How to approach and Prepare for USMLE exam

January 24, 2017
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The key to successful exam preparation lies not in what you study, but in what you choose to ignore. If you try to learn everything, every little fact in too short amount of time, you will not succeed. A better system is to use the guidance of your faculty and your own native intelligence to decide what is most important and what is not to concentrate your efforts accordingly.

Assemble all the materials you have:

A truckload of bricks and a stack of lumber may contain everything you need to construct a house, but you will never have a house you can live in until they are all assembled in the right order. In the same vein, a pile of books may contain everything you need to prepare for your USMLE, but you are not ready to take your exam unless the material is organized it a way that makes it useful. Collecting the essential pieces is not enough. You must assemble the pieces in a way that allows you to see the fundamental patterns which are the key to successful problem-solving. Beyond simply having the knowledge, you must make sense of it.

Divide all material that you study into three categories:

  1. What you must know
  2. What you ought to know
  3. What it would be nice if you knew

Your goal is not to learn all the trees in the forest, but to come to an understanding of how the forest fits together. If you have trouble making these decisions on your own, that is what faculty are for. Faculty will guide you through the peaks and valleys of the material, helping you to separate the essential from the merely interesting.

Understand how to correlate the USMLE materials:

USMLE preparation is a time to move from collecting the pieces to assembling the puzzle picture that organizes and brings clarity. Remember that your goal at the end of this process is not to simply know things, but to understand how they all fit together. Only from that perspective can you respond to the sort of problems that you will encounter in each exam question. The key to effective study is not the accumulation of individual pieces of knowledge, but grasping the essential patterns that tie together the pieces and give them significance. In short, the core task is not to learn about things, but to learn the relationships among things.

So, how do you gain this larger understanding? How do you get attuned to the relationships so you are not blinded by the multitude of facts? Learning relationships occurs by three basic methods: examples, metaphors, and contrasts.

Examples show you concrete instances of the thing under discussion. By the concrete example you can understand the context very well. Examples let you grasp core principles by inductive reasoning. When I talk about an autoimmune disorder, you hear all of the defining features. But when I describe the process and progression of HIV/AIDS, you have a picture of something specific that anchors your retention of these essential features.

Metaphors highlight essential relationships by carrying over a known relationship to another context. A metaphor focuses on the essential relationship by virtue of the specified comparison; not an example of a thing, but an example of a relationship. To say one of the signs of Lupus is a red facial rash is correct information, but to say it looks like a butterfly gives a picture of a cluster of essential details which are otherwise difficult to convey verbally.

Contrasts highlight features by comparison. This comparison serves first a positive function, focusing our attention on certain features by virtue of the referent chosen for the contrast. Each thing in the world has a large number of characteristics or properties. Contrasts among things help us to see which characteristics are more worthy of our attention. It focuses us on what is unique and, thus, what is most essential. Trying to recall all the features of an elephant is too hard. But, being able to say how an elephant is different from a hippopotamus clarifies our understanding of the unique features of each animal.

Knowing things is not enough. The most essential insights of medicine are not what things are but how things relate to each other. You build up your USMLE score as you build this understanding of how things fit together.

How to manage your timings for USMLE Exam:

“If only I had more time,” is a common lament of students as they walk out of the USMLE. The simple fact is the USMLE is a timed test. And time matters. No, time by itself does not determine your score. But the time limits that govern each exam provides a constraint that restricts your potential and lowers your score.

Making the most of every minute requires efficiency. Here are three tips to help you get the most out of your limited time:

Practice a question routine

Learn and practice a question answering routine before you take your exam. Develop a set behavioral routine in which you do the same steps with each and every question you encounter to reduce wasted effort. A practiced habit for answering questions will free you from focusing process and allow you more time to mentally absorb the question and think though the content issues you encounter. A practiced question routine means more questions covered in less time.

Spend the bulk of your time on the question stem

Each question can be seen as having two parts. The question stem, which presents material in a clinical case format, and the options, which list the available answer choices along with a corresponding letter. A good rule of thumb is that 75% of your time on any question should be spent reading and thinking about the question stem, and only 25% should be spent on the options. Read the question stem carefully, but only read it once. You do not have time to read the long question stems on the USMLE twice. Then, when you turn to the options, be decisive and make your choice.

Make yourself choose faster

If you find yourself chronically short of time, the best solution is to train yourself to choose faster. Do not short your time on reading the question stem, you need time to take in the information provided and to gather the clues provided. The way to gain more time for yourself is to force yourself to make a choice as soon as you can. Research suggests that the time we spend on the question options can be divided into two parts. The first part we spend considering our choices and actually making our decision. The second part of the time we spend reconsidering, double checking, and doing other things to try to make ourselves more comfortable with the choice that we have really already made.

Train yourself to give up this search for comfort. Make your decision, live with it and move on!

How do you learn to deal with the distraction that time limits induce?

The most basic solution is to make sure you do all of your practice questions under time constrains so you can become accustomed to the feeling of the seconds slipping away. The clock is always running. You can’t stop it. But you can get used to the feel of the time limits and learn to pace yourself accordingly. Use your practice experiences to train yourself to see time limits not as an additional thing to worry about, but as a basic fact of exam.

By learning to control your time on your exam, you are learning to control your own destiny. And if you do that, then nothing, not even the pressure of time will keep you for achieving the success that you deserve.

Problem solving strategies for USMLE exam:

The USMLE is not only testing your content knowledge, but also your ability to problem-solve on your feet. Success on the USMLE depends on identifying issues and thinking clearly. Yes, you must have memorized essential content. But, the exam wants more from you than a demonstration of what you have memorized. The exam wants you to show that you know how to use what you have learned.

To make a right decision you must be a person who can assess, think and decide. The USMLE expects you to be in control of yourself and to demonstrate that by your control of the exam.

  1. Begin by making decisions and taking action based on those decisions.
  2. Decide what is essential and what lower yield is.
  3. Decide what study material resonates with you and helps the content to make coherent sense.
  4. Plan your study to cover the material you have selected.
  5. Make a study plan that maps your how much time you will study each day, and then follow it.
  6. Avoid excessive focus on percentage of questions right.
  7. Diagnose “why” for missed questions to improve performance.
  8. Avoid studying “every waking minute” and treat study time like a job.
  9. Make sure your strategy is one you can maintain long term, not just over a couple of days.

By making decisions all the way through your study preparation, you are not only going to do a better job of learning, you will also be teaching yourself the mental set and the self-control the USMLE requires. You know how to take charge because you have learned to take change of yourself. Your final USMLE score is a much a reflection of you control of the exam as it is your memorized knowledge. Take charge of your preparation and you will take charge of your exam.

Focus not on the accumulation of facts, but in fitting the facts together in a way that makes sense. Once these relationships are clear, the knowledge will never leave you. And from the building blocks you will have constructed a “house” you can live in for life.

The content is taken and reposted from THE PINNACLE from BECKER

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About the Author
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Dr. Steven Daugherty is the author/co-author of over 70 published papers and numerous book chapters and is Becker’s Director of Faculty and Curriculum. For the past 26 years he has worked preparing students to pass the USMLE, COMLEX and similar exams.

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