gigiMD
Forum Junior
Topics: 11
Posts: 32
| | 05/22/06 - 07:05 PM
3 of 9 forum leaders found this post helpful
| #1 |
This is my 3rd time: 1st=59 2nd=68 and now 3rd=73, i'm kind of down, i really wanted to applie by november, and i really though i was going to make it this time, is there hope for me, can i still make it for next mach  ??!!!!!!!. i just don't now any more... (i was planned to take 2ck by sept and 2cs by nov but now i dont know what to do  )..........But i will keep trying no mather what 
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| Shakeels
Forum Guru
Topics: 27
Posts: 468
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Hi,
well I'm sorry to hear that, but I'm glad ab one thing that you are not thinking to give up. This is very positive thinking, no one wants to fail this exam but it happens like this. I will ask you to do GOLJAN notes with his audios, with KAPLAN, and we have got many new questions besides KAPLAN Q BANK, so that you can check your self and your performance. Nes web sties are usmlerx.com and usmlesteps123.com. I heard that both are amazing and cheaper then q bank, I hope it will work, and one thing more GOOD LUCK for nex time.
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| spitmetal
Forum Guru
Topics: 25
Posts: 635
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gigimd are u an img?? good luck never give up !!!!
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NEVER REGRET IF U DID YOUR BEST--"THE PEOPLE WHO CAN'T DO SOMETHING WILL KEEP SAYING THAT YOU CAN'T DO IT.....BUT REMEMBER YOU CAN DO IT!!" by Dr. Luck a member of this forum
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| mjl1717
Forum Hero
Topics: 955
Posts: 5,451
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Thats right, dont EVER give up! [Do more qs -40,000 if necessary and go over the wrong choices also]
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Smell the coffee! "Is That an Osler move??"
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| askdoc
Forum Senior
Topics: 1
Posts: 79
| | 05/23/06 - 05:29 AM
5 of 9 forum leaders found this post helpful
| #5 |
Just givng my two cents worth. I believe we can use the skills we learned as physicians in any aspect of our life including preparing for an exam. If a treatment strategy is not working (in this case 3 times already), the problem lies either in the treatment or in the diagnosis.
I took the exam on april 24,2006 and as per OASIS trick last May 17, I have passed it. Just tweedling my fingers waiting for the postman. I went into this exam with the following statistic.
NBME form 1: 740 (3 weeks before exam) (1 hour timed per block)
Kaplan QBank: 84% (all random, timed blocks no repeat. Answered 1250 questions in groups of 2 to 4 blocks/day over 9 days.)
USMLE CD : 46, 44, 48 (2 months before exam)
I reviewed for 7 months ( 4 months seriously) for this exam. I am an IMG. A very, very old IMG. so that you'll have an IDEA, when I was studying
1. DOC for Typhoid Fever was Chloramphenicol.
2. when I first encountered the word 'p53' all I could think of was that he was senior member of this forum .
3. There was no treatment for AIDS.
4. 50% of our graduating class who went to the US after graduation are now practicing physicians in the US and most have already finished their J1 Waivers and some are already citizens.
I've used this framework for analyzing my weak points throughout my review.
We can divide our whole preparation into 3 parts,
1. Knowledge Acquisition(KA) - This is where you put information into your Knowledge Bank(KB) Most new graduates are extremely fine here (Except if you're one of those who barely made it. Crammed for every test and promptly forgot everything afterwards. Most Old graduates and some IMG graduates usually have problems here. If your deficiency is primarily here (like me both old and IMG ), I'm sorry, I don't think there can be any successful prescription but to hit the books.
2. Knowledge Recall or Review(KR) - This is how well you extract information from your KB. Most new graduates have some problem only here. FA and the QBank makes a fantastic tool for improving Recall. So people with problems here usually give fantastic ratings to FA and Qbank.
3. Test Preparedness (TestPrep) - If you are not familiar with CBT, MCQ or clinical slant to questions, this is where your problem is. Problems with sitting for 8 hour exam is also classified here. Difficulty in answereing 2 to 3 step thinking questions also fall here. This is where QBanks are the most effective.
If the problem is primarily in KA, answering 100 thousand Q's will not help, IF your KB is full and you have problems only with KR and TP, hitting the books will be a waste of time. QBank, FA, HY and Flashcards should be the way to go.
How do I know where my primary problem is?
Well a quick way to know is to use an evaluation examination, preferably one that's very near like to the actual exam. (The Kaplan CD examination comes to mind)
If you find while answering the questions that either the choices, the question itself or the pictures makes you think out loud "What the Heck is this?" You have a KA problem.
If most of the time it is, "I know this, but I can't recall how you differentiate between drug A and drug B (or symptoms, presentation, treatment, mechanisms,etc.)" You're having a KR problem.
If you thought you had the answer, then find out it's wrong, but after reading the explanation, you are surprised that you had misunderstood the question, It's a TP problem. Running out of time answering questions is also a TP problem.
As the medical adage goes, from the Diagnosis all things flow. After you've correctly diagnosed your problem, then the treatment is routine.
I'll discuss the solution to each identified problems in my next post and particular strategies you can use to improve your TestPrep ability.
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Step1 99/256, Step 2 99/258, Old IMG, 1989 grad. A man's reach should exceed his grasp, or what's heaven for. http://blogs.askdoc-usmle.com
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| OBO
Forum Senior
Topics: 10
Posts: 106
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Dear ASKDOC ,
YOU are super in diagnosing and evaluating the problem as welll as in treatment!! Thank you very much for the nice post . Are u going to write more ?
Best of luck for the score. Thanks Again.
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| p53
Forum Guru
Topics: 51
Posts: 804
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askdoc wrote:
when I first encountered the word 'p53' all I could think of was that he was senior member of this forum
NBME form 1: 740 - are you joking? it's almost 2.5 Standard Deviations above of mean!
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"Everything should be made as simple as possible, but not simpler." - Albert Einstein
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| srik
Forum Junior
Topics: 0
Posts: 15
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wow,thats excellent,reading ur post i feel i shud present u with my pblm,have exam in amonth,doing my revision,scoring 6o to 70 percent in q bank n q book,? do i plan n prepare this last month?the main pblm with me is not having a clarity with concepts,do u think repated readings will help me or shud i focus on doing more questions,plz advice.
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| mitty
Forum Guru
Topics: 52
Posts: 376
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askdoc, I can not wait to read your next post.
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He will make it happen.
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| vallia
Forum Guru
Topics: 98
Posts: 889
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excellent askdoc, I know where my problem is...
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fight possessed
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| ing
Forum Guru
Topics: 45
Posts: 435
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Great point! Thanks askdoc. Wish you Good Luck!
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Never give up!!
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| gigiMD
Forum Junior
Topics: 11
Posts: 32
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Thanks guys for your replays!!,.....with that post i just realize where is my problem, (KR and TP). I bought the usmleRx i hope is good because i had done already qbank 3 time and the score is not that accurate (because of the repeatead questions). Thank again askDoc (i'm looking foward for your next post) and congrat for those score.
pitmetal: Yes I'm IGM, graduated in 2002!
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| mjl1717
Forum Hero
Topics: 955
Posts: 5,451
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askdoc wrote:Just givng my two cents worth. I believe we can use the skills we learned as physicians in any aspect of our life including preparing for an exam. If a treatment strategy is not working (in this case 3 times already), the problem lies either in the treatment or in the diagnosis. I took the exam on april 24,2006 and as per OASIS trick last May 17, I have passed it. Just tweedling my fingers waiting for the postman. I went into this exam with the following statistic. NBME form 1: 740 (3 weeks before exam) (1 hour timed per block) Kaplan QBank: 84% (all random, timed blocks no repeat. Answered 1250 questions in groups of 2 to 4 blocks/day over 9 days.) USMLE CD : 46, 44, 48 (2 months before exam) I reviewed for 7 months ( 4 months seriously) for this exam. I am an IMG. A very, very old IMG. so that you'll have an IDEA, when I was studying 1. DOC for Typhoid Fever was Chloramphenicol. 2. when I first encountered the word 'p53' all I could think of was that he was senior member of this forum . 3. There was no treatment for AIDS. 4. 50% of our graduating class who went to the US after graduation are now practicing physicians in the US and most have already finished their J1 Waivers and some are already citizens. I've used this framework for analyzing my weak points throughout my review. We can divide our whole preparation into 3 parts, 1. Knowledge Acquisition(KA) - This is where you put information into your Knowledge Bank(KB) Most new graduates are extremely fine here (Except if you're one of those who barely made it. Crammed for every test and promptly forgot everything afterwards. Most Old graduates and some IMG graduates usually have problems here. If your deficiency is primarily here (like me both old and IMG ), I'm sorry, I don't think there can be any successful prescription but to hit the books. 2. Knowledge Recall or Review(KR) - This is how well you extract information from your KB. Most new graduates have some problem only here. FA and the QBank makes a fantastic tool for improving Recall. So people with problems here usually give fantastic ratings to FA and Qbank. 3. Test Preparedness (TestPrep) - If you are not familiar with CBT, MCQ or clinical slant to questions, this is where your problem is. Problems with sitting for 8 hour exam is also classified here. Difficulty in answereing 2 to 3 step thinking questions also fall here. This is where QBanks are the most effective. If the problem is primarily in KA, answering 100 thousand Q's will not help, IF your KB is full and you have problems only with KR and TP, hitting the books will be a waste of time. QBank, FA, HY and Flashcards should be the way to go. How do I know where my primary problem is? Well a quick way to know is to use an evaluation examination, preferably one that's very near like to the actual exam. (The Kaplan CD examination comes to mind) If you find while answering the questions that either the choices, the question itself or the pictures makes you think out loud "What the Heck is this?" You have a KA problem. If most of the time it is, "I know this, but I can't recall how you differentiate between drug A and drug B (or symptoms, presentation, treatment, mechanisms,etc.)" You're having a KR problem. If you thought you had the answer, then find out it's wrong, but after reading the explanation, you are surprised that you had misunderstood the question, It's a TP problem. Running out of time answering questions is also a TP problem. As the medical adage goes, from the Diagnosis all things flow. After you've correctly diagnosed your problem, then the treatment is routine. I'll discuss the solution to each identified problems in my next post and particular strategies you can use to improve your TestPrep ability.
that was nicely put together
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| askdoc
Forum Senior
Topics: 1
Posts: 79
| | 05/24/06 - 11:13 AM
2 of 2 forum leaders found this post helpful
| #14 |
Thanks for reading my post and your kind comments. To continue.
As we all know, Medicine is a very broad subject, so broad that we are divided into specialties. However, for the purpose of the board we are required to know a little of everything. So for the purpose of the board, What you need to know is divided into 3 parts.
1. Knowledge that need to be mastered. - The so called HY materials that are almost always tested.
2. Knowledge that need to be known. - you must know enough so that they are taken into consideration in your decision making.
3. Knowledge that you need only to be familiar - aware that it exists.
Subsequently our own knowledge bank is divided into 3 parts
1. What we have mastered -we can recall this information at any time in whatever way it is twisted in whatever condition we are in.
2. What we know - we can recall this information only when condition is optimum. We may need some time to think about it.
3. what is familiar- we can recall this information only with some clues and enough time to think about them.
The more closely the component of our knowledge bank conforms to what is expected of us by the board, the higher the probability of acing the exam.
Why is this important? Because of the way the examination is structured. The concepts that you are required to master are usually presented in 2 to 3 step thinking format. Physio and Pharma concepts requiring calculations usually include not only irrelevant numbers but also may need multiple calculations to come up with the answer. The exam is extremely fair in this regard. I'll give 2 examples in my exams (without giving away the actual question since this is prohibited)
I had a question involving p21 Cyclin D and Cyclin E2. Now I had mastered the p53 and Rb concept since I had expected this to be one of those that should be mastered. As you all know p21 and cyclin D are two components that mediate between p53 and Rb. I had also read about cyclin E2, which is the component that normally initiate the process that pushes cyclin D and Rb into allowing the cell to proceed to the S Phase. The function of p53 if you would recall is merely to act as a gatekeeper and does not initiate the process. However, I did not memorize in detail the whole process, ie. I was familiar with the role of cyclin E2 but did not master it. (Good thing the question popped up in the 4th block when my mind was still functioning). Any way they were good enough to give details in the question stem on cyclin E2 (instead of presuming you know it) Giving me a reasonably good chance of answering the question.
Another example is on transcription factors. They gave a drawing of the chemical formula of a transcription factor (believe me it was fairly obvious which transcription factor it was if you are even just vaguely familiar with it) and asked its function. If you know it, you can answer it. If you are familiar with it, it gives you a reasonable chance to get the answer.
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Step1 99/256, Step 2 99/258, Old IMG, 1989 grad. A man's reach should exceed his grasp, or what's heaven for. http://blogs.askdoc-usmle.com
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| askdoc
Forum Senior
Topics: 1
Posts: 79
| | 05/24/06 - 11:59 AM
2 of 2 forum leaders found this post helpful
| #15 |
So if you mastered what needs to be mastered and so on, you'll probably ace the exam. Except that that is impossible. Kaplan and all those in the prep-review business will give an arm and a leg to be able to do that. If you mastered what they want you to master, you'll say that was fair. If you mastered what they expected you to know, you'll say that's easy. If you know what they expect you to master, you'll say that's hard, If you are only familiar with or don't know what they expect you to master, you'll probably curse and call it experimental questions.
In reality experimental questions can be easy or hard. They're called experimental questions since not enough statistics have been gathered on the question to rate them as hard or easy for the purpose of grading the block.
Now going back to the quick and dirty method of analyzing your weak point. If the QBank you used does not reflect the emphasis of the board (Master what needs to be mastered, etc.) What you thought is a KR problem may be a KA problem after all. The Qbank may have presented that concept in a straightforward manner (ie, you know the concept) and you readily got it, but the Board will present it in a 2 to 3 step thinking manner (expecting you to have mastered it which you didn't) Another disconnect, hence the danger of relying only on Qbanks for review.
So what concepts should I master? Well, that maybe impossible to answer for certain, but there can be reasonable ways to arrive at what are the most probable ones. You may think FA. But FA includes all concepts tested on the exam, whether you are expected to master it, know it or be familiar with it. If you have the time to master all the concepts in FA fine, but that would probably be more time-consuming than reading entire texts. Remember memorizing is not mastering. Mastering for example the Brachial Plexus requires not only knowing the anatomy, but also what they innervate, pattern of denervation or injury, etc. Reading one line in FA should bring back a dozen or so paragraphs that represent the concept that that one line in FA represents.
A more reasonable way is to use HY books like HY and BRS. For example, you've decided to use Big Robbins as your main text for pathology because like me you've forgotten half of what you know about pathology and the other half is obsolete. You need BRS Patho because it is practically impossible to master everything in big Robbin's. A reasonable strategy is to master and know most information in Big Robbin's that are also found in BRS and just be familiar with the rest. If you are a more recent graduate, you could start with BRS and reference to Big Robbin's for concepts to master.
Another good example is Micro and Immuno by Levinson and Jawetz. Master all Organisms contained in its "Brief Summaries of Medically important organism". Know what is discussed in the text and be familiar with organisms in the minor pathogen sections. Exception is of course Immunology which you should probably master.
I think this is a reasonable place to end this post. I'll continue with the rest next time.
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Step1 99/256, Step 2 99/258, Old IMG, 1989 grad. A man's reach should exceed his grasp, or what's heaven for. http://blogs.askdoc-usmle.com
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| tolito
Forum Fanatic
Topics: 119
Posts: 2,164
| | 05/24/06 - 04:19 PM
1 of 1 forum leaders found this post helpful
| #16 |
well askdoc, i join the others in duffing my hat to you. this is probably the best analysis of the exam i have read and thank you for spending the time in writing it.
i am encouraged being an old img too that i can also soore 740 in NBME if i can be as diligent as you.
i believe you will certainly get a 270/99.
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| askdoc
Forum Senior
Topics: 1
Posts: 79
| | 05/25/06 - 03:45 AM
2 of 4 forum leaders found this post helpful
| #17 |
This part is especially for gigiMD.
Just like any diagnostic exam, our quick and dirty evaluation has its share of false positives.
While most people who have a KA, KR or TP problem really have a KA, KR or TP problem. A minority have a mixed problem, combination KA,KR or KA, KR, TP problem. They often evaluate themselves to having a KR or TP problem and so missed out that they also have a partial KA problem.
I had thought of discussing this when we reach the KR portion of the discussion, but judging from gigiMD's post, I felt I should address this immediately. One symptom is inability to raise your grade even with repeated qBank drills. A pure KR problem should be remedied promptly by answering huge number of Q's. Failure to raise grade,or extremely small increments of grade increase in relation to number of Q's done points to a KA deficit.
There are a few more concepts we need to understand in order to know why this is the case. I'll discuss this here before we go back to discussing KA further.
In order to understand this we need to go back to the concept of mastery, know and familiar. We can divide our Knowledge Level (KL) of particular concepts as Mastery level, know level and familiar level.(In reality, there is more than 3 levels, but limiting to 3 levels make for easier discussion.) We can also divide question difficulty(QD) to 3 levels, Mastery, know and familiar. A question is easy, fair, hard or impossible(experimental questions!!) for you depending on the QD level of the question in relation to your KL level of the particular concept being tested.
A table follows:
-------------------------QD Level-------------------------
KL Level -------- Mastery--------- Know---------Familiar
Mastery------------ Fair ------------Easy------- Very Easy
Know -------------- Hard------------ Fair--------- Easy
Familiar --------Impossible -------Hard--------- Fair
To further illustrate: let's take the drug Valproic Acid.
All information available on it is as follows:
Broad Spectrum Antiepileptic that acts by Enhancing GABA accumulation, Inhibiting repeated neuronal firng by actions at Na channel, and inhibition of low threshold (T-Type) Ca channel. DOC for Myoclonic sz. Alternative for Partial and Generalized Tonic Clonic sz, Absence sz. Tx for Mania Side Effects, dose related anorexia, nausea, vomiting and idiopathic hepatotoxicity. Teratogenic (Spina Bifida) Hepatic Metabolism.
At KL of Mastery, you know and can easily recall all the above facts when presented with a question. (Of course, you need to know more than what's presented above incl. mechanisms, clinical presentation, etc. to be considered as having mastered the above concept, but for the purpose of illustration, I've kept it simple.)
A question presented at QD level of Mastery would need most or all of the above information to be answered quickly and your KL is at the right level to answer it. Questions presented at Know or Familiar QD levels would be a walk in the park for you.
At KL of know, the following information is easily recalled by you:
Antiepileptic that acts on GABA, Na and Ca Channel. DOC for Myoclonic Sz. Alternative for other sz. Side Effects, Gi, hepatotoxicity, teratogen.
You probably can recall this subset of information either because:
a) You read all the data as presented on the first case but decided to remember only the above facts. You mastered it at the KA Phase but only know it at the KR phase. You have the potential to raise your Level to mastery at the KR phase by doing lots of questions.
b) You can recall the above topics, because you used a source that presented only the above facts. You know this topic both at the KA and KR phase.
You may be able to answer questions presented at the know and familiar QD level but you can only answer questions presented at the mastery level under the ff. circumstances.
a) Given enough time, you may be able to recall having read some of the information before that will enable you to choose one answer over another. You may need to find some clues in the question stem, but you eventually arrive at an answer that have a fairly reasonable chance of being correct.
b) You need even more time because you had used an abbreviated source as your main review and the only way you can remember any of the more obscure information is because a couple of years ago you had the opportunity to use the drug and did some minor reading.
Nonetheless, the common denominator you need is time, which is a precious commodity indeed in USMLE.
At the familiar level all you know is Valproic Acid is an antiepileptic.
At QD level of Familiar this is fine, since they usually give enough information and clues in the stem to help you (as illustrated earlier in my exam) or the other choices are so obviously wrong(because your KL level for all the other choices is obviously higher) that you can clearly pick the right choice. At other QD levels, it will obviously be extremely difficult and you will need lots and lots more time and lots more clue in the stem to get the answer right.
If you had KA this in mastery level, you can remedy this in the KR phase by doing lots of questions. But if you KA this at familiar level, questions are of no help.
So why is it important to have a KL level higher than the qd level the question was presented at the exam?
You could imagine the situation in the last 3 or 4 blocks of the examination, when fatigue makes concentration and recall a little harder. You need to read the questions twice because you don't get it the first time. It takes longer to recall the answer even if you've mastered it. So if your KL level for a lot of the question is at a lower level then the QD level it's presented, not only will you get a lot of it wrong, you'll run out of time.
The situation when you are answering the Qbank at home or in the library is more like the situation when you are doing the first 3 or 4 blocks of the actual exam. And if you are only getting 65% of the questions right, you can extrapolate what is happening in the last 3 or 4 blocks and understand why the end result is what it is.
The problem of KL levels is a combination KA and KR problem. You may have mastered the concept at the KA phase but only know or are familiar about it in the KR phase, in which case its a KR problem. But if you did not master it at the KA phase, you cannot master it at the KR phase. which makes it a KA and KR problem.
So it is possible for you to think you only have KR problem because all the questions are familiar to you, but you can still fail because you do not know and have not mastered enough concepts to pass the exam at the qd level presented in the actual exam although you are familiar with almost all of them.
To remedy an inappropriate KL level problem, you may need to go back to KA not just KR.
So gigMD, I believe that your problem is a KL problem. It's primarily a KR problem but with a KA component. You have not mastered enough concepts at the KA phase that you cannot master the concepts at the KR phase even after doing lots of Q's. So if I were you this is what I would do.
First, I would do qBanks and FA to improve recall on concepts that I have mastered at the appropriate KL level.
But I would supplement it with the ff.
Since Pathology and Pathophysiology is 40% of the exam, I will increase the amount of concepts I have mastered in this subject. And if you have time, concentrate on the other 2 which is Micro-Immuno and Pharma.
So how do you master a topic. This is one quick way I use. It cycles you directly pairing KA and KR on a subset of topic for quick mastery.
For Patho, you can use BRS Patho, either big or small Robbins and Review of Pathology.
Read and try to master or know the topics in BRS Patho one chapter at a time. Answer the review q's in BRS for a quick recall test. Less than 90% correct, reread the areas you got wrong. Next open to the appropriate chapters in big or small Robbins. Read and try to master or know the topics covered in BRS patho as discussed in Big or small Robbins (this is impt as BRS is weak in pathophysio which is remedied in big and small Robbin's) For all the rest just scan and familiarize yourself with them. Then if you are fairly confident that you know and/or mastered the right amount of info, Do the q's in Review of Pathology. The actual number of Q's you need to do right depends on your goal. I set a standard 90% for myself or else I repeat the entire chapter. Actually needed to repeat only 1. However, in your case it's up to you, You can put a lower standard, 75 or 80%. But not too low so as not to make the whole exercise useless. Then go on to the next chapter.
Remember don't read everything. If you already feel you've mastered a topic at the appropriate level, skip it or just scan through it, slowing down only on topics you need to master.
How do you decide which topics to master. Well, that's a judgment call. For example, you know you have to master ulcerative colitis and Crohn's disease. For lung CA. Master Squamous and small cell and know the rest, etc. However,if you studied the topics the way I described, you will tend to come out of it mastering what needs to be mastered, knowing what needs to be known and familiarizing yourself with the rest, since the authors would emphasize and repeat what is important and the exam will test for the more important concepts.
Can I use Kaplan Qbank or the other Qbank for the KR part of this mastering process? My answer would be no. The reason is that your KA and KR session files the info into your KB in a topic by topic manner which makes it easier for you to extract the information in a topic by topic manner. The actual examination requires you to recall information in a random manner, which makes recall more difficult even if you've mastered the topic. There is an exercise that can train your brain to be more efficient in random recall and I will tackle that subsequently. Use Kaplan Qbank only in random timed manner as there are other less expensive Qbank you can use. Why this is so I'll explain when we reach the TP portion of the discussion.
Look at your USMLE score report and see which subject you are weaker, Micro-Immuno or Pharm and if you have time tackle them in that order.
For Micro-Immuno a good source is Levinson and Jawetz. Rarely is there a book which lets you master and know the right info all in one book. Don't wait to finish the whole book before tackling the exam at the rear of the book. Tackle it immediately after you finish appropriate sections. Set minimum passing scores, reread areas you got wrong.
Should I master for example viral classification. Well for the purpose of the USMLE, I think you should just know it. If you've sat for the exam, you know that they never just present the classification of the virus (eg. non-enveloped, icosahedral, single stranded Positive sense RNA virus) They usually give other clues. However, Kaplan Qbank tends to give some questions giving only the viral classification in the stem. So you only need to know this fact to answer the USMLE Step but you need to Master this to answer the Qbank.(Does this mean Kaplan QBank is inappropriate? No. Actually if Kaplan Qbank does not do this, it will not be as effective as a review source. I'll explain in a subsequent post why this is so.) Actually Kaplan notes emphasizes mastering classification which is consistent with the way it is presented in their QBank.
For Pharma, the gem is Katzung's review. The best way to learn pharma, is to master the prototype drug, know difference between prototype and other major drugs and be familiar enough with more obscure derivative as belonging to this class of drug. Although that may not be the best way to recall it, so Flashcards are very useful in this regard. Most questions in the USMLE allows you to conclude that a particular class of drug is the correct answer for example SSRi. In the list there is only one SSRI, if it's the prototype, well and good but sometimes, it's an obscure derivative belonging to that class of drugs.
With Katzung, you know what info to master at the appropriate level. It tells you what prototype to master, What major derivatives you have to know and what obscure derivative you just have to be aware belongs to that particular class. However, the information in Katzung Review does not allow you to master a particular agent, but only know it. You'll need either Lippincott or Big Katzung to master particular drugs.So get Katzung review with either Lippincott or Big Katzung as supplement.The exam in Katzung Review at the end of each chapter is an appropriate KR material for mastery.
For all the rest, just do q's for them. Even Q's will raise your mastery level in both KA and KR, especially if you take time to repeatedly read the explanations to the answers. But at a much slower pace then the method I've outlined.
I call this "Master the Big Three Know the Rest" Protocol. Appropriate for "patients" almost passing the exam, or for those who want to do well but do not plan to ace it.
Now how do you increase your ability to recall random facts very fast?
Well first get a qBank with large source of Q's, can even be obsolete. BSS, Rapid Review come to mind. Then try to answer blocks of 50 questions in 30 minutes or less without reviewing any of your answer. This way:
1. you train yourself to read questions fast
2. you force yourself to come up with answers fast or move on if you don't know instead of wasting time in a particular questions.
3. You force yourself to recall information faster in a random manner.
Of course you will initially fare poorly doing questions in this manner. The difference initially between doing it this way and the slower way with complete review is as much as 20% or 10 correct answers. But as you get used to it, the difference will narrow.
That is the way I did it with USMLE CD Q's, 30 minutes no review, so my actual score maybe higher than the ones I got.
When I was doing NBME and Kaplan, I usually finish first round answers between 25 to 30 minutes. Giving me 30 to 35 minutes to review my answers. On average, I get 74% of the questions right the first go and the review adds an additional 12% since I tend to change 6 answers from wrong to right in subsequent reviews. I also tend to change 1 answer from right to wrong so my average comes out 84%.
In the actual examination, I finished first round in first block in 24 minutes flat. By the 4th and 5th block, I was running over 30 minutes. By the 6th and 7th Block with fatigue taking its toll, I was doing 41 minutes. Either way I didn't find finishing the block a problem. Faulty recall due to fatigue was the main problem.
So gigiMD, hope these recommendations help. I'll tackle the rest of KA, KR and TP in my next post.
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Step1 99/256, Step 2 99/258, Old IMG, 1989 grad. A man's reach should exceed his grasp, or what's heaven for. http://blogs.askdoc-usmle.com
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| mjl1717
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For those who dont know: askdoc is probably an exampe of - altruism or the act of being altruistic which is a mature defense mechanism.
[actually first aid misguides in this respect, because you do NOT have to be a criminal eg. Mafia boss to be altruistic.]
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Smell the coffee! "Is That an Osler move??"
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| askdoc
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| | 05/25/06 - 05:37 AM
2 of 4 forum leaders found this post helpful
| #19 |
To Srik:
The choice whether to read or continue questions depends on what concepts you still find yourself shaky in. Remember shaky recall of concepts can be a KA problem (you never studied it properly or know too little) or a KR problem (you studied them well but cannot recall all the details) KA problems are solved primarily by reading while KR problems are solved primarily by flashcards and QBanks.
I believe the reason you feel you are shaky in some concepts is a problem of level of Mastery. When I was doing Kaplan QBank, I noticed that the same concept is tested 2 to 3 different times. I also noticed that the level of difficulty is different. This is reflected in the percent of Kaplan Users who answered this question right that accompanies this exam. Q's with Mastery QD levels have about 20-25% right. The same concept with lower QD levels have 50%++ and 85%++ who got them right. If your KL for a concept is at KNow level you are able to answer the last 2 Q's correctly. When suddenly presented with the first Q you got it wrong since the QD level of the question is higher than your KL. Your first thought is that you did not understand the concept when in reality, you did except the question expected your level of mastery of the concept to be higher.
As you know it is impossible to master all the concepts, So it is impossible to get 100% correct in both the QBank or USMLE.
So, why does Kaplan test the same concept at different levels of difficulty? Because it does not know at what level of difficulty will the question be presented in the exam. So if you are able to answer questions with higher QD in the QBank, the higher your score in the QBank and the better you will be able to answer higher QD questions in the actual examination.
So if faced with a question that you cannot answer, ask the simple question? Should I increase my mastery of this topic. The answer depends on the topic. For example, Kaplan occasionally presents questions on obscure drugs and expect you to know more than just be familiar with it. Personally, I ignore this, secure in my knowledge that the concept is too peripheral, that I doubt it will even come out of the exam. If for example, I failed to answer a Q with a high QD and the concept it tests for is a very high yield concept which I think USMLE expect me to master( eg. AIDS, Lung CA, etc.) I will take it seriously.
Evaluate it. Do I know the correct answer, except that I cannot recall it at the exact moment I was answering the question? Then it is a KR problem. I would read the explanation two to three times and depending on difficulty of memorizing the details, even print it out for more review.
If I know the concept, but did not know the crucial information needed to answer the question (and this is very impt) Then this is a KA problem. I failed to master this topic at the KA level. I would usually go back to the main text source and reread it.
That's it! Hope this helps.
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Step1 99/256, Step 2 99/258, Old IMG, 1989 grad. A man's reach should exceed his grasp, or what's heaven for. http://blogs.askdoc-usmle.com
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| askdoc
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mjl1717 wrote:
For those who dont know: askdoc is probably an exampe of - altruism or the act of being altruistic which is a mature defense mechanism.
[actually first aid misguides in this respect, because you do NOT have to be a criminal eg. Mafia boss to be altruistic.]
Actually MJL717, I'm the capo de capo of a big crime family.
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Step1 99/256, Step 2 99/258, Old IMG, 1989 grad. A man's reach should exceed his grasp, or what's heaven for. http://blogs.askdoc-usmle.com
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| arrhythmia
Forum Junior
Topics: 13
Posts: 37
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Can I ask some question Askdoc? Which books of physiology and biochem. did you use and how to use it ?
Thank you for your recommendation.
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| p53
Forum Guru
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altruists are doing good things for other people because thay feel good themselves when they are helping others; so, altruism can be considered as some kind of the mature selfishness.
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| srik
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Thank u so much askdoc,that was an excellent analysis n indeed now i know,my pblm is KA,cos i am just sticking 2 kaplan notes n nothing else for any subject n when i am doing that i need to b at least very good at the concepts explained in kaplan,which is not the case.Every sentence of what u wrote has so much meaning in it that now i think i need 2 device a strategy 2 overcome my shortcomings.
I wish u a very good score n may God bless u.Keep giving advice which i am sure is going 2 help a lot of us.Thanks again.
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| gigiMD
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AskDoc, I want to thank you for your post, it really have help me to understand where I have to concentrate my effort, and I know I’m not the only one that will beneficed from your posting. I really think you should give classes or something because of the way you explain thing. Thank again, and I hope to keep reading from your post.
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Dominicana soy, de mis raices no puedo olvidarme!!!!!
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| gigiMD
Forum Junior
Topics: 11
Posts: 32
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AskDoc, I want to thank you for your post, it really have help me to understand where I have to concentrate my effort, and I know I'm not the only one that will beneficed from your posting. I really think you should give classes or something because of the way you explain thing. Thank again, and I hope to keep reading from your post.
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Dominicana soy, de mis raices no puedo olvidarme!!!!!
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