10 days to go

November 14, 2017 § 4 Comments

The time has finally arrived where I can answer “next week” when asked when my exam is. Do I have time to be writing this? Not really. But I don’t have time for anything. Not sleeping. Not eating. Not washing my hair. Accepting that was crucial. This is not an exam for which you can be “done” studying. It is not an exam for which you can perfectly prepare. It is not an exam that will allow you to feel confident with every question. So, I’m simply doing the best I can. And that is going to have to be enough.

I’ve had dips of panic in the past few weeks when examining the discrepancy between the days I have left and the things I want to get done. There are so many different recipes, techniques, methods of attack for this exam that it’s possible to lose your mind trying to figure out what you should do, how you should handle your last days. I’m lucky enough to have people in my life who have been through this and who knew exactly what to say when I needed to hear it.

Preparing for this exam has been unlike any challenge I’ve experienced before. I look forward to being able to fully reflect on this experience and to finally entertain and indulge those fleeting moments of reflection I experience throughout the day. There are so many thoughts I want to express now, but if I’m being honest with myself, now is not the time for reflection.

At present, I’m a perfect blend of anxiety and calm. The anxiety is self-explanatory. The calm comes from taking a moment to step back and appreciate how lucky (yes, lucky) I am to be where I am now. Seeing how I’ve progressed since I first started, to experience how quickly my brain works to diagnose a case, to witness how I recall and store information has been such an amazing and humbling experience. Sometimes I will actually laugh when a question comes up because I can so vividly recall the first time I dealt with that same topic in a different question, how much guilt and shame I felt then for not knowing the answer. I’m so proud of my knowledge now. I feel confident in areas I felt so weak in before. My knowledge is so much more accessible and my differentials so succinct. I have to appreciate where all of that came from, from all those moments of weakness, of feeling worthless and stupid, from all of those incorrect questions… I’m stressed, but I’m also really happy and genuinely enjoying myself. I’m giving it everything I can, I’m learning from my mistakes, I’m evolving and most importantly, I’m growing, personally and knowledge-wise.

My brain has noticed that this is not USMLE-related, so I have to go back to UWORLD, but I’ll leave you with this picture and amazingly accurate description of what these questions are like (discovered by my reddit pirate younger brother):

Original Post

Hey guys, I just took the beast a week ago. I’ve been using this forum as a resource for a while now, and I just wanted contribute those who have yet to take it.

I also posted it on SDN. This is for those want to have a “feel” for gauging the test.

One thing very difficult to grasp and that I’ve wanted to know prior to my exam was: What is the STYLE of questions compared to the practice tests. Here is personal interpretation from my exam:

Type 1. Straightforward knowledge-based question. Seen in typical NBMEs, and a good deal of questions on the Step.

What’s the state capital of California?

a) Kathmandu

b) New York City

c) Sacramento

d) San Francisco <– The only other “PLAUSIBLE” answer

e) Beijing

For these questions, if you read that paragraph on FA or heard Sittar’s beautiful voice on Pathoma, you’ll get it. Pretty straightforward.

Type 2. The verbose stem but straightforward type. Good deal of questions UWorld, some on the real Step 1.

State capitals are really nice. Some are big, some are small. The patient comes from some the state capital, and he really likes them. He also likes dogs and cats, but not skunks. Why not skunks? Because they smell. Here’s a map of Nevada:

By the way, what’s the capital of California?

Same answer choices.

For these questions, it’s simply a matter of skipping to the end (if you’re confident) or skimming it (if you’re a fast reader) and ignoring irrelevant BS. The trouble is not getting bogged down. I distinctly remember a handful of questions on my test that had the key facts in the middle of the literary novel.

Type 3a The straightforward question with HARD answer choices. Some Uworld, a large minority Step questions.

What’s the state capital of California? “OOO I KNOW THIS”

a) a large commune sitting at the base of the Himayalas. <– “OH **** can’t be Himalayas”

b) New York City <– easy elimination

c) a population center which has a subpar NBA team windward of the Sierra Nevadas. “WTF…this..maybe?”

d) a metropolitan area closely associated with the MUNI transportation system. <– you gotta know MUNI is SF and NOT Sacramento

e) a city in a province <–Classic vague answer choice.

As you can see, the QUESTION itself isn’t hard. But the answers PARAPHRASED with additional facts that you must know to answer that question. You might know that the Sacramento Kings are a bad NBA team which would help. You may have never heard the word “windward”, but you can sort of guess what that means. This is when good ELIMINATION and INTUITION come in.

Type 3b. Straightforward ANSWERS but vague QUESTIONS. A large minority of Step.

There’s areas that may determine the legislative future of its surrounding area. That large region around the Pacific that’s part of the US, what’s that legislative-area?

a) California. “What? no?”

b) Oahu. “Well, it is around the Pacific…but legislative?”

c) Sacramento

d) the White House. “It IS politically-related…but it’s not an AREA?”

e) Dolphins <–easy elimination

I would say 3a/3b are why people come out of tests so unsure. Notice how it’s awkwardly phrased with non-specific words. It’s not terribly long, or terribly anal in its wording, yet it’s hard. I suspect there’s only so many ways you can test one fact, so they gotta soup it like this.

Type 4. “WTF?!” Only seen in real Step 1.

Who’s that one construction worker who worked on that capital building of the capital of California? <–super specific

or…

Where do you get sandwiches around the capitol building? <– easy if you KNOW the answer but WHY WOULD YOU?

I would argue there’s NO DELIBERATE WAY to study for these questions, other than having incidentally heard it OR having closely listened to professors during your first two years. It helps to have good long term memory too.

On MY TEST (YMMV), I would say the approximate break down would be:

40% Type 1 questions.

15% Type 2 questions.

40% Type 3a/3b questions.

5% Type 4 WTF.

These are obviously arbitrary classifications (just as in a lot of medicine). There’s overlap and some questions can be a combination. But I hope you get the idea.

So in summary, MOST Step questions (Type 1/2/3a/b) can be answered with UFAP studying, but a good amount require ADDITIONAL processing of the question or the answers. And obviously some questions are next to impossible (type 4) but I wouldn’t worry about those.

Hope this will help someone with a similar mind to me 🙂

Still here? Let’s take a look at some snapshots from Biancasfantasticsuperamazingexcitinglife.

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