Before I went to college, I was professional ballet dancer and I loved to practice pirouettes—turning around on the tiptoes of one foot. One of the first things I learned about pirouettes is that if I tried something completely different in my technique every time I practiced, I wouldn’t improve. Occasionally I would get lucky and do a few more pirouettes, but it never stuck, and I always regressed back to where I had been. I thought I was just bad at pirouettes in some intrinsic way, the way many of my students claim they are “bad test-takers.”
But when I was 15, I had a sharp teacher that told me to stop trying so many things. “Try one way of doing things for a while, make sure you can do that consistently, and then make small changes to see if they help.” The progress was slow, but consistent, and learning to approach my technique this way was a large part of why I was able to become a professional ballet dancer—and do quite well on the MCAT.
For this reason, I take a systematic approach to solving problems on the MCAT. When I miss problems (which these days is in medical school, not on the MCAT) I am able to look back at my process and see exactly what went wrong, and figure out the best way forward to prevent missing similar problems in the future. In other words, by having a systematic approach, every wrong answer provides specific actionable feedback. Below is an explanation of a basic approach and two of the things I ask my students to do when doing practice problems.
Initially, I teach my students to read the passage, (take notes if doing CARS, more on that in a different post) read the problem’s question, and then assess the answer choices one at a time for truth and relevance in an active question-driven fashion, until only the correct answer remains.
In analyzing an answer choice, I ask my students to have an explicit guiding question. Here are some examples: Is X true? Does Y follow X? Is X indicated in the passage? There are many permutations of questions based on the answer choice, but the fundamental point is that students need to be actively looking in either the passage or their memory of specific evidence in favor of the answer choice or specific evidence against the answer choice. (For my rationale behind requiring specific justification, see my post on Total Justification). By having a specific, even if simple, question to guide the student in assessing the truth of an answer choice, students prevent against the rambling purposeless assessment of the passage which is so common among MCAT test-takers.
Answer choices have to be correct in terms of reflecting either the knowledge being tested (biology, chemistry, physics, psychology, social science etc…). There are two primary places a test-taker can draw from when assessing the truthfulness of an answer choice: the passage or memory. I teach my students to go to the passage first (with a question-guided approach) for two reasons: first, often the information is in the passage, and even if not, often the passage attaches conditions or important context to information that must be drawn from memory. If there is no helpful information in the passage, then I will let my students use their memory. I recommend this sequence of sources of information because in my experience, most students over-rely on their content-studying to answer questions and miss problems that have answer choices that are true in the abstract but not in the given situation of the passage.
Simply put, does the answer choice correctly answer the question? Many answer choices are true in and of themselves but don’t correctly answer the question. A common mistake among MCAT test-takers is to pick answers that reflect real phenomena, but don’t actually address the question. By specifically addressing relevance, we can guard against that mistake. I really like this paragraph.
Let’s pretend the MCAT gives us a nice long passage saturated with information about the excretory system and explains that a common medication- Furosemide, acts by inhibiting the Na/K/Cl transporter in the thick ascending limb of the loop of Henle, which transports those ions out of the lumen of the nephron and into the interstitium. For this reason, Furosemide can be used to reduce blood pressure. Here is a possible question:
How does Furosemide directly affect blood pressure?
- Furosemide acts on receptors in vascular smooth muscle to cause vasoconstriction.
- Furosemide acts on hepatocytes to decrease ion reabsorption allowing increased secretion of water.
- Furosemide reduces the osmotic pressure differential across in wall of the nephron
- Furosemide reduces Vitamin K absorption thereby inhibiting the coagulation cascade.
Below as are analyses of this question in terms of truth and relevance.
Truth: Does Furosemide act on smooth muscle cells? That’s beyond the scope of the MCAT, so we don’t have to assess that. The MCAT commonly includes information that test takers are not expected to know; learning to recognize that is essential.
Relevance: Would vasoconstriction explain how Furosemide lowers blood pressure (as stated in the last sentence of the passage)? No, part of basic MCAT biology is the vasoconstriction, or reducing the radius of blood vessels increases the pressure on the vessel walls, which means there is increased blood pressure. Thus, even if Furosemide does act this way on vascular smooth muscle (it doesn’t) it would be irrelevant to the passage and question, and could be eliminated.
Truth: Does Furosemide act on hepatocytes: Not indicated in the passage. The passage indicates that Furosemide acts on nephrons, which are in the kidney, not the liver. Furthermore, test takers should know that the Kidney is the primary organ regulating blood pressure as opposed to the liver. Thus we can cross off this answer.
Relevance: Normally I don’t recommend assessing relevance if we have already determined that the answer choice is untrue, but in this case, we should acknowledge that while untrue, the increasing water secretion would lower blood pressure, so this answer choice is relevant.
Truth: A knowledgeable test taker familiar with both the kidney and osmotic pressure will recognize that by inhibiting the ion transporter indicated in the passage, there is less transport of ions out of the nephron tubule and therefore a reduced osmotic pressure differential. Thus this answer choice is true.
Relevance: Does reducing the osmotic pressure differential explain how Furosemide lowers blood pressure? Yes, if there is less osmotic pressure forcing water out of the nephron and back into circulation, the kidney is then excreting more water, which would reduce the volume of blood in the body and thus lower blood pressure. This answer is relevant in addition to being true, and therefore is the correct answer.
Truth: while the effect of Furosemide on Vitamin K absorption is beyond the scope of the MCAT, knowing that Vitamin K is involved in the clotting cascade is testable information, and thus one might think this answer choice is true, and not be unreasonable. (It so happens that Furosemide does not affect Vitamin K absorption.)
Relevance: The coagulation cascade has doesn’t affect blood pressure. This answer choice is irrelevant.
Problems with Truth
With this approach, my students can tell me if they are missing problems because they can’t correctly assess the truth of an answer choice. This may mean they need to study specific content in a targeted manner, practice reading graphs and figures, or perhaps they need more practice in applying passage details to answer choices. By classifying missed answers in this way, clear paths forward to improve are easily revealed.
Problems with relevance
Problems with relevance can manifest for a variety of reasons, but often because students don’t completely understand how the problem relates to the passage and (if not in the CARS section), how that passage relates to the content they have studied. This reflects a failure to discern what is important and then strategically apply knowledge to the problem. Fixing this type of error requires practice and often guidance by a teacher or a tutor in how to approach certain types of problems.
Above is a simple way to approach MCAT problems that allows for specific actionable feedback on incorrect answers. However, as this is not the only way to look at MCAT problems and in the future, I will be writing additional posts on more nuanced and flexible methods to approach problems. That said, even when using different approaches, there should still be a solid and planned approach so that one’s mistakes can be improved upon in a consistent fashion.
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Want to learn more tips from Henry on how to master the MCAT? Read some of his previous posts below: