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2 back to back failed EOR exams


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Hello all,

I am seriously struggling right now. I just had my 4th EOR and failed it quite badly. The first 2 exams, I was borderline. I passed with a few percentage points to spare. I failed the 3rd exam and remediated within days and passed it by a single percentage point. I don't know when I will be remediating this last EOR, but I don't have enough time to drastically increase my exam grade from a 57% to anything passable.

I've been using roshreview, I've been using the blueprint to go through Pance Prep pearls and pick out pertinent topics. I've been going through a few powerpoints. But I just cannot seem to get it. I have slowed down so much since didactic. 

I think what happened was that I studied well for the first one and felt prepared, but my grade was borderline, so I figured well, there's no point in burying myself if I will always be borderline. Then I went through a few personal things that threw me for a loop and I got very depressed and anxious at the start of rotation #2. I definitely didn't study for that one because my headspace was so bad. To my surprise though, I passed, but again, by a hair. So I know I need to up my studying habits, but even still, I can not focus. After that, I was in hospital medicine followed by gen surg, 2 very difficult and vast areas. I'm barely home due to the rotation hours and commuting, and any moment I do have at home, I'm logging patients and need to decompress (in the form of social media, apparently), and am just SO unable to focus. I can't retain a single thing. My memory is literally failing and my distraction doesn't help.

I felt pretty good about this most recent EOR, thinking I'd gotten a mid to high B, but I was so far off. I literally have no idea how to get back on the wagon or if it's even possible at this point. I have to meet with my advisor (again) and I really don't think she likes me. After I had failed EOR3, I had a game plan set in motions, as I always do before a new rotation begins, and I shared it with her. Yet I cannot seem to stick with it, and I don't know how I am going to explain myself this time. She wanted me to hit a certain target grade-wise, and it was very stressful to say the least, to have the overarching thought of "well, I need to get this grade this time". I end up cramming the week prior to callback and this is not how I imagined clinical year would go. I just have no direction, my motivation for everything is waning, I don't feel as smart as my colleagues. I know this is self-sabotage. To have made it this far, with not too much more to go, I am literally in the worst position. Please help.

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Unfortunately as I hope you already realize your attitude after the first EOR was the wrong one.  Being borderline passing should have kicked you into high gear, not complacent that the effort wasn't worth it.

You likely need to find a different way to study and study more.  At some point it's will power - you just have to do it.  Consider study groups.  Consider study guides.  Find a different question bank.  Find a different book (although PPP is actually pretty good).  Use the blue prints.

Hopefully you are learning on your rotations.  Use down time to review things.  While you certainly can't just use your clinical experiences to pass, it should help.

It could be that you aren't appropriately identifying the important information when studying.  Maybe you're having a hard time going from regurgitated, straight forward questions to secondary and tertiary questions.  I don't know.  

Something has to change and it has to change now.  Yes inpatient and surgery are some of the hardest EORs.  Not sure what your first 2 were.  Talk to classmates about what works for them.  You need to be passing EORs or you will have difficulty with PANCE.  I don't want to alarm you, I just want you to be prepared.

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Are you taking the PAEA EOR? If so, put Rosh away for a while and focus solely on getting through Smarty PANCE questions (the best money you'll ever spend). Rosh is targeted to PANCE and these EORs aren't the PANCE, but they are their own breed of test which Smarty covers VERY WELL. I'm on my last rotation now and am easily getting As by just doing smarty PANCE questions a few days before the tests. I struggled with my first couple of EORs before I started doing Smarty. The questions are very similar to EORs, some even word-for-word. You can pick up Rosh once you're a couple months out from the PANCE. Right now you need to just make it through clinical year.

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It sounds like you have a long commute to rotation sites. I do too, so I use that time for "passive studying" and listen to podcasts- PA exam review, Audio pance and panre, core IM, EM clerkship, Pimped OBGYN are all good ones. My commute is an hour long and I usually get 2-3 in each way. It helps me to just hear the words. I also will read up on interesting patients/cases I have and correlate them to blueprint topics. 

As for EOR's I agree with other posters- get Smarty Pance, but keep using Rosh. Try and set a goal for like 10-20 questions per day, everyday. Doing a little bit at a time will be far more beneficial than cramming the week before. @MT2PA is right though, if you are having trouble now, you are in big trouble for the PANCE.

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