OldManDave's Method for Mastering the MCAT Subsequent Med School Exams

I am starting this thread in reaction to the “Thoughts on the MCAT” thread started by Adam (Pi). I have been asked many times to elaborate on what I mean when I say you need to approach the MCAT NOT as a simple factual recall exam, but as an interpretation & application exam. So, here goes my first stab at laying out my argument & resultant strategy.

The million dollar question is, “How does one prepare for an intepretation/application exam?” Honestly, this is probably the most difficult type of exam to prepare for, esp since the entire US education system emphasizes wrote memorization/factula recall exams. The “assumption” this style of testing makes is that ‘IF’ you can regurgitate all of those factoids, then interpretation & application of them into a dynamic system will naturally follow. Two problems immediately arise with this tactic: 1) it is very difficult to write valid exams to test your capacity to take the next step - interp & app. 2) this assumption is far far from valid. I am sure that you can vividly recall classmates in HS & college who could vomit up facts like there was no tomorrow, but when they were prompted to explain what they meant or, even worse, to make extrapolations of those premises to unique situations - they were stymied. But, since the focus of US-education’s testing paradigm was & is factual recall, they were not penalized, and in fact were rewarded, for their limited abilities…I would even proffer that many of our high-ranking classmates found themselves substantially challenged when they attempted to get beyond HS & Ugrad because graduate work & professional schools require the ability to interpret & apply not just regurgitate.

To prepare, you will still need that ‘fund of knowledge’ I mentioned, which is essentially the information & processes from all of your pre-med courses. While there is no direct testing of genetics, biochem or math, per say, there is some benefit in having had these courses as they start demanding that next level of ability over & above the general pre-reqs. And, they convey a familiarity with some of the concepts & terms you may encounter both on the MCAT & in the first 2 years of med school - make no mistake, these courses at the Ugrad level go no where in sufficient depth nor is the focus the same such that years 1 & 2 of med school will be “easy” or a repeat. But, simply having memorized a bunch of facts & formulae will not get you successfully through the MCAT.

The next layer is the interp & app level of understanding. To get here requires loads of practice MCAT questions. I do not mean just doing practice exams over & over again. Take the exams in smaller blocks & know the ins & outs of each question. Not only must you know the correct answer was correct; but you should also know why the other choices were less correct or wrong. This is dynamic learning - you begin to resolve the concepts into congent, working models that you can mentally manipulate. If I have this system - ALL systems are dynamic to some extent - and I do ‘x’ to it, what can I expect the result to be? The questions you use do not have to be from the old MCATs sold by the ACME, although those are great. But, you can employ the question sets from any MCAT-prep book that provides the answers, a break down of the rationale for the choices made & references - a very common format for exam-prep textbooks to be printed in. Unavailable to me at the time were the on-line question banks. I am not sure how great these are because I did not use them for the MCAT. However, I did use the Kaplan Q-Bank for both USMLE & COMLEX steps 1 & 2 and it worked well. The downside is that you could print out the questions, answers & answer rationales. But, you could still employ the same concept - know why the correct answer was correct AND why the ones that were less-correct or even wrong were that way.

The next layer is what you will need to work towards in medical school. This requires the above skills & strategy with an additional twist. Prior to med school, the overwhelming majority of multiple choice exams were formatted such that there is a question stem followed by x-number of choices. Of those choices, there was 1 correct one, 1 or 2 slightly correct (but, if you ‘knew’ the material, obviously not quite as correct) choices & the remainder were damned near silly. In med school, ALL of the choices will be varying shades of correct with 1 being the most correct. Most professors will maintain large databases of question sets where they can manipulate the stem & any one of the subsequent choices such that any of those choices can be made to be the correct one. If they didn’t, they’d spend all of their time writing & rewriting exams & never have time to do research. But, this habit can be a dynamic learning GOLD MINE! If you can obtain copies of old exams - many med school allow student organizations to sell old test files for fundraising purposes - the absolute best way to study is from old exam files. No, it is not cheating because the liklihood that you will gain a significant number of free points from memorizing question & answer combinations is phenomenally low - I know people who tried this & learn the hard way. However, by taking those question sets, you can yourself learn how to manipulate question stems & choices to make each one correct or incorrect & why they are that way. You have now gained the ability to not just vomit up a collection of facts, but to place the data into a cogent, dynamic system that you can mentally manipulate. Once you can do this, YOU KNOW THE MATERIAL IN DEPTH!

No, this is not easy - it is NOT supposed to be. But, if you attack the MCAT in this manner…and all of your subsequent exams…then you will truly be mastering the material. Of course, time limitations in education, esp in med school, will limit precisely how much you can truly master. But, your ability to recall & apply the info you are perusing will expand phenomenally with this approach.

One of the featured speakers this year at the OPM Conference is Dr. Francis Ihejirika, the Founder and CEO of Physician, Assisted Student Success Program (PASS Program) and coauthor of Dissecting the USMLE Steps 1, 2, & 3. He will be discussing how to approach and pass the MCAT,USMLE, and COMLEX exams. It will be interesting hear from a physician who has specifically designed a program to master medical school exams


BTW, another example or application of Dave’s method can be seen in technology troubleshooting. In large complicated computer systems running over complex and vast networks, I have seen technologists try to solve things by trying everything they know. This knowledge-based method is an attempt to use simple factual regurgitation to solve a issue in the real world. In other words, they try every solution before understanding what the issue is. The opposite method, which I call “process-based” is the equivalent of problem-oriented system. Here of, course you try to analyze, isolate, and identify the problem. It basically funneling into a realm of smaller and smaller possibilities until you can easy apply your knowledge to fix it.

Returning to medicine, this of course is the general way a doctor goes about diagnosing a patient. The same underlying concept is the approach that can be used for complex exams. I am a BIG believer in process-based methods.