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Is there a problem regarding a 120/90 blood pressure?

120/90? The short answer: “Almost certainly not”.The long answer is important because billions of dollars are at stake and every single person reading this is likely to be affected. Ignore it at your peril!But first the slightly longer answer, which will make you sleepy—while your pocket is picked: “A single reading means very little. Blood pressure varies a lot, naturally and depending on circumstances. We need the average of many readings. Instruments must be trustworthy and calibrated—many get this wrong. But—if reliable and representative—your reading is likely fine, and highly unlikely to be a hazard to your health”.Boring, isn’t it? At this point, most eyes glaze over. Quite sad, because the long answer makes for interesting if somewhat cynical reading. Whether you read it or not, you will also pay for the long answer—through your medical aid or as a taxpayer.The long answerThe long answer is that many doctors will shortly tell you that my short answer is utterly wrong.Let’s look at a screenshot of the 2017 guidelines of American Heart Association and the American College of Cardiology criteria for hypertension, freely available on the Web:[1]How can I be so wrong? You’ll see that by this authoritative definition, if your diastolic blood pressure is 90 mmHg, you officially have “Stage 2 hypertension”. That sounds bad. Why the discordance between what I’m telling you and their version?A full answer would likely fill several thick volumes, but here’s my take:If you visit a doctor today and they’ve read the most recent US guidelines, you may well walk out the door with two new, lifelong drugs. If however they’re a bit uncomfortable with the new, official line, they may look at the “90” and advise you about certain lifestyle modifications. They may bring you back for yet more measurements. They may even measure precisely according to the guidelines.But you’ll likely fail “lifestyle modification” and end up on drugs. You likely won’t benefit, and may come to harm from the drugs.This is in distinct contrast to higher blood pressures—say 160/90, where there is unequivocal benefit from blood pressure medication. Through its effect on the blood vessels, heart and kidneys, high blood pressure is the number one killer in most societies today.The bottom lineAlmost everyone will now be classified as having ‘hypertension’ at some point in their life—and be put on lifelong blood pressure tablets. Many will be harmed, and the cost will be immense, for small added benefits.Why and how?I have been carefully watching the field for a couple of decades now, and published a few papers on this. As I see it:For many decades the threshold that defined ‘high blood pressure’ was about 140/90. Although imperfect, this made sense, because all of the studies showed no net benefit of treating pressures lower than this. There was some enthusiasm for treating particularly ‘high risk’ patients like those with diabetes down to a blood pressure approaching 120/80, but these were dashed as recently as 2010 in the ACCORD trial, published in the prestigious New England Journal of Medicine (NEJM).Despite this, the large companies that make blood pressure tablets saw that if they could change the definition of ‘hypertension’—lower the threshold—they had a new market: somewhere between 17 million and 70 million ‘patients’ in the USA alone.They pushed hard. The first thing they did was establish a label. If you have a diagnostic label, then you have ‘something to treat’. It’s important to get into the clinician headspace with a label. The label was ‘prehypertension’. It was defined in something called JNC 7.Prehypertension was a bust. But they continued to push. An important—if somewhat bizarre—study was the TROPHY study, again published in the NEJM. The authors claimed that this study demonstrated the benefit of early treatment of ‘prehypertension’.I know a bit about the TROPHY study as I spent well over a thousand hours analysing it. MJ Turner and I published a thorough refutation in one of the top three hypertension journals (Blood pressure variability causes spurious identification of hypertension in clinical studies: a computer simulation study) which the authors of TROPHY have never bothered to answer. There are multiple other issues with TROPHY, including millions of dollars of sponsorship by drug companies, failure to adhere to their own pre-set criteria, and huge conflict of interest on the part of most authors. But it is still cited unthinkingly.TROPHY caused quite a bit of controversy, but didn’t change practice much. Unlike SPRINT, a study recently published in the NEJM that is freely available here. In this study—for the first time—intensive treatment of blood pressure down to 120 systolic showed a large benefit over and above a more conventional target of 140 systolic.SPRINT changed everything. That a single study could overwhelm all the previous studies may strike you as a bit strange, but I’m not surprised. Cynically, advertising can get you almost anywhere, and SPRINT has been punted to the point where small green creatures from Proxima Centauri are asking “What’s this SPRINT thingy?”A mad SPRINTSPRINT has been punted because it is exactly what the drug industry wanted. Almost alone, SPRINT appears to have resulted in re-definition of hypertension, down to a threshold where the greater part of the US population now officially ‘has hypertension’.If I were simply to say “Go figure” at this point, you might leave with a thoughtful expression on your face, but—if you can bear the length of this post—SPRINT is so important that it may we worth looking at it in a little more detail.Superficially, SPRINT is brilliant. Here are the positives:It was not funded by drug companies. The authors look squeaky clean.*It showed benefit. The positive effects of aggressive blood pressure treatment were huge. Donald Trump would be proud.The study was fairly large: 9361 patients.Diabetes was an exclusion criterion, suggesting we could apply the results ‘more generally’.The patients were older—at least 50 years old.These are the points that have been emphasised far more than the following ‘slight negatives’:The study was stopped early. The thinking here was that the benefits were so large, it was wrong to continue. The catch is that there’s a large literature about how early cessation inflates perceived benefits. We are rightly a bit suspicious about early stopping. Perhaps however, this is a small quibble.The side effects were not small—twice as high in the intensive treatment group. These are described well in the Appendices to the paper—4.7% as opposed to 2.5%, with increased risk of fainting, low blood pressure and acute kidney damage (all more-or-less doubled).** A one-in-twenty chance of being clobbered by the drugs.Blood pressure monitoring was if anything too good—compared with what most clinicians normally do. It’s reasonable to assume that a blood pressure of 120/80 in the study may well correspond to at least 130/90 in a normal doctor’s surgery! (This is complex, and has been argued about at length).Most of the patients (90%) had already received the diagnosis of hypertension. (According to the old definition).The main criterion was systolic blood pressure. Diastolic blood pressure was an also-ran. This has implications for your “diastolic of 90”.There are lots of other fiddly issues that I don’t have space for here, but the absence of adequate blinding is potentially a huge issue.The results are discordant with those of other trials like ACCORD. Why should a group without diabetes have greater benefit than those with diabetes? To their credit the authors analyse this issue in some depth, pointing out that the SPRINT subjects were older; their new study is also more precise.The big questionBut the million-dollar—excuse me—multi-billion-dollar—question is this:“Is SPRINT representative?”In other words, can we generalise this to the 17–70 million US citizens who now fall under the revised definition of ‘hypertension’—especially younger people with a slightly raised diastolic pressure, measured by an ordinary clinician in an ordinary office? Does this single study justify a radical revision of the definition of ‘hypertension’?I’ll leave you to make your own decision. My answer is an emphatic “No”.Some might disagree, but I’d say your BP is likely fine. And treating it will cause more harm than good.Just my 2c however, Jo.[1] Image from a long powerpoint at http://www.onlinejacc.org; the full text (PDF, large) is downloadable here. Those who are really keen may wish to reconcile the entire 2017 JACC document with the network meta-analysis they cite, particularly the last bit of the latter document.*I’ll leave you to wade through the statement of conflicts of interest, especially those who appear on the list of authors of both the ‘squeaky clean’ SPRINT study, and other studies (like TROPHY) that were heavily industry funded. Suzanne, I’m looking at you :)**Acute kidney injury is expensive.‘Eyes glaze over’ image from What Do You Say When Their Eyes Glaze Over?

What is the lamest excuse someone has given after cutting ahead of you in line?

Excuse me, I have 5 (20) pages. May I use the xerox machine, because I have to make copies?exactly this phrase was used as an excuse at the line to the photocopy machine. It is safe to assume that every single person’s intent to be at that line was exactly the same as used as an excuse. Yet 94% of respondents actually have complied.This, in fact, was a study by Dr. Ellen Langner of Harvard University back in 1977. The results have shown that even the lamest excuse will provide a high chance to cut the line.Here is the link to the original paper: [PDF] The Mindlessness of Ostensibly Thoughtful Action: The Role of "Placebic" Information in Interpersonal Interaction - Semantic ScholarAnd here is a short description of the experiment for those, who don’t want to read academic papers at this time of the day: The Copy Machine Study Shows That One Word Can Help You Get Your Way

Which books should I study for getting an assured rank and admission at AIIMS New Delhi?

Disclaimer :All of the content I mentioned below has been my experience and understanding of the situation and I do not claim that this is the only way to do things. The purpose of this post is to give an idea on how I studied for AIIMS PG entrance exam. Also I am not getting paid by any institute or authors to promote them, this is an honest review of the material I used. Feel free to disagree with me totally!!(edit: I decided to add a section of FAQ at the end of this post based on the questions I received…so keep on contributing as questions/comments and I will keep on adding more to this article…the aim is to compile everything for your prep…what to study and HOW TO STUDY!)(the FAQ section has my approach to “smart study” in somewhat detail so even if that FAQ is not your question still give it a read because it might help you in some other way)(also the aim of this post is to connect to you as a fellow student so i have written it in a very informal way with a lot of “…”and ”!! “.)Credentials for answering the question :I joined AIIMS NEW DELHI as a MBBS Student in 2013 (All India Rank - 7).Completed my Internship during Jan 2018 to Dec 2018 period from AIIMS.Gave AIIMS PG entrance exam in November 2018 during my internship :RANK 152 ( the old pattern exam)Joined as a Non academic Junior Resident in AIIMS NEW DELHI in Department of Cardiac Radiology & Endovascular Intervention from January 2019( which I am continuing at the time of writing this post) .Gave AIIMS PG entrance again in may 2019 :RANK 26 (the new pattern exam)(For the exam pattern of AIIMS PG entrance and how to tackle the "new pattern" you can refer to another question that I have answered.)Komal Gupta's answer to What do you think about the new paper pattern introduced in the AIIMS PG entrance exam?Now on the topic of preparation :1.I joined DAMS (PG Medical Entrance Coaching Institute, NEET PG )during my pre-final year (from Jan 2016) in foundation batch2. I had joined DAMS and DBMCI ( Dr. Bhatia Medical Coaching Institute ) TND during my internship year (from Jan 2018)3. I was a MARROW(Gold standard for NEET PG & SS ) pro plan B user from July 2018 till may 20194. I had also joined various facebook groups by subject faculties5. I had attended separate classes by various faculties : including -Medicine lectures (10 days) by Dr. Thameem Saif (Welcome to Bright Medicos )Orthopedics lecture(2 days) by Dr. Apurv Mehra (Dr. Apurv Mehra )Ophthalmology lecture (3 days) by Dr. Utsav Bansal (SOCH | Dr. Utsav Bansal )Anatomy lecture (4 days) by Dr. Rajesh kaushal (HUMANANAT-ACADEMIA )6. I had a full subscription for Uptodate (Smarter Decisions. Better Care. ) (which all AIIMS UG & PG students get for free from the institute)(in case you don't know about Uptodate-- it's an online learning platform that is a point-of-care medical resource and is marketed as an evidence-based clinical resource... Envision it as Harrison - but on steroids...online + getting updates ASAP + has information on all the clinical subjects... But super expensive)7. I had a lot of review books and notes.8.I Read few topics which I could not find anywhere else from wikipedia (Wikipedia ) and Medscape (Today on Medscape )too(on a side note : I didn't pay for a lot of these resources or got them on a discount which was provided to me because of my performance in college professional exams)DO YOU NEED IT? ALL OF IT?NOI just mentioned what options I had.Looking back at it now I feel most of it was just to prevent FOMO.(Because FOMO during entrance preparation is a real thing. May be that one lecture or one book can stand between selection and taking another year drop. May be this, may be that, a lot of may be! )In reality i was a very very very very selective reader.And this along with my exam day strategy was what made my preparation "smart work" instead of hard work.(you can read my exam strategy in the article I mentioned above)HOW MANY MONTHS I PREPARED FOR?All the studying i did during 2018 (during internship) was very irregular and rare... But I attended all the lectures and TND that i needed during that time and made good notes so that when I start my "serious" prep for may 2019 I have all the sources already available.Overall i gave it - 4 months of dedicated studyingWith January - February 2019 : focusing on 1st and 2nd year subjectsMarch - april 2019 : for revision of all 19 subjectsAnd I feel 4-6 months is enough time if you have a good understanding of your topics and have read from standard textbooks during your professional exams.You will need to give more time to cover up whatever deficit you have in your knowledge.So decide for yourself.Now...Coming to the actual point...WHAT AND HOW I STUDIED :(again mentioning that this is just my personal experience and we can agree to disagree here...)I studied only the important topics!How i knew what was important?I referred to previous year AIIMS PG question papers and marked all the topics from that subject that were asked previously into my review books even before I would start studying that subjectLogic behind it :1. 60 - 70 % questions in AIIMS are from repeat TOPICS (not saying questions are repeated though they are a lot of times, but the topics which are usually asked are almost consistent)2. Topper scores around 70%-80% marks usually3. No one knows answers to the weird and new and cool questions, not even the topper4. Everything "new" is either something that no one knows or an update to previous guidelines.5. I should know the strength and weakness of my enemy before I start preparing for the fight.6. I didn't want to read all the topics in all the chapters (!)Refer to previous 3 - 4 years of question papers (total 6-8 papers)(older questions based on older patterns and older guidelines are not needed... Also pattern changed a lot from November 2016 onwards and now again from may 2019)Now...The subjects...What I actually studied...ANATOMY :I attended Dr Ashwani's TND class (DBMCI) (Anatomy App by Dr. Ashwani Kumar ), it was really good.But i needed someone to teach me all that is needed for the exam once so that I don't have to read and get lost in anatomy on my ownI attended Dr. Rajesh kaushal 's class... It covered anatomy very well... Almost 100%... If he didn't teach something in the class then I never tried to read it on my own to prevent myself from getting lost in anatomy.(but spoiler alert :class is boring and long... Because that's how anatomy is... He repeats every topic a million times in the class... Listen to it... Imprint it in your brain... Try to survive through it)Must do electron microscopy images of cell from grey's anatomy (41 edition)PHYSIOLOGY :Dr. Somman Manna's review bookFirst aid to step oneGraphs from Ganong review of physiologyALL THE FORMULAS!RBC, WBC and platelet count calculation as we did during 1st year practicalBIOCHEMISTRY :First aid to step oneFew topics from Dr. Rebecca james ' review like porphyria, glycogen disorders.List of all the enzymes affected by insulin and glucagonProtein, starch and ketone testsPATHOLOGY:First aid to step oneDr Devesh Mishra' s reviewIMAGES (in AIIMS images are not asked from any book... They just ask the most typical image from the Google image page... So I compiled screenshot of those... Also Google gives you many perspectives of the same image so that helps too)Blood transfusion protocolMICROBIOLOGY :Dr. Apurb Shastri's review bookTND notes of Dr. Shivika (DBMCI)First aid to step oneIMAGESParasitology life cyclesFORENSIC :Dr Magendran 's review book ( felt more colourful and readable than sumit seth... I didn't die of boredom while reading it!)PHARMACOLOGY :Dr. Gobind rai garg' s review bookALL THE FORMULAS!(I was told to read the new drugs that are approved from FDA in the previous year.. Just Google it and you will find the list.. I tried... Couldn't memorize even 1... So decided to take the risk of leaving that question if asked.. It wasn't asked)Make a lists of drugs safe & Contraindicated in renal disease, liver disease, pediatrics and pregnancyMechanism of action of all drugsList of drugs of choice for infectionsMEDICINE :Dr. Thameem 's notesKnow how to identify ECG, acid - base imbalance questionsSummary of Uptodate articlesNew topics and updates of latest CMDT .(refer to FAQ section to know more about CMDT)Emergency medicine from emergency medicine module on DAMS emedicoz app by Dr Naman (Emergency Medicine, AIIMS)Dr. Arvind' s notes (DAMS) for CVS examinationSURGERY :ATLS manual (10th edition) (just Google it and you will get the pdf)Few selective topics from Dr. Pritesh Singh' s review(in surgery in AIIMS hardly anything other than trauma is asked... So just read that in very much detail)DAMS DVT (for cannula, sutures & catheters etc)PSM :High yield biostatistics for USMLE 4th editionDAMS DVTMalaria, TB, HIVWhatever new disease is famous that yearUpdates that are added in the latest Parks textbookALL THE FORMULAS!OBS-GYNAEDr. Deepti Bahl's TND / regular batch notesUptodate summaryImagesPEDIATRICSDr Meenakshi Bothra's reviewNeonatal resuscitationI was told to read "AIIMS standard treatment protocol" (they are treatment protocol for all diseases which are published by AIIMS faculty, available on google for free download and also as a book), I didn't get time for it(New Born Baby )AIIMS pediatrics youtube channel ( you will find the video of Silverman score that was asked in November 2018 there)OPHTHALMOLOGYDr. Utsav bansal 's class(for the first time in MBBS i understood what was going on in that subject)IMAGES from GoogleORTHOPEDICSDr Apurv Mehra' s class /review bookImages of tests and x rays from GoogleENTRead the chapter on hearing assessment from Dr. Sakshi Arora's bookThe multiple versions of the image of mastoidectomyANESTHESIADr. Ajay Yadav 's book from dbmiMedscape ( Today on Medscape ) for reading how to do procedures - I read how to take bp, insert foley, ryles, rapid sequence intubation and arterial sampling.RADIOLOGYDr Sumer Sethi' s TND classImages from GooglePSYCHIATRYDr Praveen Tripathi 's reviewFirst aid to step oneDAMS DVTUptodateDERMATOLOGYDr Saurabh Jindal' s review bookDAMS DVTImages from GoogleMISCELLANEOUS STUFF/MUST DO1.PEP & Blood spill guidelines ( just Google "AIIMS blood spill protocol"... A pdf from AIIMS Jodhpur will appear... Read these 2 topics from it)(https://www.aiimsjodhpur.edu.in/quick%20docs/HIC%20FINAL%20MANUAL%20AIIMS%20JDH%202-1-2018.pdf )2.DAMS DVT slides (will cover most images, instruments, clinical stuff and updates )3. IF IT HAS BEEN ASKED IN AIIMS EXAM PREVIOUSLY THEN YOU MUST KNOW IT4. Keep your eyes and ears open during your postings and grab as much information as you can. Examining a patient is the best way of understanding a disease. With the recent trend in the exam of more clinical knowledge and procedures based questions attending postings sincerely will surely give you an advantage.Question practice :1. MUST SOLVE PREVIOUS YEAR AIIMS QUESTION PAPERS (I have done them 5 times till now and revise all the topics from it)2. Give 3 hour grand tests / CBT/CLT (whatever you would like to call it)... Make a strategy on how to attempt questions... Knowledge and information doesn't matter... Just know how to solve questions... Learn how to find answers by logic even when you have no idea about the question. To get knowledge use your books, don't rely on any question bank for that.(read FAQ section below for more on this)3.Know your weakness4. I have given a detailed plan on how to manage time during the exam in the article that I have mentioned above. Give it a try on one of the grand test.In conclusion,Take advice from everyone, but do only what you find Useful/doableDon't go crazy due to FOMOAvailable knowledge in endless but you have a limit to your efforts so be selectiveAll the best.(EDIT!)So I decided to add a FAQ section based on comments I received here and in Facebook messages and to continue updating it frequently . Hope it solves any further doubts you have.FREQUENTLY ASKED QUESTIONSQUESTION : Is DAMS notes (or any other notes that you studied from) enough?ANSWER: I cross checked DAMS notes / DAMS books / review books/ notes from some subject faculties.I felt all these have almost the same content.So I decided to go ahead and read review books ( I am more comfortable reading from a book rather than reading hand written notes…probably because I have a very bad hand writing… so choose one of these sources (or whatever other notes you have) based on what you find most comfortable)I had used my foundation notes from DAMS a lot during my prefinal year when I was reading my final year textbooks for the first time . After that during my final year I felt a lot of topics were updated (like there was a new Parks PSM that year so foundation notes of PSM felt useless) so I read only my standard textbooks . During my internship I read from only the latest review books ( reading 2 year old notes at that time didn't make sense to me) and TND notes of the classes I liked of DAMS/DBMCI.Whatever you choose…just stick to one source…trust them with your heart and soul…don't waste time because of FOMO.QUESTION : How to manage time along with internship /whatever other work post you have.ANSWER :I was very irregular with my studies during my internship (it wasn't because I could not get sufficient time off from postings, it was because I wanted to take some time off from studies for a while)I studied regularly during January 2019 - April 2019 period.I was doing Non Academic Junior Residency in Department of Cardiac Radiology and Endo vascular Intervention at AIIMS NEW DELHI during that time.It helped a lot because :It was only few hours of work in the morning. I used to always get free before 1 pm and I could study in afternoon then.It provided me with a structured day…work every day in morning…study in afternoon… I needed that kind of structure for myself a lot at that time. For the first time during my MBBS I was sleeping on a fixed time and waking up on a fixed timeI have a tendency of binge watching TV series for days but going for work in the morning would break that cycle of endless binge and I would get to study after work so I wasn't binging anything for more than half day.I changed my perspective…I need 8 hours of sleep…at maximum on any day I can study only for 8 hours ( even 8 hours feel like torture to me…4-6 hours is my comfort level)…so even if I have to work for upto 8 hours my schedule should be OK. We worry so much about the time we are working that we ignore that during the time when we are not working we are actually wasting it away on youtube /facebook etc or wasting it on complaining about work. My focus was that non work time and how to utilize it most effectively.I feel I am addicted to my phone (aren't we all these days!)…so I used apps which would block me out of whatsapp/facebook/Instagram /youtube (there are literally endless number of such apps on play store) (also as we say poison kills poison…so using apps for my phone addiction! )…I would adjust block time in such a way to give me 1 hour slots of study and 10 min break after each slot.QUESTION : Which book you used for AIIMS previous year question papers and did you read the explanation?ANSWER : I had used Dr. Pritesh Singh AIIMS essence review and also Aim4AIIMS question papers (for the latest question papers which were not there in my AIIMS essence) … They both need corrections to be made to their answers…when in doubt search that topic (just type the key word in the search option ) in DAMS exclusive facebook page/any other subject faculty facebook page you follow…you will surely find that question already asked by someone and answered by faculty. Stick to that answer instead of what is given in the question paper.Use these books only for seeing the question…then go ahead and read the explanation from your notes /review book that you usually use.QUESTION : Is Harrison a must??!??!??ANSWER : It is not, but reading any good medicine book for building your concepts is.I didn't read Harrison.I gave it a try during my pre final year( read CNS, CVS, leukemia from it) . It was TOO much for me. I could not finish chapters. Those chapters which I could finish didn't make any sense in my head at the end.The best test for knowing whether you understand your topic well is by teaching it to others or trying to write it down for yourself in a single sheet of paper without referring to the book.You will be able to write a flow chart for it if you understand it…there will be deficits of factual values which you can always look up in books/latest guidelines …for example…symptoms /signs of stroke…do NCCT head…it's either hemorrhagic stroke…then do nothing just manage the blood pressure if it is more than *insert the latest BP cutoff for hemorrhagic stroke here*…or it could be ischemic stroke…then check for *latest* contraindications of thrombolysis…if it not contraindicated then check BP…too high BP becomes a contraindication *insert the latest BP cutoff for thrombolysis here*…then do thrombolysis…post thrombolysis management. Hope i made some sense here!I failed both those tests with Harrison. I was trying to read Harrison only because everyone around me was doing it and i had FOMO.I read CMDT + “choti harri” instead.CMDT (CURRENT MEDICAL DIAGNOSIS AND TREATMENT by McGraw-Hill publications) :It's a book which gets updated every year and a new edition is released every year. It has investigations and treatment explained very beautifully…it uses the words like “drug of choice is” (and all everyone cares about is what to answer…I don't want to read 2 huge pages in any book where I am left on my own to decide what should be the drug of choice!)…it doesn't have Pathology part in much detail (I was okay with that because Robbins is the best source to read Pathology from…not Harrison!)…. DR. THAMEEM TEACHES FROM IT DURING HIS LECTURE (I know i could have written just that last line and it would have been sufficient)“choti harri / baby harry (!)” (Harrison MANUAL of medicine):This book is the short version of Harrison PRINCIPLES of internal medicine (badi harri /papa harry) from the same authors. It has ALL the algorithms, flow charts, tables and a summary of everything from badi harri. So you don't have to carry around the burden of badi harri and still you get all the needed information. Highly recommend it.( on a side note, choti harri is usually released 1 year after that edition of badi harri…so 20th edition of choti harri is yet to be released as of June 2019).I didn't read any other textbook like Davidson /Matthew's. So I don't know how they are and i dont like to give a judgement about a book without actually reading it. So I will suggest you to ask someone who has read it themselves.OrJudge a book for yourself. Take an important topic…say asthma…read it from every source available…Harrison/CMDT/Davidson /whatever book you want to give a try…record how much time it took for you to complete each source, the amount of information given and how understandable it is/ease of reading. Then stick to what you like the most. All 3 factors are equally important.QUESTION :How to memorize so much content available?ANSWER: I feel if you can understand the logic behind something then you can avoid adding it to your things to remember list. And logic stays in your head for much longer. While what you try to memorize, you will eventually forget.I also analysed AIIMS previous year question papers well and felt that they very very rarely ask factual information so I was able to skip those.So I just used a small notebook in which I would write down all that i wanted to memorize for example all the formulas, cutoff for BP in strokes, and other such key information which is relevant clinically . I don't have a good memory for factual stuff so I didn't try to force myself in memorizing stuff which is not asked in AIIMS exam and is not relevant clinically like diameter of eye, length of some nerve etc. If you can look it up in your book then why should we memorize it and thus should not be asked in a good quality exam. The notebook which I mentioned here I used to carry with me all the time, I used to read it if i would get free time during postings and because it had clinically relevant stuff only so I used it few times to look up something for patient management too.QUESTION : I couldn't find the mock test on AIIMS website which you had mentioned in your previous post.ANSWER : It is available on your registration page from where you download your admit card. It will be available 1-2 week before your exam.(I wanted to add screenshots of that page here to give you idea about it in advance but it has already been removed from my page…may be one of you can send those to me when you get to access the mock test in November 2019 session)QUESTION : How much MARROW question bank you used and is it worth buying?ANSWER : I was a MARROW PRO plan B user from July 2018 - May 2019. Plan B contain test series and question bank, it doesn't include lecture videos. I didn't use MARROW much, I had solved only few modules in it. Also as I didn't have access to the videos i dont know how they are. I don't like giving judgement about a source without using it myself. MARROW test series had previous year question papers given in the form of tests which I thought was a great initiative from their side.My view point on the amount of question practice one needs is a little different.What is the logic behind question solving :To know how to apply your knowledge into the questions ( if you can't use your knowledge in getting marks by answering questions correctly then you need to do more practice…no excuses allowed!)Solve 3 hour grand tests /CBT /CLT/whatever your coaching calls it : start around mid year…don't leave it for the end…don't wait till you have “sufficient” knowledge to start solving it…YOU WILL NEVER FEEL YOU HAVE SUFFICIENT KNOWLEDGE…so start today…test takes around 3 hours or 3.5 hours based on the pattern…doing an analysis of the test takes another 5-6 hours (without the analysis part the 3.5 hours that you spent giving the test is almost useless). I used to watch discussion videos of the test at 1.5* times speed and add the new information to my notes…I used to try and see the entire explanation video because even when I knew a topic very well there was always something new that faculty could add and it makes a great revision source as the most important topics get repeated in every test and listening to it again and again just works as revision. ( you have no idea how many times till now I have heard Dr. Deepti Bahl explain the most common and 2nd most common uterine anomaly in a video discussion and I dont think I can ever forget it).Don't leave grand tests for the month just before your exam as I mentioned above each test takes around 9-10 hour (3 hour for the test and 5-6 hours for the explanation)…that's atleast one entire day worth of studying!!…you should be doing revision of your notes during the last month instead.Try to solve every question, especially those that you have no idea about. You learn how to apply logic in question solving by those questions. You will never know all the answers accurately. But you can learn how to rule out options, how to identify keywords, how to increase speed of question solving. Initially you will apply faulty logic, eventually you will learn and get better at it and finally you will have the confidence to take those risks in your main exam. (also if you can solve 150 questions when you have knowledge about just 100 questions sounds like a good deal to me)Make your own exam strategy. (I have mentioned my exam strategy in the post whose link i have mentioned above, feel free to take inspiration from it)Having said all this, don't use question banks as your source of learning a subject (you need notes or textbook for it) and don't do stuff because of FOMO. I feel DAMS /DBMI content in itself is sufficient but you should decide it for yourself.QUESTION : I just have * insert any time duration in months * before exam left, is it sufficient?ANSWER : I think 4-6 months of dedicated studying is sufficient if you already have good understanding of your subjects. If you are weak in any subject then you will need to give it extra timeOf these 4-6 months keep last 2 months for revision and 1 week before the exam for quick revision.QUESTION : How many revisions you did?ANSWER : I did 2 structured revisions before the exam as I mentioned above. Having said that everytime you hear or talk about a topic with your friend is a revision and everytime you solve a question in a grand test and listen to the discussion video is a revision.

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