wamba
Forum Guru
Topics: 149
Posts: 664
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Hi there!
I did the exam yesterday and I would like to share my esperience with everybody.
I got 360 in NBME form 1 two weeks ago, 480 in NBME form 2 one week ago and 580 in NBME form 3 three days ago. I have read through this forum that it is very difficult to improve ones mean. I personnally do not agree with this point of view because the score is not only a matter of knowledge, but also depends on your approach to the test. It is very important to consider all the tests as a challenge. And before any challenge, one needs to be mentally prepared and concentrated. There are few steps to pass prior to starting any test.
First: sit comfortably. Close your eyes and empty your mind. forget about your life and your problems and take few minutes in focusing on your incoming challenge. This is your only way to assemble ALL your knowledge for the test.
Second: Before Reading the Questions, give a fast look to the answers (just 1-2 seconds). Don't read them, just give a look to understand if you will are dealing with diagnosis (A. Conversion disorder; B. Mania; C. Malingering), with treatment (A. Buspirone; B. Buproprion; C. Lithium), with diagnostic test (A. Echocardio; B. X-ray; C. Reassurance) or with the popular "what is the next step in management" (A. Observe; B. resume X and add Y );
Third: Read the questions fast but not too fast because you may loose important points. IMPORTANT: try to do a non-stop reading maintaining the same speed of reading through the test. Remember the age of the patient while you are reading. Also remember that the patient's race or job is almost always correlated to the answer.
Fourth: memorize the normal labs. You should feel confortable while reading them.
Fifth: Read all the answers. When you choose one, go forward and forget about the previous question. Don't waste precious seconds in wandering if the answer is correct or not. If you are concentrated, you read the vignette properly and you read all the answers you will pick YOUR best answer and all the further meditations will only be a waste of precious time.
Sixth: If at the end of the vignette you do not get the point of the question, READ THE FIRST SENTENCE which contains the age, the sex of the patient and the reason of his visit. and then GO TO THE MIDDLE F THE VIGNETTE: "On examination... Labs... diagnostic test..." and read the questions again. If you don't get the point again, PICK THE MOST FAMILIAR ANSWER YOU SEE, go forward and forget about that question.
Seventh: Don't pick an answer when you feel it is not correct. For exemple, the following happened to me yesterday: Pregnant woman with syphilis and allergy to penicillin. what is the best treatment.
A. Penicillin; B. Doxycicline; C. desensitization prior to give penicillin; D. wait until delivery to give Doxy; E. Erythromycin. I excluded A, B and D. I also remembered that (Very important) in kaplan notes and Crush step 2 erythromycin is not related to syphilis. I picked C.
Eighth: Even though some questions are very long, if you do a constant-speed reading of all the questions, you pick an answer and you go forward you will have enough time to finish the block without stress.
My exam was more difficult than UW and by far more difficult than kaplan Q banq. There were no classic vignette with easy diagnosis or therapy. And when the vignette was pointing toward a classic diagnosis, the questions was a step 1 type question. exemple: middle age patient, aggressiveness, chorea, dementia, his father had the same symptomes at that age. and the question is "what is the mecchanism of the most likely disease? A. enzymatic def; B. Chromosomal deletion; C. genetic abnormality; etc. About 80% of my simple vignette had this type of questions and I found it a bit frustrating.
Hope this will help
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| lucky
Forum Guru
Topics: 23
Posts: 505
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it helped. hope u score real good . good luck.
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| kingsofke
Forum Guru
Topics: 24
Posts: 715
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It is amazing. The description is so good that i cant find word to say. I follow 90% of it and it helped me always. It explains how you improved your score in NBME so fast. You definitely get a good score in step2. All the best and keep it up.
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In Life there are neither rewards nor punishments, just consequences.
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| ARJ
Forum Guru
Topics: 133
Posts: 792
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A very good technique..Thanks for sharing..
All the best to you Wamba
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"Live as if you were to die tomorrow. Learn as if you were to live forever." --Mahatma Gandhi
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| amariah
Forum Junior
Topics: 0
Posts: 10
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Wamba,Thanks and I'm glad to read your contribution... Surprised to know that they included Step1 style of Qs in your exam. Though it is frustrating but hope that u did answer right/the best in your exam and score well.
I was thinking to raise a question on guide/strategy to tackle the Qs and answering step2..till I found womba's post.
This is my weakness and in need for the right method to handle the QS esp when it ask for that popular "the next step in management" and "the next approriate management"..etc, I always ended-up choosing the 2nd best answer!!#
This made me annoyed of myself+frustated+whatever negative feeling I always develop after knowing that I've missed the right answer....(I wish I can give an example of Q which I encountered but cant seem to remember it now)
I hope someone can point out to me what should I look specifically in the given senario when the Qs ask for:
1) most appropriate initial step in diagnosis? management?
2) most appropriate next step in diagnosis? management?
3) most appropriate management?
These are common Qs that trapped me...
LAstly, thanks in advance for those who help to shine the light and willing to clear my problem... (I appreciate your opinions and contributions)
amariah
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| KEROCHI
Forum Guru
Topics: 60
Posts: 971
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Good luck with your result wamba. Your post helps a lot!
Amariah, you can scan/read the 1st part of Qbook about your q's, it would help you. Plus when you do Q's such as Qbank, UW or Qbook you'll get use to answering your q's. In other words.. the more q's you'll do the more you'll get accustomed in answering the q's.
Do MCQ's early in your review accompanied by active reading of FA, Kaplan notes or your review materials you're comfortable at. Good Luck!
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| frontal
Forum Guru
Topics: 53
Posts: 421
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Thank you wamba for posting your experience and advice. I hope you do well. Good luck.
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| wamba
Forum Guru
Topics: 149
Posts: 664
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tx guys! happy to help. I have a question from my exam.
A 17 yrs old girl comes to your office for a 3 months history of polyuria and a weight loss of 15 kg. she has been drinking 4 to 5 liters of water every day and she's been feeling so tired that her daily activities have been impaired. she's on no medecine. her medical history and her physical examination are unremarkable.
labs are the following: hct: 45; hb: 11; rbc: 4,500 000; wbc: 6,000; ast: 20; alt; 18; Ldh: 55; glycemia: 420;
To which of the following is she most likely at risk in the next 20 years?
A. myocardial infarction;
B. pericarditis;
C. venous thrombosis;
D. cancer;
E. osteoporosis
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| kingsofke
Forum Guru
Topics: 24
Posts: 715
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A. MI
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In Life there are neither rewards nor punishments, just consequences.
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| wamba
Forum Guru
Topics: 149
Posts: 664
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I picked B. pericarditis; the patient has diabetes, which is, according to kaplan notes, a major risk factor of renal failure to the point of needing dialysis, which is an important cause of pericarditis. Pericarditis is one of the criteria, along with hyperkalemia, severe acidosis, fluid overload and encephalopathy for dialysis.
I did not pick MI because a 37 yrs old woman is too young for heart disease even if she has diabetes. She is still too young for osteoporosis and cancer even if diabetes is related to some cancer (uterus, if my memory is good). i don't think diabetes is a risk factor for DVT. I chose B. But I'm still not sure it is the right answer.
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| anothergoljanfan
Forum Senior
Topics: 18
Posts: 83
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may u get amasing score.
hey can you please tell which all books did you use
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| wamba
Forum Guru
Topics: 149
Posts: 664
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amariah wrote:
"I hope someone can point out to me what should I look specifically in the given senario when the Qs ask for:
1) most appropriate initial step in diagnosis? management?
2) most appropriate next step in diagnosis? management?
3) most appropriate management?
These are common Qs that trapped me..."
First of all, you must know that these questions are the most difficult to answer. I had the same problem when I started to study for the boards because here in Italy where I'm a family practitionner, the doctor is free to give penicillin, cephalo or macrolid for bacterial tonsillitis. There is no first or second treatment. I have never been to the USA but what I have understood about the practice of medecine there is that there is no place for improvisation.
Everything depends on the way you study. Any time you study a subject, you must always REMEMBER the diagnostic tests, the treatments and the complications in their hierarchic order.
Exemple: Even if you know that penicillin AND doxycycline are effective in case of syphilis, you will miss the right answer in an easy vignette which point to the treatment of syphilis if the two drugs are present (most of the cases). Always remember the first and the second choice. also remember the treatment in case of allergy, pregnancy, elderly or early childhood.
As i said above, everything depends on the way you study every subject. I can give you many exemples:
if the patient was gunshot always think exploratory surgery as the next step in management
if the patient's BP is 80/40 next is most commonly Fluid administration (remember ABCD in trauma)
the most common cause of white reflex in a baby is cataract but the most serious complication is retinoblastoma. you must know all this when you study; the rest come with the Qbanq, UW, etc.
good luck
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| amariah
Forum Junior
Topics: 0
Posts: 10
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Thanks so much wamba for your generous advices and a sample of Q&A you've shared.
Yup, you pointed out important msgs to pay attention while studying and answering Qs. I may have done mistakes for not paying extra attention on those hierarchy of informations which can be different from one case to another / disease to another disease and treatments too. Sometimes, overwhelm with informations easily crowded my thought. (not a good habit to have...)
Glad for your help again...
amariah
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| wamba
Forum Guru
Topics: 149
Posts: 664
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anothergoljanfan wrote:
"hey can you please tell which all books did you use"
I used kaplan books and crush step 2.
did questions from Q bank (VERY USEFUL), mock exam (it has long questions and it helps you to get used to it), Usmle world (A MUST, the questions are more difficult but you can learn a lot with it).
good luck
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| anothergoljanfan
Forum Senior
Topics: 18
Posts: 83
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thanks wamba
your posts are very useful
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| kald
Forum Junior
Topics: 4
Posts: 35
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wamba your posts have been very enlightening thank you.. and continue to post the kind of questions you got in your exams
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| aimhigh
Forum Elite
Topics: 22
Posts: 148
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Hey Wamba, thanks a lot for your inspiring notes!! I am very certain that you will get a 99!
May I ask you what you did in the last 4 weeks before your exam?! Thanks in advance!
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| aimhigh
Forum Elite
Topics: 22
Posts: 148
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Hi Wamba, just saw the question you posted. I feel the most related to diabetes is MI. If diabetes were not controlled properly, a 20 years process is long enough to damage CVS. pericarditis is more related to connective tissue disorders such as sle, ra etc. It's just my thought...may be wrong...open to discuss
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| zip
Forum Senior
Topics: 16
Posts: 47
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congrats wamba
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| zip
Forum Senior
Topics: 16
Posts: 47
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I followed the same steps as you and it worked for me.
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| usmlecracker
Forum Elite
Topics: 37
Posts: 136
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Hi wamba,
U are amazing!!!
Thanks for sharing the information...
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| punjaban
Forum Newbie
Topics: 0
Posts: 9
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hi,
could u pls guide me as to whether kaplan q bank is usefull or not?? and y
also pls share ur views as to which nbme form is closest to the actual exam,,,i m thinkin of takin only one of them,,which would be the ideal time for taking it??
thank u so much
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| zip
Forum Senior
Topics: 16
Posts: 47
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kaplan q banq is useful to learn but the real exam is much more difficult.
If you have to choose one NBME choose form 3 or form 4, which are closer to the real exam.
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