CRISBERT I. CUALTEROS, M.D. - physician's licensure exam
   
DR. CRISBERT I. CUALTEROS
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  Clinical Practice Guidelines

CRISBERT I. CUALTEROS, M.D. Family and Medicine

Introduction

The Philippines Physician Licensure Examination (the “Boards”) is given twice a year

(February and August) usually during 4 consecutive weekends (Saturday and Sunday) in 6 sites –

3 in Manila and 3 in Cebu. Every medical graduate who has finished his internship in the

Philippines need to pass it in order to obtain his medical license and practice medicine in the

country.

The Boards has 6 Basic Sciences subjects (Anatomy, Physiology, Biochemistry,

Microbiology, Pathology and Pharmacology) and 6 Clinical Sciences subjects (Internal Medicine,

Obstetrics & Gynecology, Pediatrics, Surgery, Legal Medicine and Preventive Medicine). 3

subjects are tested during each exam day. There are 100 questions for each subject.

Registration

To take the exam, you must personally register at the Professional Regulatory

Commission, located at P. Paredes St., corner Morayta St. Sampaloc, Manila. This is near the

area between the University of Santo Tomas and Quiapo. You’re in the right place if you start

seeing all these review centers and vendors selling medical DVDs and books.

You need the following documents to register for the Boards: one original and one

photocopy of the following documents: NSO-certified Birth Certificate, Certificate of

Graduation, Certificate of Internship and Medical Transcript of Records. If you are going to take

the August exams, request for the last three documents as early as May from your school since

they take some time to process.

Aside from these documents, you also need the following: Four 2x2 full-face

photographs, with name tag (Last Name, First Name and Middle Name), postage stamps bought

from INSIDE the PRC compound, one government-issued ID, one long brown envelope,

pencils(Mongol #2), erasers, black ball pen and paste.

 

The Realities of the Boards

No one can truly be prepared for the board exams. And the answers to the board exam

questions can only be found, at the most, 40-50% of the time from even the most high-yield

reviewers that you can read. And don’t even think about reading your big textbooks, like

Harrison’s or Schwartz, for the Boards. You won’t have enough time to read them or enough

brain cells to retain them in you memory.

You also cannot rely on stock knowledge for the Boards. Though passing the boards

may seem a daunting task, cheer up! More students pass the boards than fail it. (>50% overall

passing rate) If you’re taking the August Boards, you have 2-3 months to prepare. It’s actually

enough. Do your best and pray.

The Process of Making Board Exam Questions

The Board of Medicine is composed of 5-6 doctors not affiliated with any medical

school who are appointed by the President of the Philippines to create all 1200 questions for

the Boards. The members of the Board of Medicine divide the 12 subjects among themselves

and submit thousands of questions to a computer which randomly chooses the questions for the

Boards.

Are there any specific books where the Board of Medicine bases their questions on?

The PRC actually releases a guide containing suggested books (textbooks!) to read for exams.

Based on our experience and those who have taken the exams before us, the examiners get

their questions from… textbooks, reviewers, clinical experience, the planet Mars…(some

examinees remarked that the questions are “out of this world!”)

The following measures were instituted to prevent cheating and leakages in the board

exams:

1. Exam questions are printed on the day of the exam.

2. Members of the Board of Medicine are incarcerated inside the PRC Building during the

duration of the Boards.

3. Answer sheets are identified only by numeric codes, not by the names of the

examinees. Only the computer has the master list of codes matching with names if the

examinees.

4. Any unnecessary marks on the answer sheet would invalidate the examinee’s score.

How the Exams are Actually Graded

To pass the Boards, your average grade on the 12 subjects must be 75% with no grade

lower than 50% on any of the subjects.

A grade of 75% on one subject doesn’t mean you only had 25 mistakes out of 100. The

mean passing level (MPL) of the entire batch of examinees is obtained per subject. Your raw

scores are then transmuted based on the MPL. Because of the MPL, the passing rate may

change depending on how easy or difficult the exam is. Usually, the MPL is less than a raw

score of 75. You would probably still pass if you answer 50-60% of the questions right.

Preparing for the Boards – During Internship

Start preparing for the boards as early as your medical internship. Buy your review

books early from vendors roaming the different Metro Manila hospitals. Expect to spend around

P2,000-3,000.

Study the book that you would read on your review while your rotation is on the same

subject. This would serve as your first reading for the Boards and also as a review for the final

exams of your rotation.

Here are the books that you should study during your internship:

1. Surgery Rotation – Surgery Recall and/or Rush Surgery

2. Pediatrics Rotation – Baby Nelson’s and Peabrain

3. Ob-Gyne Rotation – OB NMS or OB BRS or OB Blueprints

4. Internal Medicine Rotation – IM NMS or High-Yield Internal Medicine

5. All other Rotations – USMLE 1st Aid Step 1 (for the basic sciences)

Learn from your teaching rounds. There are a lot questions in the Boards whose

answers have been discussed in the teaching rounds.

Preparing for the Boards – After Internship

Congratulations! Enjoy the first two weeks of your freedom – party, sleep and watch all

the DVDs that you’ve been dying to see. Afterwards, for one whole day, plan for your board

review. Do the following:

1. Set your goal – do you want to merely pass the exams or be one of the twenty

topnotchers? Set your goal, make your plans to reach this goal and execute the plan

with die-hard determination. Topping the Boards is not impossible – you could have

average grades in med schools and still top the boards by studying earlier (start during

internship) or longer. (take the February Boards) If you make this your goal in your own

board exams, don’t think you’re being too ambitious. Dream, plan and then execute.

2. Analyze how you learn – be honest! Ask yourself the following questions and conduct

your review in a manner most beneficial to you:

???;???; Do you learn better if you’re alone or with a study group?

???;???; Are you a “visual” person who can absorb more information by reading books or

an “audio” person who can absorb information better if there is another person

who verbally quizzes you?

???;???; Do you study better if you’re in a room full of gorgeous people (e.g. in

Starbucks) or in a quiet library?

???;???; Can you retain more information if there’s music in the background, junk foods

in front of you, bright lights in the room?

???;???; Would a review school motivate you to learn better and help you brush up on

topics you’ve had difficulty with in med school or would you prefer to just read

on you own?

3. Make your plans based on your goal and learning style. Create a schedule and stick to

it – this consists of a daily routine and schedule of subjects to be studied.

A daily routine for the board exams depends on you and your learning style. Put

whatever you think would help you pass the boards in your daily routine e.g. exercise, going to

mass, yoga, answering samplex everyday. The rationale for a daily routine is to keep your body

clock as regular and as predictable as possible so that you’ll be at your most attentive yet

relaxed state during your review and the exam itself.

After planning for your daily routine, make a schedule of subjects to study.

The study schedule you have made, you’ll realize soon enough, doesn’t always go

according to plan and you would sometimes finish earlier or later than you have planned. Yes,

that’s correct. You would sometimes finish earlier than you expect.

If you finish ahead of schedule, you could give yourself a day off to relax or you can

move on to the next subject. If you fail to finish a particular subject on the day that it was

supposed to be finished, my advice is to keep studying for the subject and lessen the time of

other subjects. Make your first reading a complete one – it’s hard to go back to that particular

subject if you have to skip several chapters.

There would really be days when you would get burned-out. Relax, watch a movie or

sleep the whole day. Burn-out is expected, and you would really have to take a rest for

awhile. But bounce back as soon as possible.

Many people would recommend doing two readings of basic sciences subjects and one

reading of clinical sciences subjects. Some people would read lots of books for the board

exams including the NMS series for IM, Pedia, OB and Surg.

Again, this would all depend on you learning style. That’s why you should really take

time to set your goals and analyze your learning style.

Personally, I’ve decided to read as few pages as possible for the board exams and to

master these pages as much as possible. That’s why I was able to do 3 readings of basic

sciences subjects and 3 readings of clinical sciences subjects.

Physiology is a subject you should definitely study first since it serves as a good

background for all the other subjects. Study Biochemisty and Anatomy after all the other

subjects since you would be more likely to forget these subjects if you study them in May or

June. Prev Med and Legal Med are crammable; study them last.

Don’t forget the basics in studying -- eat well, sleep well and pray hard.

On the night before the exam, prepare the things that you need (brown envelope,

Mongol #2, erasers, sharpeners, testing permit, watch). Prepare your snacks for tomorrow.

Preparing for the Boards – Exam Day

Go to your testing site a day before the exam so that you’ll know whether you should

bring a mini-fan or a jacket during your Boards. (depends on the temperature of your room)

You are required to take the exams in your school uniform although in our experience this isn’t

strictly enforced.

Come to your site around 6:30AM. Make sure that you are never late for the exams! Do

some last-minute pep talks with your friends and classmates.

You have one hour breaks between subjects. You can eat during these breaks -

separate rooms are provided. Attend to your CR needs since you won’t be able to go out of the

room once the exam starts. While taking the exams, maintain your focus and never panic.

Review Schools

If you’re preparing for the February Boards, review schools could really help you. If

the program is done right, those taking the August Boards can also benefit from review schools.

In Manila, there is UPEC and all the other “in-house” review schools. The Faculty of San Beda

College of Medicine is planning to put up its own review center – we want it to be the best in

the country – and we’re gearing the review not just for those taking the February Boards but

also for those taking the August Boards. In Cebu, the Cebu Review Medical Center provides

excellent education to its reviewees. People coming from Visayas and Mindanao troop to this

review center to prepare them for the Boards.

 

After the Boards

Results are released 2-3 days after the last day of the exams. People text or call those

who have passed immediately. You can tune in to the radio or view the PRC website to

confirm. For those who have flunked the exams, your grades are mailed to you as soon as

possible. For those who have passed, your grades are mailed to you 1-2 months after.

The oathtaking is set 2-4 weeks after the last day of exams and is usually held at the

PICC. The Philippine Medical Association sets up a booth there so you can apply as a member.

Your PRC card is given immediately after the ceremonies; however, it’s advisable to just get

them a week after to avoid the stampede.

Review Books

 

 

DISCLAIMER:

At best, only 40-50% of the answers in the exams can be found in any review book. But reading

them is still better than reading your textbooks (you won’t have enough time), transcriptions (you won’t

know which topics you should focus on), samplex (not enough by themselves), or stock knowledge (its

suicide if you rely on these for the Boards).

The review books are analyzed according to content (must provide high-yield material) and

readability (there’s no use reading high-yield material if the writing is so complex that you cannot retain

the information). I have made my recommendations based on these, taking into consideration the medical

graduate with average grades in med school.

However, you may have your own learning style, and the other review books may work better for

you. Some people are obsessive-compulsive and want to read the most comprehensive review books.

Others would prefer shorter books that they could really master. Read the analysis of each book and

decide whether that book is for you.

I. Basic Sciences

A. Anatomy

1. UPEC Anatomy Review Questions (2-3 days) – compilation of previous board exam

questions on anatomy. Very useful, since it would give you ideas on what you should

focus on in your review. And remember that anatomy never changes, (ever heard of a

new organ discovered recently?) thus, examiners could only ask so much questions.

That’s why reading previous questions would work for anatomy.

2. Hi-Yield Gross Anatomy (2-3 days) – some hard-core toxic students think it’s too

superficial, but this book really contains must-know clinical facts about anatomy. It’s

also very easy to read and retain.

3. First Aid Anatomy (½ day) – easy to read and high-yield, but not enough material.

4. Clinical Anatomy Made Ridiculously Simple (3-5 days) – as easy to read as your

newspaper comics. However, the problem with this book is that it's systems-based,

(cardiovascular, skeletal, renal, etc) and not region-based. And it's not that fun to

read as Micro MRS.

5. Snell’s Clinical Anatomy Review (10-14 days) – very comprehensive. Most would read

it just to feel that they’ve read something “substantial” for Anatomy. However,

important points are not emphasized on this book, and there is a lack of clinical

correlations. It’s hard to read and even harder to retain.

6. BRS Gross Anatomy (2 weeks minimum) – comprehensive but Snell is better. Little

illustrations and clinical correlation.

7. Hi-Yield Histology, Hi-Yield Neuroanatomy, Hi-Yield Embryology (10-14 days) – there

are only about 10 questions in the Boards about these topics, and the two weeks that

you would spend to study them is simply not worth it. Just read about these topics

from UPEC Anatomy.

Recommendations: A lot of medical graduates are afraid to study of Anatomy for the Boards –

they say that this is one of their weakest subjects (along with Biochemistry) and so they try to

compensate by reading Snell Clinical Anatomy which is very comprehensive. I myself have read

Snell for our Boards, (along with the other anatomy review books) however, I haven’t been able

to retain much after two weeks of reading it – there’s just too much information that you don’t

know what you should focus on. If you think you can, or you just want to have a comfort

blanket, read Snell. However, if I were to do it all over again, I would just read the following

three books: Anatomy Recall, Hi-Yield Clinical Anatomy and UPEC Anatomy. Use the Netter

Atlas at all times when you’re reading these books.

B. Physiology

1. BRS Physiology (2-3 days) – concise, easy to read and high-yield. One of the most

useful books for the Boards.

2. First Aid Physiology (1 day) – similar to BRS Physiology, it emphasizes important

physiologic concepts.

3. Special Topics in Guyton’s Textbook of Medical Physiology - Read chapters on

sport/exercise, space, high altitude, diving, ageing, temperature and sleep physiology.

These topics are not found on the other review books.

Recommendations: Read all of the above. Make notes on your First Aid Physiology based on

BRS Physiology.

C. Biochemistry

1. Digging-Up the Bones Biochemistry (1 day) – must-read! Contains must-know facts

about biochemistry in just 110 easy-to-read pages. Would give you a good outline of

biochemistry.

2. First Aid Biochemistry (1 day) – contains very useful diagrams and mnemonics. Cannot

stand on its own, but it is a good supplement to the other books.

3. Kaplan Biochemistry (7-9 days) – focuses on molecular biology, DNA and clinical

correlations. These topics are more frequently tested now than metabolism thus this

book is better than Lippincott. And it takes almost the same amount of time to read. If

you have poor background on biochemistry during med school, this book is for you.

4. Lippincott Biochemistry (5-7 days) – comprehensive but easy to read. Focuses on

metabolism. Between Kaplan and Lippincott, choose Kaplan.

5. Hi-Yield Biochemistry (1-2 days) – short, but hard to retain since important points are

not emphasized. Competes with Digging-Up the Bones which is actually better.

Recommendations: Read Digging-Up the Bones Biochemistry and First Aid Biochemistry. Then

master Kaplan Biochemistry.

D. Microbiology

1. Microbiology Made Ridiculously Simple (4-5 days) - one of the best review books ever

made. Makes microbiology fun and easy to read. And it’s comprehensive too. Read

the chapter on antibiotics – it would help you in pharmacology.

2. First Aid Microbiology (1-2 days) - complements MMRS. Summarizes important points.

Recommendations: Read all of the above and you won’t have any problems with microbiology.

E. Pathology

1. First Aid Pathology (2-3 days) – In about 70 pages, must-know topics in pathology are

presented in easy-to-absorb format with tons of useful mnemonics. You must read this.

2. BRS Pathology (3-4 days) - write down notes regarding the first few chapters of the

book and put these on your 1st Aid book. The rest of the book is also useful and you

should read them, but only so that you could put some more notes on your 1st Aid book.

3. Compton’s Review (4-5 days) – pathology board exam questions were allegedly lifted

from this book a few years ago. But not anymore. The above two books are better in

terms of content and readability.

Recommendations: Master 1st Aid. Then read BRS and write down notes on your 1st Aid book.

Illustrations in Mama Robbins are also useful as visual aids.

F. Pharmacology

1. Katzung’s Pharma Review (1-2 weeks) – a thick book, but chapters are short and easy

enough to understand. Excellent diagrams. If you want to excel in pharmacology, read

this.

2. Pharmacology Companion (4-5 days) - This is a book made by students for students,

like 1st aid. Complex information is seamlessly synthesized in very simple tables. A

well-kept secret, get a copy from Fatimah and FEU graduates.

3. First Aid Pharmacology (1-2 days) - makes certain topics in pharmacology clearer and

easier to absorb. Easy to read and full of must-know facts. Not as comprehensive as

Katzung’s.

4. Pharmacology Recall (3-4 days) - The question and answer makes relevant, must-know

topics easy to absorb. Not as comprehensive as Katzung’s.

5. Lippincott Pharmacology (5-7 days) – just a little shorter than Katzung’s but harder to

absorb.

Recommendations: Katzung’s is the most comprehensive pharmacology review book and it is

easy to absorb although it takes some time to master. Read it and follow it up with First-Aid

Pharmacology. As an alternative, you can read Pharmacology Companion followed by

Pharmacology Recall and 1st Aid.

II. Clinical Sciences

A. Internal Medicine

1. Hi-Yield Internal Medicine (2-3 days) – concise, easy to read and contains must-know

information that you haven’t realized before. Not as comprehensive as NMS.

2. Blue Prints Medicine (3-4 days) – easy reading but contains material that you probably

already know.

3. NMS Medicine (6-7 days) – the book for the obsessive-compulsive. Comprehensive.

However, not as easy to read as the above IM books. You would probably forget the

information it contains as time goes by since important points were not emphasized.

Recommendations: The internal medicine exam is multidisciplinary – questions are about

subjects such as physiology, pharmacology, microbiology and pathology. No single book would

suffice to give you a good preparation for IM. It is recommended that you master one of the 3

books mentioned and stick with it. There is NO need to read about treatment protocols,

memorize dosages or know topics such as ECG, CXR interpretation, metabolic derangements or

common formulas.

B. Pediatrics

1. Peabrain Pediatrics (1 day) – very short. Inadequate yet it provides good information

about congenital heart diseases and common illnesses such as dengue and tetanus.

2. Baby Nelson’s (4-5 days) – Easy reading but would take some time to read. Also, if you

look closely, most of information found here is a little bit superficial.

3. Blueprints Pediatrics (3-4 days) – incomplete but easy to learn. Most reviewees turn to

this book for pediatrics.

4. NMS Pediatrics (4-5 days) – the most comprehensive. For the obsessive-compulsive.

However, the problem with this book is similar to Snell’s – you would probably forget

the material by the time you do your second reading. There’s just too much

information and important points are not emphasized.

Recommendations: Board exam questions in Pediatrics are lifted directly for the big Nelson’s

textbook. However, reading Mama Nelson’s for the Boards would eat up too much of your time

for the other subjects. And the alternatives are simply inadequate – most read Blueprints or

NMS even though it’s not that high-yield just to have something to read for pediatrics. Some

have suggested that the best way to prepare for Pediatrics is to study the sample exams based

on the Mama Nelson’s – they are available on the internet for members of the American

Pediatrics Society. I think this is the best way to study pediatrics for the Boards, after reading

Blueprints or NMS. Request someone who has access to these questions to give them to you.

C. Surgery

1. Surgery Recall (4-5 days) – delightful to read and easy to recall. Contains hi-yield

topics not only for surgery but also for anatomy, physiology, microbiology,

pharmacology, internal medicine and pediatrics. You must read this.

2. Rush Surgery (10-14 days) – very comprehensive and if you’re the obsessive-compulsive

type, this is probably the most high-yield for surgery. However, it would eat up a lot of

your time for the other subjects, and it may actually be overkill for surgery.

3. NMS Surgery (6-7 days) – as toxic as IM NMS. Thorough but not high-yield. Read Rush

Surgery rather than this book if you’re the obsessive-compulsive type.

4. BRS Surgical Specialties (2-3 days) – a good book for the different surgical

subspecialties (Orthopedics, Ophthalmology, ENT, etc.) but Surgery Recall is more than

adequate.

5. Blueprints Surgery (3-4 days) – easy to read but incomplete.

Recommendations: Surgery Recall is your best bet – it provides must-know information, it is

easy to read and would not take too much time. You should complement it with the latest

surgical clinical practice guidelines especially about breast, colorectal and thyroid CA. Read

Rush Surgery in addition to Surgery Recall if you have the time (e.g. you’re taking the Feb

Boards) and if you want to score high in the exam.

D. Obstetrics and Gynecology

1. Blueprints Obstetrics and Gynecology (2-3 days) – easy to read and contains all you

need to know for the exam.

2. NMS Obstetrics and Gynecology (5-6 days) – a little bit more comprehensive compared

to Blueprints or BRS. The best in the NMS series. Still easy to read.

3. BRS Obstetrics and Gynecology (3-4 days) – similar to Blueprints – easy to read and

contains must-know facts.

4. Baby William’s (6-7 days) – the most comprehensive. However, it’s just too long. And

it only has information for obstetrics, not gynecology.

Recommendations: You have three choices: Blueprints, NMS or BRS. Any of the three would

prepare you well enough for the Boards.

E. Legal Medicine, Ethics and Medical Jurisprudence

1. UPEC Legal Medicine, Ethics and Medical Jurisprudence Review Questions (1-2 days)

- Since none of the Members of the Board Examiners are lawyers, they frequently lift

questions from previous legal med exams and from Solis. One of the easier subjects for

the Boards. Read and correct questions from this reviewer and you’ll do great.

2. Legal Med and Med Juris Summary (1-2 days) – complement UPEC Legal Med with this

book. Don’t try to read its baby version called Legal Med and Med Juris Notes.

3. Solis’s Medical Jurisprudence and Solis’ Legal Medicine (1-2 weeks) – You would get a

high score in Legal Med subject of Boards if you’ve mastered these two books since all

questions in Legal made are based on them. If you’re obsessive-compulsive, read

them. Otherwise, it’s overkill.

Recommendations: If you want to save time, just read UPEC Legal Med and Legal Med & Med

Juris Summary. If you want to score real high on this subject, you would have to master the

two Solis books.

F. Preventive Medicine

1. UPEC Preventive Medicine Questions (1-2 days) – You have to read this for the Prev

Med exam – this would give you a fighting chance in the Boards.

2. UE Notes/MCU Notes/UST Notes (1-2 days) - complement UPEC with these books. UST

Notes is the best, try to get a copy if you can.

3. Dr.Banzuela’s PhilHealth Primer for the Med Boards (2 hours) – social insurance was

tested in the past board exams. This is the best source about PhilHealth – it’s highyield

and easy to read.

4. Hi-Yield Biostatistics (1/2 day) – helpful in understanding biostatics, but a little

difficult to understand.

 

Recommendations: Read all the above

.

Final Advice

Those who have taken the exam know that the Boards is neither a good indicator of the

medical knowledge one possesses nor will it predict whether or not one would be a competent,

ethical and caring physician. Thus, those of us who have taken the exams never look down

upon those who have flunked it. However, the problem is that the public (which includes our

relatives, friends and lower classmen) mistakenly thinks otherwise – thus there is so much

pressure to pass on your very first try. In reality, one can flunk the exam even if one has good

grades during med school and adequate preparation during the review.

More than a test of your knowledge, the Boards is a test of your character. The best

tip I can give you – in the end, it doesn’t really matter what particular review books you have

read; motivation, discipline, concentration and faith in God – these are actually what you need

to pass the Boards. Give your best, study harder than ever before and think positive.

Good luck to you, Sons of Hippocrates, and may you pass the Philippine Physician

Licensure Examinations!

 

   

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