askdoc-usmle

Note: This was initially published in 6 parts and was then consolidated into a downloadable ebook.

Why create a study plan?

This is probably the question foremost in the mind of anyone who ever thought of tackling the USMLE. I remember when I was starting out, how this pre-occupied me a lot. Although studying for the USMLE is a big endeavor, studying how to study for the USMLE is no mean feat either. Just like an architect or engineer needs to plan out how to build a building before actually building it, we need to plan out how to prepare for the USMLE before we even begin studying.

Now some people can just jump right into reviewing and 3 to 5 months later take the exam and come out with a 99. I’m not one of those and so are I believe majority of those taking the USMLE. Some will start by applying and scheduling an exam 5 months later, only to find out that they’re not ready. So they extend their period of eligibility and still they’re not ready. Some will take the exam and fail or score so low that it amounts to the same thing. Some will forfeit the application fees and reapply later. Of those who do, some wind up getting good scores because they’ve learned their lesson and did better preparation this time, while for others the results are going to be poor because they did not change anything they’ve done before. Proper planning is crucial for proper preparation

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We will now continue with Part II of our series on “Answering USMLE Type Questions”. In Part I we discussed the 3 most common problems people have with USMLE type Questions. In part II we will discuss various strategies to correct these weak points. There are strategies you implement during the preparation phase and other strategies you do during the exam itself.

However,  the strategies during preparation is more effective than those you employ during the examination and therefore it makes sense to fix these problems before the actual examination day.

The main challenge in clinical vignettes is to be able to diagnose the case as fast as possible. As a medical student, the way we learned clinical cases starts with a diagnosis, say Myocardial Infarction. Then we study the signs and symptoms that accompany myocardial infarction followed by laboratory tests that suggest or confirm the diagnosis. Lastly we study therapeutic interventions. That is how clinical vignettes are presented in Underground Clinical Vignettes, which is fine for medical students having their first taste of medical cases. Unfortunately for most people who are ready to take the USMLE, they’ve already gone through that process and will probably need only a short review and it will still not help them with diagnosing clinical vignettes. The reason is that clinical vignettes are presented the other way around with signs and symptoms as clues while you come up with the diagnosis.

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I wrote this initially in response to someone who was really having a hard time answering tough USMLE type question. Most of the time, when people think their problem is answering tough USMLE type question. the reality is that they have a KA (Knowledge Acquisition) problem. In other words, they did not do their review properly and their problem is primarily with insufficient knowledge base rather than difficulty with USMLE type questions.

Therefore, I always make it a point to test their knowledge base first. This is usually done by testing them using straightforward questions that test knowledge and recall without the common tricks that accompany USMLE type questions.

Now as you may know, I have an online prep site at http://prep.askdoc-usmle.com.  The prep site contains all the courses available to course participants of my USMLE Step 1 prep course. There is a demo prep course for Review of Pathology which features the first chapter  out of 25 total chapters of Review of Pathology. It covers cell pathology. The online quiz is a straightforward quiz which directly tests recall and does not use USMLE type question. Do well there and it proves you do not have a knowledge base problem.

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Everyone knows the usefulness of keeping a large amount of high yield information in your head just before the actual examination. This can help a lot in boosting your score up in the last few days before the actual examination. Although I am never an advocate for last minute cramming for an examination like the USMLE, the benefits of having a large number of high yield facts in your immediate memory is something no one can ignore. The reason is that unless the information is in your immediate memory, chances are it will take some time for you to recall that information and in the context of timed examination like the USMLE, that can make or break you.

Most reviewers acknowledge these facts. First Aid for Step 1 has its Rapid Review section. Levinson and Jawetz has its “Brief summaries of Medically Important Organisms. and Trevor and Katzung’s Pharmacology Review has it’s “Key Words for Key Drugs”. All to be reviewed just a few days before going into the examination.

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We now come to Part III of our discussion on “Preparing for the Step 2 CS” In Part I, we discussed how to prepare for the medical interview part of the clinical encounter. In Part II, we discussed the physical examination part of the clinical encounter. We will now tackle the social aspects of the clinical encounter which is usually called bedside manners.

We can further divide the social aspects of the clinical encounter into two. Those that you do in every clinical encounter and those that you do in specific situations. We will start with the first one.

So what are the things you do in every clinical encounter?

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