How Exam Prep Time Is Often Wasted

It’s not merely how long you study but what knowledge and exam-taking skills you achieve. Today, I share with you three ways exam candidates waste their precious study time.

Gauging Study Success By Hours Spent ‘Studying’

One way exam candidates waste time is by tracking their study hours without reference to how effective that study was. For example, if you can barely keep your eyes open or you’re reading material over and over because you’re not paying any attention to it, then that is wasted time.

If you count that as having studied, you’re fooling yourself. It’s not like there is someone, the imagined Big Teacher looking over your shoulder, that you can turn in your ‘study card’ to and say, “Look, look how many hours I devoted. You should appreciate me and my efforts.” Sorry, no one cares. You either pass or you fail. No ‘A’s for effort are on offer.

If you’re physically and mentally exhausted, you’re likely better off going to bed and waking up early.

Here’s my update to the resident’s motto: eat when you can, sleep when you should, and study when you’re alert. Anything else is make-believe.

The practical side of this is: reserve your most alert and focused time to exam preparation. Studying is effective only to the degree that you actively process the information you’re reading or listening to. Learning is work, mental work, different from but no easier than hard physical labor.

It takes intense effort to convert information into knowledge. Information is what you find on a page, on a computer, or in a lecture presentation. Information is inert until it is processed in your mind into knowledge. You don’t own information – it is mere potential – but you do own and control your knowledge. The knowledge that you have acquired and incorporated into your conceptual landscape – through your hard study efforts – can then be deployed to understand the relevant issues at hand, diagnose and foresee problems, and elaborate solutions – medical treatments in our case.

Studying In Groups

I do not come to bury group study, but to cast a note of caution: study groups work well for certain people when used for certain kinds of study. Often, though, group study is spent socializing and kvetching. In small measure, this in itself can be good: it can maintain motivation and remoralize a demoralized learner. Studying for boards is time- and energy-consuming and thankless. Sometimes an inviting ear brings relief and inspiration to keep going.

But these potential benefits do not directly further your knowledge acquisition nor your ability to deploy that knowledge in correctly answering board exam questions. It is these outcomes that truly matter, and group study can as often interfere with that knowledge acquisition and ability to deploy as to further it.

So, if you already engage in group study or are considering it, ask yourself exactly how it is benefiting you.

Here are some ways that it may be of benefit:

• Group members quiz each other.
• Group members review board-style MCQs together and share insights on the structure of these questions and how they test candidates’ knowledge.
• Group members ask other members for explanations about knowledge they lack or exam question structure they don’t understand

Please add your own reasons. And note that each of the above can be done – perhaps better, perhaps worse – alone. For instance, if I lack knowledge about some aspect of board-relevant content, then I’ll find a definitive source, like a recent textbook, for example, rather than asking a colleague who is an exam-taker.

Also, if you’re in a group, one of you will be more knowledgeable than the others. It could be that for you, spending time with others who are less prepared than you isn’t helpful to you. It might nevertheless be helpful because answering others’ questions can help you clarify and consolidate concepts you thought you knew well but, perhaps, did not.

I, for one, never ever engage in group study. Why? Because it is not compatible with my way of learning. I learn best by isolating myself in a bubble of intense focus for the purpose of acquiring knowledge and then taking board-style practice tests to assess my ability to deploy that knowledge.

Again, I’m not making a blanket condemnation of group study but rather asking that you reflect on the utility of group study for you. And, if you find group study is useful, next ask yourself in what ways, to help ensure that’s how you’re actually spending that study time together. You can develop mutually-agreed-upon ground rules when forming a group. My very rough guess is that group study works sufficiently well for about a third of learners.

Memorizing Instead of Knowing

Oh, my. This is so common, yet it is based on a fundamental misunderstanding: that memorizing a series of facts is the same as having incorporated them into one’s knowledge base. It is not, although memorizing relevant facts is often a necessary first step.

How can one have memorized something, even deeply memorized it, and still not know it? Since I’m a psychiatrist, I’ll use a couple of psychiatric diagnostic examples.

First example: One can memorize the diagnostic criteria for anorexia nervosa, bulimia nervosa, and binge-eating disorder and yet answer incorrectly on exam questions that present a case vignette and ask for the most likely diagnosis.

How can such a failure occur? Like this: to be able to confidently recognize the correct or most likely diagnosis means to be able to differentiate it from closely related other diagnoses. So, to truly know anorexia, bulimia, and binge-eating means to know how they differ from each other, which exact criterion differentiates them from each other when most criteria overlap.

Second example: Another common source of confusion is differentiating somatic symptom disorder from illness anxiety disorder. To know two disorders requires knowing three things: diagnostic criteria for disorder #1, diagnostic criteria for disorder #2, and the differences in diagnostic criteria between the two disorders.

Only then can the candidate confidently deploy their diagnostic knowledge when confronted by an exam case vignette.

To make this point concrete: board exam questions are unlikely to test your diagnostic knowledge by asking the following type of question: “Which of the following criteria defines Stage C heart failure?” Instead, they will present the candidate with a vignette that incorporates several pieces of information that need to be parsed and recognized as being one condition vs another.

The End.

I hope this helps. Feel free to push back, add, or comment your own effective and ineffective study methods.

Yours in board success,

Jack Krasuski, MD