One of the toughest parts of medical school was coming home after 12-or-more-hour work day and doing practice questions for exams. It was as if I was being expected to make studying my hobby (possibly, my only hobby).  Even more, the questions were draining; they simulate a testing environment and require staring at a computer screen (after spending much of the day staring at a computer screen).  This is in contrast to taking a physical book and “reading up on” conditions seen that day, which I think many older professionals in the medical field associate with “studying.”

Ideally, one should not need to do these question banks at all – one should learn everything one needs to know “on the job,” perhaps supplemented with some old-school “reading.” However, perhaps due to the success of the major test prep companies, one must study their question banks—or else.  Even a small deviation from this material can mean failure. The test companies have begun to define the core knowledge that is required for a medical degree.

If a medical school has some issue with this, it should be taken up directly with the examiners. It’s important that the curriculum not ignore or minimize the question banks—this just leads to the medical students paying the price. Thankfully, when I was in school, some clerkships did give protected study time; although this took away from clinical time, I think that I got more out of my clinical time when studying was allowed; I was less stressed and more present. 

By the way, I know this kind of post is sort of off-topic—I usually talk about statistics and medicine. The thing is, not having time for test prep during work hours in medical school is an issue.  I think the root of the issue may have something to do with external curricula interacting with internal, institution-specific curricula and controversy about what material is important.  

Given my background in statistics, I feel perhaps a similar concerns when I see statistics board review questions, many of which I would have written differently.  This is really tough. However, as much as possible, I try to direct my grievances at those who are responsible—e.g., via question-specific feedback to the test prep companies and surveys after USMLE exams—not at medical students who are just trying to keep their heads above water as they learn the material, whatever it might be, for the first time.* 

For some strategies on taking exams (test-taking strategies can be important in the setting of limited study time), see here.

*I have in the past given medical students lectures (e.g., see here) that were sort of “off-topic” with respect to the boards. Going forward, I will try to instead use my expertise to provide pearls while remaining within the confines of the board material (this is not always easy to do).