OnExamination:

Overview: At £44.03 for 3 months it’s the more expensive option (as discount is available if you’re a BMA member). OnExamination offers over 4000 questions in a variety of styles e.g EMQs (extended multiple choice), MCQs and short answer questions. In total, OnExamination has 800 more questions than Pastest.

User Interface: OnExamination has a user intuitive interface which allows questions to be selected by speciality or randomly. I didn’t notice any faults with the system and it ran smoothly. One minor point is that the user is not able to search for specific questions e.g if I wanted to do some questions on warfarin, there is no “question search” feature.

Questions: This is OnExamination’s biggest weakness. The questions are very repetitive and often test fact recall rather than clinical reasoning. Considering most medical finals do not test fact-recall, many of the questions did not seem applicable. UK medical schools are using more and more Extended Matching Questions (EMQs) in exams, OnExamination has 2000 of these. There was a mixture of quality with these EMQs, some tested facts, while others involved some clinical reasoning.

There is a big question quality discrepancy between specialities, for example, the cardiology section is much more challenging than the general surgery section. Hard questions are a great way to learn, but the cardiology section was too advanced.

The quality of the question explanations is apauling with OnExamination. The explanations were short, poorly structured and had spelling errors. The explanations didn’t address the questions, they were often facts regarding the conditions. However, my biggest disapointment came when I noticed some of the explanations had been copied directly from Wikipedia. Don’t get me wrong, I love Wikipedia, but a ‘copy pasted’ article from wikipedia as an explanation to a question is unacceptable.

The poor quality of explanations is the main reason why I would not recommend OnExamination to any student revising for medical finals.

Value for Money: £44.03 may seem a little expensive compared with Pastest, it is resonable considering there are almost 4000 questions. If you did every single question, the site might be worth the money, but most students only get through 1000-2000.

Pastest

Overview: £27.39 for 6 Months. Over 3200 questions and 91 OSCE scenarios. Pastest is an established company within medical revision. They have many books available and the online question bank reflects their maturity as a organisation.

User Interface: This is Pastest’s weakest area. They recently released a new interface which improves matters slightly, but it isn’t as flawless as OnExamination’s. At times Pastest’s website lacks stability e.g it says “an error occured, please check back later”. This only happened 3-4 times for about 10 minutes in the months that I was using the site.

The best part about Pastest’s user interface is the “search” function. This allows a user to search for specific questions using a keyword search. I found this very useful if I studied an obscure topic and wanted to find some questions related to it or if I wanted to find a question I had done previously.

Questions: The questions on Pastest are better than OnExmination’s. Pastest’s questions are mostly at the level appropriate for a final year medical student. The explanations are short yet give the necessary information (there are occasional spelling mistakes). I used these explanations are part of my revision on multiple occasions. Pastest seems to understand what medical students are supposed to know. In contrast OnExamination sometimes felt like the questions were not based on medical school learning outcomes.

Pastest also features 91 OSCE scenarios. The site presents a scenario and you can think about it before looking at an explanation. The explanations for these scenarios are excellent. The scenarios are clinically relevant and are very helpful for revision (although you will still need a dedicated OSCE book).

There are some additional multi-media features such as eLectures or audio revision guides, however, I didn’t use these.

Pastest isn’t perfect. There are almost 900 True/False questions which are not useful, especially due to the wording e.g “it is not uncommon for..” - a double negation makes it uncessarily complicated. Additionally, the paediatric section is weak, after having completed all of the paediatric questions I didn’t feel confident. Therefore, you’ll need another resource for paediatric questions.

Value for Money: £27.39 is an amazing deal for 6 months, especially because it includes the 91 OSCE scenarios.

ThugMed’s Recommendation: Pastest is the overall winner. Great value for money,  excellent search function and good explanations. I wouldn’t hesitate for a second to recommend Pastest as the question bank of choice for UK Medical Finals.

The main reason why I signed up to OnExamination also was because I felt like I should do as many questions as possible. The closer to exams I got, I realised this approach wasn’t necessary, stick to one question bank (hint: use Pastest). OnExamination is expensive and has low quality explanations - avoid it.

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1. Be into what you’re doing - In a field like medicine it isn’t always easy as we have to go through rotations we don’t enjoy. But these rotations are only temporary, as soon as you walk out of the hospital, shift your focus to what you’re into. Medicine is such a diverse field, there’s no need to pigeon-hole yourself. If you can’t find a field you’re interested in - create one.

2. Be You - In medicine there is always a pressure to act according to certain ’standards’. That’s fair enough as patients need to feel comfortable around doctors, but that doesn’t mean you have to act like your seniors. Communication skills seminars about the Calgary Cambridge model are all good, but don’t let that hide your personality. All too often medical students try to find a personality that will suit their career as a doctor instead of just being themselves - I’ve tried this approach too, but it never felt comfortable. I learned instead to just be me - people sometimes think I’m crazy because my approach is ‘different’, but in real patient scenarios it has never failed me. This doesn’t mean I can’t learn new skills, I’m always trying new approaches, but at least I’m using them within a framework which is natural to me.

3. Don’t stop - Lil Wayne is always in the studio or on stage. This goes against conventional work-life balance theories. Maybe it’s time to forget the balance, if you love what you do, work ain’t work then there’s no need to balance, it becomes a part of life.

4. If it ain’t working implement change - I’ve sat in outpatient clinic listening to doctors complain about their careers saying “this is never the field I wanted to go into” - I don’t want that to be me. If something ain’t working, I’m gonna change it. Either change speciality or change career completely - to many people this might sound crazy, but seriously if it ain’t working it’s time for change. Personally I would rather experience the short term discomfort of change versus a life of struggle.

5. Sleep when you’re dead - I’m not sure about this one….

The Hustler over at mindofahustler.com defines a hustler as someone who has the following characteristics:

• Hunger - Not in the literal sense (every one needs food and ThugMed always recommends a top quality diet). Instead it’s about hunger for knowledge, self-improvement and your passions. This hunger becomes the motivating power to propel you to success. If you lose your hunger you’ll get eaten by someone who’s hungrier.

• State of Mind - Anything is possible. That’s a powerful sentence that has been shrouded in cheesiness, but try to put that aside. If you don’t believe something is possible, you won’t achieve it. If you at least believe it, you give yourself a chance to make it happen. In a field like medicine, this attitude will set you apart. You’ll be the one advancing medicine. I’ll say it again; anything is possible.

• Plan - Set yourself an ultimate goal. Don’t worry if you can’t see how it will come about, just set the goal and take baby steps. Fake-hustlers will fall along the way, but true hustlers keep their eye on the prize.

Ultimately a hustler can be defined by this equation:

Motivation + Plan + Focus = Hustler

So how does this apply to med school? Here are the ThugMed Hustlin’ tips:

Get Hungry - Medicine is a huge field, find an area that makes you hungry and go after it.

Never accept “No” - a medical hustler sees opportunity even in the face of adversity. Things don’t always work out the way you expected.

Clear Vision - I won’t stop till I’m at the top of the medical field and creating dramatically positive results for my patients. I also visualise sippin’ Cristal on a Gulfstream 500 flying to a medical conference which I am hosting in a city where I’m building a hospital. When I tell this to people they laugh and ask me “how?”. I respond with “I don’t know”. In order to reach a goal, you don’t have to know every step along the way, just focus on moving in the right direction. If you believe it’s possible, somehow things always fall into place.

Being a medical hustler isn’t a skill that’s taught at medical school but it’s a code to success. You may face resistance when implementing these strategies but that’s just part of the process. If you have questions about how to implement this in your career just post a comment or send us an e-mail.