Timed NBME style finals tips/help!

[Zippy92]

For my medical school, each organ system module has a midterm with questions written by the professors, and a final that is NBME style with previous Step I questions. In undergrad I used to be a great test taker, but now I've found that I'm awful at test taking. They allot 1.5 minutes per question (just like Step I).

Currently I go through, and unless I am 100% sure, I won't answer the question, mark out any answers that I 100% know are wrong, and move on. I usually end up not answering/marking a significant amount of questions (like half). Since the majority of questions are clinical vignettes, it takes a while to read each question and the answers, and I have to re read the questions I marked when I go back through. I end up bouncing around and stressing out and I don't think I've finished an exam before the time has ended more than twice. (I always answer all the questions but am still looking over the ones I don't know)

So I know that's a horrible way to take exams. I would really love tips or strategies on ways that would work better.
Read the answers first? Answer each question as I read it, whether I know the answer or not, as to save time? Mark only the ones I think I might be able to answer confidently later and guess the ones I have no clue on but don't mark them? I'm stuck. And welcome any advice.

---

Members don't see this ad.

 

[kbeitz]

Do what you do but when you get to the end, calculate how many you have marked and divide by the total number of test questions. If the result is > 70% submit the test.

Also only mark a question if you can't get it down to 2 choices.

 

[Zippy92]

Do what you do but when you get to the end, calculate how many you have marked and divide by the total number of test questions. If the result is > 70% submit the test.

Also only mark a question if you can't get it down to 2 choices.

My original post was confusing I think (it's edited now). So when I said I mark the ones I'm not 100% sure on, I meant that I leave them blank. So for about half of the questions or more (they're typically 100 question exams), I have to read the entire clinical vignette again which ends up running down a pretty large amount of time.
So you would suggest answering every question as I read them, not marking the ones that I guess between two answers, but do mark the ones that I guess between more than two answers?

 

[673441]

My original post was confusing I think (it's edited now). So when I said I mark the ones I'm not 100% sure on, I meant that I leave them blank. So for about half of the questions or more (they're typically 100 question exams), I have to read the entire clinical vignette again which ends up running down a pretty large amount of time.
So you would suggest answering every question as I read them, not marking the ones that I guess between two answers, but do mark the ones that I guess between more than two answers?

You wouldnt happen to be a Ross student would you? Haha

 

[kbeitz]

My original post was confusing I think (it's edited now). So when I said I mark the ones I'm not 100% sure on, I meant that I leave them blank. So for about half of the questions or more (they're typically 100 question exams), I have to read the entire clinical vignette again which ends up running down a pretty large amount of time.
So you would suggest answering every question as I read them, not marking the ones that I guess between two answers, but do mark the ones that I guess between more than two answers?

Answer every question as you read it, regardless of whether it's between 2 or 5.

 

[Zippy92]

You wouldnt happen to be a Ross student would you? Haha

Nope! Not even sure where that is haha. I'm assuming we have similar finals though!

 

[Zippy92]

Answer every question as you read it, regardless of whether it's between 2 or 5.

I'll do that on my midterm in two weeks and hopefully see some better results

 

[dempty]

My original post was confusing I think (it's edited now). So when I said I mark the ones I'm not 100% sure on, I meant that I leave them blank. So for about half of the questions or more (they're typically 100 question exams), I have to read the entire clinical vignette again which ends up running down a pretty large amount of time.
So you would suggest answering every question as I read them, not marking the ones that I guess between two answers, but do mark the ones that I guess between more than two answers?

If you've spent time reading the question, and you're not above your comfort threshold, do your best to pick an answer and mark the question before moving on with the exam. You'll never have the possibility of leaving something blank if you make it through the final question. I think you can decide how you want to use the marking feature, but at a minimum, don't leave a question blank after you've read the vignette. You may come back later and realize the answer you selected was spot on, or you might reread the vignette and see you missed an important piece of information.


Good luck!

 

[operaman]

1) read the question first. This guides how you read the vignette.

2) QUICKLY skim the answer choices. No more than 2 seconds in this. You're not trying to think, just understand the scope of the choices. If the question asks for diagnosis, a quick skim says "rheum stuff" or "heart valve problems." Just broad categories, again so you can be actively engaged while you read

3) take another 2-3 seconds and think about what info you might need to answer the question based simply on points 1 and 2.

4) read the vignette. Thanks to the 6 seconds above, you are ready to read with purpose. Don't rush. Let it be voiced in your head. I like to imagine someone is presenting the patient to me. Whatever works - just make sure you're actively engaged and working through the problem while you read.

5) if its even remotely a clinical question, ask your self what your diagnosis is. Sometimes that's the actual question and you're done. But even if it's a mechanism question or a next step in Mgmt wuestion, make sure you have made your diagnosis. If you can't make one, briefly list your top 3-5 ddx.

6) only NOW should you actually attempt to answer the question. Ideally you already have a solid answer before even going back to the choices.

7) if you don't see your answer, look for something that means the same thing (i.e. Urge incontinence = detrussor hyperactivity = overactive bladder). The nbme loves to pull this one. You may be thinking afib, but they'll find some strange assinine way to say it.

8) still stumped? Now it's time to start eliminating. Start by cutting things you can prove are 100% wrong. The nbme is good about putting lots of info in vignettes so their answers are unimpeachable. Use this to your advantage. If it randomly mentions her lmp was a week ago, scratch off any pregnancy related options. Yes I know this doesn't 100% mean she isn't pregnant - but this is an exam and 9/10 that means not pregnant unless the entire focus of the question is that, so I'll take a 90% (~270 on step 1) and you can keep the other ten percent of questions. This applies to any topic.

9) other test strategies if you're still stumped. Pick the longest answer choice. Pick the wierdest one. Pick the one unlike the other ones. Pick the most common one.

10) pick an answer before you move on. Leaving a question blank after the first pass may be the worst strategy I've ever heard.

11) mark anything you think more time will change. I do something a bit different. I mark anything I'm not 100% sure on and keep a separate tally on paper of each question I'll actually go look at again. Basically only spend time on questions where more time may help. Things like arrow questions for endo where you need to carefully think through pathways. I do this so I can estimate my score when I'm done which helps me sleep better and move on. I know from practice what fraction of those insures I'll get and what fraction of the rest I'll get.

12) guess wildly and punt time suck questions to the end. In step/ ck these are the drug ad questions. If you see a huge vignette on step 1 that just makes you cringe, pick a random answer and come back to it. Don't be that guy who realizes the last 5 questions are super easy gimme questions but you spent all that time on one big one earlier. Again, you may sacrifice the time suck question for 2-3 easy ones. Worth it. Obviously you go back and answer the time sucker when you're done.

Try that way on a few sets of practice questions and see how it works.

 

[kmp0410]

If you know the material, your first instinct will be right most of the time. Not saying 90% of the time...but most of the time. Make sure you just read the question and answers carefully the first time through and pick the best answer. However it is that you do that, if its POE, or if its just your gut feeling. You can mark them if you are REALLY unsure. But outside of that, I would just move forward. We have these NBME tests as well and I have done the best when I trust my intuition. I tend to leave feeling like I have no idea how I did, but end up doing well.

 

[stepone2015]

To add what others have said, I like to highlight important pieces of info (age, sex, symptoms, vitals, etc), so when I look at the question again, the important stuff sticks out.

I answer every question the first time I go through it even if I don't really know the answer. I mark anything I don't know to return to later.

If I don't know, I use information I do know about other diseases, other pathophysiologies, other drugs - any parallel I can draw from other information and try to apply it to this question.

Alternatively, if I don't know, I go through each answer choice and try to draw a connection as to how that might actually be the answer. If it seems insane, I scrap it. If it seems reasonable, and it's the most reasonable I got, I choose it.

If I'm between 2-3 choices, I pick the 'simple' answer, the 'obvious' one. That, I have found, is usually the answer (unless you are doing UW questions, in which case, it is rarely the correct answer).

 

[Zippy92]

Thanks so much you guys. I really appreciate all of the help! I'm definitely going to start answering each question as I go along, and I'll apply these strategies. I don't think any strategies could cause me to be more stressed out through the exams, so hopefully I'll see some improvement.