Introduction

The first and foremost important thing that any candidate trying to clear the PG competitive exams is the mentality!

The way one thinks when approaching a question is what determines their success rate in solving that problem. Solving Clinical based Medicine questions is like solving a puzzle, where you are a detective and the question (patient) is your mystery. So today I am going to take you along with me to a path where you will learn the approach of this case solving

There are a few basic steps to solving every Clinical based question or case-

• Reading out loud to yourself the question
• Sorting out the keywords that will take you finally to your diagnosis
• Jotting down the probable differential diagnosis
• Ruling out the ones which don’t go along with some of the given information

Let’s elaborate on these points a bit-

1. Reading out the question aloud to yourself–

This is important since if the question is a long-form question, there is a high chance you will forget what you read by the time you reach the 4^th or 5^th  line of the question. So reading aloud helps you to remember the key aspects of the question.

2. Keyword sorting-

A very vital aspect of diagnosing a condition, is getting hold of all the necessary data and discarding the unnecessary part since they are mostly distractions and only there to support that story dictation. Keywords mean all those words or phrases which point towards some abnormality like fever since few weeks, or different types of tremors or episodic Hypertension, etc.

3. List out the Differential diagnosis(DD) –

This helps in narrowing down to a close range of possibilities matching the primary key Symptoms of the patient.

4. The final step is to think about the Individual DD Symptoms, and ruling out those that don’t match into those Symptoms, thus finally arriving at your answer.

• Now one thing should always be clear to each candidate-

“The eyes can see only what the brain already knows”.

Thus, the primary step is always to go through your theory part, be it from your books or some notes, be thorough with the theory.

• While you are studying any topic, always think about it from a clinical perspective, look up cases related to that topic on the internet, keep a tab of those links where you find the relatable questions.

The study should be in an integrated form since that what medicine is all about. You are not studying to pass exams, you are studying to save lives, to diagnose cases. So, suppose you are learning about some respiratory disease, you always need to know its complete pathology, physiology of respiration, anatomy, and pharmacology to treat the condition. For a better understanding of these ways of learning, I will give a few YouTube video links here-

https://www.youtube.com/watch?v=4mUnx7pGevo

https://youtu.be/VSUuA0kBqSw

• Now initially when approaching a clinical problem, don’t look at the options. This is for preventing you from getting biased and losing your brain’s ability to be neutral and allowing you to postulate the different possibilities of diagnosis.
• Even after hovering about a question for quite a while, if you feel you can’t reach a conclusive diagnosis, then go for option elimination, i.e. read out the options and eliminate them based on the Symptoms provided in the question
• MCQs are designed in a way that they consist of mostly the relevant information, so if there is information of certain symptoms not being present it mostly is important as it is meant to rule out certain differential diagnoses.
• While studying for clinical question solving, maintain a separate notebook to keep a record of all the clinical questions related to the diseases you study. In that notebook, note down just the relevant information related to the disease, like its pathophysiology, etiology, major presenting symptoms, etc. Also try to make this information presentable by using various color coding, symbols, and Mnemonics. In this way, you can easily recollect in your exams what you had written in your notes.
• Also, club the similar Symptoms of various diseases together while studying to make differential diagnosis quicker. Try imagining similar scenarios in other diseases as well.

For example-

Platypnea- means dyspnea in sitting position which indicates Hepatocellular syndrome

Orthopnea-Dyspnea in supine position indicates acute CHF

Trepepnea- Dyspnea in lateral decubitus position indicates unilateral pleural effusion

• A very good way to learn all these ways to approach various clinical-based medicine questions, that is actually available free of cost on Youtube itself, is Dr. Marwah’s live channel. He runs the best fmge coaching in delhi and india overall . It shows how you need to combine various subject knowledge to approach a clinical case and determine the diagnosis. It teaches the mentality of approaching clinical-based medicine questions in a very effective way. The channel link is provided below for your reference.

https://youtube.com/c/DrMarwahLIVE

• Clinical questions are meant to test our understanding of the subjects and our ability to imply the knowledge we have gained into solving the questions and diagnosing the case.
• In the exam hall, we need to diagnose cases based on the given data within less than a minute.
• So to do so, we need to have a very clear idea about the individual diseases and conditions, else we most of the time, will find ourselves intimidated and overwhelmed by the questions.
• The only way to do this is via an enormous amount of practice in solving such questions and conditions from Fmge solutions app. It is best app for fmg students who want to practice in india after doing MBBS abroad.
• We need to solve a huge number of clinical problems while practicing so that our eyes become efficient in picking up the clues and read in between the lines.

The examination hall will already be accompanied by a lot of stress and if you are not mentally prepared you won’t be able to take up the clues for diagnosing. So, to be ready, put yourself time and again in difficult situations and face tough clinical questions to make this stress nothing more than your everyday chore.

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