Medical Examination MCQs, AMK, AKT

In our work in medicine, we tend to get involved with medical schools and their examinations. In fact, recently scored 84.5% on the most recent medschool MCQ exam - unfortunately, lower than the other 2 doctors - one of whom works with me! As a general rule, we are told GPs score better than hospital doctors.

In the hope of helping any of you readers through these exams, these are my techniques. After all, I find too much preoccupation with worrying about these exams and not enough time focusing on actually learning the hands on medicine. Once you have the exam technique, do what is really more important. See patients.

Preparation, preparation, preparation. To get to medical school and pass your exams, did you study from the text book, or did you do question, after question, after question? Nights and nights of trying to work out a pattern so that the next time you saw the question, you would recognise it and what to do about it. I did, and I think a lot of you did. They say 'past performance is not an indicator of future performance' but it is the best indicator.

So, what I do know about Multiple Choice Exams in Medicine is that they are all becoming the same. I have done practice questions and exams from the USA, Canada, and the UK. What if I told you that most of the Canadian LMCC examination questions came from USMLE Step 2 questions, and that international question banks use questions from various countries, all coming back to USMLE questions? Yes, why would you study anything else? Go to the source. The reason for this? It is big business in the USA, there is one standardised exam with a lot of rich people in a litigious country, and there is lots of data and investment in setting and marking these questions. 

If you get a chance, please try to purchase the infamous Goljan Lectures. He talks brilliantly of the way questions are set and that there are more clues than just one for each question to lead you to the right answer. Or the most likely answer...

I will give you the title of the best USMLE revision book I can recommend :

This is just a revision book of complete papers. From this, you will get an idea of which questions are repeated, and the answers at the end of the book will teach you how to answer a similar question with a different answer.

For example, my favourite question is the one about 

' An overweight 14  year-old boy playing basketball (or other sport) who suddenly complains of hip pain and presents with a limp'

This then leads to a choice of what the diagnosis is, or what to do next, or the X-ray appearances of the condition.

Of course, the answer will be Slipped Capital Femoral Epiphysis. However, one of the choices is bound to be Perthes Disease, and others may be fracture, infection, irritable hip, sickle cell aseptic necrosis. This would account for all the causes of a limp in a child and they will no longer need to assess you about children and hips as you would know it all. A perfect question for every exam.

I will follow up soon with more tips etc