Identifying the Problem: Test-Taking Strategies for Medical Boards

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On the STATMed Podcast: Uncommon Pathways Episode 3

Host Ryan Orwig speaks with STATMed alumni who share their uncommon pathways to their dream careers in this podcast miniseries. In the first episode, Ryan and JT, a surgeon, discussed the challenges low boards scores could cause when pursuing a competitive field like orthopedic surgery. 

Test-Taking Strategies for Med Students and Doctors

In the third installment of our Uncommon Pathways podcast miniseries, Ryan is back with JT, an orthopedic surgeon, who shares how the STATMed Boards Workshop transformed how he approached board-style exams. They dig into the importance of implementing test-taking strategies that yield results and the benefits of identifying test-taking issues. 

“What frustrated me was that I didn’t have words to articulate the mistakes that I knew I was making. And so it was like, finally, I can identify the problem, and once you identify the problem, you can do something about it. And so y’all gave me this lens through which to identify my problem. And a big part of that was misreading and then twisting what the question was asking. And I would realize I was answering the wrong question like it was right in my head because that’s the question that I was answering, but it’s not the question on the test. That was a big error for me that I realized pretty early on.” – Dr. JT

Have your test-taking strategies been letting you down? Our Boards Workshop can help.

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Announcer: Welcome to the STATMed Podcast where we teach you how to study in med school and how to pass board style exams. Your host is Ryan Orwig, a learning specialist who has over a decade of experience working with med students and physicians. In the third episode of our Uncommon Pathways Mini Series, we’re back with JT, a former Doctor Study Skills Course participant and Board’s Workshop participant who shares his journey to becoming an orthopedic surgeon. In this episode, JT and Ryan dig into test-taking strategies for medical boards.

JT: And honestly, like I truly believe had I not had a system and those rails to stay on, I just would have completely collapsed and I would’ve freaked out and been like, man, this is crazy hard, this is nothing that I studied for. I’m running out of time and going back and changing answers, it would have been a train wreck.

Ryan: There’s a real nightmare scenario there.

JT: Yeah, y’all’s system gave me the rails to stay on for those seven hours that I was in there taking that test.

Ryan Orwig: This is Ryan Orwig with the STATMed Learning Podcast, where we talk about studying, time maximization, and board style test-taking for doctors, med students, and those in related fields. Today, I’m here with Dr. JT, who is going to share some insights into the challenges he faced in his uncommon pathway to becoming a surgeon. So then you did that and you know, you worked on your stuff for a while, you’re not really in contact with us ’cause we give you the tools and set you out into the world to go work on it. And then you come back and you’re like, hey, now I’m ready to really re-engineer my test taking, this is done with our board’s workshop, it’s very mechanistic. You know, I’ll talk to somebody and see if it’s a good fit for them. And then once somebody like you says, yeah, I want to do this. We don’t say well, let’s tinker with your test-taking approach, let’s evaluate your test-taking approach. I mean, the evaluation comes in the interview and I’m like, is this good or bad? For you, it was like, yeah, it’s bad. So what we do is we tear that sucker to the ground. It’s like, if test-taking is a house, we’re not gonna renovate the house, we’re gonna raze it, we’re gonna flatten the sucker, and build our system in its place. So we build the system and then you’re applying it to your own questions and really teaching you how to identify what you’re doing right and wrong. What we say is we’re teaching you two things, how to play the game the way we want you to play it, and then to be your own trainer, to be your own coach. This unlocks what’s called deliberate practice. Because we’re making you, we’re using our expertise to graft that onto you so you can use our expertise to train yourself moving forward. So I don’t know, what were some of the insights that you made through the workshop that really changed your test taking?

JT: Yeah, so I’ll start with this and this is for anybody listening that’s it’s trying to decide if they want to do this or not. You’ve got to commit 100% to the process. Like it’s just-

Ryan: So true.

JT: If you don’t do it, like it it just doesn’t work. Because I think you said this at one point to me, and I 100% believe it, it’s like if you’re coming to STATMed, like you’re coming for a reason. You have determined that your test taking is a big reason for your issues, then you can’t carry any of your old test taking habits with you. And it really like dug up a lot of stuff in my test taking that like looking back, it’s like, man, that is so bad. Why would I ever do that? Like, I was so, I didn’t think of test taking as a skill. It was one of those things you hear is like, oh, test-taking is a skill. And I would always be like, yeah, yeah, sure, whatever. But I did not fully understand it until I started working with you and breaking down what was my process? If you could even call that a process, for working questions.

Ryan: It is a process even vague, ugly, inconsistent, it is a process, it’s what you plug in. But again, I think we think of it as just one large gross motor action. But it’s actually a very discrete process, and there are patterns that we can see, that are both good and bad. And at the end of the day, it’s behavioral, you’re engaging in either negative or positive behavioral patterns. I think a lot of us have a bad taste in our mouths for test taking, because I know I was taught like this deductive reasoning garbage, like ways to try to outsmart the test, try to beat the test. And that stuff is just not relevant in general, I don’t think. And certainly not relevant for medical board exams that are statistically normed and validated. So yeah, we gotta get rid of all that stuff, And what I tell people is like, you might think like, okay, I’m going to take 80% of what they say for this process. And I’ll get 80% of the benefit. I mean, I didn’t build it this way on purpose, It’s just how it works, that doesn’t work. For whatever reason, the way this whole thing works is like you’ve got to have, I say 95% fidelity to the system or greater to get the benefit. And again, I don’t do it to be malicious or whatever. That’s just how this thing works. I didn’t build this because this is what I wanted to build, it’s just what I found needed to be built for our demographic, for the people that come to us that are smart, that are knowledgeable, and they just are not plugging into these questions in a way that’s effective. So we have to fix that. So I don’t know what else can you say about it? Go into some of the insights or any other broad thoughts on your test taking?

JT: So I think one of the things that it does, it allows you to take control of the test. Whereas for somebody like me, I was always at the mercy of the test. And y’all’s process of reading the question, reading the answer choices, coding everything, like it gives you these rails that you’re going to stay on, on the test. And regardless of how you’re feeling that day or how hard the test is, if you stay on the rails, and if you’re consistent, and if you have been consistent with your process and you know, roughly like, okay, this is how I answer these questions and I’m probably going to get about this if I stay on the rails, like it will hold true. And I realized, I got to the point with y’all’s process and working my practice questions that I had a pretty good idea about every block, like where I would hit percentage wise. Like I knew at the end of it, it’s like, if I just stay with this process, I know that I’m probably gonna hit between 70 and 75% of my questions.

Ryan: It’s because you trained so rigidly, like somebody like you, is a lot of fun, because it’s just having that hungry athlete that you’re coaching. And you know you give them like a workout regimen to do between practices or training sessions. I know you’re going to do it and then some. Sometimes you meet people and they’re not doing that, but I knew you were going to go and get it and drill down and ask the right questions of yourself and of the system. This isn’t a magic wand, this is work that you have to do, and it’s going to really show you a lot about yourself. And it’s hard. Like people get really frustrated because you’ll see the mistakes you’re making pretty quickly and then they don’t go away immediately. That’s the frustrating part. Because it’s behavior change at the end of the day. What you’re talking about though is, a lot of times we take test-taking as like an internal locus of control, where it’s like our emotions and our fears are overwhelming us and consuming us and tearing us apart, either in training, or certainly on test day. What you were just describing though, is making the locus of control on test taking an external locus of control. It’s like, hey, it’s not me, it’s the system. And I think people that really can put the system between their emotions and their fears and the test, and then use that as a scaffolding to hold them and carry them through the test, which only is going to happen if you train with it rigorously, really holding that scaffold accountable. It’s like, hey, it’s not me, it’s the system. You know, like I want to freak out, I want to deviate, I want to dump it, nope can’t, the system dictates. Like, maybe you make a prediction and you see that option as option A and you want to just jump on it, but that’s not the system. The system says, okay, let me think about A, let me weigh it, let me judge it, let me code it, then B, then C, taking each one and putting it on the scale by itself and coding it, why? Because that’s the system and those are the rules. And I think that that’s something that you really really acquired through some blood, sweat and tears through the training.

JT: Yeah, definitely. I mean, I wish this was on video and I could like show my stack, because I still have them, I have my stack of question sheets that I had coded.

Ryan: The trainers, these training tools that we give you.

JT: Yeah, yeah, yeah, yeah, yeah, the trainers. And I mean, I don’t know. I wish I would have like calculated how many questions, I worked thousands and thousands of questions, and they were all through the STATMed process. I’ll say this to you, just kind of as another pitch, like I love data, like I love just like looking at analytics and stuff, and that is what this.

Ryan: Yeah, we turned it into data.

JT: Yeah, and you can look and can analyze like all these just my minute details of like, why you missed this, like, I loved it. So part of it was just in a way kind of fun for me to figure out like what these mental holes I was getting myself into in these questions, I kind of enjoyed it to some degree.

Ryan: Yeah, we break the act of working a question into those three phases, first phase, second phase, third phase up in the question, the vignette, through the answer options and then tie breaks. But you know what I tell people, and I probably said this to you, is that any test taker knows what their decision was, I chose A, right, but what people don’t often know, certainly our struggling test-takers, they don’t know about the micro decisions they made en route to picking that decision/macro decision.

JT: Man, and that is what drove me absolutely nuts because I love to know, that’s just kind of who I am. I want to know exactly why it was that I did that, and that’s one of the things that the first videos that I saw, that kind of talked about, it’s like, I want to know why I chose that wrong, why do I consistently choose the wrong answer? And anyway, it really kind of gets you into these inner workings of like what you’re doing. And I realized that it was very rarely, like, I would say very rarely, but oftentimes it was not a knowledge miss.

Ryan: You would know, you would know because you could quantify it. You turn it into real numbers, you might say like 60% of my misses were test-taking misses, 40% knowledge. Who cares about the 40%? Miss those questions, that’s not going to get you in trouble, it’s the 60% or whatever. If you’re consistently missing questions you shouldn’t miss based on what you know, we call those test-taking mistakes, test-taking misses, these unforced errors, those are what are killing you. And then I think what you’re also alluding to is you’re making the same mistake patterns, like a handful of mistake patterns over and over and over again. What were some of the mistake patterns you identified for yourself?

JT: Yeah, so big thing that I realized really early on was, and I feel like a lot of these kind of overlap-

Ryan: They do, they do.

JT: So I’ll kind of put some of these together, but like misreading and twisting. That was a big one for me. And this goes back to the reading process, I would look at it, a lot of times when I was going through the test, I would be like, all right. I just want to get this thing over with, I’m just going to read the question and the answer’s just going to pop out to me. And if it doesn’t, then I’ll go back and really drill in. So I was doing a very surface level read of questions. And so I was misreading stuff like all the time. Like I was just going fast and you would miss a key word or just a key point of the prompt. So it could be like a prompt based issue. Or I would realize sometimes that it was an answer based issue where I was misreading an answer choice.

Ryan: Misreads are often for somebody like you, you might read the prompt or the last sentence, the question being asked and you might pick out two words and then your brain auto-fills the rest, making it mean who knows what. That’s like looking at 10 plus 10 and being like, well, maybe that plus sign is actually a minus. Or you look at an answer option, and again, you look at one word, you might make a prediction early on and look at an answer option that looks sorta kind of like it, and your brain interprets it as that other thing. These are these misreads that again, people think misread, they think, oh, I missed the word, not or I missed the word, except, it’s so much more nuanced than that.

JT: Sure, oh yeah, 100%.

Ryan: It gets so much into the way that the brain, the eye is tracking the words on the screen, to you using your knowledge. It’s actually like when we get into these twists, making square pegs fit in round holes. It’s you using the stuff that you know, to validate wrong answer choices often by misreading, twisting, distorting the words or something like that, right?

JT: Yeah, oh, absolutely. And I realized that was a habitual problem for me. And it was just so sloppy. I can think about that and just how I worked through stuff. And it’s just lazy test-taking. And it’s just not a, and it’s because there was no structure. Like I didn’t have, I just didn’t have that vocabulary, that skill set to employ to the question. And that’s exactly why I was in the position that I was in. And that’s kinda what y’all told me, how to deal with, so.

Ryan: And adding structure and adding vocabulary is so empowering, right?

JT: Yeah. It really was, and that’s what turned me on to y’all and I keep going back to this, but when I watched that video, it’s like, man, y’all are speaking my language. Because what frustrated me was like, I didn’t have words to articulate the mistakes that I knew I was making. And so it was like, oh, okay, finally, I can identify the problem, and once you identify the problem, you can do something about it. And so y’all gave me this lens through which to identify my problem. And a big part of that was misreading, and then twisting kind of what the question was asking. And I would realize, I was answering the wrong question, like it was right in my head because that’s the question that I was answering, but it’s not the question that was on the test. So yeah, I mean, that was a big error for me that I realized pretty early on. The other thing too, is like the difference between like partial true, partial false, and hugging the familiar. And this goes back to just again, sloppy reading. When you’re scanning through a question like you see, oh, this is the question about ankle fractures. Oh, I know a lot about ankle fractures, so this is probably what they’re going to ask me here. Or like, this is something, I like this concept. And so I realized I would kind of inadvertently, subconsciously like, err towards like answering or choosing the answer that was the concept that I liked. If that makes any sense.

Ryan: Oh, you know, well, it makes sense to me, this is absolutely what people do. So you look at option C and you know more about it and it’s almost like a cognitive dissonance is happening where you look at the clues, the one clue that fits, option C, and you ignore the other clues. And that’s why it’s also partial true versus partial false. And so you’re hugging that familiar, you’re gravitating toward it. And I think you end up using your knowledge to validate that wrong answer.

JT: Oh yeah, yeah.

Ryan: Because you’re only looking at the clues, either the concrete clue that’s up in the passage that fits it, ignoring the clues that go against it, or twisting a clue that’s up there to make it fit either by genericaying it, rounding it down, or by adding a what if or a but maybe that’s not actually there in the black and white print.

JT: Oh yeah.

Ryan: And again, and this is never stuff you would do clinically, you would never make these mistakes clinically, and that’s the disconnect between the test-taking and the clinical experience, right?

JT: Yeah, that was my experience so oftentimes with these questions. And to somebody that doesn’t do it, like if I told my wife this, and I did, and she just looked at me like I was crazy, she was like, why would you do that? And I’m like, I don’t know, it’s just what I do.

Ryan: It’s really hard though, it’s really hard for your wife to understand. So anecdotally here, my wife also, so my wife’s a clinical pharmacy specialist in infectious diseases. So she’s an ID clinical pharmacy specialist. But she is the exact opposite of me, she is a bottom-up learner like your wife. She was an amazing test-taker. She assimilates knowledge on the fly, so I think it’s a mystery to her what it is I do. I don’t think she can possibly, she knows it works, and she knows that my brain is wired like this. If you explain it to somebody who is from the other end of the spectrum, they’re kind of like, that’s what you’re doing? That’s what you’re doing wrong. It’s so hard for them to understand. And that’s why I think intervention can be hard sometimes because the ones that are really good test-takers are often the ones who get handed the chore of helping the bad test-taker. But that’s like having the amazing athlete help the struggling athlete. You don’t want Michael Jordan teaching you how to, I don’t know, work on your jump shot or something.

JT: Yeah, exactly, and again like talking to you and David and working through this, and realizing that what I was, I guess having someone to validate what I was struggling with was so helpful too. ‘Cause you’re around a lot of people that are just good, they’re just good test-takers. And it was just always discouraging for me, it’s like, well, like I feel like an idiot. It’s like, why can’t I get these right? So it is good to talk with guys like you who really know this stuff and have seen it for 15 years. And it’s like, yeah, it’s real, people do that, and you’re not crazy.

Ryan: That’s really interesting, I don’t know if I’ve thought about it so specifically though, especially where you are in your field, surrounded by all these amazing test takers. So I think it’s like they are looking through a clear glass window and being asked to read the piece of paper, like the eye chart on the other side of the clear sheet of glass. And you are looking through a muddy sheet of glass, the bad test taker, you’re being asked to read the sheet as well. And it’s like this unfair imbalance, like if we could see this pane of glass clear versus muddy, it’d be obvious. Like, hey, it’s unfair where we’re asking JT to do here. But since we don’t know, this is just a metaphor, it’s like, why doesn’t JT read the chart as well as we do? And I like this idea. I think sometimes people wonder how David and I can be so incredibly good at this. We’re not medical professionals. We haven’t spent time in med school, we are reading and learning specialists. So people are sort of like, how do they do this? It’s because we have this profound expertise in the way the reading and learning works. And we’ve just worked with only med students and physicians and related fields who have struggled. So we understand where these interventions are and we understand the constructs like the USMLE, your specialty boards and all that stuff. So really interesting stuff there on the test-taking, and then you have a little bit of a broader, you had one more point on test taking and test day maybe, the workshop helped you with as well.

JT: Yeah, so just the overall time management concept. So I always had a fear of running out of time on the test and I never ran out of time on tests, but I always had this fear of like, oh, I’m going to run out of time on the test. And so what I would do, and I realize in y’all’s process, I realized that I was working the test too fast. And so that led to all these problems, like misreading, twisting, and looking for the path of least resistance on these tests and that led to bad results. And so I would fly through these tests and if I got to a question that I struggled with, I would be like, okay, well, I’m probably gonna have time, I’ll come back and look at this again. And you’d mark something and it’d be like, oh, okay, well just in case I don’t get back to you, I’m gonna mark this. And so I would like mark questions on my tests on like old tests. So I would have literally, if it was an entry exam, I don’t know, like a 200 question test, I would have, I would have 100 questions marked. I mean, it’s just crazy. Because I like had this thing of like, oh, like maybe if I could go back, and maybe this will be like later on the test, I’ll find an answer that could help me with this. And so just all these things.

Ryan: You know how I feel about all this.

JT: Yeah, yeah, exactly. So I realized that I was, and I knew this about myself, I knew that I changed answers and my wife always said, don’t change your answer, like, never change your answer, but I just couldn’t mentally do it. And it took me working through this process and realizing, oh, like, I’m going way too fast, I’m not reading the questions correctly. I’m not making good decisions on what answers I’m choosing. And then I’m going back and changing them based on like, and then I’m going back and doing that whole bad process again. So I’m making horrible decisions on the first pass of a question, and then even worse decisions on the second pass of the question. Yeah, just total disaster.

Ryan: It’s a train wreck, there’s so many things wrong with that.

JT: And this is why I say like, you have to stick with the process. And so having that formula for every single question is like first thing that you do, read the prompt, second thing you do, go back, read the body of the question. Then you work through each and every answer choice in a systematic way, you code it. And then you look at your codes and then you’re like, okay, what’s my high code? Boom, move on, done. And then it allows you to forget about that question. Like I never-

Ryan: Put it to bed.

JT: Yeah, and I would realize that I will keep these questions hanging around in the back of my head. By the end of a test. I had like a million different things flying around my head. And like you said, I have no elves, So it’s just this maelstrom of information. And so what this allowed me to do, you pick your answer and you move on, you have a clear head and the mental capacity to work the next question. And so you just systematically go through these. And I realized my test taking really slowed down, but it wasn’t a bad thing. I ended up still finishing with plenty of time on my practice questions.

Ryan: Well, we make you train with time and that’s a big part of it, right. Really using the splits, the compartmentalization.

JT: Yeah, yeah, exactly.

Ryan: So that you learn how to operate in that sort of pocket space.

JT: Yeah, man, and that was huge for me because I never, when I would work questions, I would always like, I would work them on un-timed tutor mode, or sometimes I work on timed tutor. Like just again, there was no system, there was no reason for what I was doing. And using y’all’s process of of saying like, okay, this is how you’re going to do it. You have to recreate the test taking environment, you practice how you’re going to play. And I had not ever done that consistently.

Ryan: Yeah, that’s a big deal.

JT: Through that process, you know, I realized it’s like, I’m actually, if I just stick to this process, like I’m finishing with plenty of time and I feel good about it when I’m done and I’m not going back and changing questions. And so it is amazing how I would still do it from time to time, throughout the process, wish I actually like got these down and like actually got the stats of like, what percentage I changed the answer to and got it right. I mean, but it was minimal, it never really happened. Like I would usually change it to the wrong answer and I would get to the end of a test-taking thing and I’d change an answer and sure enough I’d miss it, like why did I change that? It’s crazy how it works.

Ryan: But there’s patterns, usually what happens when somebody changes an answer is they go back and they see one phrase, one clue in the passage that fits a different answer option.

JT: That’s your confirmation bias.

Ryan: Yeah, boom, or, you know, you’ve twisted something or something like that. There are usually patterns to it. People will call me and say, one of the things I ask them is, is time a problem for you? And somebody like you might say, no, time’s not a problem for me, ’cause I get through with plenty of time leftover. And I would say no, time’s possibly a problem because you’re going too fast, time cuts both ways. If it’s too slow, maybe somebody is just hemorrhaging time doing a bunch of bad things, the way you’re reading it loosely, and then coming back and reading it again, all that stuff. But you really internalized one of the key principles of our system, which is you will never get as clear and clean and comprehensive of a look at a question as the first time you read it. And the idea is that when you’re done with it, put it to bed, even if it’s like between question marks or minuses, you’re not 100% sure, I don’t care, pick the best answer.

JT: Yep, 100%.

Ryan: Pick it and move on. I mean, this idea of like doing a 200 question test and having 100 flagged questions, that cannot feel good.

JT: No, it’s crazy. And to your point about looking at every question like that, one, the way I thought about it was like, you got to treat every question in a vacuum, and there are some things, they will tell you, this question builds off of the last question, and you know that, and you accommodate for that. But in general, like you gotta treat every question in a vacuum. And then on top of that, you got to treat every answer choice in a vacuum. And something that I was doing as well, I would do comparative coding off of an answer, and I’d be like, well, you know, this one as compared to this. And just that’s bad.

Ryan: Yeah. I don’t know why it’s so bad. There are some systems that are out there and it’s all about comparing options against each other. My theory on it is it must overload that working memory in some very specific way. I tell people it’s just bad, just don’t do it. And this is all built into the system, obviously.

JT: Yeah, yeah, and I realized that I have a very short-term working memory. I think that hurt me a lot, and I think that just speaks more to what I’ve realized about myself. It’s like, I’m just kind of, I like concepts a lot, and so I think people that are conceptual tend to have shorter working memories. I mean, I don’t know, you make it speak more to that, but I found that for myself and that really-

Ryan: For you, for sure.

JT: And that really hurt me on tests. Was this idea of working memory. It really, yeah, it was a problem for me and y’all’s system really brought that home and it gave me the tools to fix that.

Ryan: Yeah, you’ve worked through this stuff for about six months while in the last year of your residency. And then you took your test a few months ago, right? And what happened?

JT: Well, I passed and it was, getting that email was one of the greatest, I mean, honestly, one of the greatest days of my life, I’m surprised you didn’t hear me screaming over in West Virginia, because I was so excited. But you know, it was such a huge relief. I mean, it was a validation of five years, it was just kind of that, I had to say like, man, dodged the bullet of failing a board, but like, it is, it’s just such a relief.

Ryan: You don’t know, it happens.

JT: It’s like, man, I’m so glad that I never have to worry about a standardized test ever again.

Ryan: Wow.

JT: I told you the other day, it’s like, I’ve watched more college football in the past two months, than I did in the past five years just because for me, at least, it was always just a source of anxiety. It’s like, man, I’ve always got the OIT coming up, like I probably should be studying, and you’d spend two hours on a Saturday, reading stuff. And you know, you just don’t have that pressure gone and be able to like just enjoy things without having to worry about standardized tests, it’s awesome.

Ryan: Well, yeah, the two hours you had to do the work, but then even in the four hours when you’re watching the game or sitting down to watch a movie or whatever, you’re even still like, I should be studying, this constant, it’s like chronic pain, like this constant nagging, issue, that’s always seeping away. Or like, how present are you with your wife, is it one eye on the book or 20% of your consciousness feeling bad about it?

Ryan: It’s gone, it’s gone.

JT: Yeah, yeah.

Ryan: You can focus on being a professional, you can focus on your career, you can focus on the other aspects of your life. And it’s an amazing thing. What were you telling me about like the success rate, fail rate of this year’s ortho?

JT: Yeah, so one of the things that they tell you, there’s a big review course that most residents go to. And one of the things that they really harp on is like, look, there’s a really high pass rate for this test, like 97% of y’all will pass, like basically saying study, but don’t worry too much about it. And I heard all that, but I was like, I’m still gonna study like crazy. So last year, the failure rate for all test takers,

Ryan: This is prior, the year prior to you taking it?

JT: Yeah, yeah, correct. The year prior for all test takers, meaning people that were international graduates or were retaking it again, it was 9%. And for this past year, it was 14%. So there’s a pretty big jump. And I knew, I talked to the guys that took it last year, they were like, it’s fine, there’s a lot of very reasonable stuff, a lot of the questions are really easy. Well it was without question, it was the hardest test I have ever taken in my entire life and everybody this year, in kind of talking with people, other guys that took it, you’re like, man, that was really, really hard, it was an exceptionally difficult test. And I left there thinking, man, like, I really was worried about if I passed, but the actual day of the test though, I looked at the first question and I was stuck on that first question for like three minutes. And I was like, my gosh, this is brutal. And that was the story of that day. I finished almost every block with a minute or less than a minute left. I stuck to the system and I was really freaking out about my time, at that point, I was like, okay, time really is a problem here because the prompts were very, very long, there was a lot of images that you had to feed into in a question. And I was like, this is a real problem, from a time perspective. I remember like, I just heard your voice, it’s like stick to the system. And that’s what I did, like it did not matter how close I was. It’s like, I’m going to write down, I’m going to code everything. And that’s what I did, I stuck to the system. And honestly, I truly believe had I not had a system and those rails to stay on, I just would have completely collapsed and I would have freaked out and been like, man, this is just, this is crazy hard, this is nothing that I studied for, I’m running out of time, I’m going back and changing answers, it would have been a train wreck.

Ryan: There’s a real nightmare scenario there, right? There’s a real what if nightmare scenario there that you don’t wanna think about.

JT: Y’all’s system gave me the rails to stay on for those seven hours that I was in there taking that test. Every question, you treat every question as new, you code it, and you just go through the system and stay with it, and it paid off. For overall test takers, yeah, it was like a 14% fail rate, up 9% from the previous year. And then for first time test takers, last year, it was a 3% fail rate and it was an 8% fail rate this year. So it was a very, very hard test for whatever reason. And again, I really think I would have been that statistic.

Ryan: Man.

JT: Had I not had a system to stay with.

Ryan: Well, you definitely took what we taught you and you drilled down, and you worked it to the bone, and the payoffs are pretty amazing, just to not have this test hanging over you. And look, these things do happen to people, but you cleared that hurdle and it’s quite exciting. I’m glad that you could have my dry monotone voice droning on in your ear as you’re taking it, I’m like, you know what, glorious.

JT: Yeah, it works, it works. If there’s one voice to hear, it’s yours.

Ryan: That’s right. That’s a weird thing for me to hear and say, but yes, I am fine with that as the cost of doing business. Well, hey, I really appreciate this. We ran long as we always do on these things. I really appreciate you coming on here and sharing this story with us. We might get you back on here again, and we might talk about some of your story, on how you got to where you were in med school and some of your thoughts on mentorship, which I think are really exciting and interesting. So thanks again for coming on here.

JT: Thanks Ryan, this was great.

Ryan: We’ll be back with some more conversations here in the following weeks. Thanks for listening.

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