COMMENTARY

USMLE-Rx: Best Practices for Students

Neil Bhavsar

Disclosures

January 31, 2019

Editor's Note: This video and transcript have been edited for clarity.

Neil Bhavsar: Hi, and welcome to Best Practices. My name is Neil Bhavsar. I'm a Medscape medical student representative. Today I'm sitting down with Dr Tao Le from Scholar-Rx, the creator of First Aid. He'll be talking about the First Aid series. Welcome, Dr Tao Le; thank you so much for sitting with us. What are some recommendations on how to best use USMLE-Rx?

Tao Le, MD, MHS: USMLE-Rx works best if you use it longitudinally with your course work. I would suggest that you use it starting about a year, maybe a year in a half, before your actual boards. People would say, "Wow, that's a long time!" If you think about it, time flies when you really are engrossed in it. All of a sudden, you'll realize, "Gosh, I feel like I don't have enough time." If you actually invest [the time] and use it along with your coursework all along the way, then you're going to be that much more prepared for the boards.

The idea is that you're re-exposing yourself to all of these constants and actually learning them many times throughout the year. You're obviously using your First Aid book, you're using USMLE-Rx questions, and the way students can do that is to use the questions before or after class. I like for the students to use it before they get to class. You do the questions, you're presented with a case vignette, you don't know exactly how to solve this yet. You're going to inevitably stumble, but then that creates questions: Why did I get that question wrong? What was I missing? You come into class primed to look for the answers. Of course, you can also look for the answers in First Aid.

Students, when they go between USMLE-Rx, the question bank, and First Aid, will annotate. As you know, in USMLE-Rx, we provide the First Aid facts at the very end so you can see where they're at. You can either annotate there, especially if you have the Rx 360 package, which allows you to annotate First Aid, or you can go straight to the book and then annotate there as well.

Bottom line: Use First Aid with your coursework throughout the year, especially as soon as your curriculum goes into organ systems. Most curricula [involving] organ systems have integration now—pathology, pharmacology, and so forth. Use it along the way. Same thing with the First Aid Flash Facts—do that along the way. Flash Facts is a fantastically active way to learn First Aid, because if you get the answer to each digital flash card, you'll get a direct section out of First Aid that's [linked] to that flashcard. You're getting multiple passes through First Aid just by doing the digital flashcards. Do that just like you were doing Anki; try to do anywhere between—if you're starting your second year—50 to 100 flashcards a day. It [will only] take between 5 and 10 minutes—it's really fast. Or [maybe] 5 to 15 minutes. That gives you the testing effect and the spacing effect over and over again. That's how you learn it from a cognitive psychology standpoint.

Bhavsar: That makes a lot of sense; I see a lot of students use Anki. That's very interesting that the flashcards have First Aid right there, so you have another pass alongside the questions.

I want to transition to the explanations. How can students take the most information and learn the best while reading the explanations in USMLE-Rx?

Le: The explanations we use in USMLE-Rx are very unique. Obviously, there are other question banks out there. The one thing that we do, I think really well, and just about better than anybody else, is that the explanations are actually patient-centered and case-centered. Think about it: Next year, when you're on internal medicine, or whatever, that person in front of you is not a multiple-choice question. That person is a person. You going to be trying to solve it through their eyes, what information they're giving you. We try to position all of the information through a little bit of the eye of the patient. They're presenting this, they're saying this, but [what] they're actually having is dyspnea upon exertion. What they told you [is] that because they were walking up some stairs, they were having some problems. In this, we break it down that way and then we logically break down the multiple steps you have to go through to solve the question.

Once you go through these explanations, over time you'll realize that it's based on the stem—the stem is the case—and then based on the lead-in, which is the actual question. We'll give you the tools to figure out whether that's a one-step question, a two-step question, or a three-step question, and then the sequence that you have to solve in each of the steps to be able to get to that answer. [You will] actually be able to break down the case through the eyes of the patient which, by the way, is what you want to do when you're a good doctor, whereas a lot of others tend to be disease-centric. They'll just say, "Ah—this is asthma" or "Hey—this is COPD," and then they try to track backwards. That's the wrong way to approach it. You've got to actually look at it through the eyes of the patient.

Bhavsar: Yes, that's very unique. I wasn't aware of that.

Thanks so much for checking out the video. I know the USMLE journey is not fun, but hopefully these videos are making it better. Let us know in the comments. See you next time.

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