Audio learning is a powerful yet woefully underused resource in education today. How many songs can you remember the lyrics to? Someone only has to start humming a few bars and you can probably jump right in and sing along. Some estimates are that people can do this with hundreds or even thousands of songs!

How many of these songs do you know by heart?

Put together, that’s enough words to make a pretty hefty novel, but if you were asked to memorize a novel word for word you would probably think it was impossible. Why is it you can learn just as much material almost perfectly without even trying, but the thought of memorizing a 500 page book seems impossible?

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How many should I do?

Next in our series of classic boards study mistakes:  Doing too few questions. How many questions should you do?  How many qbanks?

Read on to learn more….

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If you’re a medical student or someone from overseas who will be taking the USMLE, you already know that your score on these exams will determine your future options. Foreign grads already face steep hurdles in finding a program, and scores for matched American grads are going up each year as well.

We read in the news about more and more medical schools opening without any new residency positions being made. All of this means that competition will keep getting tougher, so you’ll need a high score on all your steps, but especially on Step 1.

There are a lot of approaches out there, but the successful test takers do seem to follow some similar patterns. On the other hand, unsuccessful test takers have some patterns of their own. Lets talk about a few of the biggest mistakes that people make in preparing for the most important test of their careers.  This will be a series of posts, each dealing with a different mistake that students typically make.

Mistake #1: Starting too late

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Goljan Audio has been passed down from class to class at every med school for the last 10 years. A decade ago, these were burned onto CDs and circulated, but now they’re just downloaded en masse from torrent sites and the like. A lot has happened in 10 years, and many people are starting to realize that there are much better resources out there that will get you a better score with less time.

The audio files of Dr. Goljan’s lectures were never meant to be released for general listening. Remember, these were pirated without his knowing at the time! Because of this, we don’t see the images he constantly refers to. We’re left out of the interaction with the class. Even the pacing is rather slow and filled with digressions, something that’s effective in a classroom but frustrating in an audio review product. Goljan is a brilliant teacher and his Rapid Review books are fabulous, but these recorded lectures are not the best use of your time.

It’s been 10 years and a lot has changed in that time. He references recent studies that are no longer recent. We have seen the results of major clinical trials get published in the last decade that have changed management of many conditions. This material shows up in questions because the NBME wants young doctors in training to know the latest. If you’re drilling Goljan’s audio into your brain, you will be drilling some inaccuracies and misconceptions as well. They weren’t wrong at the time, but times have changed and even what he teaches in his live classes has changed as well.

Today we have even better resources on the market. The Pathoma series from Dr. Sattar out of Chicago is revolutionizing pathology prep for Step 1. These videos were actually intended for release and were produced within the last 3 years so they remain current. Because they’re video, we can see the pictures that are referred to and pictures are commonly tested on the exam. The best thing, though, is that they are exquisitely taught and presented. He is a gifted teacher and makes the concepts simple and memorable and many people credit him with their scores on Step 1.

Instead of pirating decade-old recordings, consider using some of the latest products like Pathoma or USMLE Audio. UA lectures are densely packed with the highest yield material and cover all the topics found in the most popular high yield review books. They don’t waste your valuable time with stories about anyone’s grandkids or give sermons. They don’t have Q&A sessions with the class where you can’t hear the answers to questions.

Average scores for step 1 are going up all the time. If you want to stay competitive, make sure you’re using the best resources and mastering the content that gets tested. Read Dr. Goljan’s pathology book, but save your audio review time for something like USMLE Audio that will give you the biggest return for your time invested.

Medical students are some of the most passionate book collectors I’ve ever met.  Look at any medical student’s bookshelf and you’ll see countless review books and textbooks and possibly even some undergrad textbooks they brought “just in case” they need to reference something.  This carries over into class and the library where people see their classmates using books they don’t have, which makes them feel like they need it too.

Sound familiar?

I know I’ve been guilty of it myself, but rarely have I purchased a book that I looked back on a year later and felt was truly worth it.  More often it just made me feel better at the time before it sat on my shelf collecting dust.

Book collecting syndrome seems to increase around more stressful exam, so it’s no wonder that some students seem to buy every single step 1 review book they can find.  Unfortunately there are still but 24 hours in a day and most of those books will get a brief skimming at best.

Allow me to make a suggestion for all my fellow book collectors:  buy fewer books but know them better.

When it comes to boards, this means buy a broad review book like Kaplan’s Med Essentials or First Aid and KNOW IT COLD.  This does not mean look at the pages and think you know it, it means really dive in and know it so well you could reproduce the charts from memory and spit back any fact in its pages.  Remember: you won’t get exam questions that simply ask you to spit back facts; you’ll need to integrate them and you can only do this if you really know the material well.

These books cover 80-90% of what you’ll see on Step 1.  Don’t be like most students who freak out about that last 10-20% and neglect the most important stuff.  These people will spend hours memorizing obscure diseases that will MAYBE get them one point, but neglect to learn vitamins or the adrenal steroid pathway really well and blow 4-5 questions.

Was this a good use of time?  Would this have been avoided if only they had more books?  Probably not.  Pick a major review book and commit to learning it completely.  Remember that some of that 10-20% of minutiae will be stuff you’ve learned in MS1 and MS2 so you will pick up a few of those points just from associative memory.  When you’re practice NBME tests are consistently around 250-260, maybe then you can start thinking about learning a little more minutiae.  Even then, 20 hours of minutiae vs 20 hours of deeper understanding of high yield material…which do you think will translate to more questions right on test day?

If you’re doubting this, go on SDN and read reports from people who took it.  Does anyone ever say they think the minutiae are what killed them?  Notice how so many of them seem to get tests that are coincidentally heavy in their weakest areas?  Inevitably they all say that there were some questions that no amount of study would have prepared them for, so don’t waste your time.  These people also say that a lot of what they missed was in their main review book but they just couldn’t rememeber it in the moment because of how the question was asked.  Don’t fall into the minutiae trap.  Master the stuff you can master.

Obviously I’m a little biased because our product is basically designed to help you memorize and master the most tested high yield material.  I wouldn’t be putting out a product I didn’t think could help others do significantly better and I hope you’ll consider giving it a try when the time comes.