How to choose your specialty

One of the most important decisions in your practice is the specialty you want to dedicate yourself,since this decision will define your daily life in most cases for the rest of your medical practicing years, it’s a decision that should be taken seriously and also requires you to look for as much information as possible before applying to a residency program.

There is always time:

First it’s important to take your time before deciding, there is no reason to rush your decision based on a good impression or a good mentor being great in their fields, every one of us is different and you should take your time to investigate in to all the different specialties before selecting one.

There is always time to investigate, sometimes it doesn’t take that much to know what you like, many doctors as much as 50% know from very early on what specialty they like, although this might be true many of those are trying to be like a mentor.

Remember that there is also a chance to change your specialty during your first year of residency, so it’s okay to take a chance in a specialty you decide, there is enough time to make a change.

Compare to your experience:

During your clinical rotations you will have a firsthand experience with different specialties including their daily activities, routine work, common cases, physical demands etc. your experience is one of your best tools to compare and decide, although you should look at work and not the glamorous life of some attendants, it’s important to take in consideration more of the work being done than the lifestyle some staff can have, this second part matters but it should be secondary to your decisions.

Pay attention to which rotations you found very passionate about, also discard the one you hated for reasons of work and not people, not all places are alike so if people where the problem do not discard that specialty yet, maybe it needs more consideration.

Your personality counts:

It’s important to know how you take different situations, for example the way you respond to high stressing situations, your attitude towards repetitive paperwork, contact with patients etc., be honest about your limitations and your strengths many people like to be focused for hours others get desperate when standing still for more than 15 mins., try to make the best guess of the person you are in practice, what you like and what you really don’t like so your selection has more foundation in your own personality.

There is always affinity to one type of specialists and you may have a clue of this affinity by the way you handle your relation with residents, they after all represent the personality traits of each specialty, if you find yourself getting along great with a type of residency program students maybe you could be great doing what they do.

It’s what you do:

In the end of all your studies this is the most important thing to take in consideration, it being what you will be doing for the rest of your practice, remember that not all work is done in hospitals and private practices differ from institutional work, so it’s important to consider the way of life of a graduate in your selected specialty as well as the kind of work that they do in a daily basis.

Here are some important questions you should look for a selected specialty at the end of your training:

-Patients: do they take a patient and get to know them well, or is it a high volume a day type of practice.

-Schedule: how many hours a day do they work, do they have time for family and children, travel etc.

-Free time: are they always on call, do they have time to take vacations, are their weekend free etc.

-Stress levels: is it a consultations type of work or is the work more of stressful situations.

-Team work: is it a solo operation or do they work in teams.

-Data: is it required to do research, manage data and analysis.

-Solutions: is the work about finding new solutions and problem solving or is it more a routine structured type of practice.

-Teaching: does it require teaching or talking to audiences or is it more a person to person type of work.

-Income: how much do they make a year?

Take your own research

When deciding your specialty take some time to make a little research for your decisions, there are a lot of resources online to get more information about the salaries, work hours, specialties by personality etc. for every specialty there is, but don’t just take it from the web, make some real research and try contacting real physicians that work in your selected field, ask them all that you can and all they can let you sometimes is better to ask by emails, but a call should be quicker. Don’t take for granted what you red try to contact as many as you think you need to take a decision after all this is a very important decision for your own good.

Most practicing specialist will be glad to find a student interested in their field of work, and most will happily give you some time to answer your questions, just be sure to have them written and ready before you call.

Finally your decision should be made by your own investigation and the things you like and dislike, try not to take in consideration the life of other people since they have their own practice and everyone is different, as always thanks for listening to our ideas, don’t forget to leave your comments below, and visit us at www.usmleprepguide.com and take a look at our USMLE tutoring guides.

USMLE QUESTION BANKS

Question banks are surely one of the most helpful and used methods to prepare for USMLE examinations, it is a great way to test yourself while preparing as well as finding out those subjects you missed or for those where you are having a hard time remembering, using a question bank is surely a great way to increase your understanding and retention of all that material that needs to be covered.

The following tips are meant to improve the results you will get from using question banks:

Get used to the format:

It’s important to get used to the format in which questions are made, using question banks will help you understand how the software works, and this will give you at least 10 mins. More during the real exam since you can skip the tutorial, also is important to learn to use the lab data tab to be able to find quickly reference values.

End of session questions:

The best way to review and increase your retention of a given topic is making questions at the end of the day, at least one hour a day you should take questions of the material revised that day, and this practice will increase your understanding and retention of the material for that day. Taking questions at the end of the day will make your last review of all the material faster and more thorough.

Questions all the way:

There is no reason to wait for the last month to start using question banks, in fact you should start as early as possible, in many question banks you can select the topic you want to review making it easier to test the areas you have reviewed during the day. You should start doing question in the first month of your preparation, this practice will help to increase both your knowledge as well as the way some material will be used in questions, it is important to remember that the way topics are used in a question needs practice as well. 

Take 46 question blocks:

Most question banks can be set to emulate real blocks of 46 questions, this setting will help you in getting used to answer each question within a minute of time and leave the rest of the time to review the questions you leave in blank, also it will help you asses the time you are taking for the whole block. If you practice this way the exam will feel easier and you will have more resilience to long periods of questions.

Read the answers carefully:

Most question banks have their answers with detailed explanations including images, cycles, etc. Explanations are an important part of using question banks, it’s not just about doing a lot of questions, it is better to do less questions and read their answers because this is the way you learn new information, explanations are as important as having the questions wrong, read carefully each answer and their explanation, don’t assume you knew it and skip their answer, sometimes many new information lies in their explanations some may be helpful for the real exam.

Take your own notes:

Once you know what an answer was about, it’s important to do your own notes, also remember to write it down in your own words, explaining something increases your understanding and your retention of that subject, so explaining it to yourself is a really great way to remember important details as well as cycles and mechanisms.

 Follow a study guide:

Using a study guide can help you in organizing your study and keeping track of the questions you have to take for a given week, also it can help to focus on important subjects and high yield contents.

Test your weaknesses:

A great way to increase your retention of confusing or hard to remember material is to test yourself against question banks, it doesn’t matter that you have them all wrong, the fact that you tried will make pay more attention to the answers and will increase your retention of that subject, and also many explanations are detailed and easy to understand.

Your final month:

During your last month before your exam, try to take as many 8 hour question sessions as possible including all subjects, and making it as real as possible to get used to the long hours sessions, during this month you should review your notes as well as answers you are getting wrong.

Hopefully these ideas will help you improve your use of question banks to start tackling all those facts and improve your knowledge, remember that the sooner you start the better your odds will be, as always check our tutoring guides at www.usmleprepguide.com  for detailed guides on every step, Our tutoring guides will provide you with guidance during your preparation, helping you keep track of important topics, it has a design from the most important to least asked topics and also includes tips and hints of how some topics may be asked and when you should memorize formulas, diagrams and images.

if you have other experiences and ideas, please share them with us in the comments,

Step 2 CS hints...part 1

There are lots of anxious candidates when it comes to step 2 clinical skills exam, but in reality it is the easiest of the series it only takes some preparation both in practice as well as knowing what the exam is about,  if you’re planning on taking the exam soon, these tips will help you on your preparation,

Practice a lot:  and we mean a lot, find a partner to practice, its better if its another candidate because both can review  mistakes and improve on your techniques but it could be anyone the important part is to have someone real to practice your physical, your most important aim should be to memorize the contents of each physical exam including neurological, and being able to do the exam without thinking what comes next, you have to practice until it feels easy to make a full body physical and also until you can make it in less than 5 mins. 

The only way to feel you are doing something automatically is to practice a lot; this should be one of your main focus during your preparation.

It’s about the technique not results:  this is important, many of the actors don’t have real findings in many parts of the exam, some can simulate findings like cardiac murmurs, but the reality is that most simulated patients will not have real pathologies, that means that the most important part of the process will be your physical and the correct application of each technique, for example fundoscopy.

Remember that this exam is videotaped for further analysis of your performance and this includes the correct application of each examination technique.

There is no diagnosis:  This is one of those things you should have in mind during all your patient encounters, all the simulated patients have syndromic diagnosis, that means symptoms that are common for many different pathologies and not a specific diagnosis, this is important since every encounter could be many different pathologies and your job is to explore this syndromes looking for the most common diagnosis, this means you should keep your interrogation and physical open to any possibility related to that syndrome, as an example an acute abdominal pain can be many different pathologies like acute appendicitis, pancreatitis, endometriosis, familiar intestinal polyposis etc. it all depends on the gender and age of your patient in relation to the symptoms presented.

If you keep in mind that all patient encounters have syndromes and not specific diagnosis, both interrogation and physical comes down to your imagination and your ability to explore different possibilities. You should prepare for the most common syndromic differentials to make your exploration easier.

Doorway information:  all rooms will have a general view of each patient that includes patients name, age, vital signs and chief complaint. It’s important to asses quickly if there are irregular vitals, remember the patients name and use it, and the most important thing is that the chief complain will give you a hint about the symptoms the patient could have, this is also important to elaborate toward differentials related to that syndrome. 

Once you have a syndrome in mind questions and physical will be directed toward each different diagnosis, this will make every case easier.

Ask a lot:  This sounds easy but it can be a little difficult, since many syndromes could make you focus on a specific diagnosis it becomes hard to think in other types of symptoms to ask, this is why it’s important not to think that each patient has a specific diagnosis, if you have 3 or more differentials in mind you can ask more questions related to  different diagnosis, interviewing skills depend on how much you explore a patient and a big part of this is how many different questions you can make.

A great advice would be to focus on each differential one at a time to be able to explore every possibility.

Hopefully these ideas will help you while preparing for your exam,  we will continue next week with part 2 of our step 2 CS hints, if you have other experiences and ideas, please share them with us in the comments,

Our USMLE STEP 2 CS TUTORING GUIDE, will help you prepare for your examination, it includes tips and information to help you in your preparation. For more information visit us at www.usmleprepguide.com

FINDING THE RIGHT PARTNER FOR USMLE

It’s common for medical students to work in group while preparing for their tests, having someone to share the experience and keep you on the right track can be a great aid for your preparation, especially when tests are so extensive and studying becomes a lifestyle,

Even when our recommendation for studying theoretical subjects is to get used to study without a partner since someday along your career you will have to learn to study alone, it could wait if you feel you work better with a partner by your side, not changing too much your habits can help increase your results and of course having a study partner becomes necessary to practice and master the physical exam for clinical skills, doing a neurologic exam in less than 5 mins. needs practice after all.

If you are looking for a study partner it’s important to have some details in mind before accepting someone in your study group:

-Study schedule:  Not everyone has the same study schedule as much as there are morning persons and night owls, find someone who shares your schedule or the one you are trying to get used to.

-Type of learner:  Not all types of learners will work well together. Are you a thinker and need quiet time to process things or are you the type to do quick  flash cards, read aloud type, having a noisy partner when you are trying to concentrate could be holding your learning, be sure to find someone who understands you and has the same type of learning.

-Study habits:  some people’s habits while studying can prove to be really distracting, for example chewing gum, listening to music, texting, phone, games etc. if your selected partner has some distracting habits be sure to let them know beforehand.

-Shared goals:  to have a partner that understands you, he/she should have the same core goals as you have, if you’re aiming for a top class you should study with someone who has the same motivation and drive.

-Doesn’t criticize you:  Choose someone who won't cut you down if you answer incorrectly, and won't get mad at you if you're 1 minute late, it’s important to find someone to help you maintain your motivation and enthusiasm. 

Having a study partner is like all ohter human relations some work others don’t, if you feel someone is keeping you from achieving a great score, you can change your study partners; here are some reasons to change your study partners:

Is distracting:  if someone is distracting you all the time, maybe it’s not the type of partner you are looking for.

Gets lousy grades:  someone that gets low scores will probably teach you all their bad habits.

Is unmotivated:   someone who is lacking motivation will get you down, be sure to stay away from people that thinks they are going to fail all the time.

Is unprepared:  if you find yourself having to explain even the most basic concepts all the time maybe it’s time to find someone else.

Criticizes you:  if someone constantly keeps telling you why you are going to fail, or the reasons why you don’t have what it takes, maybe it’s time to let them go into the world and find someone better in the process.

Hopefully these ideas will help you find a great partner for your exams, if you have other experiences and ideas, please share them with us in the comments, 

 Please remember to visit us at www.usmleprepguide.com to find our latest USMLE tutoring guides, 

Studying HIGH YIELD Contents in USMLE

While preparing for each USMLE exam, many courses offer high yield contents that are commonly used in questions although not in the same way, you have to keep in mind that each question for a step is not repeated and will not repeat itself since the exam is made to be different along the year and for all students.

So if questions are so different about the same content, it is in the way you study these contents that the difference should be made, to prepare using high yield facts is more than just reading them or memorizing questions, you have to really understand these concepts, be able to explain them, know them by heart and even memorize diagrams for cycles and mechanisms, many examples come to mind when talking about high yield like membrane cell transporters, ETC, crebs cycle, thyroid function etc. 

When studying a high yield fact you should know everything about it, not just be able to explain it but also know the drugs that act on it, uncoupplers, exceptions, this also includes formulas, diagrams, frequently used images, structures etc.

A common mistake is to take high yield facts and memorize them by reading again and again the same line, you should be more active in your study, look it up in the book, read all about this fact, memorize it, find the odd information about it and mostly write it down in your own words, make a high yield facts card using your own information as well as the information provided by the courses you are using.

The most important part of your preparation comes by your own interest for improving what you know about a particular subject, in this line the more you investigate and discover by yourself about a subject will make you more capable to answer new questions that were not expected in your preparation courses.

Always remember that every single student that has aced or failed a particular step had almost the same information and material to study, it always comes down to the way you study and prepare not just by following a schedule or a course but actually taking an active role in your own formation, investigating, reading different sources, making your own explanations, sure it will take more time and yes sometimes this fact can  make your preparation more difficult and boring, but the important thing is to get this exam right once, and you won’t have to worry about studying again since all this information will be stuck with you for the long run.

So in short today is a perfect day to start tackling all those facts and improve your knowledge, remember that the sooner you start the better your odds will be, as always check our tutoring guides at www.usmleprepguide.com for detailed guides for every step, Our tutoring guides can help you also giving you guidance during your preparation, helping you keep track of important topics, it has a design from the most important to least asked topics and also includes tips and hints of how some topics may be asked and when you should memorize formulas, diagrams and images.

As always please leave your comments below in the comments section.