why can't med schools teach to the USMLE

[nonsciencemajor]

---

Members do not see this ad.

As I was looking at a medical textbook and sample notes it was a lot of information. Then I picked up a USMLE review book, and that was 10000000000x easier than the textbook and notes. I knew every word of it.

I was wondering why med schools don't teach exactly what the USMLE contains and teach additional info which the USMLE would not ask?

 

[nonsciencemajor]

for example I was looking at a friend's textbook and class notes (he is in medical school).

Then I picked up a USMLE review book and I have to say it was a 100000000000000x easier and I knew every word of it. How come med schools dont teach to the USMLE... like every med student should only read all these review books, memorize every word of it, and then be tested on it.... btw, I think this method would have a med schools average USMLE like 260 😉

it is perfect both for the students and the med school

 

[MilkmanAl]

Well, now you're seeing why I despise texts. They're a serious waste of time, in my opinion. There's plenty to learn in med school without reading tons of extraneous details.

As for your question, I think you'll find that schools do teach to the boards, for the most part. You'll run into some occasional extra stuff if you have a very enthusiastic researcher teaching a subject or a lot of prominent research in a subject going on at your school, but they're pretty good about sticking to the basics of what the NBME expects you to know.

 

[ruralmd]

Their job is to guide you to becoming a competent physician and not a 2 year course on USMLE test taking.

 

[howelljolly]

1. how are med schools going to know exactly what your USMLE will contain?

2. how can you be a competent physician if you only know the one-liners in that review book, rather than pathophysiology of disease and mechanism of drugs?

3. what makes you think that that review book is consistent with what's on the USMLE? Review books cover the basic common-denominator type material, and specific topics which are known to make for good multiple-choice questions. Its a review.

Are you in med school?

 

[Spiker]

Patients dont come with multiple choice written on their face?

 

[nonsciencemajor]

1. how are med schools going to know exactly what your USMLE will contain?

2. how can you be a competent physician if you only know the one-liners in that review book, rather than pathophysiology of disease and mechanism of drugs?

3. what makes you think that that review book is consistent with what's on the USMLE? Review books cover the basic common-denominator type material, and specific topics which are known to make for good multiple-choice questions. Its a review.

Are you in med school?

Being a nonscience major having only taken the required courses of a year of general bio, chem, orgo, and physics I wanted to know how med schools teach their courses... (I start med school in August).. so I asked a friend who is in med school if I could look at his notes... he gave them to me and when I started reading the notes, I saw there was A LOT of information.... but then I picked up a USMLE review book and noticed that it was just much much much easier than the lecture notes.... and I heard preclinical grades dont really matter to PD's, so I guess med schools should aim to teach to the boards..... it would increase the average USMLE score of med schools and also students would be getting higher step I scores....

FMG's do exactly this I heard in just studying for the boards

 

[twilightdoc]

I was wondering why med schools don't teach exactly what the USMLE contains and teach additional info which the USMLE would not ask?

I am responding as an individual and not as a representative of the NBME (which I am not). But I have served on several USMLE item writing and item review committees, and can offer some observations from those experiences.

Staff at the NBME say that they don't intend to "drive" med school curricula, although in reality this does happen to a great extent. Remember that the USMLE Step exams that they offer are written to identify individuals who have achieved "minimum competency" to progress toward medical licensure, as measured by their exams. The exams are not overtly written to determine graduation, rank medical students within or among schools, or to identify residency applicants who will be particularly successful in a given medical specialty.

How USMLE exam content is determined is a complex process, so that med schools would have some difficulty in "second-guessing" what will be on the exam for a given year. There is a very large question pool from which questions are chosen, and questions have been pre-tested and analyzed before they are included as a "live" item. And although some medical schools have faculty members who participate in item writing and review, we all sign an agreement not to divulge specific information related to the test items of which we are aware.

Medical schools should strive to train competent, caring physicians who are empowered to continue to improve their knowledge base and clinical skills as a lifelong process. I don't think that "teaching to the test" would advance that noble goal, even if it were possible.

 

[ACSurgeon]

.... but then I picked up a USMLE review book and noticed that it was just much much much easier than the lecture notes....

I disagree. I would rather study for any of my pathophys courses over step 1. Reading First Aid is painful. I actually appreciated the extra background in med school courses that you don't get in undergrad or see in board review books. While it takes longer to read the information, IMHO it is a lot easier to retain for the exam and for a decade later. So, at least at my school, lecture notes were much easier to read and learn than board review materials.

it would increase the average USMLE score of med schools and also students would be getting higher step I scores....

If all students did better, then, national average would be a 230 and today's amazing score of 250+ would become 270+... Thus, not necessarily helping students at all.

FMG's do exactly this I heard in just studying for the boards

Not always true. Maybe carib schools, but most other schools have a [more] grueling curriculum to get through in pre-clinical and clinical years. It is true, though, that they spend a lot more time preparing for the steps then we do (yet still do worse than us, on average).

 

[howelljolly]

Being a nonscience major having only taken the required courses of a year of general bio, chem, orgo, and physics I wanted to know how med schools teach their courses... (I start med school in August).. so I asked a friend who is in med school if I could look at his notes... he gave them to me and when I started reading the notes, I saw there was A LOT of information.... but then I picked up a USMLE review book and noticed that it was just much much much easier than the lecture notes.... and I heard preclinical grades dont really matter to PD's, so I guess med schools should aim to teach to the boards..... it would increase the average USMLE score of med schools and also students would be getting higher step I scores....

FMG's do exactly this I heard in just studying for the boards

OK. First of all, FMGs review the material in a board-specific manner after having learned the subjects in a broad and comprehensive sense.

It's really not easy to review something that you haven't learned yet.

You must have missed my point before. You're looking at USMLE prep material - it covers basic common material which is likely to be on the USMLE in some embellished complicated form. You have to first learn and understand the full concept from a text book. Later on, you can use the review book to remind yourself of the basic underlying principles. But on the USMLE they will complicate the principle within a clinical case, and tie it into another subject and concept entirely (double-jump questions). If you dont understand the broad topic, you probably won't even recognize the simple underlying question.

Also, this approach can really only train you to PASS the boards. Rocking the boards basically requires you to have read the textbooks and recall minutiae - such as recognizing the unused/other name of something relatively common, or knowing the 7th most common cause of something. On my Step2 I had four questions on a topic which probably isnt even in the textbook, not common. I'd just happened to have read one article about just that topic in the Annals of Internal Medicine a few months before, very lucky.

What's the point of having everyone to better on the Step1? It's scored on a bell curve. All you'll do is shift the curve up.

I think its short-sighted of you to think that medical school should focus on teaching students to do well on a test, rather than teach medicine.

 

[howelljolly]

I disagree. I would rather study for any of my pathophys courses over step 1. Reading First Aid is painful. I actually appreciated the extra background in med school courses that you don't get in undergrad or see in board review books. While it takes longer to read the information, IMHO it is a lot easier to retain for the exam and for a decade later. So, at least at my school, lecture notes were much easier to read and learn than board review materials.

That too. I can't stand First Aid. Those one-liners.... ummm duh.... ok.... I dont know how to use that statement to answer a question.

I also find it much easier to retain a complete concept than to retain a bunch of one-liners... especially for the Boards every ten years. The Step1 is not boards.

 

[OddNath]

for example I was looking at a friend's textbook and class notes (he is in medical school).

Then I picked up a USMLE review book and I have to say it was a 100000000000000x easier and I knew every word of it. How come med schools dont teach to the USMLE... like every med student should only read all these review books, memorize every word of it, and then be tested on it.... btw, I think this method would have a med schools average USMLE like 260 😉

it is perfect both for the students and the med school

USMLE review books do not teach you the material. They take hours worth of lecturing and condense it into a few dirty mnemonics and a diagram. This is great when reviewing for Step 1 and don't have time to re-read all your class notes, but it doesn't actually teach you anything. It only helps you cram.

You need to have been exposed to all of the big concepts and nitty gritty details before you can jump to the mnemonics. So, if from day one, a school just had everyone memorize First Aid for Step 1, I guarantee the class average would NOT be a 260. In fact, I found that the students who did best on step 1 (250 or 260+) were the ones who really read the big textbooks in addition to the classnotes all throughout the 1st 2 years. They had the best grasp of the material and then weren't jerked around by tricky questions on the boards.

 

[ar2388]

what i am finding out med school is that the way i used to study and the feeling of being "prepared" that I felt in undergrad doesn't even come close to fully understanding and comprehending all the material that has been thrown at me. if i keep studying like I did in undergrad, then maybe i will pass my exams but i wont learn anything.
you really need to get your hands dirty in a textbook or two and really really understand the material, make it your 2nd (or3rd) language.

 

[Climberak]

Then I picked up a USMLE review book, and that was 10000000000x easier than the textbook and notes. I knew every word of it.

Don't let the readily accessible style that review books are written in lull you into thinking that they are easier to learn from. To remember anything in the long term (+2 years; after step one), you need to have an active component in your studying. Going (podcasting) to lecture, writing notes, synthesizing your notes, relating concepts to other concepts, objectively testing your knowledge, and finally reviewing are how you are going to get a grasp on the material for the long term. Review books are part of that process, but not the sole part.

 

[njbmd]

A monkey can sit down and parrot-back words written on a page but that doesn't make that money a good and competent physician. Having a few lines of information does not mean that you know the subject matter. As others have said, you need far more than what is on one exam, to become a competent physician.

Nothing stops you from memorizing a USMLE review book but you are going to find that it's not enough for your coursework. You are also going to find that third year is going to involve more than what's on USMLE Step I which tests the bare minimum of what you should be mastering in your pre-clinical years.

I am a practicing physician and work very hard to add to my knowledge base on a daily basis. If I just mastered what was in the first two years of medical school, I would never have completed residency or fellowship or be able to continue to move forward to be be the best physician that I can be.

"Motion in the fulfillment of what exists potentially insofar as it exists potentially" (Aristotle). If you can't keep moving forward and adding to your knowledge base, you are going to struggle with medicine and the nature of its practice. Believing that a medical school should just "teach you what is on Step I" is potential setup for non-mastery even of Step I. I am thankful every day that my medical school didn't teach just what was on USMLE.

 

[ensuii]

I'm not sure if I agree with the textbook bit...but I do agree that one cannot read a handful of review books and have a command of the material. I think I have a good memory. In fact, I'm pretty sure most med students can memorize large amounts of information fairly easily and routinely. The thing is, by just reading a review book and skimping on lectures, discussions, assignments, modules, etc., you're endangering your ability to have a conceptual knowledge of the material. From my knowledge, the boards are not comprised of mostly first-order questions.

For the record though, medical schools don't make it their mission to get you to score well on a test. Their mission is to make you into a good physician. To assess the extent to which this is happening, evaluations are constructed to determine your progress as a physician in different dimensions. It lets them know where their students have problems and how they can fix it.The USLME is a test of one such dimension used to measure the body of knowledge a future physician should have given a particular point in their training. That is not to say however, that medical schools disregard the fact that students have to do well on these tests. Indeed, in curriculum planning many schools use the "backwards planning" approach where they look at the test, extract learning objectives and then teach those objectives. Therefore, instruction, learning and ultimately, assessment are "aligned". To further assure the fidelity of their assessments, many medical schools attempt to structure their exams and question format in the same manner as the boards. Some even go so far as to give student's shelf exams, which to my understanding (I may be misguided here) are retired USMLE questions.

 

[ensuii]

There's a double post of this thread in pre-allo

 

[azrael87]

for example I was looking at a friend's textbook and class notes (he is in medical school).

Then I picked up a USMLE review book and I have to say it was a 100000000000000x easier and I knew every word of it. How come med schools dont teach to the USMLE... like every med student should only read all these review books, memorize every word of it, and then be tested on it.... btw, I think this method would have a med schools average USMLE like 260 😉

it is perfect both for the students and the med school

You do realize that your post is equivalent to a high school student who hasn't taken any prereqs passing judgment of the efficiency of MCAT review books vs. actual classes and textbooks, right?

Of course you don't understand the textbooks now. That's why you have the classes. When you're in med school you're waste deep in the material discussed in the textbooks, so you should be understanding it. Review books are for just that: review. They take the complicated stuff and narrow it down to a few quick points and shortcuts to refresh your memory. As such, it is worded in the simplest possible way. However, as others have said, they alone are not enough to teach you what you need to do well on the USMLE.

Another thing that others have said: Classes geared specifically towards the USMLE will not create functional doctors because it will narrow experience to a testing format. Standardized tests should be formed around class material, not the other way around. Some high school curricula does it the wrong way, like Florida schools with the FCATs and New York schools with the regents. I remember in high school as soon as we finished the English regents, the following year in English the first thing the teacher said was "Remember all that stuff you've been learning to do well on the regents? Forget it. It's wrong. It's silly. It's bullsh*t. From now on I'll be teaching you REAL literature, grammar, and writing." She was absolutely right. Everything was different, and it was the different stuff that has served me well in future writing assignments. The people who were stuck on the regents style were the ones getting C's and D's on papers in undergrad courses.

Now I get that the USMLE's are better indicators of skill in medicine than the regents are in...well, anything. Just a general example. Life isn't standardized, therefore education shouldn't be catered to fit standardized tests. Anyway, most med students pass these things. You'll learn the best study method when you're actually IN med school. For now, just focus on getting in.

 

[howelljolly]

And as I was saying...

Review books....
It is very, very easy for the USMLE writers to "beat the review books", and they do exactly that. The writers open up the review books, and check out the mnemonics. Then they find the one or two things in the same list that didnt fit into the nice mnemonic, and ask you about them. They look at the page with different forms of the same graph - frank starling, tidal volume, volume/concentration-square things - for you to memorize and recognize on the test. Then they ask you about the variant of the graph which doesn't appear in the review book. They make sure to find out if you know the concept, and havent crammed.

They also have a lot of other tricks up their sleeve. They ask the same question 5 different ways, group some topics and scatter others, just to see if you know concepts, or have crammed trivia. The USMLE website even says that they can "statistically analyze" your test for irregular behavior. I wouldn't be surprised if you lose additional points for inconsistent answers, suggesting random guessing.

C'mon man. Dont you think the USMLE writers, the gatekeepers of the medical profession, are smarter than that? They want people who can think for themselves to do well on the test, not the ones who can memorize First Aid.

 

[go lakers]

C'mon man. Dont you think the USMLE writers, the gatekeepers of the medical profession, are smarter than that? They want people who can think for themselves to do well on the test, not the ones who can memorize First Aid.

👍

 

[turkeyjerky]

And as I was saying...

Review books....
It is very, very easy for the USMLE writers to "beat the review books", and they do exactly that. The writers open up the review books, and check out the mnemonics. Then they find the one or two things in the same list that didnt fit into the nice mnemonic, and ask you about them. They look at the page with different forms of the same graph - frank starling, tidal volume, volume/concentration-square things - for you to memorize and recognize on the test. Then they ask you about the variant of the graph which doesn't appear in the review book. They make sure to find out if you know the concept, and havent crammed.

They also have a lot of other tricks up their sleeve. They ask the same question 5 different ways, group some topics and scatter others, just to see if you know concepts, or have crammed trivia. The USMLE website even says that they can "statistically analyze" your test for irregular behavior. I wouldn't be surprised if you lose additional points for inconsistent answers, suggesting random guessing.

C'mon man. Dont you think the USMLE writers, the gatekeepers of the medical profession, are smarter than that? They want people who can think for themselves to do well on the test, not the ones who can memorize First Aid.

Calling bull$hit on that, the rest of your post is legit though. I do think professors could learn a thing or two about organization from review books though. At least at my school, the handouts are atrocious, with a few exceptions, and textbooks are too detailed to really use as a primary source for learning.

 

[Law2Doc]

USMLE review books do not teach you the material. They take hours worth of lecturing and condense it into a few dirty mnemonics and a diagram. This is great when reviewing for Step 1 and don't have time to re-read all your class notes, but it doesn't actually teach you anything. It only helps you cram.

You need to have been exposed to all of the big concepts and nitty gritty details before you can jump to the mnemonics. So, if from day one, a school just had everyone memorize First Aid for Step 1, I guarantee the class average would NOT be a 260. In fact, I found that the students who did best on step 1 (250 or 260+) were the ones who really read the big textbooks in addition to the classnotes all throughout the 1st 2 years. They had the best grasp of the material and then weren't jerked around by tricky questions on the boards.

Agree with this and with njbmd's posts. The boards are the absolute minimum level of knowledge that the licensing bodies have determined one should obtain a passing level on in order to be licensed. The material is just that -- a weak minimum. If your med school doesn't teach you more than this, you should get your money back. Sort of like going to college and taking nothing but MCAT prep courses -- you probably could do decently if you took nothing but Kaplan and TPR over and over for 4 years, but I sure hope you went to a public college because what you got in 4 years sure wouldn't be worth the six digits some colleges charge. This isn't vocational school. You aren't in school just to learn the minimum you need to know to do a specific job.