How to Make Step 1 Anki Cards That Actually Work — Transcript

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1. 0:00Are your Step 1 or Step 2 scores stuck,
2. 0:01and you're not sure why? Don't worry,
3. 0:04you're not alone, and it doesn't mean
4. 0:06you're dumb. The secret to success is to
5. 0:08first know exactly what our problem is
6. 0:11before we start looking for solutions.
7. 0:13Antibiotics are great treatment for
8. 0:14pneumonia, but a horrible treatment for
9. 0:17heart failure. If your studying isn't
10. 0:18working, it may be that your plan is
11. 0:20solving the wrong problem.
12. 0:22As someone who scored in the top 0.1% on
13. 0:25Step 1, I've created the SCORE framework
14. 0:27to help you identify and overcome your
15. 0:29own obstacles, no matter where you're
16. 0:31starting from. We've had students use it
17. 0:33to go from the bottom 3% to the top 3%,
18. 0:36some in under 2 months. Because
19. 0:39remember, it's not what you got, it's
20. 0:41how you use it. Let's dive in. So, the
21. 0:43SCORE component is comprised of five
22. 0:45parts. S stands for study concepts, not
23. 0:47memorization. C is to commit to memory.
24. 0:50O is optimize application. R is repeat,
25. 0:53and E is execute analytically. With this
26. 0:55framework, what you can do is is
27. 0:57understand exactly where you are in the
28. 0:59framework to understand why your score
29. 1:01is stuck and how to fix it. Let's start
30. 1:03with study concepts, not memorization.
31. 1:06As we talked about before, the NBME,
32. 1:08which is the National Board of Medical
33. 1:09Examiners, the people that write Step 1
34. 1:11and Step 2, they are testing concepts.
35. 1:14They're testing your ability to apply
36. 1:15concepts and to use them appropriately.
37. 1:17As we've discussed in the past, one of
38. 1:19the most important things that you're
39. 1:21going to be tested on, and one of the
40. 1:22biggest differences for Step 1 and shelf
41. 1:24exams and Step 2, is that these exams
42. 1:27are testing your ability to apply
43. 1:29concepts. So, let me repeat this, cuz
44. 1:31this is probably the most important
45. 1:33thing that you're going to hear about
46. 1:34studying for the USMLEs, is that it's
47. 1:36not like the memorization test that
48. 1:38you've typically had. So, when I went to
49. 1:39Stanford for medical school, the
50. 1:41professor has tended to write questions
51. 1:42that you could just memorize, where they
52. 1:45would kind of, you know, scour their
53. 1:46PowerPoints to find things that they
54. 1:49could test you on, that they could pull
55. 1:50out, and they could put on the exam. And
56. 1:52so, what med students are typically
57. 1:53trained to do up until they take Step 1
58. 1:56and shelf exams is that they're
59. 1:58typically trained to just memorize
60. 1:59things. This does not fly for step one,
61. 2:02step two, or shelf exams. And so, for
62. 2:04people that are struggling to pass, the
63. 2:06biggest problem that they have is that
64. 2:08they're just trying to memorize things
65. 2:09and regurgitate it, which is A, not very
66. 2:11efficient, and B, not adapted to the way
67. 2:14that they're asking questions. And so,
68. 2:16one of the ways in which we assess
69. 2:17whether someone is mastering the
70. 2:19concepts as opposed to just memorizing
71. 2:21details, is that we'll look at their
72. 2:23flash cards. So, let's take an example
73. 2:25of say pulsus paradoxus. If you are
74. 2:27memorizing it, your flash cards might
75. 2:29look something like this. Pulsus
76. 2:30paradoxus, what is it? Pulsus paradoxus,
77. 2:33what are the causes? Or maybe even
78. 2:35pulsus paradoxus, what is the
79. 2:37pathophysiology? Note that the answer to
80. 2:39these questions could be pretty
81. 2:40straightforward, and there's something
82. 2:42that you could regurgitate from a
83. 2:43relatively small flash card. Now, let's
84. 2:45look at someone who's made a really
85. 2:47excellent flash card that puts together
86. 2:50not only the pathophysiology, but also
87. 2:52the causes, because they made sense of
88. 2:54it. They've mastered the underlying
89. 2:55concept. So, what this person said is,
90. 2:57pulsus paradoxus, use the
91. 2:58pathophysiology to explain the causes.
92. 3:00And then, they went and then they
93. 3:02described what it is, so it's greater
94. 3:03than a 10 mm mercury drop in systolic
95. 3:05blood pressure during inspiration. And
96. 3:08then, they also took the next step,
97. 3:09which is remarkable. So, let's let's
98. 3:11look at this. So, they said, on
99. 3:12inspiration, you have an increase in
100. 3:14venous return, which means you're going
101. 3:15to have an increase in right ventricular
102. 3:17preload. And basically, what happens is
103. 3:19is that anything that's going to
104. 3:20compress the heart from the outside and
105. 3:22prevent ventricular filling, so
106. 3:24something like say croup or OSA or
107. 3:27asthma or COPD, right? Some sort of
108. 3:28obstructive pulmonary disease where the
109. 3:30lungs are going to get air trapping and
110. 3:32get overfull and push in on that heart,
111. 3:34or something like tamponade where
112. 3:35there's going to be fluid outside of the
113. 3:37heart that's going to push in on the
114. 3:38heart. Any of those things is going to
115. 3:41basically prevent the left ventricle
116. 3:43from filling, which is going to restrict
117. 3:44the left ventricular preload, which is
118. 3:46going to decrease the stroke volume,
119. 3:47which is going to lead to that decrease
120. 3:49in pulse pressure. Because every single
121. 3:50time the ventricle's contracting,
122. 3:52there's going to be less blood pumped
123. 3:53out, which means that the the increase
124. 3:55in blood pressure that you see between
125. 3:56the diastolic and the systolic is going
126. 3:58to be less. You can tell from this card
127. 4:00that this person really understands this
128. 4:02concept in any way in which they're
129. 4:05going to be asked this, they're going to
130. 4:06have a very good chance of answering it.
131. 4:08Contrast that with the other flash cards
132. 4:10where you've got, you know, just the
133. 4:11simple things like what is it or what
134. 4:13are the causes or what's the
135. 4:14pathophysiology? If you're not asked
136. 4:15those specific questions close to that
137. 4:17specific way, it's going to be much more
138. 4:19difficult to get those questions correct
139. 4:21because it you don't really understand
140. 4:23the concept if you're just memorizing
141. 4:25the details. And so again, if you're
142. 4:27struggling to pass, one of the biggest
143. 4:29problems that we see is that you're not
144. 4:32going deep enough with the concepts. And
145. 4:34so this is rule number one, two, and
146. 4:37three for people that are struggling to
147. 4:39pass. So if you found this helpful and
148. 4:40want to get more questions correct for
149. 4:41the knowledge you already have, be sure
150. 4:43to click in the description for our
151. 4:4514-step free program. And if you want
152. 4:47help getting there faster and want to
153. 4:49work with our team, you'll have the
154. 4:50option of booking a free assessment with
155. 4:51our team and if it makes sense to work
156. 4:53with you, we'll explain exactly what it
157. 4:55would look like so that you can get a
158. 4:56higher score in less time.