How Many Times Should You Take a Mock Exam before the Real Deal?

mock-medical-exam

Mock exams are a part of life for medical students, and while these exams can seem boring or excessive, they actually play a very important role in your overall success. Below, you will learn more about the importance of mock exams and the number of times you should take them before the date of the real exam.

What is a Mock Exam?

A mock exam is a set of questions designed to look and feel like your real exam. The difference is that the score you get on a mock exam is of no matter and bears no consequence on your future career whereas your actual medical licensing examination does. A mock exam may be shorter than the real thing, or it may be roughly the same length. The closer the mock exam to the actual exam, the better prepared you will feel on exam day.

What are the Benefits of a Mock Exam?

There are many benefits associated with medical mock exams.

  • It provides a sense of urgency. Because up to 75% of students procrastinate, and because 50% of these students procrastinate to the point that it causes academic issues, mock exams are phenomenal for creating a sense of urgency and encouraging students to prepare.
  • Spacing out revision sessions improves memory and recall. Mock exams are great for reviewing content because they allow enough time for students to forget and then relearn that content, which improves memory and recall significantly.
  • Asking “why” improves recollection. Mock exams force students to ask themselves “why”; in other words, rather than simply reading a book, students who take mock exams must think critically. This makes them up to 50% more likely to recall information than students who do not take these exams at all.
  • It promotes success. Finally, a study on groups of students who took mock exams prior to final exams showed that students who took mock exams scored far higher than students who did not take them and studied in other ways, instead.

How Many Times Should You Take a Mock Exam?

This is a common question, and the truth is that there is no one universal answer. You should always take mock exams a minimum of three times to ensure that you have covered all your bases, but for most people, even more is better. Mock exams serve as a study aid rather than a guide to your preparedness to take the real exam, and if you find yourself panicking or missing questions on your mock exam, there’s a good chance you may feel the same way on test day. Continue to take mock exams until you are getting high scores and you feel comfortable with your outcomes.

Mock exams are a great way for medical students to prepare for their licensing exams, which are some of the most rigorous exams in the world. Taking high-quality tests regularly is a great way to measure your knowledge, learn new content, improve your memory, and even familiarize you with the exam that you will see on the big day.

Evolving AI Technology is Keeping Med Students from Pursuing Radiology

Radiology

While most of the world agrees that breakthroughs in artificial intelligence (also known as simply ‘AI’) have made life considerably easier, there are a few drawbacks for certain individuals. One set of individuals who feel at a slight disadvantage are med students.

Reduction in Radiology Demand?

A great number of medical students are under the impression that new breakthroughs in AI have reduced the demand for radiologists. If ongoing trends are to be believed, these students say that demand will continue to drop, thus making radiology a very cut-throat field.

A recent study published in Academic Radiology says that the fear of an AI takeover (so to speak) has gone so far as to discourage some current students from even considering radiology as a possible concentration.

About the Survey

The survey was conducted among the students of seventeen different Canadian schools in March of 2018. Three hundred responses were recorded among the potential student pool, and two incredible statistics stood out.

First, 67% of all respondents stated that evolving AI would generally reduce the demand for radiologists. That’s more than half of people surveyed, which says quite a bit about what the next generation of medical professionals feel.

But that wasn’t even the craziest response. An incredible 29% of all respondents stated that they believed AI would replace the need for radiologists entirely. In other words, AI would replace radiology completely with no more need for an actual person anymore.

Some people were still considering radiology as a possible (or definite) concentration. Among only those who are still considering this career path, almost half of them said that evolving AI has made them feel anxious about their future.

Among those who no longer consider radiology a choice, 14% stated that it would be their top field choice were it not for ever-advancing AI in that particular field.

What the Survey’s Authors Had to Say

Bo Gong, the leading author of the survey, had this to say about the survey’s results: “Our study revealed considerable anxiety among medical students’ interest in radiology, caused by their perception of the impact of artificial intelligence… Such anxiety discouraged a significant number of medical students from considering a radiology specialty.”

The authors stated there are steps the current radiology community could take to help med students understand the true impact artificial intelligence may have on their chosen specialty. In fact, they went as far as to create a list of possible ways current radiologists could help students to understand more on this topic.

Yet despite anxiety regarding their future careers, most responding students did support the idea of collaboration with the IT industry to support the role of AI in radiology and in improving patient care across all medical sectors.

As for whether or not AI will replace radiology all together, most practitioners are doubtful. This isn’t to say it couldn’t happen far into the future, but for now AI is complementary to radiologists and do not displace the need for human care.

 

Could Cannabis Education Become Core Curriculum for Future Medical Students?

Cannabis Education

Dr. Michael Verbora works at the Canabo Medical Clinic, located in midtown Toronto. He has been giving resident doctors from the nearby University of Toronto with the fundamentals of medicinal cannabis, so they can better care for those who rely heavily on the plant.

Becoming Familiar with Medicinal Marijuana

Doctor Verbora is also the chief medical officer for Aleafia – a medical cannabis company. When students come in to complete their residencies, they have a very limited (if any) education pertaining to the role of cannabis in the treatment and support of diseases. By the time they leave, however, they have a good understanding of:

  • The endocannabinoid system – how it works, what its role is in health and disease
  • The most appropriate way of consumption for medical cannabis, based on the disease or symptoms it is treating
  • The risks and benefits of treating individuals with medical marijuana
  • In what instances it is (or is not) appropriate to prescribe medical marijuana to a patient

Why This is Important

Education is always important, but it is especially so for physicians. The more a physician can know about a wide range of relevant topics, the better. Unfortunately, a great number of physicians do not currently understand how medicinal cannabis works nor how to effectively utilize it in the treatment of patients.

How the Issue is Getting Fixed

With widespread legality of cannabis for medicinal use, more doctors need to become knowledgeable on the subject. This is imperative for safe, practical use – as well as the potential advancement of research into what role cannabis plays in a wide variety of disease (like cancer, fibromyalgia, and Crohn’s Disease, for example).

There was such a gap in education surrounding this subject that the Canadian Federation of Medical Students (also known as the CFMS) have proposed that a new course covering a “longitudinal, evidence-based cannabis course” into all medical undergraduate programs across the country.

The paper states that there is a very large gap surrounding cannabis education. In fact, there are little to no courses currently available for those who would like to become more educated. What is learned is either through independent studies or residencies, like the one mentioned in the beginning of this article.

 Roadblocks and Controversy

Legalizing medicinal marijuana is not a new idea. Many states (US) and provinces (Canada) have allowed cannabis for medicinal usage for a number of years. Yet this has not fully dispelled the reputation of weed as a drug, as set about by the infamous “War on Drugs,” launched decades ago.

Due to misinformation in the decades since, many professionals and patients believe that marijuana is an “evil” substance of the likes of heroine or methamphetamines. Yet this isn’t true. While street weed may, indeed, be contaminated with other substances, marijuana itself is a very natural plant which is primarily non-harmful to humans. The slew of side effects seen in recreational usage are primarily attributed to a high THC content caused by cross-breeding programs exactly for those desired effects. Medicinal cannabis, on the other hand, leans towards a higher CBD content which does not produce as many – or any – unnecessary side effects.

The 5 Best Medical Test Taking Tips for 2019

Taking Medical Exam

Preparing for an exam is one thing, but actually preparing yourself to sit down and take one of the most intense exams you’ll ever take in your life is something else entirely. Here, you’ll learn five of the best tips from the experts for taking medical exams like a pro.

#1 – Maximize Your Study Time

Making your test day the best it can be all starts with studying. Make sure that you start studying for your exam early on, and to get the most out of your time, use programs and tools that allow you to take mock exams and review your incorrect answers. Not only does this help get you in the right frame of mind for answering the questions on the actual medical exam, but it also puts the information you need most in front of you and helps to ensure your overall success on the real test.

#2 – Get Plenty of Rest the Night Before

Though it may seem beneficial to stay up late and study the things that have been giving you trouble, getting a good night’s sleep is even more important. In fact, studies have proven that better sleep improves academic success. By staying up late and getting fewer than seven to nine hours of sleep, your mind will not be as clear as it could be on test day, which can lead to reading comprehension issues and silly mistakes you may not otherwise make.

#3 – Eat a Good Breakfast (and Plan a Good Lunch)

Food is fuel for the body and the mind, so even if you’re feeling butterflies in your stomach, make sure you eat a well-balanced breakfast. Ideally, it should contain an excellent source of protein such as meat or Greek yogurt, and it should also contain a good source of complex carbohydrates that will help keep you satisfied and energetic until lunch. If your test lasts several hours and you will have a lunch break between, be sure to pack a meal that closely mimics breakfast. Fast food can be tempting, but a balanced meal is far better for your brain.

#4 – Wake Up Early to Prepare

Another excellent tip involves waking yourself up early the day of the test and taking your time to prepare. Rather than giving yourself an hour to get dressed, eat, and travel to the testing area, try to give yourself two or even three. Plan what you’ll eat for breakfast the night before, and perhaps lay out what you will wear before you go to bed, too. This will help reduce the number of decisions you have to make in the morning and may aid your overall focus.

#5 – One Question at a Time

When faced with an important exam, many people feel overwhelmed by the sheer volume of questions they must answer in the allotted time. Rather than allowing yourself to stress out and start reading ahead, focus on the question in front of you until you have the right answer. By giving the question or problem on the screen all of your undivided attention, the odds of making a mistake or getting the wrong answer are much, much lower.

Many of the best test-taking tips for 2019 involve the time leading up to the test rather than the test itself. After all, the things you do before the exam will have the biggest impact. Be sure that you’re as prepared as you can be, and make sure that you take care of your body and mind, too. These things will keep your brain sharp and allow you to perform much better on test day.

 

How Much do Canadian Doctors Earn in a Year?

canadian doctors

Across Canada, the doctor-to-patient ratio has been on the rise since 2011. As of 2015, there were roughly 228 doctors per 100,000 people in the nation. Doctors in Canada earn a handsome living, as well; as of 2018, Canadian doctors earned an average of $307,482 a year. Of course, these earnings vary by specialization, and more importantly, by province.

British Columbia

In British Columbia (BC), the government releases a document each year called the Blue Book that shows the amount of money different specific types of physicians earn based on their specializations. Many doctors in BC earn less than the national average for all specializations, and the average family doctor here earns roughly $273,000 a year.

Alberta

Alberta is one of the better Canadian provinces for anyone interested in working as a physician. It boasts the highest salary for physicians at an average of $384,380 a year. This is well above the national average – and it’s much higher than the other provinces, too. This could by why Alberta’s doctor population is growing more quickly than that of many other provinces.

Saskatchewan

The government in Saskatchewan has a little more control over physician earnings, and they cap the amount doctors can charge for services that insurance companies cover. This means that physicians are limited, but they still earn a handsome salary of $288,995 a year.

Manitoba

Doctors in Manitoba are considered public sector employees, and they are required by law to report their earnings to the public every year. The highest paid doctor in the province is an ER physician who earns $680,000 annually, but the average annual salary for all doctors in Manitoba is much lower at $354,705.

Ontario

Ontario is a highly populated province, but despite this – and despite the limitations placed on medical charges by other provincial governments – these caps do not exist in Ontario. The average doctor here earns right at $360,000 annually, which is slightly more than the national average.  It should be noted that Ontario doctors are not required to disclose their earnings.

Quebec

Doctors in Quebec earn salaries in line with the national average at $325,000 a year, but many feel as if they earn far too much and would like to see part of their salaries appropriated to other areas of the healthcare system in general. Specialists and surgeons earn quite a bit more than general practitioners in Quebec, too.

New Brunswick

Doctors in New Brunswick earn salaries that closely compete with the national average at right around $302,123 a year. This average is much lower than some other provinces, but they still live quite comfortably. Startlingly, more than two dozen doctors across the province earn more than $1 million each year – likely specialists and surgeons.

Nova Scotia

Doctors in Nova Scotia earn well below the country’s national average at just $259,368 a year. Though this is a handsome salary when compared to many other professions, doctors here have expressed their desire to work in other parts of the country for the higher salaries, and many say they would move if they were not already important community figures.

Prince Edward Island

Doctors’ salaries on Prince Edward Island are very similar to those of doctors in New Brunswick. Doctors here earn an average of $305,091 a year. Prince Edward Island is unique in that doctors can simply work more hours via the fee-for-service method – essentially charging for every individual service provided – and earn far more. Many who do earn well over $1 million a year. In fact, one ophthalmologist earned $1.4 million in a single year.

Newfoundland

Newfoundland is right behind Nova Scotia, which has the lowest average salary for doctors in Canada, at $269,646. In the last few years, doctors in Newfoundland have petitioned the government for higher pay, claiming that they earn far too little to cover their costs and employees while still living comfortably.

Keep in mind that these numbers are averages across all specializations and fields of medicine. Though some doctors in Canada do especially well for themselves – especially in higher-paying provinces – others struggle to pay their staff and cover their expenses. Just as some doctors are earning well over $1 million each year (such as that incredibly successful eye doctor), others earn well below the average, too.

 

Why the MCATs Are So Important for Medical Students

Canadian Medical Students

MCAT stands for the “Medical College Admission Test,” and it’s a major milestone for all premed students. In fact, it can be argued that it is one of the most important (and difficult) exams potential medical school students will ever take. But why is this test so important?

Why the MCAT Matters So Much

The MCAT is the first step in medical school. After a traditional four-year college program in premed, students must pass the MCAT to obtain entrance into medical school. If a student fails their MCAT they will probably not be accepted into any reputable medical school, and their hard work up to that point will be for naught. But why is this single test so very important?

The answer to this question lays within the test’s ability to predict the future, so to speak. Studies have proven that a student’s ability to perform well on the MCAT correlates with their performance on the all-important USMLE.

The USMLE (United States Medical Licensing Examination) is a three-part test which must be taken to receive licensing, prior to obtaining a doctorate. The parts are broken down into steps, and are as follows:

  • Step One: Typically taken after the second year of medical school. This first step assesses basic understanding and application of important concepts regarding basic science and the practice of medicine – including underlying health, modes of therapy, and disease.
  • Step Two: Typically taken in the fourth year of medical school. This second step assess the ability to apply the knowledge and skills accumulated during schooling, with special emphasis placed on physical patient care.
  • Step Three: Typically taken during an internship or during the first year of residency. It is the culmination of everything learned, from book knowledge to patient care and beyond. This final step will also test a student’s knowledge on laws and regulations as it pertains to physicians and patient care.

Keeping this study in mind will make it clear why medical schools place such an emphasis on it. If performance on the MCAT directly correlates to the USMLE, and the USMLE is the most important test towards graduation, then schools who wish to ensure a high graduation rate will want students who have proven they can do well.

Other Variables

The good news is that the MCAT is not the only indicator of how well a student will do on the USMLE. While it definitely factors in, there are a number of other variables which will influence a student’s final score. These might include:

  • What type of test-taker a student is. Those who are naturally better at taking tests will obviously do better than those who do not.
  • How well a student prepares through studying in the days, weeks, and months prior to the examination.
  • How dedicated a student has been in their studies. Those who are more attentive in class and hold higher grades tend towards doing better than those who slack or do not pay attention.

Low Tuition Universities for Canadian Medical Schools

MCCQE Examination

Canadian medical schools are in high demand and competition to be accepted is stiff. There are many more hopeful applicants than there are positions. This makes it vital to have a great application, which should include (but may not be limited to):

  • High School Diploma
  • Relevant extracurricular activities in high school and/or first four years of college
  • Good grades in pre-med
  • A good score on the MCAT
  • Fully filled out application, turned in before the deadline date

What Does Medical School Look Like in Canada?

A typical medical school program lasts between three to five years, depending upon both the University and the background (or pre-education) of the student. In five year programs, the first year is dedicated towards prepping students who do not have a background in science. To enter the four year Canadian medical program a student must hold at least a bachelor degree in Biology or another appropriate scientific field.

What is the MCAT?

The MCAT is required to enter medical school in not only Canada, but also the United States. If an applicant fails their MCAT examination they will not be allowed to enter graduate schooling.

The Medical College Admission Test is a standardized, multi-choice exam which was designed to asses the critical thinking, problem solving, and writing skills of an applicant, in addition to their knowledge of science principles and concepts.

There are four sections of the test. These include Verbal Reasoning, Physical Sciences, Biological Sciences, and Writing Sample.

Low Tuition Universities for Canadian Medical Students

With only 15 percent of all applicants receiving spots in Canadian medical schools, it can be hard simply to find a spot. Those who are lucky enough to be admitted into a medical university are lucky, but sometimes financial restraints can stand in the way.

The good news is that there are a number of different universities which offer low cost tuition in comparison to their counterparts. The following is a list of those schools, which are both in English and French.

  • Cumming School of Medicine
  • Dalhousie University Faculty of Medicine
  • Memorial University of Newfoundland Faculty of Medicine
  • McMaster University Medical School
  • McGill University Faculty of Medicine
  • Northern Ontario School of Medicine
  • Queen’s School of Medicine
  • Schulich School of Medicine & Dentistry
  • University of British Columbia Faculty of Medicine
  • Univeristy of Alberta Faculty of Medicine & Dentistry
  • University of Manitoba College of Medicine
  • Univesity of Ottawa Faculty of Medicine
  • University of Toronto Faculty of medicine
  • Universite Laval Faculte de Medecine
  • Universite de Montreal Faculte de Medecine
  • Universite de Sherbrooke Faculte de Medecine et des sciences de la sante

Other Options

If you are not lucky enough to be one of the 15 percent admitted to Canadian medical schools, there are other options available. The first, of course, is to take a year off and try again the following year. Many students, however, do not want to wait.

If this is the case, there are foreign study programs available in a multitude of overseas countries, as well as the United States. A large number of Canadian medical school students choose to do their graduate programs in other countries before returning to complete their residencies in Canada.

Could Narrative Medicine Lower Doctor Burnout Rates?

Narrative Medicine

Doctors and current medical students are at the highest risk of mental illness and suicide when compared to other fields. These stem directly from doctor burnout, which is when a medical practitioner or student is over-taxed emotionally, physically, mentally, and sometimes even spiritually.

It has been an ongoing process to find something that could help to lower the rates at which doctors suffer burnout. By decreasing burnout, the rates at which current and prospective physicians suffer mental illness and commit suicide are thought to also decrease.

The latest hope in this ongoing research process is Narrative Medicine. New research has shown that this little-known field of study could prove highly beneficial to physicians.

What is “Narrative Medicine”?

Narrative Medicine may not be a term many people (even within the medical community) are familiar with. This is because it’s a fairly new area of interest, which was first written about in the 1990’s. At least, in its most modern sense. The concept from which the study area stems is absolutely ancient.

Narrative Medicine is an idea that doctors should treat the whole person versus a set of symptoms or diseases. It incorporates mental and emotional health with the physical, to provide a more effective set of treatments.

Narrative Medicine can be taken much further than this, however. In fact, it can prove to be a highly useful and effective tool for doctors.

How Does Narrative Medicine Help Prevent Doctor Burnout?

The idea of narrative medicine is to look at the whole picture. This allows physicians to see their patients as real, living people who have stories. Results, information, and patient demographical information all creates a story, which the physician writes with what they have been given.

While this is a useful diagnostic tool which can help to identify patterns in treatment and illness, it is also much more than that. It is useful for the doctor’s health also.

When creating this narrative, the doctor has an ability to place their own feelings into perspective. If, for example, a longtime patient has died, the issue could prove traumatic. When so much of a person’s lifetime has been placed into the health and care of another, there is a lot of personal investment. A narrative allows the doctor to express their sadness.

In effect, narrative medicine is medical journaling. The mental health benefits of journaling have been extensively researched and proven. Using this knowledge, narrative medicine aims to pair this therapeutic technique with medical treatment and diagnostics to help doctors avoid burnout.

How Serious is the Doctor Burnout Issue?

As discussed in the opening paragraph, burnout contributes highly to the levels of mental illness and suicide in the medical community. But just how serious is this issue?

The rate of doctors who suffer from depression is as high as 30 percent. It varies among different specialties, but is astoundingly high overall. The reason is well-known. Long hours, little sleep, high stress, and life-altering decision making all contribute. Often, doctors will work extended shifts without regard to their own personal health. In addition to lack of sleep, doctors might fail to eat regularly, hydrate, or enjoy any type of social life period.

 

Canadian Medical Students Can Get Credit for Marijuana Production Studies

Credit for Marijuana Production Studies

Beleave Kannabis Corporation is an Ontario marijuana company that wants to do more than just grow pot. Their goal is to build an empire of marijuana production specialists who know the science behind planting, regulation, and proper safety methods. The issue? A lack of experienced marijuana producers.

Since Canada legalized marijuana for both medicinal and recreational purposes, the industry has literally exploded with a demand for both more untarnished marijuana and experienced people to help tend the plants. The North American country was the very first industrialized country to fully decriminalize the plant this past October.

Turning to Universities for Assistance

The answer to the industry’s labor shortage has an easy answer – the recruitment of university science and medical students. Beleave Kannabis Corporation has asked local universities to send them the top of their classes.

In response to the new industry’s request, around a dozen colleges around Canada have added or expanded upon current courses to help train a brand-new generation of marijuana production specialists. These schools even allow the classes to count towards student’s associate’s or bachelor’s degrees. Other schools have chosen to offer special certifications.

The Era of the “Green Rush”

Alison McMahon is the founder of a web recruitment site called Cannabis At Work. She has dubbed this sudden boom “The Green Rush,” and the term is remarkably appropriate. The rush to learn the marijuana production trade, coupled with the public’s desperate need to end marijuana shortage issues, is reminiscent of the American Gold Rush in the 1840’s and 1850’s.

Canada legalized medicinal marijuana nearly two decades ago, in 2001, but October marked the beginning of this new era with recreational now being legal, also. This full decriminalization has led to a hiring boom. Growers need more hands to help scale up production, while distributers need more people to help supply the public directly.

The hiring boom is so large that marijuana openings now account for 34 of every 10K jobs posted in Canada, according to Indeed.

McGill University Becomes First to Offer Degree

Although many schools have incorporated classes that will count towards credit in science, botany, or medicine, McGill University has decided to take things a step further. Starting in January of 2020, students at the school will be able to receive a graduate degree in marijuana cultivation and production.

To be entered into the graduate program, a student must have completed a bachelor’s degree in botany or a related field. This could include earth sciences, biology, chemistry, pharmaceuticals, or any number of other fields.

Many thinks that the strict requirements of the graduate program are a little insane. When you consider the extensive knowledge needed to grow, understand, harvest, and otherwise tend to marijuana plants, the requirements are pretty standard.

Others thought a graduate program in marijuana cultivation was a little unorthodox in its own right. McGill University fired back to these statements, saying that a lot of science and understanding of agriculture is required to grow the many different strains of marijuana.

 

3 Unconventional Studying Techniques that May Just Work

Unconventional Studying Techniques

When it comes to being a university student, one thing dominates all areas of study – studying. Students are always looking for new, better ways to study. This is especially true for medical students, who must sustain an admittedly ridiculous amount of knowledge in an extremely limited amount of time.

You’ve undoubtedly heard of the numerous basic studying techniques that dominate schooling. But how about trying some slightly unconventional techniques? Here we discuss a few that just might work for you.

1: Fifteen Minutes of Cramming Before Sleep

Science tells us that the brain processes its day backwards. In theory, this means whatever you did last will hold a stronger place in your memory. Using this idea, you can get the most effective studying done in the fifteen minutes before you go to bed.

This doesn’t entirely replace all other times of study. But, if you’re having difficulty remembering something in particular, take fifteen minutes just before you tuck in for the night to read as much information on that subject as possible.

Many people say that using this technique has helped them master the subject areas most difficult for them. If nothing else, it gives students an extra fifteen minutes of studying each day – which can never be a bad thing.

2: Make A Song

Songs get stuck in your head for a reason. They’re catchy, lyrical – all the things your brain is “hooked” on, so to speak. You can leverage this when studying for an upcoming test by turning your notes into a song which can be memorized.

If you look on YouTube, you’ll find that a lot of people have created study songs already. You could luck out and find one that pertains to the subject and/or test you’re already studying for. If not, just get creative and lay a few phrases over your favorite song’s rhythm.

Word of warning, however: don’t randomly burst into song during your test. Instead, sing it in your head and/or quietly (very, very quietly) hum it to yourself.

3: Make it a Game

The last unconventional method of studying is to turn the dull, boring act of studying into a game. This works especially well for people who have naturally competitive personalities. Compete against yourself or a study partner.

A few ideas for study games which will help you to memorize your coursework (while having fun at the same time) include:

  • Who can name the most anatomy parts in three minutes?
  • How many definitions can you accurately recite in five minutes or less?
  • How quickly can you complete a fill-in-the-blank sheet of pharmaceuticals and their definitions?
  • Who can complete a worksheet quickest, with the most accuracy? (Create your own worksheet or find one online)

There is a good chance that one or more of these unconventional studying techniques will work for you. Some students swear by these, while others prefer more conventional methods. The key is to figure out what works best for you.