How to Plan Your Comprehensive Review Period

The Comprehensive Review period is the time period at the end of your Intensive Study Period where you make one final pass through all topics in a strategic way. At this point, you either feel as if you are running out of time, or you’d like for the test to be over already. Either way, now is your opportunity to start tying ideas together and get your game-face on.

In this last week, you should be finishing up your last subject topics and starting on your comprehensive review period. Here is a quick guide you can use to guide your activities when you get to that point.

What is the Comprehensive Review Period?

You will have covered hundreds of individual topics by the time you walk into your test. Many of these topics were covered at the beginning of the ISP, or at the end of the 2nd year. You want to walk into the test with all the information refreshed, accessible, and at your fingertips. The best way to do this is to attempt to review as much as you possibly can before the test. You also want to make sure that you spend a disproportionate amount of time on the areas that need the most review or still need some attacking (i.e. your weaknesses).

You should spend at least 10-15% of the total time at the end of your intensive study period doing comprehensive review. For a month long study period, this should be between 3 – 5 days.

The Comprehensive Review time period should be spent doing three things: practice tests, skimming your first aid, and doing questions in random grouped topic groups.

Practice Tests

Depending on how much time you have, you want to do an NBME practice test < 1 week before your actual exam. This will simulate the actual test. Remember 4h of simulation is enough to simulate the entire test; don't take the 8h QBank practice tests, they will just waste your entire day and they won't be diagnostic. The key at this point is to get you into the mindset of hunkering down, and knocking out 46 questions in 60 minutes, and doing it repeatedly. Here is when you should be practicing the question strategy tips (Skipping questions, canceling out wrong answer choices, last question first principle). Take the practice NBME in a timed format to simulate the experience.

Take a look at your score report. This is the last opportunity you will have to take a look at your weaknesses and strategically attack them. In the below content review steps, prioritize these areas of weakness. You will use the information from this score report to spend a disproportionate amount of time attacking your weaknesses during the remaining days before your exam. In general, pick 4-5 of your weakest areas, and spend roughly half of your CRP days attacking these areas (1/2 day each). Then spend the remaining CRP days covering the remaining majority of topics. This will allow you to hammer out these persistent weaknesses and get the easiest questions right on the test.

For some students struggling with simulating the test and worried about passing the exam, they choose to take an NBME at the beginning AND at the end of their CRP. This is completely optional. I would stress that the practice NBME at the beginning of the CRP is mandatory. If you are not worried about passing, the extra NBME may be more anxiety producing than anything, so it is up to you. For those who have yet to achieve a passing score on an NBME, then it is a must that you pass an NBME before taking your real exam.

Skimming the First Aid

You should plan to skim through the entire First Aid (central text) during your comprehensive review period to take in all of the information you have covered. Instead of just reading the first aid, do it in concert with questions. The best way to do this is to do questions as described below, but instead of just reading about the topic in the question, read about the peripheral topics in that topic group. For example, when doing a Biochemistry question about the Krebs Cycle, don't just read about the Krebs Cycle, read about all of metabolism. This will allow you to cover entire First Aid sections after 20-30 questions.

It is truly an amazing experience to look back at your central text and see your scribblings and have your memory jogged back to the question that was the source of that information. Don't re-read everything! You've already read the information; your goal is to refresh and remind yourself that these topics exist and to go through the frameworks in your mind. When faced with questions, your mind will access the relevant information. The refreshing piece is key; your goal is to remind your mind that those topics are available for its use. The best way to do this is in an organized fashion along with questions, see below.

Blocks of Grouped Random Questions

You should also do questions at random, so you begin to get a feel of your mind being able to bounce around between topics. You will also get this experience with practice tests, so don't feel as though you need too much practice with this random format. Save it for the comprehensive period, once you have covered all of your subject areas.

A great way to do this is to identify 3 topics you will cover (e.g. Cardio/Pulm/Renal or Micro, Biochem, Pharm). Spend 1-2 hours skimming the first aid in these topics and then do a random block of 20-30 questions in these areas; or do this process of question completion and reading simulataneously in the S1M format.

Repeat this format, until you have finished the first aid. This should take you at least two full days, if not more. Make sure that you spend a disproportionate amount of time attacking areas that are still weak (based on your NBME test 1 week out) during this time period. For example, if you are still weak in Biochemistry, spend 2-3h or up to a 1/2 day on this weakness alone in your comprehensive review period. In these areas of weakness, you will want to go through as many questions as you can in the S1M format to reinforce the frameworks, and see which individual topics are unclear to you. That said, do not overlook the review of topics you know well. You want to walk in to the test feeling that you have refreshed all of the info you have seen. Budget your time ASAP after receiving your last NBME results to figure out how long you will spend on each topic.

I hope this analysis helps you to plan your Comprehensive Study Period. It will help you to refresh all topics and strategically attack those last minute weaknesses.

Best of Luck and happy studying.