Tag Archives: question sets
You’ve heard whispers around your medical school of a variety of question banks to use during boards, and there are a lot. To be specific, this article is going to hit on the main points of question banks only, not to be confused with the variety of coaching or training programs out there.
As mentioned in the opening article of the USMLE Step 1 Series, choosing a question bank has little dependence on your individual learning style. Before we get into the individual options, it’s important to note that this can be one of the largest detriments to your student loans for the Step 1 exam, outside of the exam itself. While we always encourage smart purchases, this is not a time to be frugal. You should purchase a question bank, and round up on the time compared to your exam (e.g. if you exam is 1.5 months away, get a 2 or 3 month subscription). Never try to “exact fit” a question bank with your pre-determined study time. Overestimate slightly.
This is our top recommendation, without question. When groups of medical students are surveyed about resources, this is consistently rated the highest of the question banks, with around 95% of students who used it rating it “Very Good” or “Excellent” after taking the Step 1. (Evidence for the win!) Buy it.
Review: The interface and question types are the closest approximation to the actual FRED2 format you will find on the actual Step 1 exam. More importantly, the question stems and content are in a similar style. Difficulty overall is slightly higher than the real deal, but at an appropriate level that doesn’t feel ridiculous like some of the other question banks. Answers are comprehensive, high yield, and fulfilling. Performance is tracked by subject and topic, but overall analytics leave something to be desired at times as improvement-graphing is not a feature. While tracking progress can be reassuring during this stressful time, it’s not why students should purchase a question bank. This is a large cost, so as a (repeated) point of disclosure, MedStudentBooks receives absolutely no benefit or compensation from USMLE World.
Usage: You should do questions every day you study, with a heavy focus on the topic you just reviewed. Some questions every day should be general (randomly chosen) questions. This number should increase as you get closer to the exam date. Number of questions should be tailored to individual learning style. However, if you find yourself burning through the question bank quickly and expect to finish it early, we recommend saving approximately 300 for the very last week of studying. Purchasing a second question bank (see below) is only recommended for this scenario for those who really excel by doing questions.
USMLERx comes from the group that makes First Aid for the USMLE Step 1. Questions are true to the exam in content and difficulty, with great answer breakdowns. This corresponding question bank to First Aid does extend past the book’s knowledge and can be used as a true supplement (not just rehashing the exact same content), which is why it represents our runner-up question bank recommendation. When surveyed, about 60% of students who used this question bank rated it as Very Good or Excellent. One money-saving tip is to use the corresponding book First Aid Q & A for the USMLE Step 1 (often referred to as “paper USMLERx”) and/or First Aid Cases for the USMLE Step 1. This last title is actually not a question book, but rather goes over cases with multiple questions that could come up for any given question stem. Unlike question banks, this is usually self-selected by those whose learning style works well. Furthermore, either of these titles can be picked up used or borrowed from friends. Keep a lookout for your medical school hosting a USMLERx “Scholarship” which is code-word for “promotional free qbank subscription that coincidentally creates free advertising.”
Kaplan tends to get extreme opinions. People either love it or hate it. When a class of med students were surveyed, 30% of those who used Kaplan Qbank rated it as Very Good or Excellent. As opposed to the above two options, Kaplan takes a different approach, by asking questions that do NOT approximate the Step 1 exam in style. Questions usually focus on specific factoids, and are sometimes perceived as being detailed minutia. Nevertheless, some people swear this is a helpful method of studying. If you are curious about this option, you can use the above link or below banner ad to check a free trial before purchasing it. Either way, it shouldn’t be your first choice.
What about the NBME?! As we mentioned in the opening article in the Step 1 series, everyone should take an initial Comprehensive Basic Science Self-Assessment (CBSSA) exam to get some hard evidence of performance. While these are great at providing a big picture of strengths and weaknesses, these exams unfortunately do not provide great answer descriptions or aid in learning. The NBME has started rolling out exams with “Enhanced Feedback” but they still don’t match up to any of the above as learning tools, and wind up being more expensive per question.
USMLE Consult: This is the question bank famous for being backed by the Great Goljan. We love Goljan’s teaching, but we don’t have enough evidence on USMLE Consult to say it’s necessarily a strong choice. Without the Goljan stamp of approval, this option would probably fade into the background with many other countless banks.
Exam Master: Many med schools provide this to students for free. The price tag reflects the quality. This has a lot of negative reviews and responses associated with it. Questions are unfocused, unclear, and often times have poor answer explanations. Learn from med students who came before, and avoid dedicating time to this option. If you are interested in free questions, hit up the question banks that come with many new books (check for scratch-off areas on the inside cover) or use the Lippincott free 350 question set.
USMLE Weapon: This Pittsburgh startup gets a curious honorable mention as a rising question bank gaining popularity. While USMLE Weapon has not yet stood the test of time or produced a lot of evidence regarding its perceived value, it has impressive analytics and may yet give USMLE World a run for their money one day. At this point though, MedStudentBooks cannot endorse this option, but we will be following it for future years.
Family medicine can be a tricky clerkship in many medical schools due to the vastly different experiences based on location. Some are heavily procedure driven, while others are very hands-off. Some experiences are well balanced, while others exclusively focus on family medicine subspecialization such as dermatology, sports medicine, or ob/gyn clinics. Regardless of whether you experience an urban or completely middle-of-nowhere rural practice, all students at a given med school take the same final exam, and often times that exam is an NBME shelf.
It is not uncommon for students to feel that clinical experiences on a family medicine rotation do not comprehensively prepare them for the exam, especially when the specialty has such a wide breadth and oftentimes unknown depth. For students who know they learn best with practice questions, the below two titles tend to come up for comparison.
PreTest Family Medicine by Doug Knutson continues on in the same style as other titles in the series, providing high yield questions and helpful answers that are geared specifically towards medical students. As each book is written by a different author, there is some variability within the series, but Family Medicine is one of the stronger PreTest titles.
The book is about 5.5 inches wide, which allows it to easily slip into a white coat pocket. This really came in handy during canceled patient appointments that created a good amount of downtime. The 500 USMLE styled questions in the book specifically focus on preventive medicine, doctor-patient issues, acute conditions, and chronic conditions. Question explanations generally go into both right and wrong answers, which helps solidify learning.
The National Medical Series for Independent Study (NMS) produced their own Q&A for Family Medicine, written by David Rudy. The book is full sized, meaning there’s no way it can fit within a white coat pocket. However, it does come with a scratch-off on the inside cover, and every owner is a winner! The prize? Online searchable access to every question and answer in the book, making it easy to use from any computer (if your Family Medicine practice happens to have available computers).
It is important to note that the “nearly 500 exam-style questions” advertised on the cover is actually over 900 questions. This brings up one of the larger complaints of the book. Previous editions had a number of spelling errors and even outdated content. While the content appears accurate, some of the typo issues have remained.
Answers in the NMS question book similarly overview all of the right and wrong answers, allowing for a full learning experience. However, the feel of the questions doesn’t parallel USMLE format as much as PreTest. Content seems to be more advanced overall, with more detail. It can probably serve as an effective learning tool well into residency.
The winner: This round goes to PreTest Family Medicine.
Overall, PreTest provides questions that are more geared towards the NBME Family Medicine shelf exam, in both format and content. For a third year medical student who benefits from practice questions and wants a white coat resource, PreTest is the way to go. For those who anticipate blowing through all of the PreTest questions and coming up hungry for more, try out NMS Q&A Family Medicine for more in-depth content as a subsequent resource. Special consideration should be taken by those who plan to enter family medicine as their chosen specialty, in which case the breadth and depth of NMS Q&A may provide a larger challenge with greater long term benefits. Keep in mind that neither of these titles is recommended for USMLE Step 2 CK study, despite both of them advertising it.
It is finally time to review Goljan: Epic King of Pathology. All of the legends and rumors you heard were true. He’s an arm wrestling champion, rides a white stallion around his massive pathology fun house, and can break a man’s finger clean off during rectal exam. Indeed, some believe that the mere act of saying his name aloud increases their board score by one point every time. If you don’t understand these things, it is simply because you are not yet enlightened.
Edward Goljan is a world class Pathology Chair from Oklahoma State University. Back in the day, he began doing pathology review courses for his medical students, which have been condensed over the years into the most comprehensive yet concise pathology review available. More importantly, it is perfectly tailored to the USMLE Step 1, USMLE Step 2 CK, and even USMLE Step 3 boards exams, as Dr. Goljan has further refined his teachings based on constant feedback he receives from students after they take the boards. As he states:
These notes took 25 years to put together over time. And it dwindled down to the absolute quintessence. It’s like espresso. You just have a little drop and you’re already fixed.
At some point, one of his students recorded his epic lecture series, which continues to float around the internet and med school back-alleys to this day, obtained and abused like crack for the boards. To complement his lectures, he handed out his condensed notes, mentioned above. Over time, these notes coalesced into Edward Goljan’s Rapid Review Pathology book.
The book itself is newer than the audio and has undergone further revisions, whereas the audio remains in its temporally frozen preservation.
Specific chapters of Goljan’s Rapid Review Pathology include: Cell Injury, Inflammation and Repair, Immunopathology, Hemodynamic Disorders (Acid, Base, Electrolytes, Water), Genetic and Developmental Disorders, Environmental Pathology, Nutritional Disorders, Neoplasia, Vascular, Heart, Red Blood Cells, White Blood Cells, Lymphoid Tissue, Hemostasis, Immunohematology, Upper and Lower Respiratory, Gastrointestinal, Hepatobilliary and Pancreatic, Kidneys, Lower Urinary Tract and Male Reproductive Disorders, Female Reproductive Tract and Breast Disorders, Endocrine, Musculoskeletal and Soft Tissue, Skin, Nervous System, and Special Sensory Disorders.
Goljan’s Rapid Review Pathology also comes with Student Consult, the online portal and electronic copy of the book, giving you access to all of the text remotely, as well as the images (which come in handy for powerpoint presentations). Student Consult for Rapid Review Pathology also comes with a little over 400 USMLE style pathology questions related to the book itself. However, to truly lock in the information with a fantastic complementary USMLE style pathology question bank, Robbins and Cotran’s Review of Pathology (reviewed here) is the recommended book of choice.
Robbins and Cotran Review of Pathology, 3rd Edition, AKA “Red Robbins,” is the best pathology USMLE style question bank/book for the boards, and a great complement to Goljan’s review books and audio. The true strength is mixing clinical scenarios with pathology concepts, which makes a topic that is easily boring for many medical students into a very relevant and high yield exercise in the thought process necessary for excelling in pre-clinical class exams, USMLE Step 1, USMLE Step 2 CK, and USMLE Step 3 boards.
The pertinent questions is: should this be used with a question bank such as USMLE World or Kaplan? The answer is definitively yes. At some point, you’re going to hit up Goljan (to be reviewed later), and this book is what will lock in that information with an alternate perspective on the same topics. This should not replace or be used as a substitute for a primary question bank. As for using it with “Big Robbins” or “Baby Robbins,” neither are really needed for the boards past Goljan. At times you may want to reference these resources for topics that require a bit more detail, but they are not a necessity, and can usually be borrowed from friends or the library. (Both of these will also be reviewed in more detail later.)
Robbins and Cotran Review of Pathology does a particularly good job of pulling glossy high resolution color microscopic and gross images that are actually representative of the pathology being reviewed. This really is one of the most important aspects of any pathology teaching. Explanations are thorough, including why the wrong answers are wrong, and the questions are representative of what comes up on the boards.
The three major pathology review sections are comprehensive. Unit 1, General Pathology, covers Cellular Path, Acute and Chronic Inflammation, Tissue Renewal and Repair, Regeneration, Healing, Fibrosis, Hemodynamic Disorders, Thromboembolic Disease, Shock, Genetic Disorders, Diseases of Immunity, Neoplasia, Infectious Disease, Environmental and Nutritional Diseases, and Diseases of Infancy and Childhood. Unit 2, Organ Systemic Pathology, has individual chapters on Blood Vessels, the Heart, Diseases of White Blood Cells, Lymph Nodes, the Spleen, the Thymus, Red Blood Cells and Bleeding Disorders, the Lung, Head and Neck Pathology, the Gastrointestinal Tract, Liver and Biliary Tracts, the Pancreas, the Kidney, the male and female lower urinary tract, the Breast, the Endocrine System, the Skin / Bones / Soft Tissue Tumors, Peripheral Nerve and Skeletal Muscle, the Central Nervous System, and the Eye. Clearly, all of these chapters combined hit every organ system from the large to the microscopic, but I listed them as a reference. The final Unit III, Integrative Reviews, has two long chapters on Clinical Pathology and a Final Review and Assessment that combines information from prior chapters. Robbins and Cotran Pathology Review can also be purchased for Kindle as an eBook on Amazon, but that is not recommended.
The American College of Physicians (ACP) produces a number of resources, but MKSAP For Students 4 is one of the best things they have to offer medical students on inpatient internal medicine or outpatient primary care medicine clerkships. There are a number of USMLE style question banks and books out there, but this one really covers all the bases in these fields. In case you were wondering, it stands for the “Medical Knowledge Self Assessment Program”.
More valuable than the physical text itself is the CD that comes with every copy. Questions can be loaded directly onto a computer, which comes in handy if you like to study around town with a laptop. Your progress and answer choices are tracked and can easily be reset at any time. My personal favorite use is loading the question bank onto my smart phone so I can listen to music and answer questions while waiting for the bus. Keep in mind that certain Android browsers do not support linking through websites that are on the phone itself. All this means is that you will need to hit the back button and load a new question from the browser instead of just hitting “Next” on the question page itself.
There are a number of different MKSAP question sets, which gets confusing. Bottom line: As a medical student searching for a good book, get MKSAP 4, followed by MKSAP 3 if desired. An article will be posted soon regarding all the differences, including the higher numbered books.
As for MKSAP 4, it covers all the expected topics, complete with dermatology images and EKG interpretations. Specific chapters include Cardiovascular Medicine, Endocrinology and Metabolism, Gastroenterology and Hepatology, General Internal Medicine, Hematology, Infectious Disease, Nephrology, Neurology, Oncology, Pulmonary Medicine, Rheumatology. By the end of the book, you will know every etiology of common presentations such as cough, chest pain, abdominal pain, etc. It really is a great tool for inpatient Internal Medicine, outpatient Internal Medicine, a large portion of Family Medicine, shelf exams, and the USMLE Step 2 CK exam.