For the August 2011 Physician Licensure Examinations, I decided to review independently for two reasons. One, review schools are expensive. The tuition fee at Topnotch is around Php 16,000. For UST, it amounts to, if I remember correctly, around Php 12,000. Second, based on my average attention span, the structure of review schools would only result in my yielding to the law of diminishing returns. In retrospect, I don’t regret the decision that I made. Note that I am advocating neither one nor the other, as each approach has its own merits.
Should you decide to self-review, there are two exceedingly helpful medical board primers in circulation. One is authored by the founder of Topnotch Board Prep, Dr. Enrico Banzuela, and the other is written by Dr. James Philip Esteban, who placed fifth in the August 2010 licensure exams. These primers were what I used in planning my review sessions. For the particularly neurotic, there’s a helpful section in Survival Guide for Doctors and Non-Doctors, co-authored by Dr. Willie Ong and Dr. Banzuela, in which the latter includes a sample calendar for the three months prior to the exam proper. Read both primers first before you proceed.
Done? Okay, great.
For disclosure, I consider myself an ‘average’ medical student in that I do not belong to the top ten of my class (although I do belong to the upper 15-20%) and the level of motivation I had for the past five years varied from non-existent at worst to half-hearted at best. I graduated from a medical school which I believe to be quite competent, yet if we are to be objective, still has much work to do before it can ascend to the ranks of UP and UST. The point of this is not to demean or praise medical schools and their graduates. As I said, the above primers were very helpful; however, they were written from the point of view of medical interns who were stellar students of one of the best medical schools in the country. What I’m going to do here is make suggestions from the point of view of an average medical student – the one who didn’t get around to reading any of the mama books from cover to cover, the one who realized a little too late that the best preparation for the boards is to have invested one’s best efforts in medical school. Take everything with a grain of salt, and remember to adjust according to your own eccentricities.
BOOKS I USED
|Anatomy||Clinical Anatomy Review by SnellHi-Yield Gross AnatomyNetterEsteban and Gonzales HistologyUSMLE Step 1||For the life of me, none of these turned out to be high yield. I read Snell during my community rotation, so I had the illusion of having accomplished a first reading. Don’t make the same mistake. Personally, I thought anatomy was the most difficult subject during the boards. Read as much as you can, as many times as you can. No new tips here. Use Netter. Read. Pray. A lot.|
|Biochemistry||Digging Up the BonesUSMLE Step 1||The combination of these two turned out sufficient for our exam. Since each material is composed of about 60-70 pages, each source can be finished in a day. At least two readings are necessary. However, if you have time and want to have a better yield of Biochemistry, most topnotchers recommend Lippincott. I recommend studying Biochem during the last weeks before the exam. During our exam, several questions on steroid hormone synthesis turned up, so be sure to familiarize yourself with this.|
|Physiology||BRS PhysiologyUSMLE Step 1||BRS Physiology was one of the best books I used. During my first reading, I placed notes in the Physio sections of my USMLE Step 1, including the pages of the original text in BRS (should I need further explanation during my second reading).This turned out to be a good system for me. Study this subject first.|
|Pathology||BRS PathologyUSMLE Step 1||Dr. Esteban recommends reading the sister Robbins. Rumor has it that he scored a 100 in the Patho exam. If you have the time, I suggest reading the sister Robbins and placing your notes in USMLE. If you’re pressed for time, use BRS instead.|
|Microbiology||Microbiology MRS||Very, very helpful read. What I did was photocopy the tables at the end of each chapter, and placed them on index cards. As I read each chapter, I placed side notes on the corresponding topics.|
|Pharmacology||KatzungUSMLE Step 1||I didn’t actually finish Katzung, which sucked, as the answers to most of the questions from the Pharma exam could be found in this book. I suggest photocopying the chapter summary tables, and making notes on your tables as you go along.Feedback from Topnotch reviewees: the Pharmacology handouts were very useful and well-organized.|
|MEDICINE||Aherrera IM Notes(Intern/Resident Edition)Hi-Yield IM||The IM exam was surprisingly fair. Integrate with Physio, Pharma, Micro and Patho for better retention.|
|PEDIATRICS||Hand-me-down HandoutsPocket Pedia||Pocket Pedia wasn’t as helpful as some people said it would be. Feedback from the Topnotch reviewers: handouts were okay, especially the Pedia Pearls.|
|OB-GYNE||OB BlueprintsBlack Book||Most of the questions were situational, and most of the answers were those that I learned during my clerkship and internship rotations. I placed notes from OB Blueprints on my black book. Same drill.|
|SURGERY||ABSITE First Aid||Anatomy and Surgery – KMN. Read and pray.|
|LEGAL MED/MED JURIS||Hand-me-down HandoutsSummary of LM/MJ||Make sure you read the sample exams.|
|PREV MED||Hand-me-down HandoutsPretestUST Notes/UE Notes||Instead of using all of these sources, I recommend the handouts and Pretest. Make sure you read Pretest, because about 20-30 items were taken from this.|
I consider myself a relatively fast reader. However, with regards to the estimation of the amount of time it takes to finish each reviewer (as noted in Dr. Banzuela’s primer), it turns out that a) I am not as fast a reader as I thought, and b) Dr. Banzuela is an even faster reader and is decidedly more patient and disciplined than I am. So for the average medical student, I suggest you add an additional day or two for his estimations, and consider this when making your schedule.
The biggest distraction while reviewing was the internet. I rationalized its use as a study tool and stress reliever, but ten minutes easily turned into an hour. An alternative to going cold turkey is writing down what you need to look up online then allotting an hour (and a half? Your call) to all things web-related. And sticking to that limit might translate to an extra ten points on the subject you’re currently studying for. No studies confirm this, but I’m thinking that’s the trend.
Another one of the mistakes that I made was reading leisurely during the start of the review season. I imagined that since I alloted time for a second reading, I would begin the actual memorization then. I argued (internally and foolishly) that I would most likely forget what I memorized early in the game. Don’t do as I did. Internalize what you can, when you can, as much as you can.
Keep in mind that you will only have one or two days per subject for your second reading, so distill your materials. Don’t reinvent the wheel. If you made tables during med school, or if the book has pre-made tables (e.g. MRS and Katzung), use them and just add your notes.
Pray, pray, always pray.
Peace and more peace.