End Of Rotation Exam Study Plan

We have been halfway done with clinical year since early February!! That is such an exciting and thrilling thought. I can finally see the light at the end of the tunnel. I am soaking up time with my classmates and being a student for as long as I can, even on the most challenging of days. I'm currently on Psychiatry for my 5th rotation and wrote a post sharing what that entails!

Since I've taken 4 end of rotation (EOR) exams, I'm finally sitting down to share with you all how I usually prepare for them. I've had several emails and messages from PA students asking me what resources I use and how I study for EORs. Honestly, studying for each EOR has looked different for me. I can't stay that I've used the same method or resources each time but the backbone of my plan has been pretty much the same overall. As I always say, what works for me may not work for you, so take anything I say with a grain of salt.

For those of you not familiar with what an EOR is, here is a quick rundown. An end of rotation exam is an exam every PA student takes at the end of each of their rotations. The exam correlates with the rotation that they just completed (Family Medicine, Surgery, Psychiatry, Internal Medicine, etc.). There are two sections of the exam, with 60 questions in each section and the time limit is 60 minutes per section. Only 100 of those questions are scored, and 20 of them are pre-test questions that are added to gather data to see if they can be used in future tests.

All the PA programs across the country administer the same exam (there are different versions) to their students and then a national average and a personal score is determined. Don't ask me about the statistics and math behind it because I still am not sure myself. However, that's pretty much the gist of it all. Now that we have that out of the way, lets dive in.

PAEA topic list 

This is the topic list provided by the PAEA, the association that is responsible for generating the question bank for the EOR. The topic list covers the topics that for sure will be on the test in one way or another. This is a good guideline to use to study for the EOR. However, there have been a few random questions on each test that were not included on the list. Having said that, the list is still reliable and has done more than enough to prepare me to do well on these exams. This is my go to list in preparing for the exam. I study each topic and each section related to it as listed in the blueprint, which we'll talk about next.

PAEA Blueprint

The blueprint breaks it down even further and shows you how many questions to expect from each section and what each section is worth on the exam. This is what I use to determine how much time I need to spend on a particular section and whether I need to focus more on the diagnosis, clinical intervention, etc. I go over the H&P (history and physical),  diagnostic study, diagnosis, health maintenance, clinical intervention, and clinical therapeutics. You will notice pathology or pathophysiology is not included on the blueprint, but it's good practice to quickly review that as well because the better you understand how something goes wrong, the better your chances or remembering how you treat it.

Come up with a plan

If you've been on this journey with me for a while, you know I need repetition to really have it in my brain. In order to have time to be able to go over some of the major disease states more than once, I have to start studying earlier and have to be smart about my time. Our rotations are 6 weeks long and I don't usually start intense studying until end of week 2/beginning of week 3. This is because the first 2 weeks I focus more on touching up on disease states  we see the most or the medications that are prescribed the most on the rotation I'm currently on that I need to review. If the list not too long, I try to go over the highest yielding sections twice to make sure I'm really prepared. Not everyone does this, but it has just always been my learning style and it takes me longer and my brain requires repetition to really solidify the information.

Make use of the free time

I take at least one resource with me to work every day that I can study from. This has been so helpful because if there is a long break in between patients at the clinic, I get my studying in for the day before I even get home. Depending on which rotation you're on, life during clinicals is a lot more relaxing and you'll have more free time then you did in didactic, if you are smart about it. It all depends on your priorities and how disciplined you are about managing your time. This way when I get home, I can have a life and watch tv, read a book (which I've been doing a lot of lately), hang out with friends or family, or simply do nothing at all! :)

A word of caution: if you are going to use an electronic device to study or look up things at work, make sure you run it by your preceptor so they are aware. I made it a good habit to bring it up the first day of each rotation and get their thoughts on it before I even did it. I never want myself or anyone to get in a situation where their preceptor thinks a student is on their phone all day while in reality they're studying or looking things up. Most preceptors have no problems with it and even appreciate your eagerness to learn.

Limit your resources

It's easy to get caught up on everyone's recommendations on what resources they used to study for a particular EOR exam. As always, what works for your friends may not always work for you. Take a look at all of your options and pick a few. I personally tried to use a maximum of 3 resources, because when I tried to use too many, I'd just spend more time figuring out what was important from each and run out of time to actually study the material  (like I did for my OB/GYN exam). I usually make study guides or use study guides made by classmates to reconcile the information from the resources I used in one place. I also use TrueLearn to quiz myself and also because it is a requirement by our program. Our school requires us to do 110 questions per rotation on TrueLearn which is apparently a lot harder than the PANCE. It helps me reinforce the information by testing myself with their quizzes.

To sum it all up, I use the PAEA topic list and the blueprint to guide my studying. Sometimes I make my own study guide and other times I use existing study guides made by my classmates and edit them to what I think is most important using the resources I discuss below. I do one section of the topic list at a time and work my way through it. I focus more on the sections that have more questions on the EORs and also the sections that make up most of the PANCE. I use TrueLearn questions to quiz myself and keep reviewing as much as I can.

Don't forget that studying during clinical year is a year long (or more for students in other programs) process of preparing for the PANCE. Take it seriously and you'll thank yourself later on in life.

These are some of the resources that I've used over the course of clinical year:

• PANCE Prep Pearls
• HIPPO Summaries
• Case Files (they have one for each specialty)
• The Washington Manual of Outpatient Internal Medicine
• Surgical Recall
• Lecture PowerPoints/Study guides from didactic year
• Blueprints Book (I have only used the OB/GYN one)
• FirstAid (only one I have used is for Psychiatry)
• DSM V
• TrueLearn questions

I hope this was helpful. Please let me know if you have any questions or have any suggestions of your own that you want to share with the rest of us!

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