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Friday, July 8, 2011

My Suggestions For Path Exams 1, 2, 3

This is a disclaimer in the sense that I am not garunteeing your testing experience in Path will be similar to my class and the class before me, but I would like to make you aware of how exams in the past have gone in the past. The path department is aware and seems to change up their tests every time to prevent student from predicting how hard the exams will be and keep everyone on their toes. But, it seems that without doubt, one of your exams will be scary hard (for us it was a timing issue that made it so bad). It is possible that all 3 exams are made hard, so again I don't want to mislead anyone, but for our term, we had one incredibly difficult exam, and a lot of people either had to drop the class, lost their morale, or just settled for a grade lower than what they were hoping for, and I don't want this to happen to you too. So I wanted to at least give coming students the heads up all of us should have gotten.

What to study
  • The notes. Study the notes like Crazy, read them over and over
  • Know the lab slide topics directly from Robbins (big one preferably), make sure you get all relevant information about them. You can do this by reading robbins and being nice to, and getting as much info from the tutors as possible. They know exactly how things will be on the exams. Know IMDEPS for all lab items. That's Identify the organ, Morphology, Diagnosis, Etiology (cause), Pathophysiology (mechanism), Similar Pathologies/Symptoms/Signs, Investigations, Complications (Sequelle). You'll also want to know epidemiology as well, age/sex, symptoms at early onset, risk factors. This is how you'll want to set up your lab slides too. 
  • Objectives. Objectives!! THIS IS IT. You must study these. It's literally all in the notes. Sometimes, occasionally, some objectives are not covered in the notes, you should goto Robbins for the rest of the information. That will be enough for the exam. 

Ok. You have to get your studying habits down, its a ton of material, like usual. 
So, first just take a deep breath, you'll get through it, no need to feel stressed out and make bad decisions.

Here are some things that helped me and others:

1) During the exam, as you flip through the pages (to see if they are all there) when they ask you to do so, you should be scanning for 2 things:
         1)  Where, and how many matching questions there are
         2)  How long the question stems are throughout the exam

If your tests are like ours, you may notice that the vinettes tend to be much longer in the beginning of the exam, and get progressively shorter towards the end of the test. You may want to start at the end of the exam and work backwards in order to get as many questions answered before time runs out if time is going to be a problem. 

When I say time is going to be a problem... I mean... if you're one of those people who finish the exam early... you will not even finish the exam, so you HAVE to be prepared. That was how bad our second path exam was, and in the past is has been the final which is such a big issue in terms of time. (by the way, for our final, timing was not an issue, so again it changes term to term, but you should be aware that this can become an issue for one or more of your exams).
Which brings me to the next (albeit obvious) point:

2) BUBBLE IN AN ANSWER FOR ALL QUESTIONS. Atleast guess for god sakes. Do not lose track of time, glance at the time clock and make sure you bubble in before time runs out. The Path Dept is relentlessly strict about the timing issue. You won't get time to bubble those guys in at the end. 

More about the exams...
  • Some may be, but Many of your "clue" or "keywords" will NOT be used on the exam. So this means not only do you have to know these key terms, but you also must know how to describe histological and macroscopic features of organs with certain pathologies with descriptive terms. Colors, shapes, patterns, etc. not just "Psamomma Bodies". You should be able to recognize it if they say "papillary structures with eosinophilic calcifications". Don't go on a rampage trying to study this every way possible. There are standard descriptions that pathologists like to use, and you'll pick up on them as you go through the class. For the most part, Big Daddy Robbins Basis of Path has what you need here in the "Morphology Boxes". Don't forget about the morph boxes. Seriously. don't forget.
  • Again, italicized points for any covered topics from lab/lecture in Big Robbins can and have/will be tested
  • There will be visual slides..30-35 of them. The key is DON'T LOOK AT THE SLIDE. Here's the strategy: Read the vignette straight away and try to answer the question. If you need to wait for the slide to make your answer, decode all of the answer choices while you wait. This won't make sense until you see a sample question. What happens on the exam that you aren't used to is that you need to make a diagnosis from the information given. After you have done so you will look at the answer choices and see that the diagnosis is not an answer choice, but you will have 5 histological descriptions, or a complication, or a risk factor or a causative agent, one of which will be characteristic or MOST Characteristic of that Pathology. So, you will have to make a diagnosis, know what features are present in such a pathology, know which one is most common, and then be able to describe it in common terminology to make your answer. SO... while you are waiting, decode the descriptions, and write the name of the pathology that each answer choice is trying to depict. After you have done this, you have basically turned the question into a 1st order question. This is the best use of time.
  • There will be matching questions. Hard ones. It will be many descriptions and will require decoding like I just described. In your freetime you have gained by not looking at slides, you can finish the visual section early, and skip right to the matching questions. Find each set of matching, and decode all the answer choices A, B, C, D, E... writing the diagnosis next to each answer, turning it into a 1st order question as best as you can. Now head to the back of the exam and work forwards. 
  • Lastly, for long vignettes, Read the last sentence first. This will give you an idea of what to look for in the vinette when you read it. You will get bogged down by things like lots of symptoms, lab values, etc.
  • The golden rule, Look for that one thing that makes each pathology unique. Whether it be a positive test, a histological feature, a symptom, an age/race predeliction, etc and know everything about that unique feature. If its a positive test, for example, know how the test is done. Know how to interpret the test, know the test's name, know what fluids are being tested, etc.
  • Know your most commons. There will be questions asking what the most common complication is, what the most common cause of death is, what the most likely diagnosis is, so you must know your epidemiology as well. Age, Sex, and Race are very important. Know most common cancers, most common cause, most common route of spread. 
  • Make connections, dont forget they can ask you to make a diagnosis, figure out what features are characteristic of that pathology, then the final question will ask something like "What other pathology has similar features/risk factors/complications/causes/morphology? So make connections, and know when things cross paths. "what other pathology demonstrates Psammoma bodies?" 
That's all for now. Utilize what works best for you.

Exam 1 is typically more 1st order questions, asking diagnosis, asking straight questions. 
Exam 2 will be more oriented the way I have described, with 2-4th order questions, which are a matter of diagnosis, decoding, and then answering the questions.
Exam 3 (the final) will be the same as exam 2 in terms of toughness of the questions.

All three exams are not easy. One or more is usually a time game. Just relax, get as many questions as you can, and lastly... GOODLUCK!!

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