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USMLE Camouflage!
by mantan 11-23-2009, 06:11 PM

The USMLE is no longer straight forward. There are no more buzzwords and classic clues that will alert you to the diagnosis. They will use every possible synonym instead of the original familiar terms.

They will not tell you psamomma bodies, they'll say a whorling dark blue pattern. They will not tell you increased Iron, they'll say the patient caught by a metal detector. They will not tell you ballerina skirt, they'll say abundant cytoplasm with peripheral condensation. They will not tell you Prostaglandin, they'll say oxytocic activity. They will not tell you Currant Jelly, they'll say thick bloody. They will not tell you a deaf baby, they'll say a negative startle response. They will not tell you Koplik's spots, they'll say hypopigmented spot in anterior buccal mucosa. They will not tell you clubbing, they'll say a thickened convex nail. They will not tell you acetone breath, they'll say a nail polish remover smell....

We have to be astute and we should read between the lines. We should be in our feet and we should try to enter the brain of the question maker and find out what he's up to.

I don't think this is just a test of medical knowledge, this is a test of language skills, a test of verbal inferences, a test of your IQ.

Many students came out telling us: questions were just about the thing we already know but in a different style.

They'll try everything to camouflage the question. They will put the left ventricular volume on the X axis and the pressure on the Y axis. They'll put the true positive in the right lower corner of the 2X2 box instead of it's classical upper left position.

They'll play with us hide and seek. The clue is there and you know it's there but you have to be smart to find it.

Let's be smarter, let's find them, let's eat them for lunch before they take us for dinner, let's fight for our future, let's not be fooled by their exceedingly failing attempts at camouflaging the question.

Good luck to all my USMLE friends.
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Old 11-26-2009
 
Steps History: 1+CK+CS
Posts: 236
Threads: 57
Reputation: 468
This is all absolutely true and it kinda makes me mad, because it's now not about the medical knowledge it's about how fast (not smart) you can think.. most of the synonyms are not that difficult to figure out, they just need time to consider the possibilities. I'm not saying that they should ask direct questions, rather than clear understandable ones. A rash in the buccal mucosa could be anywhere other than opposit the 2nd molar, could be of any number, so either they show you the picture or they give you the right discription. It's not really hide and seek, and this won't really affect your clinical judgement. At least this is what I think.
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Old 11-28-2009
 
Steps History: Step 1 Only
Posts: 919
Threads: 134
Reputation: 1348
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Originally Posted by DrSeddik View Post
This is all absolutely true and it kinda makes me mad, because it's now not about the medical knowledge it's about how fast (not smart) you can think.. most of the synonyms are not that difficult to figure out, they just need time to consider the possibilities. I'm not saying that they should ask direct questions, rather than clear understandable ones. A rash in the buccal mucosa could be anywhere other than opposit the 2nd molar, could be of any number, so either they show you the picture or they give you the right discription. It's not really hide and seek, and this won't really affect your clinical judgement. At least this is what I think.

hmm.. im scared now...
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