventual doctor (i.e. part of them being your med school lectures/exams) and there are things you need to know to score high on standardized exams (i.e. memorizing FA, etc.) and these two things overlap but there are significant portions of each that don't.

My advice is to have priorities regarding what to focus on. I encourage prioritizing your school studies/assignments and fill in any free time you are willing to volitionally do the other stuff. Over the course of M2, these priorities may shift and you might be doing the bare-minimum for school and spending more time on board-specific stuff. At the end of the day, this time (pre-clinical years) is the time to build a good medical knowledge foundation... and you will not have time to do this again (unless you take time off or something which you shouldn't do just to "restudy" stuff...) so keep that in mind.

I will leave you with two anecdotes that I will have you analyze instead of me putting my thoughts in your head:

1. There was this below average med student in my class and he completely disregarded school stuff during M1 and M2 year and solely focused on Step I. If something wasn't related to step I, he didn't care. He ended up killing Step I, but marginally passed M1 and M2 year--consistently being on prohibitionary status. He tanked M3 year because he didn't like the real world and his same "if it's not on exams, I don't care" attitude carried over. He ended up almost not matching.

2. There are always several students that fail the last M2 exam because they spent too little time actually learning the material (which also is on Step I) and only focused on boards. They had to do a make-up exam before they took their board exam...not good.

All in all, do what you want, but please remember the utility of what you're doing and what you want to get out of it. This has been said many times, but the first thing to do to do your best on Step I is to grasp the material and do well in your first and second year. It is an investment (in many ways) that will pay out--not only for Step I--but for the rest of your career.

FS

OP this is extremely sound advice^

 

[Matthew9Thirtyfive]

Almost none of us that are given mainly in house exams completely forsake lecture. We just focus on step stuff 90% of the time and then cram slides at the end of the block. It works beautifully for me because there's good enough overlap such that cramming really isn't as stressful as you'd think. I imagine this differs curriculum to curriculum though.

This is basically what I do too. It has worked great for me.

 

[Goro]

Just finished 1st semester MS1 at a school with a systems based 18 month preclinical curriculum, and was planning on starting Zanki this coming semester. I was wondering how to go about balancing boards studying and lecture. I would still like to do decently on in-house exams, but do recognize that school lectures don’t always line up with board content. Should I completely forsake lecture in favor of Zanki, first aid, pathoma, and sketchy?

You really shouldn't be bothering with Boards study until MS2.

Is your grading system Pass/Fail? If not, I believe that studying for your classes is still studying for Boards, UNLESS you have that type of Faculty who teach minutiae and/or their own research.

I am reminded of an SDNer who blew off all class study in lieu of Board prep in the hope of scoring a 260+. He scored a 249. Obviously an great score, but this kid was devastated.

 

[Matthew9Thirtyfive]

You really shouldn't be bothering with Boards study until MS2.

He is at a school like mine with a 1.5 year systems preclerkship curriculum. Not sure about his curriculum but we don’t take step until halfway through 3rd year. If I wait that long to start board prep I’ll have forgotten too much.

 

[DaktaD]

You really shouldn't be bothering with Boards study until MS2.

Is your grading system Pass/Fail? If not, I believe that studying for your classes is still studying for Boards, UNLESS you have that type of Faculty who teach minutiae and/or their own research.

I am reminded of an SDNer who blew off all class study in lieu of Board prep in the hope of scoring a 260+. He scored a 249. Obviously an great score, but this kid was devastated.

He is at a school like mine with a 1.5 year systems preclerkship curriculum. Not sure about his curriculum but we don’t take step until halfway through 3rd year. If I wait that long to start board prep I’ll have forgotten too much.

We are pass/fail, and we also take Step midway through 3rd year

 

[slowthai]

You really shouldn't be bothering with Boards study until MS2.

I completely disagree with this. There is a crapton of information that you're expected to master for step. It makes no sense to wait for an entire year (or however long depending on your curriculum) before you start. I have never heard people say, "I wish I hadn't started studying for step so early." I have heard the opposite multiple times.

You are decreasing your daily and future (during dedicated) workload by starting early. Instead of having a mountain of material to review during dedicated, you can just spend time aggressively attacking your weaknesses and fine tuning your test taking skills. This is only the case because you would have been reviewing everything you've learnt longitudinally.

This is a proven approach. We have a ton of anecdotes of people ignoring lecture and prioritizing step with great success.

Is your grading system Pass/Fail? If not, I believe that studying for your classes is still studying for Boards, UNLESS you have that type of Faculty who teach minutiae and/or their own research.

Whether it's pass/fail or not should have no bearing on this decision. Everyone needs to know that preclinical grades are irrelevant, as long as you're not gunning for AOA (depending on the school's criteria for nomination) or failing classes. Again, avoid being in the bottom of the class as well.

I don't think there's any point wasting brainpower trying to analyze whether your school is teaching true minutiae or not. It's much easier to just focus on BUFAPS and do enough to pass comfortably. As far as research slides, they're easy enough to ignore.

I am reminded of an SDNer who blew off all class study in lieu of Board prep in the hope of scoring a 260+. He scored a 249. Obviously an great score, but this kid was devastated.

I'm pretty sure that was Foot Fetish, and he actually scored a 257.

 

[Goro]

He is at a school like mine with a 1.5 year systems preclerkship curriculum. Not sure about his curriculum but we don’t take step until halfway through 3rd year. If I wait that long to start board prep I’ll have forgotten too much.

That does change the equation

 

[Matthew9Thirtyfive]

We are pass/fail, and we also take Step midway through 3rd year

We have NBME exams and faculty-written exams. What's been working for me so far is that I basically completely ignore lecture. I only go to the stuff that's mandatory. I do all my primary learning by doing Zanki, then I watch BnB and annotate FA as I watch the videos, and as soon as I'm done I take the video quiz. I do questions from USMLE-Rx once or twice a week to get some more active learning and context. Sketchy when there's a video on it. I look at the powerpoints for our lectures to see what they harp on and make sure I have that stuff solid. If there is anything in there not really mentioned in the step resources, I'll add some cards on it.

I also study with a group once a week or once every two weeks, and everyone in the group teaches the rest of the group a topic, preferably something you feel shaky on.

I'm only halfway done MS1, but it's worked really well so far.

 

[FindersFee5]

I completely disagree with this. There is a crapton of information that you're expected to master for step. It makes no sense to wait for an entire year (or however long depending on your curriculum) before you start. I have never heard people say, "I wish I hadn't started studying for step so early." I have heard the opposite multiple times.

You are decreasing your daily and future (during dedicated) workload by starting early. Instead of having a mountain of material to review during dedicated, you can just spend time aggressively attacking your weaknesses and fine tuning your test taking skills. This is only the case because you would have been reviewing everything you've learnt longitudinally.

This is a proven approach. We have a ton of anecdotes of people ignoring lecture and prioritizing step with great success.



Whether it's pass/fail or not should have no bearing on this decision. Everyone needs to know that preclinical grades are irrelevant, as long as you're not gunning for AOA (depending on the school's criteria for nomination) or failing classes. Again, avoid being in the bottom of the class as well.

I don't think there's any point wasting brainpower trying to analyze whether your school is teaching true minutiae or not. It's much easier to just focus on BUFAPS and do enough to pass comfortably. As far as research slides, they're easy enough to ignore.



I'm pretty sure that was Foot Fetish, and he actually scored a 257.

Agree with all of this. @Goro, I think there's a lot more overlap between "board studying" and studying for class than you think. I crammed details for class exams a few days before and never scored below average on any exam throughout second year. Because I was continuously keeping up with anki as well, I actually remembered and integrated material much better than my classmates who would focus entirely on classwork for the current unit.

 

[Goro]

Agree with all of this. @Goro, I think there's a lot more overlap between "board studying" and studying for class than you think. I crammed details for class exams a few days before and never scored below average on any exam throughout second year. Because I was continuously keeping up with anki as well, I actually remembered and integrated material much better than my classmates who would focus entirely on classwork for the current unit.

I believe that studying for your classes IS studying for Boards. there's a reason why pre-clinical GPAs are the best predictors for Boards scores.

 

[FindersFee5]

I believe that studying for your classes IS studying for Boards. there's a reason why pre-clinical GPAs are the best predictors for Boards scores.

Preclinical GPAs are a worse predictor than MCAT scores, I believe, but for basically the same reason - good students remain good students.

When classes are filled with irrelevant minutiae with no attempt made to distinguish between what is really important for boards and wards, then it is more worthwhile to focus on board-centric materials. Even sometimes when they're not: Dr. Sattar, Dr. Goljan, and Dr. Ryan (to a lesser extent) are really good teachers, force students to think integratively, and cover probably 80% of what you really need to know for a medical education.

 

[FalconSlice]

It's very hard to make generalizations with individual schools and curricula, but I will try. I am in a meandering mood today and this might seem aimless, but I hope someone enjoys my thoughts:

1. Medical school is there to train you to be a physician. Obviously, it's not the only thing (i.e. residency, fellowships, etc.), but don't lose sight of that. When all is said and done, you'll be a practicing physician, and what do you want out of that? Do you want to only know your field? Do you want to be a "doctor's doctor"? Do you want a regular 9-5 job so you can golf on the weekends? What will make you happy?

2. There are many things involved in obtaining what you want in being a physician. Many times, exam scores are part of that, but seriously consider what you do and the utility of it. Acing Step I means you did well on Step I and have certain specialties and certain residencies open to you. That's ALL it means. Understanding and truly internalizing class material (regardless of how well you do on class exams) means you have a strong foundation that makes any of your goals from #1 still a possibility. Corollary to a previous post of mine, there exists a large proportion of physicians who have weak foundations but are still practicing physicians who are okay at what they do... are you okay being one of them? (not a value judgement, but a serious question... not all of us want to be the top dog in our fields).

3. I'll emphasize what I said before, doing well on preclinicals is the best way to prepare for Step I (and the beginning of the rest of your medical career). There is significant overlap. Yes, there is esoterica on board/shelf exams that are not in any medical curricula, but this is blown out of proportion. Keep your priorities straight. My never humble opinion is: learn and do well in medical school for the sake of being the best doctor you can be, THEN supplement with board-specific stuff. Btw, I can't tell you how many questions over the years I've gotten correct on standardized exams because I paid attention in class/school because none of that stuff was in my prep materials (...not even UW).

4. As far as predictors of Step I scores, success in being a physician (whatever that means), etc. goes my untestable theory which I hold to be fact in my belief system is the following: it is not surprising that the better one does in medical school, the higher on avg the Step I score because of two reasons: 1. because of what I said in #3 and 2. because hard-working and diligent people do well in general no matter how "smart" they are. I am not perfect nor an omniscient being, but in my experience, what matters more in being "successful" in your career is (in order): be hard working, be nice, and be smart.

 

[Goro]

Preclinical GPAs are a worse predictor than MCAT scores, I believe, but for basically the same reason - good students remain good students.

When classes are filled with irrelevant minutiae with no attempt made to distinguish between what is really important for boards and wards, then it is more worthwhile to focus on board-centric materials. Even sometimes when they're not: Dr. Sattar, Dr. Goljan, and Dr. Ryan (to a lesser extent) are really good teachers, force students to think integratively, and cover probably 80% of what you really need to know for a medical education.

*sigh*.

There is published data (and reams of posters from medical education meeting) that show that the MCAT is a weak predictor at best for Boards scores, and pre-clinical GPAs are the best. Stop thinking like a pre-med.

And this may come as a a surprise, but at the 180+ medical schools int he US, not all classes are filled with irrelevant minutiae, or research.

 

[OrgoCoop]

*sigh*.

There is published data (and reams of posters from medical education meeting) that show that the MCAT is a weak predictor at best for Boards scores, and pre-clinical GPAs are the best. Stop thinking like a pre-med.

And this may come as a a surprise, but at the 180+ medical schools int he US, not all classes are filled with irrelevant minutiae, or research.

Poor argument. A 3.7 v 3.5 at two institutions cannot be reliably differentiated, and introduces significant confounding variables to this assessment. Stop thinking like a poorly educated statistician.

 

[OrgoCoop]

Goro can correct me if I'm wrong, but I think by "preclinical GPA" Goro means preclinical med school grades (i.e. M1 and M2 year)? Therefore, the correlation is between a med school's preclinical performance and the students' performances on Step I (not undergrad GPA performance vs. Step I performance)

Ah, confusing as s/he was referring to the MCAT in the same sentence. Same thing applies though, an Honors at one institution may be a HP or P at another. So your data is skewed.

 

[FalconSlice]

Poor argument. A 3.7 v 3.5 at two institutions cannot be reliably differentiated, and introduces significant confounding variables to this assessment. Stop thinking like a poorly educated statistician.

@Goro can correct me if I'm wrong, but I think by "preclinical GPA" Goro means preclinical med school grades (i.e. M1 and M2 year)? Therefore, the correlation is between a med school's preclinical performance and the students' performances on Step I (not undergrad GPA performance vs. Step I performance)

 

[slowthai]

It's very hard to make generalizations with individual schools and curricula, but I will try. I am in a meandering mood today and this might seem aimless, but I hope someone enjoys my thoughts:

1. Medical school is there to train you to be a physician. Obviously, it's not the only thing (i.e. residency, fellowships, etc.), but don't lose sight of that. When all is said and done, you'll be a practicing physician, and what do you want out of that? Do you want to only know your field? Do you want to be a "doctor's doctor"? Do you want a regular 9-5 job so you can golf on the weekends? What will make you happy?

But med school's really not there to train you to be a physician. Practically speaking, it's there to get you into a residency program, and that's where you'll actually learn how to be a physician.

2. There are many things involved in obtaining what you want in being a physician. Many times, exam scores are part of that, but seriously consider what you do and the utility of it. Acing Step I means you did well on Step I and have certain specialties and certain residencies open to you. That's ALL it means. Understanding and truly internalizing class material (regardless of how well you do on class exams) means you have a strong foundation that makes any of your goals from #1 still a possibility. Corollary to a previous post of mine, there exists a large proportion of physicians who have weak foundations but are still practicing physicians who are okay at what they do... are you okay being one of them? (not a value judgement, but a serious question... not all of us want to be the top dog in our fields).

Class lectures do not have a monopoly on being able to provide a strong preclinical foundation. Making sure that you truly understand the material through boards resources, class, or a combination of both is the med student's prerogative.

3. I'll emphasize what I said before, doing well on preclinicals is the best way to prepare for Step I (and the beginning of the rest of your medical career). There is significant overlap. Yes, there is esoterica on board/shelf exams that are not in any medical curricula, but this is blown out of proportion. Keep your priorities straight. My never humble opinion is: learn and do well in medical school for the sake of being the best doctor you can be, THEN supplement with board-specific stuff. Btw, I can't tell you how many questions over the years I've gotten correct on standardized exams because I paid attention in class/school because none of that stuff was in my prep materials (...not even UW).

I addressed most of this earlier. Again, we aren't saying totally disregard lecture (unless you're tested only with NBMEs). And as far as standardized tests go, like 90% of what's on step is in UFAP. You can't lose if you find a way to master that stuff.

 

[FalconSlice]

But it's really not there to train you to be a physician. Practically speaking, it's there to get you into a residency program, and that's where you'll learn how to actually be a physician.



Class lectures do not have a monopoly on being able to provide a strong preclinical foundation. Making sure that you truly understand the material through boards resources, class, or a combination of both is your prerogative.



I addressed most of this earlier. Again, we aren't saying totally disregard lecture (unless you're tested only with NBMEs). And as far as standardized tests go, like 90% of what's on step is in UFAP. You can't lose if you find a way to master that stuff.

It's only my N=1 advice. Anyone is free to do whatever he/she wants.

However saying "med school is there to get you into residency" is like saying "undergrad is there to get you into med school."

"Practically speaking" med school does much more than just "get you into residency."

 

[Goro]

@Goro can correct me if I'm wrong, but I think by "preclinical GPA" Goro means preclinical med school grades (i.e. M1 and M2 year)? Therefore, the correlation is between a med school's preclinical performance and the students' performances on Step I (not undergrad GPA performance vs. Step I performance)

Correct, I am talking about med school grades, not UG!

 

[Goro]

Poor argument. A 3.7 v 3.5 at two institutions cannot be reliably differentiated, and introduces significant confounding variables to this assessment. Stop thinking like a poorly educated statistician.

That's not what I'm trying to say.
The data out there shows that UG GPA is a poor predictor of med school and/or Boards performance. As mentioned above, it's med school pre-clinical GPA that is the best predictor of success.

The MCAT is at best a weak predictor, although it's no surprise that good test takers tend to do well no matter what the test is. But the data also shows that the mCAT is a good negative predictor. Meaning, that scores < 500 are indicators of higher risk of failing out of med school, and or failing Boards.

 

[FindersFee5]

It's only my N=1 advice. Anyone is free to do whatever he/she wants.

However saying "med school is there to get you into residency" is like saying "undergrad is there to get you into med school."

"Practically speaking" med school does much more than just "get you into residency."

Agree with this. How I think about it is that preclinical years provide the background and pathology to understand the presenting clinical pathology in M3/M4. Understanding clinical pathology lets you understand clinical treatment, which is what it seems like residency is about. Understanding treatment allows formulation of treatment plans, which is what being an attending is about. ***Disclaimer - only an M3, so personal experience currently only extends to clinical years** Obviously there is significant overlap in each step, though each step is necessary to build onto the next. Putting somebody in residency without medical school first would be a disaster - basically what a lot of NP activists seem like they're pushing more.