Dr. Steven Daugherty Reveals 10 Steps to Think Through a USMLE Question Like a Clinician

In order to excel in the USMLE exam, students must Think Like a Doctor and apply clinical thinking to each exam question. Becker faculty Dr. Steven R. Daugherty understands the underlying logic of the USMLE exam and is devoted to ensuring students’ success on test day. Through his personal USMLE exam prep resource, USMLEThought.com, Dr. Daugherty collaborated with Dr. Phillip Tisdall, M.D. to provide a ten-step process guiding students through the clinical thinking process.

  1. Collect the basics. Age, gender, time frame and other demographic information will help you to picture the patient and the setting in your mind’s eye.
  2. What’s the chief complaint? Is there a standard or clear clinical problem with a known approach?
  3. Engage the clinical “train of thought.” Imagine you and a senior physician are in the room with the patient. Read through the rest of the question stem as if the physician were talking to you about the patient.
  4. Consider the full set of information which is presented. Dr. Daugherty suggests moving away from looking for a simple association or “hook” in the question to considering the full set of information that is presented.
  5. Come to a conclusion about the disease in question. Before reading the question line, come to your own conclusion about the disease in question.
  6. Now read the question line. At this point, the question line should seem like the logical conclusion of your clinical thought process. Given all that has been presented, what does the senior physician want you to know?
  7. Decide on the answer. 
  8. Look at the answer choices. Only look at the answer choices after you’ve already decided on the answer.
  9. If you cannot think of a good answer, exclude the ones that you know are correct and pick from what is left. Eliminating false answers first will allow you to spend more time focusing on the answers that are most reasonable.
  10. Move on to the next clinical case. 

Practicing these steps and mastering the clinical thinking process will eventually help you to anticipate what information the question gives you to solve the problem. As Dr. Daugherty states: “Learning to think like a clinician is the key to understanding what each question expects from you and how to find the ‘train of thought’ that leads you to the solution waiting at the end.”

For more USMLE test-taking tips and study advice, visit Dr. Daugherty’s blog USMLEThought.com and follow him on Facebook.

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