Everyone who has been through medical school can agree on the emotional and stressful turmoil that comes with writing exams. There’s the initial surge of courage and determination, fueled by the set exam date and the focus it brings, gradually giving way to creeping anxiety as the exam looms closer and the feeling of not keeping pace with the study schedule mounts. A last-minute rush to see if you can recall everything you’ve studied and then the quiet acceptance as you witness the exam about to begin.
As the exam begins, the true test commences – not just of one’s medical knowledge but also of your ability to manage emotions and maintain your composure under pressure. You read through the work and then you meet that question you’re unsure of. Now the question is, “how do you handle it?” Well, that’s what we’ll discuss in this article.
What to do when you encounter a difficult question
Encountering a difficult question during an exam is a daunting experience. It can disrupt your flow, undermine your confidence, and even lead to panic. However, it’s important to remember that difficult questions are a natural part of any exam, and they do not necessarily mean that you are failing; with a calm and strategic approach, these challenges can be overcome and turned into opportunities for success.
So, we’ve put together a list of tips that are helpful and should be employed to aid you in handling the difficulty.
1. Maintain a calm and focused mindset: It is a sad truth that no matter how hard you prepare, there will still be that one question that throws you off your game and stalls your progress. Stay calm and avoid getting stressed out to prevent the start of a negative feedback loop. Panic will only cloud your ability to think and make you spend more time on a particular question. If you falter, take a deep breath, recover, and then focus on the task at hand and trust your ability to handle challenging situations.
2. Read the question carefully and thoroughly: As you maintain a calm mind, take the time to fully read and understand the question and identify the key information being asked. Keep your eye out for minute details that might get lost, information like age, sex, occupation, and abnormal lab values. For lengthy or complex questions, break them down into smaller, more manageable parts. This technique can make the question more manageable and easier to tackle.
3. Identify keywords and phrases: Pay attention to specific keywords and phrases that appear both in the question and answer choices. These can provide clues to the correct answer.
4. Analyze the question type: Determine the type of question, whether it is a single best answer (SBA), multiple best answers (MBA), extended matching questions (EMQ), or image-based questions (IBQ). Each question type requires a slightly different approach:
a. Single Best Answer (SBA): After reading the entire question stem, eliminate answer choices that are clearly incorrect or irrelevant. Consider the most likely diagnosis or treatment based on the patient’s presentation and history. Evaluate each remaining answer choice carefully and select the one that best fits the scenario.
b. Multiple Best Answers (MBA): Identify the number of correct answer choices. Read each answer choice carefully and select the ones that are clearly applicable to the scenario. Eliminate answer choices that are clearly incorrect or irrelevant.
c. Extended Matching Questions (EMQ): Read each patient presentation or scenario carefully and identify the relevant information. Match each patient presentation to the most appropriate diagnosis, treatment, or other relevant information. Eliminate answer choices that are clearly incorrect or irrelevant.
d. Image-based Questions (IBQ): Carefully observe the image and identify any relevant anatomical structures, abnormalities, or findings. Correlate the image findings with the question stem to determine the most appropriate answer choice.
5. Eliminate obviously incorrect answer choices: After you understand what is being asked, go through the options and rule out answer choices that are clearly wrong or irrelevant to the subject being asked. This should narrow down the options and allow you to critically analyze them, increasing the chances of selecting the correct answer.
6. Draw upon your knowledge and experience: When faced with a challenging question, tap into your medical knowledge and experience to make an informed decision. Consider the patient’s presentation, history, and the most likely diagnosis or treatment scenario, and try to recall relevant medical concepts, studies, or clinical cases that shed light on the correct answer. This will provide a framework for evaluating the remaining answer choices and increase your chances of selecting the correct answer.
7. Make educated guesses if unsure: When faced with uncertainty, don’t hesitate to make an educated guess based on your medical knowledge and understanding of the material. You can draw connections to related concepts you’ve studied well and allow them to guide your decision-making process. Scrutinize the questions you’ve already answered for clues or keywords that might provide hints towards the correct answer for the current question. Remember, a well-reasoned guess is always preferable to leaving a question unanswered.
8. Refrain from dwelling on difficult questions: Finally, if, after employing all the steps above, you still need to learn the answer, then you should move on to the next question. Spending more time than necessary on a particularly challenging one is a surefire way of preventing you from answering all the questions asked. If time permits, you can return to the difficult question after you’ve answered all the other questions.
9. Practice with Sample Questions and Mock Exams: This final tip is ironic because it’s meant to be done before you go into the exam venue. When drawing up your study schedule, make sure you pen down time to practice sample questions in a mock exam that simulates the exam environment; this will prepare you for the real deal. You can find samples on the USMLE, the MCCQE, and PLAB here.
Remember that diligent preparation must have preceded your attempt to write the exam. There is no substitute for hard work and studying, and these tips will only help where there is something to remember.
Conclusion
Difficult questions are unfortunate hurdles that most people will encounter when writing exams. However, they don’t have to be the reason why you fail to finish answering all the questions asked. Remember to maintain your calm and prepare properly before the exam to ensure you cover all the relevant topics. Consider utilizing question banks like the ones found at CanadaQBank, which have materials on all the major medical board exams to practice as you study. Regardless of how difficult the exam might seem at first, do not fear because, through a series of logical elimination, you will arrive at the correct answer.