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medstudent123
Jun 3, 2018

plateau

2 comments

What do you recommend for someone who has completed uworld using the anki for wrong answers and is still not getting a goal score of 250+ on nbmes?

 

The nbmes vary from 230- mid 240s. Is it time to start reading FA? or start a new Qbank?

 

Questions I get wrong on the nbmes are a mix of 1) stupid mistakes 2) not knowing small things in FA 3) misinterpreting the stem 4) just random questions that are not found in any resources. And the distribution is pretty equal among the four.

Alyssa
Jun 10, 2018

Thanks for reaching out! First, I would suggest making Anki cards off of your NBME incorrects as well, and cross-reference the relevant sections of FA as you do this. Depending on when you exam is, it may be time to start reading FA (I suggest doing this when you're less than 2 weeks away--very much the opposite of what most people do! Earlier than this, you will forget most of it by test day). This will help you with the content issues you describe. For those "random" questions, you should still learn the content, even if that entails a little bit of Googling.

 

However, I suspect the more significant issue is how you're approaching questions. "Stupid mistakes" are often due to not focusing on the right info in the stem. It can be helpful to work with a study buddy (or a tutor) to have a second set of (more objective eyes) looking at the questions you've gotten wrong to see if any correctable systematic cognitive errors (e.g., anchoring, premature closure) are at play. In the majority of students we work with, significant improvements can be made by altering HOW one approaches questions, and this is particularly true for plateaus.

 

Overall, it would be useful to know more about you to offer more personalized advice regarding why you are plateuing, so please feel free to schedule a free phone consult with one of our tutors here: https://book.pocketsuite.io/book/usmle-pro-tutors

medstudent123
Jun 15, 2018

Well, the thing is, I'm just not sure how anyone could solve these errors.

 

For example I made two reading errors (out of 22 mistakes), where 1) I saw a genetic sequence of bold and italic letters and for some reason assumed the entire sequence was from an exon, when in fact just the bold ones were.

 

2) I read over a stem and assumed they were asking me about the pt's stage of change to diabetes overall when in fact they clearly stated "related to the patients insulin treatment".

 

Ironically, I remember reading both stems carefully(obivously not enough) as I have made mistakes in the past on splicing errors and stage of change questions.

 

A lot of the other mistakes if I had to classify them as a cognitive error would be related to the availability heuristic. I got a q wrong b/c I remembered Sattar saying to treat temporal arteritis empirically even before biopsy. The question was about weighing steroid tx and adverse effects vs a post test probability of 71%. So I don't know how anyone could correct these errors.

 

Even by classifying the error, in some cases the availability heuristic lands me points, in other unforgiving areas it doesn't.

 

Another example was a 14y/o kid who had ataxia, headaches and I had to choose between ethanol and inhaled glue, and I went with ethanol b/c 1) its in FA 2) I've seen ethanol be tested more often than inhaled glue. So PoE didn't help me here.

 

So then, the question becomes, how do you correct systematic errors even if you were able to objectively classify them. Read slower, better sleep, do more questions, read more? That's all I can think of. I have sat with friends who do well and for some reason they just hit the right answer. Their gut feeling is just more accurate more often than not.

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