Wednesday, March 16, 2016

Preparation Tips for PG exams

Guest article by Dr. Savinay Kapur
Hello folks. When I was preparing for Post Graduate exams, I felt the need for some proper guidance as to how to go about reading, what to read, from where to read and so on and so forth. I would constantly bug my seniors, teachers at my coaching institutes and practically anyone else I could get my hands on for the same! I have repeatedly been asked the same ever since I cleared the November 2012 PG entrances. My personal belief is that everybody reads, but the difference between those who get selected and those who don’t is that the former know what to read and how to read it. So this is my attempt at making things a little simpler for those who are preparing for Post Graduate entrances.
First, a small little introduction is in order- I’m Dr. Savinay Kapur and my ranks in the November 2012 entrances were 41st in AIIMS and 5th in PGI. I am currently pursuing M.D. Radiodiagnosis at PGIMER, Chandigarh. I graduated from AIIMS and completed my internship in December 2012. I fared pretty okay in my professional exams and the MBBS entrances as well and had the honour of being part of the team that represented North India at the IAP National Pediatrics quiz and the team which won the Medillectual quiz at MAMC and AIIMS in 2012.
I’m no one to preach but I hope to be useful to at least some people who can complete the herculean task of reading this! I hope I don’t end up offending anyone and if I may add- reader discretion is advised!
The most important message that I want to convey is that there is NO SINGLE PATH TO CRACKING ENTRANCE EXAMS. I’ve interacted with many toppers and most of them had followed regimes which were quite different from each other. So just don’t follow any one blindly including me. Many people are interested in knowing how much time we need to study for getting a good rank. I think that’s a redundant question. Please remember that the amount of time one needs to read, remember and learn what they’ve read, depends on the individual. There is no universal constant for the amount of time that you need to put in. Your aim should be to give your one hundred percent and you yourself will have to introspect and judge if you are doing that or not. Having said that, you can’t sit in oblivion and be aloof from the outside world. After all, your performance will be evaluated only in comparison to that of your peers. So the best way of knowing whether you’re on the right path or not is by looking at your ranks in the various GRAND TESTS.
Give all GRAND TESTS: The one thing that I’ve found common in all methodologies followed by people who got good ranks is that they started giving Grand tests pretty early and gave all grand tests including those of DBMCI, DAMS and IAMS. The best time to start would be right at the beginning of final year. Keep giving them even if you aren’t getting good ranks. Try to compete with yourself and read all explanations. This helps in two ways; one is that you know whether you are doing the right thing, and second, the questions asked are pretty relevant and focused to current patterns and trends. So with every test, aim at reading at least 8-10 topics which have been asked in the exam from reference text books. This way you end up reading and revising some very high yield and you’ll probably end up remembering these discrete topics better as you have read these topics in isolation from similar confusing topics
Try to discuss things in GROUPS. The more you discuss, the more you will remember.
Form as many MNEMONICS as you can. However while doing so, try to make ones that are either relevant to the topic for which you are making the mnemonic or are so bizarre that you’ll remember them for the bizarreness quotient. Also visual cues in the form of small little diagrams or drawings or flow charts help. Try making them in your book next to the text. It’s easier to remember pictures than it is to remember the text
You’ll get selected if you’re FOCUSED. By focus I don’t mean staying tense all the time thinking about what will happen in the exam. By being focused I mean getting away from the multitude of distractions and constantly reminding yourself that your sole aim is to clear the PG exam with flying colors.
Don’t dismiss entrances as being just determined by luck. I agree that luck does play a role, but so does hard work. The proof lies in the fact that the top 100 in AIIMS as well as PGI are almost the same. There might be exceptions but from what I’ve seen, people who have been dedicated and hardworking, have got through.
I can assure you that most MCQ books have answered a number of questions incorrectly, including AA. Given that a large number of questions are repeated, it makes sense to correct those answers. You’ll only know if a given question is right or wrong if you’ve read well earlier. Don’t hesitate to check the answer if you have the slightest doubt that you’ve read something else in the book. Laziness at this point in time can cost you very, very dearly.
8. Another similar matter, very close to the heart of all of us and something we all are very emotional about- THE CONTROVERSIAL QUESTIONS!!
There is an order which you should follow while selecting answers to controversial questions

1. Ask the AIIMS professor who is likely to have made that question, this is for AIIMSonians as we guys know the favourites of almost every professor.
2. Ask any AIIMS professor of that subject.
3. Ask an AIIMS student if they’ve been told about it in college.
4. Try and search reference books but only standard reference books.
Plus don’t try and infer stuff from any book. Only rely on a certain book if it gives the exact same line as is asked. Don’t extrapolate things which are written to find a particular answer. Most questions are asked directly from stuff written in a particular book or journal. You just have to find the right reference.

5. If you can resist the temptation, the simplest thing to do is to go with the answers your coaching teachers tell you.
If you are still not satisfied with the answer or can’t find one, relax. The probability of that same question figuring in the exam are slim. Moreover, the probability of the answer you find now matching with the answer given in the key are even more remote.

6. If your rank in the Grand tests is within 100 then refer to online articles. Only rely on those journals which have a very high impact factor like NEJM, Lancet and the likes. Again, don’t extrapolate the things you read. Search for statements that match perfectly with what has been asked.
If your rank in the Grand tests isn’t within the top 100, you are better off not wasting time and effort in search of that all elusive answer. Read the rest of the topics rather than going after such controversial questions. You have two options if the question does appear in the exam- Chant Jai Mata Di and mark the answer or Leave the question in the paper.

9. How many questions to mark in the exam- It depends on the negative marking, the number of questions in that exam and your own caliber. If the negative marking is 1/3, mark the question if you can eliminate 1 option. If the negative marking is ¼, I suggest you attempt all questions. If the number of questions is 200 or less, scores will be more closely placed and there will be more people with same marks, so you are better off not attempting questions where you can’t eliminate 1 or 2 options. If your rank is within 100 in the grand tests, go with your gut feeling even if you can’t eliminate any option. If your rank is from 100-500, mark according to the negative marking. If your rank is beyond 500, I’d advise you to mark only if you have eliminated 2 options. But this is just my point of view, opinions may vary.
For PGI, you have to put your gut feeling to good use. Marking around 525-575 questions seems to be wise. So you can’t hold back as much as people probably tell you to do. Try to mark things that you think are correct or have read even if you aren’t a 100% sure. The seats are very limited, so if you mark less than 500, I don’t think you are giving yourself a good enough chance of qualifying.
10. TIME MANAGEMENT in the exam- It’s a very common problem that people are able to finish mock tests in time but when it comes to the real exam, everything goes haywire and people end up marking the last 50 questions in 15 minutes. That can be well and truly be disastrous. My personal approach always used to be to aim at finishing a certain number of questions every half hour. This way you can pace your exam pretty well and increase/ decrease your speed accordingly. The size of each block would obviously depend on the total number of questions in the exam.
I hope that covers most of the general stuff that I wanted to share with everyone. For the ease of the readers, I’ve divided the rest of the note into a few sections. Please read the section you currently fit in, though it might not be such a bad idea to read the rest of them as well, because I’ve wasted a lot of time and effort in writing those too :-P
SECTION A- For MBBS Students in 1st year to Pre-final year:
READ YOUR TEXT BOOKS WELL- Though this sounds dumb and boring but this is the only way which can assure you of a good rank. Read standard text books.
MCQ books will only supplement your preparations; they can’t substitute standard text books. After you’ve read your standard text book WELL and feel you remember most of the stuff, only then go on to the MCQ books. When you read MCQ books, you can’t really remember new stuff, you can just reinforce and add on a few finer points to what you’ve already read. If most of it is alien, you won’t remember anything you read. So use them only if you know the theory/ the basics pretty well and want to fill in the gaps.
Attend postings and classes- This holds true esp. for AIIMSonians. Most of what is taught in our lectures is asked in the exam. So it is a very good idea to hear things right from the horse’s mouth. Most of the so called “controversial questions” are discussed in those lectures and you know that these very people set the questions. So blindly follow what you hear in class, don’t bother reading weird references or listening to explanations from teachers of any coaching institute.
Relax and party whenever you can. It is never a good idea to read, read and read without enjoying life. You won’t get this time back ever again so make the most of it.
Differentiate between text books and reference books- Text books are the books to be read from 1st line to last line with special emphasis on “marked” topics. Try to read the whole book like a novel but remember the stuff marked by your seniors. Don’t try and remember the whole book.

Final year as such is a stressful period for all of us. Don’t try to do anything special or spectacular. Heroics in general are best avoided in final year. Read your textbooks well.
If you haven’t read Harrison even once then it might not be a great idea to start reading it now. Instead of trying to read the entire Harrison I’d personally recommend you to read those topics only, which are being asked repeatedly. Now the question is how do you select those topics? Simply read the questions from AA and Manoj Chaudhary given under medicine and read those topics retrospectively. I’m pretty sure this will help you in your professional exams as well as PG entrances. I had read different topics from different books including CMDT, Harrison, Kundu, PJ Mehta and George Matthew. You have to mix and match. But I know for a fact that if you read Harrison well, as in you are confident enough to be able to quote stuff from there when asked something, your odds of getting selected go up pretty substantially.
For OBG I had read Dutta for Obs and Shaws for Gyne. Plus the Johns Hopkins manual is an excellent read and highly recommended for those topics which are undergoing rapid changes in terms of guidelines and where protocols are universally applicable like oncology. In case of any confusion you can refer to Williams.
For surgery I myself was and still am confused as to what to do. I think for NEET, Bailey should be your go to book. But do read Schwartz/Sabiston for topics recently asked in AIIMS and All India just like Harrison is to be read for corresponding Medicine topics. A bonus point- Read M.L Saha for your practicals, that book rocks!
Pediatrics has to be read from Ghai and Ghai alone. Don’t bother reading Nelson. If you really love to read then as I’ve told you above, read the commonly asked topics or topics which are controversial from Nelson.

SECTION C- For Interns:
OK, so you’ve passed the final year and are now, an over-zealous intern brimming with enthusiasm. But somewhere deep down inside, you know that the euphoria of passing the final year is soon going to die down and will be replaced by the fear of the unknown.
First take a break for some time. But don’t lose focus! Remember that you have to start studying soon. You will want to keep telling yourself that you’ve just passed final year and you deserve a longer break. But if you keep delaying things, you’ll soon realise that you’ve fallen behind and can’t cope up now and that you must start thinking of preparing for the next year’s exam. Trust me it does not take that much time to fall behind. There creeps in a fear that there is too much to do and too less time. You soon land up in depression because you have so much to study and there seems to be so less hope; have to work in a hostile environment with odd hours, the patients hate you for being a blood sucker, the residents hate you because you keep disappearing; your parents keep reminding you that this is it, the exam your future wrests on; your friends might start looking at you as competition, best avoided. All in all, not the best time of your life!

From there on it’s a vicious cycle of not studying –> getting poor ranks –> getting depressed –> not studying. That is to be avoided. So start early.
Read for your T & Ds.
During internship it might be difficult to spare time for reading. But remember that it is the only time you’re going to be getting for that topic(s). So however you do it, from wherever you do it, try and finish that topic(s) within the stipulated time. If you’re short on time, do only the questions and answers or read your notes or anything that you’ve read before and/or believe that you will be able to read again in the future. The point is that a certain subject, if ignored, will keep haunting you. Even if you try reading it later on, it’ll seem so much like a burden that you’ll end up pushing it under the carpet and ultimately that topic will not be read again, ever. This happened to me with Ophthalmology. There was such a fear psychosis of that subject that I could never read it. No matter how hard I tried, I just couldn’t understand what was happening. Finally I ended up leaving it altogether and hardly marked any Ophtha question correctly in the exam.

Remember, only the things you read multiple times are the things you’ll be able to retain in the long run.
There are different kinds of facts
i. Some, you read once and you just remember.
ii. Some, you read multiple times and you remember
iii. Some, no matter how many times you read, you tend to forget.
i. In the first category fall things that you’ve read about in class 11 and 12 maybe or are very basic. Plus some topics you’ve read very well during your MBBS. Anything that you have read more than a month ago and have been able to remember it in any test is most probably in that Hard Disk of yours. You don’t need to worry about them now.

ii. Majority of the topics fall in the second category. These are things which someone has asked you and you get a feeling as that answer is stuck somewhere and you just can’t retrieve it or else you’ve marked them incorrectly in a test because you can’t remember what you read. These are things you should either read in more detail or note them down in a notebook for revision or do both.
iii. Into the third category fall numerical values, numbers and years and that sort of things. Things you can’t remember even a week after you’ve read them. These should constitute your last minute revision notes; not the ones in the second category.
A subset of this category are things that aren’t numbers or figures but things that you haven’t ever understood and hence can never remember. If you can’t remember stuff that doesn’t have to do with numbers then you need some kind of association to remember it. Read it from someplace else, maybe from a few different sources. Try the internet. Look for articles on wiki relating to that. You’ll surely find enough interesting cues that will serve as trigger points in your memory which will help you remember better.

Quite frankly I shouldn’t be commenting on something that I haven’t experienced first hand. However what I feel is a lot of people think that at this stage they just need to sit down with question banks and previous years’ papers. I highly doubt that is the right way of going about things. I believe that you should ask yourself if most concepts of MBBS are clear to you or not. If they are and you feel comfortable reading most explanations then go ahead doing only previous years’ question papers. However if you feel that you haven’t really read most of the topics that are being asked or if the explanations seem gibberish to you, I think you need to read those topics from textbooks to clear your concepts. That will help convert information from category ii/iii to category i.
The ultimate aim should not be to read but to remember, like I’ve already said.
I think I’ve conveyed most of the things that I wanted to. If there are still any doubts please inbox me. I will try to get back to you if I think I can help you with something.

Before I end, I would just like to thank the people without whom I couldn’t have achieved whatever little I have. My parents have been my biggest support and I owe everything to them. I’d also like to thank my grandparents, without their wishes I don’t think any of this would’ve been possible. Next in line is my brother, Pranay Kapur, my guide and friend in the darkest of times, my cousins and, my bhuas, and everybody else who have always been there whenever I’ve needed them. My friends Hameed, Aakanksha, Ankita and Veronica who always believed in me and were always there to motivate me and help me selflessly, even if it meant sacrificing their own precious time, thanks for being there people, I know how lucky I am to have you guys around. A big thanks to all my seniors for all there help and affection esp. Dudes, Khera babu and APS, thanks a lot yaar. Finally thanks to all my teachers, at AIIMS and at DBMCI and DAMS esp. Dr. Apurv Mehra and Dr. Sumer Sethi for being the mentors that I needed and for being available even a day before the exams.
To be honest I don’t think the ones close to me how much I value them and care about them, but I genuinely love each one of you. Thanks everyone :)

I’ll leave you with a list of books read by me-
BDC for gross anatomy
I.B. Singh for histology
Langman for embryology
Snell’s neuroanatomy

Di Fiores for histology

Bijlani and *Ganong*


Harper’s, Lippincott

*Robbins Robbins and Robbins*

Ananthnarayan for everything
*Jawetz*- for immunology and virology
Paniker- parasitology
AIIMS notes

Forensic medicine
Pass the Professional exam somehow and then simply read Sumit Seth

KDT, Katzung (Both are complimentary, keep KDT as your base book and just browse through Katzung like a story book)
FDA Drug information

USMLE High Yield Biostatistics
Policies and Programmes by D.K. Taneja


Not the right person to guide.

Neena Khanna

Ajay Yadav

Dr. Sumer Sethi’s book

Neeraj Ahuja, Harrison

Dr. Apurv Mehra’s notes

* are the books which I found most useful and recommend as must reads even if you are a post intern.
I’ve already mentioned the books for major subjects of final year in the text above.

Best of luck to everyone who has had the courage and determination to read this Ramayana of sorts. I hope you achieve what you want to in life and even more! May the force be with you :-D “