Saturday, November 21, 2009


I used exclusively 3 sources for all my study for USMLE
1) First Aid 2000 edition which I bought second hand on the net for $8
2) Crashing the boards (Yeh) 1999 edition which I bought 2nd hand for $10
3) Qbank 1 month $150 for online version
I did not own or use any other books. I think this is the most important aspect of preparation – RESTRICT YOUR READING MATERIAL. There are always books to read, Anatomy, Biochem, Path etc containing 100s of pages each. The list of books and sources is limitless and you could spend the rest of your life reading for this exam. I think the key to time management is not to waste time on things that yield low output. There is noneed to read a biochemistry book when 1st aid can provide you answers on 80% of the questions in exam. Reading big books is for those who need to score 99. If you want to pass there is more than enough in first aid (or any good review book). Also bear in mind that the objective is to pass and NOT to acquire knowledge, so if first aid tells you that NSAIDS preferentially constrict the afferent arteriole reducing the GFR then that is all you need to know. There is no need to find a big pharmacology book that will explain the precise mechanism or why the efferent arterioles do not dilate in response to PGE….now that is time wasting. Move to the next fact, don’t be greedy and try to get all the marks cos the time you spend, maybe 30 minutes consolidating on one aspect that might yield you one correct answer (or none) in 350, you could have used to cover a broad topic that would answer you five questions. Also ignore the questions and recalls you see on discussion forums; don’t even read them– those serve only to panic you. Nobody posts the easy to moderately difficult questions which constitute over 70% of the exam. The questions people post never reflect the real exam but the 10 or 20% that defines those who will score 99 and those who won’t. Remember even if you fail 20% you will still pass with a very good score.

QBank to me is the MOST IMPORTANT contribution to my passing the exam. My advice to you is to buy the online version. It is well worth the 150 dollars. If you pay for a month's access you will be forced to work hard and finish the 2000 Qs in a month and take the whole thing seriously as you don’t want to waste your hard earned money. If on the other hand you had a free disc you probably would not finish or would pace yourself and spend the next 12 months studying. Also the online version gives you better feedback on your progress. If you are concerned that 150 dollars is a lot to pay, I would say it is much cheaper than the 800 dollars it would cost to retake the exam. Other question banks may serve the same role but I only have experience in QBank.

QBank has 3 main roles, it gives you concentrated knowledge in a manner that is easier to retain (compared with reading a book), it offers you self assessment, and it prepares you for the real thing. To dismiss the last point first, if you have done loads of QBank tests the real exam would not overwhelm you, your time management will be precise, your marking methods will be spot on, you will learn your own limits, how to guess, when to change and not to change etc. In other words you will know how to play the game…it is a game and while knowledge is important, probably more important is how you play. For every person the optimal approach to answering questions differs, for example the traditional teaching is not to change an answer unless you have a good reason to do so. My experience from Q-bank was that when I did change answers, it was from incorrect to correct in 65%, correct to incorrect in 20% and incorrect to incorrect in 15% so this gave me the impunity to change responses in the real exam. So QBank will help define the best approach to answering questions for YOU.

NEVER do QBank in a tutor mode (or you lose on the latter 2 objectives). Always set yourself tests of 50 questions so you would have done so many simulated exams that the real one cannot faze you. Don’t despair when you fail questions. Indeed it is better to fail questions because it points you to your areas of deficiencies. No point wasting time on things you know already. After each QBank test review all the answers…study Kaplans explanations and read the relevant areas in First Aid. As you go along you will get better and learn the art of question answering. You will never get all questions right…some of them are stupid…some require too much effort. If it requires too much effort leave it and accept you will fail it if it comes out in the real exam. Like the difference between a GLUT 1 and GLUT2 receptor or FAB1 and FAB5 – there is absolutely no way of knowing that other than cramming and it will get you one mark in 350 at the most. Forget it and move to the next. Your performance should increase over the 4 weeks; I started at about 56 to 62% and ended about 65 to 75%. Overall average was 67%. Also QBank will tell you your strong subjects (forget them) and weak subjects (read relevant first aid chapter again). By the time you have finished QBank there will be few things they can ask in the exam that you have not dealt with in one way or the other. First Aid is useless for the ethics questions and doctor-patient relationship questions of which there are loads…for this QBank will prepare you.

The exam
I will not go into the exam in detail because previous discussion threads give a very good insight into the exam. Only comments I will make is that you do it as if you were doing QBank. If it worked for QBank it will work in main exam. Just imagine your USMLE was another test on the QBank…if you passed the last 10 you did with over 60% you will pass the USMLE too (provided you answer in exactly the same manner). Remember USMLE is set by human beings too and they can’t be much different from the human beings setting Kaplan so not many new things they can think of. Don’t think too hard…there is no problem with failing one question…indeed there is no problem with failing 100…you will still pass. As you go on you will realise from present questions that you failed a previous question in an earlier block…just smile or laugh and move on. Remember there is an element of competence based testing so performing ‘badly’ on a block doesn’t mean failing. Also be prepared for many strange questions, some I doubt anyone other than the person who wrote it knows the answer, smile again, mark B, C or D and move on. The question probably won’t even count to the final score. There is another type of question though which is very long and seems to ask something you know nothing about; don’t bother reading those, mark them and then come back to them if you have time. When you come back you may find the question has a workable answer (but only work them out at the end as might require up to 3 or 5 minutes).

After the exam
You will remember loads of questions you failed. You will hardly remember any you passed. That is human nature. Smile and get on with whatever else you have to do.


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