TIPS FOR THE PHILIPPINE PHYSICIANS LICENSURE EXAMINATIONS

by: James Philip G. Esteban, MD

General Tips
The best preparation for the board exams is still the preparation you made during med school because no matter how
hard and how long you study during the 2-3 months before the board exams, it is impossible to cover and remember
EVERYTHING.

Dont get me wrong. I think 2-3 months should be enough to read up on the essentials for each of the 12 subjects, enough
even for 2
nd
or 3
rd
readings. But, come exam time, there WILL BE questions that you never really read in your reviewers
or, even if you had, you most likely already forgot after just 1 pass through. Even with the best testmanship abilities, you
wont stand a chance against these questions unless you were able to recall seeing it in a mama book, or recall
discussing it during a preceptorial, or recall hearing about it in endorsements and rounds, or recall your patients history,
PE and lab results. I cant emphasize enough how much these little things ACTUALLY helped me during my exam.


During the Basic Science Years
Transcriptions are brief, to-the-point and, more importantly, would assure a passing mark with the least possible effort.
Sample exams can save your life with even less effort. But, I think these should just be used to enhance your studying.

It will REALLY help a lot if you spend time reading the mama books during the first 2-3 years of medical school. And,
seriously, the first 2-3 years is the best time to do so for the simple reason that these are the years when you STILL CAN.
Come clerkship and internship, it will be very difficult, if not impossible, to open the mama books and sift through the tons
of information they contain. Thats why the baby books, the Recall series, the black books and all those condensed
reviewers are such a hit because they only tell you the stuff you NEED to know. As a clerk and an intern, do you really
need to know the molecular biology behind this and that? At the very least, all you need to know are the things that will
guarantee that the patients under your care get better and ACTUALLY LIVE to tell others about your brilliance.

What then is the relevance of reading the mama books? They expand your STOCK KNOWLEDGE. A sound stock
knowledge base founded on 5 years of medical school is more priceless and indispensable than 6 straight months
studying for the boards. First, stock knowledge will let you as it did to me answer questions you never really
encountered in all of the 2-3 months youll spend reviewing. Second, all the subjects build upon each other. While
reviewing, I saw how much overlap there is among all 12 subjects. Your stock knowledge will be the glue that will link
everything together.


During Clerkship and Internship
Lets face it, if you fail to read the mama books during the first 2-3 years of med school, then the odds of getting around to
ACTUALLY reading them during clerkship and internship is already close to nil. In all of our 5 years in medical school, we
probably spend the least amount of time studying during clerkship and internship. And, for obvious reasons, too. During
pre-duty, its just too hard to find the motivation. During duty, its just too hard to find the time. During post-duty, its just too
hard to muster the strength.

Even so, there are still a lot you can do to help you study. The idea is to adapt your studying to your rotations and clinical
experiences:

- Read the baby books, the black books, and whatever reviewers you have. Even if they are most of the time
incomplete, they still pack a lot of REALLY USEFUL information.

- Read up on your rotation. If youre rotating in IM, read Harrisons or Washington. If youre in Pedia, read Nelsons or
Harriet Lane. If youre in Surgery, read Surg Recall or Snells Review of Anatomy. It is always easier to understand
and consequently REMEMBER something if you see and hear about it everyday.

- Read up on your patients. The wealth of patients you see in the ER, OPD and wards is unbelievable. If you manage to
read up on even just half of them, the amount of information youve already accumulated is already staggering. Our IM
and Pedia exams were quite clinical and a lot of the cases were the same ones as my patients. Never mind that I dont
remember the minutest details about the case and the disease. Most of the time, just the slightest recall that I saw this
particular case before was enough to make the answer stand out from the choices - complete with blinking neon lights.

- Attend endorsements and rounds. Think about it this way: the 2 months I spent listening in the OB summary rounds
(ok, not really EVERYDAY, not even most days of the week) already gave the answers to about 40% of the OB
questions. And do I still need to emphasize how the chief resident tends to repeat the same things over and over again?


After Graduation
But, if youre part of the majority like me, odds are we never really read Moore and Berne and Levy from cover to cover
back in the day. Chances are we never spent our waking hours during clerkship and internship slaving in front of a book.
Med school is, and should be, fun. You can never go back to the time when your anatomy groupmates had a night out
while you decided to study for an exam thats still 2 weeks away, or during that time when your blockmates went to the
beach but you stayed behind to do advance readings for the next rotation.

Like me and, likely, the person beside you a good 80% of your studying (maybe I exaggerate) for the boards will be in
the 2-3 months immediately before the exam. And like me, you most likely also know that 2-3 months is barely enough
and should be maximized the best way possible.

- Make a schedule and stick by it. I know youve heard about this piece of advice a million times, but I have to repeat it
because its THAT important. If the time you allocated for a particular subject is up, move on to the next subject. Avoid
extending by 1-2 days just to finish a subject because, for all you know, all those cheat days you squeezed in could
easily add up to 2 weeks in the final stretch before the boards. Those 2 weeks are CRUCIAL.
Also, dont forget to squeeze in time for much-needed R & R. You can do staggered, weekly R & Rs or similar
to what I did you can lump together all your vacations and out-of-town trips then study straight afterwards. Its your
call. Heres a summary of my schedule:

May
Week 1 Out-of-Town: Batanes
Week 2 ANATOMY
Week 3 Out-of-Town: Palawan
Graduation Activities

Week 4
June
Week 1 BIOCHEMISTRY
I concentrated on the basic sciences first because I wanted
to know about the basics and use these as foundation for the
clinical sciences. It worked well for me because of the
overlap among the subjects, it became much easier for me to
understand all the clinicals.

better understanding less time spent studying more
time spent reviewing for other subjects
Week 2 PHYSIOLOGY

Week 3 PATHOLOGY

Week 4 MICROBIOLOGY

July
Week 1 PHARMACOLOGY

Week 2 SURGERY
Week 3 PEDIATRICS
Week 4
OB-GYN
INTERNAL MEDICINE
I decided to spend less time in OB-Gyne and IM because
these are my strongest subjects and I felt I can survive with
less studying
August
Week 1
2
nd
Reading for Week 1
LEGAL MED

Week 2 BOARD EXAMS
Week 3
2
nd
Reading for Week 2
PREV MED

Week 4 BOARD EXAMS

- Decide whether youll do a second or even a third reading. You have to make this decision early on because it
SHOULD be part of you scheduling. Personally, I would suggest that, at the very least, you do a 2
nd
reading. You can
spend so much time studying, memorizing and making mnemonics for all your subjects. But trust me, after 4 subjects or
so, you will be really lucky to remember EVEN HALF of all the mnemonics you made previously. You need to refresh
yourself eventually.

- Think of ways on how to make 2
nd
reading faster and more efficient. Your 2
nd
reading should NOT be a mere
repetition of your first reading, and, ideally, the amount of time you will spend in your 2
nd
reading should not be more
than half of the time you will spend for your 1
st
reading. Thus, you have to be creative and resourceful in thinking of
ways on how to make your 2
nd
reading a lot quicker and a lot more efficient. The idea behind having a 2
nd
reading is to
refresh you of the must-knows and the high-yield topics, and to enlighten you on the concepts you found hard to
understand during your 1
st
reading.
What I did was make personal, computerized notes for each of the subjects. I made a lot of summary tables and
diagrams, made a list of the most commons and gold standards, and emphasized the must-knows by putting them in
boxes. I made sure that each set of notes can be finished within a day of studying since I intended to allocate only 2
weeks for my 2
nd
reading (12 days for 12 subjects). I also wrote heavily on the margins of my reviewers, so I can
concentrate on these rather than the actual text when the time came for my 2
nd
reading. Overall, I was very pleased with
my notes; I would say each set of notes had an approximately 80% yield per subject in general.

- Decide whether youll use sample exams or not. Decide also how much sample exams you will attempt to
answer. Answering sample exams seems easy and quick, but it WILL take a lot of your time. Going through all the
available sample exams can easily take away a WHOLE WEEK from your schedule. Consequently, you need to decide
whether you will use sample exams and by how much.
Personally, I suggest just answering 1 sample exam per subject just to give you an idea of where you stand. What
I did was to set goal scores per subject (usually about 80%) then answer the sample exam to see if I reach those goals.
For me, the sample exams were just confidence boosters and reality checks; I never used them as actual study
materials.
For sure, out of the THOUSANDS of questions in the sample exams, there WILL BE repeats in the boards (but I
wouldnt really know since I never used them much). But, the amount of time you will spend scouring through all those
questions (Id say about 2 days) may very well be the same amount of time you will spend doing a 2
nd
reading. If you
ask me, the MINIMUM yield of doing an additional reading far exceeds the MAXIMUM yield of all the sample exams
combined.
Of course there are always exceptions to the rule! Know which subjects are NOTORIOUS for repeat questions
and make sure to study the sample exams for those subjects. During our exams, those were the Legal Med and Prev
Med exams. I regret not studying the Prev Med sample exam; I lost a good 16 points because of that slight omission
(yes, I counted).

- Determine what kind of reviewer works best for you. My strategy was to read as much of the mama books as I can
since it jives with my study habits (before, I worked best by starting with the mama books then reinforcing it with the
transcriptions and sample exams). Sure, it ate so much of my time, but I reasoned that I need to read up on something
at least once to stand a chance. If I recall reading even the slightest bit about a particular topic, I can always rely on
good old testmanship to help me out. Testmanship is indeed VERY HELPFUL, but remember that testmanship requires
some stock knowledge and some degree of familiarity to be useful. Remove those and you are no longer utilizing
testmanship. You are gambling and relying on sheer luck.
It also helps to ask for advice from people who already took and passed the boards. It also helps very much if you
have trust on the person youre asking. After the last day of internship, I asked Dr. Phillippe Chionglo (UPCM 2009), Dr.
Tom Lo (UPCM 2009, Top 4) and Dr. Joseph Villanueva (UST 2008, PGI 2009, Top 6) about their recommendations
per subject, the pros and the cons with each reviewer, the format of each reviewer (i.e. is it in bullet or paragraph form),
and the approximate yield of each reviewer. Id say I heeded a good 50-60% of their advice. The rest, I decided on my
own.
Ultimately, your choice of books and reviewers would depend on the study habit that works best for you. Are you
the type who prefers the bulleted and outlined kinds or the type who prefers reviewers in paragraph form? Are you the
type who wants to go straight to the must-know, high-yield information or the type who prefers to know something of
everything? Are you the type who is fine with baby books and concise reviewers or the type who needs to read the
mama books?

- Decide whether you will enroll in a review class. This decision will again depend on your study habits. But, first a
short discussion on what I think are the pros and cons of a review class. I never enrolled in a review class for the board
exams, but I did teach review classes for college entrance exams previously for more than 3 years. In a way, I have an
idea where Im coming from.

Pros Cons
gives you a structure with which you can base self-studies

gives you an impetus to study on a regular basis

professors teach you mnemonics and tricks on how to
answer difficult questions

hearing your teacher and seeing visuals aid in memory
retention (more sensory modalities engaged, the better)
less time spent with self-studies

attending the class is no guarantee that youll listen and
stay awake the supposedly productive hours you spend
may easily turn into idle time

classes cost a lot of money



I didnt enroll because I know for a fact that I have the nasty habit of sleeping in class no matter how much coffee I have
or how engaging the professor is. By sleeping in class most of the time, I effectively would have cut my total studying
time IN HALF since I would only get to study by myself at night.

On the contrary, I can stay awake for very long periods of time if I study on my own. By experience, I also know that I
understand and remember concepts better if I read through them because I develop my own ways of structuring and
relating different pieces of information in my head. I figured that, had I attended a review class, I would have to adapt to
the professors ways of organizing information. That MAY or MAY NOT work for me. Its going to be a hit-or-miss kind of
thing.

- Pray. Well, to tell you the truth, I didnt really pray since Im agnostic. But, if praying gives you confidence, calmness and
peace of mind, then Im all for it.


The Books I Used
Anatomy Mama Snell
- Mama Snell is intimidating because, lets face it, its BIG and its THICK. But, its actually quite
an easy read since there are a lot of photos and the diagrams, which means that the text isnt
really very long.
- Useful parts of Mama Snell are the sections on clinical, radiographic and surface anatomy since
these parts are absent in the baby version. In addition, the board exams as of late are becoming
heavier on clinical questions, so it helps to invest in these areas.

Baby Snell
- When I started to run out of time for Mama Snell, I decided to concentrate on Baby Snell then
supplement it with the clinical parts of Mama Snell. The content is actually kind of similar, but
Baby Snells format is more on tables, bullets and outlines, which doesnt really work for me.
- If youre the type who prefers bulleted and outline forms, then I suggest reading Baby Snell then
supplementing it with the clinical sections of Mama Snell.

High-Yield Anatomy
- High Yield is incomplete when it comes to the basic anatomy stuff, but its discussions are very
easy to understand and remember.
- Discussions on clinical correlations are highly recommended. There are a lot of stuff in High-
Yield which you will not find even in Mama Snell.

Unfortunately, for our board exams, all of these books turned out to be VERY LOW YIELD. It
appeared that the highest yield would be Surgery Recall and Schwartz again, emphasizing the
need to study EVERYTHING and watch out for those OVERLAPS.
Physiology Mama Guyton
- I read this in line with my strategy of trying to read as much as I can. Though, in hindsight, I
should have skipped this and mastered BRS Physiology instead. This book is just TOO LONG.
- There are sections here that are not present in BRS Physiology, and I suggest you read through
these. While Guyton is text-rich, I dont think these sections should take more than a day:
1. Exercise and Sports Physiology
2. Space and Aviation Physiology
3. Deep Sea Physiology
4. Hematopoietic System

BRS Physiology
- Apart from the stuff in Guyton not found in this book, I would have to say that BRS Physiology is
still the BEST reviewer to read for Physiology. Make sure you master it.
Biochemistry Lippincott
- I think this book strikes a balance between being high-yield (read: not just Digging up the Bones)
and being concise (read: not like Harpers). Its also very nice that Lippincott has hard-core
Biochem stuff like detailed pathways and chemical structures, and at the same time has clinical
correlates like particular metabolic diseases. Overall, I was very happy to have read this book; I
think it had a 70-80% yield during our board exams.

High-Yield Biochemistry
- I read this concurrently with Lippincott during my more praning moments. It basically contains
the same information as Lippincotts, give or take a couple of non-essential terms. Piece of
advice: do NOT do as I did. I suggest you skip this book and concentrate on Lippincott instead.
Microbiology Microbiology MRS
- The only book I read, and I must say, a VERY GOOD choice. Its concise and to-the-point, yet
still packed with a lot of information. The diagrams and the mnemonics are very, very useful.
Pathology Robbins Basic Pathology
- Hands down, this is the BEST BOOK Ive read for the ENTIRE BOARD EXAMS

- Recall that theres Mama Robbins and then theres Fetal Robbins. This was my Sister Robbins.
Since the publisher just released a new version, Goodwill put the outdated version in all its
original, colored and glossy-paged glory, for only PhP 600. It was a steal considering that the
new version is not really very different (yes, I checked page per page well, at least in a few
random pages).
- The great thing about Robbins is that it contains basically everything you need to know for
Pathology and a lot of what you need to know for all the clinical subjects. Robbins is the book
that overlaps the MOST with all the subjects.
- The only downside is that this book is A LOT LONGER than BRS Pathology. But, trust me, the
additional time I spent with this book was more than enough to compensate for my gaps in IM,
Pedia, Surgery and OB-Gyne. Just to give you an idea: I only managed to read 2/3 of Pedia, but
I was able to snatch an 86 due to a GREAT deal to what I was able to read in Robbins.
Pharmacology Kaplans Review of Pharmacology
- Another LONG book, but another worthwhile read.
- Pharmacology IS pharmacology, drugs ARE drugs, and this book got it all. I suggest
concentrating on the mechanism/s of action of drugs and drug groups since the discussions on
this aspect of drugs are often simple, concise and to the point.
- Adverse reactions, on the other hand, are a different story. Kaplan tends to mention them all, so
there is a lot of overlap. It becomes VERY DIFFICULT to determine the classic adverse events
for each drug. What I did was to list each adverse reaction per drug then cross out all those with
considerable overlaps with other drugs. Ultimately, I end up with about 1-2 adverse reactions per
drug not too difficult to manage.

Surgery First Aid for the Absite
- The great thing with this book is its comprehensive approach on each surgical condition. It has a
little bit of everything: embryology and relevant anatomy, most commons, a little on pathology,
gold standards in diagnosis, the ideal surgical management. It also has a lot of summary tables
that highlight similarities and differences.
- While this book seems like a good choice in theory, in reality the yield was rather LOW. I guess
thats part of the peculiarities of the Philippine board exams you dont really know where the
examiners get the questions.

Surg Recall
- Surg Recall deceives you into thinking that its a short book and an easy read. I was misled into
thinking that I can finish reading it in 2-3 days. But, at 700+ pages of PURE INFORMATION, it
needs a lot of time reading, understanding and memorizing.
- My initial plan had been to read the Absite then supplement it with Surg Recall. Unfortunately, I
ended up finishing only a third of Surg Recall due to time constraints. In hindsight, I should have
spent more time to actually finish Surg Recall. While the yield in the boards isnt really high, I did
get a number of questions from what I was able to finish in Surg Recall.

Year after year, Surgery is the subject that draws the most complaints for being the subject that no
one really knows where the questions came from. Personally, I believe its either from Mama
Schwartz or Mama Sabiston. But, come on, whod REALLY read those? I think the best strategy
for Surgery is to read the Absite, Surg Recall and the other books for the other subjects. I
remember seeing quite a handful of questions on Physiology, Anatomy, Pathology and
Pharmacology. Sayang din yun.
Pediatrics Nelsons Review of Pediatrics
- This book is TOO LONG and TOO WORDY, and to tell you the truth, very LOW YIELD. I was
very disappointed that I spent close to 5 days actually reading this book. AVOID AT ALL
COSTS.

Harriet Lane
- During the last few days studying for Pedia, I switched to Harriet Lane after being disappointed
with Nelsons. In hindsight, I think I would have done much, much better had I read Harriet Lane
from the very beginning. It has information on epidemiology, common signs and symptoms,
gold standards, and treatments. There are a lot of summary tables, diagrams and flowcharts
that make understanding stuff a lot easier.
- There are 2 downsides to Harriet Lane: 1) its still quite long (but, not as long as Review of
Pediatrics); I think it would still take 5 days at the least to finish it, and 2) its TOO CLINICAL.
Some questions in the Pedia exam went back to the basic sciences Physio, Patho and
Pharma which would be impossible to answer with Harriet Lane alone.

Pocket Pedia
- A lot of people I know swear by Pocket Pedia: its really short and, they say, very high yield.
Personally, I didnt find it very high yield. Maybe its because I was only able to read slightly
more than a quarter of it.

Among all subjects, I think Pedia is the one where I was the LEAST prepared. I just didnt know
where to start and what to study. Truthfully, I think 2 things saved Pedia for me first is Robbins (I
cant really get over how much I LOVE this book) and second is the entire Pedia rotation in PGH.
OB-Gyne Baby Williams
- I started making my OB notes back during clerkship and internship, so I didnt really need to
read a lot in Baby Williams, save for the few chapters I failed to take down notes in. For all the
others, I relied on my notes all based on Mama Williams which were very high yield already
(70-80%).
- While Baby Williams as a whole IS long, the must-know topics are NOT. I suggest skipping all
the chapters on the medical complications of pregnancy, except the ones on Gestational DM
and Hypertension.

OB-Gyne Black Book
- Since I already had OB notes from before and from Baby Williams, I didnt rely on the Black
Book as my primary study material. Rather, I just used it as a supplement to reinforce the notes I
already had.
- However, I did use the Black Book as primary reading material for its GYNE part. We must
admit, while our clerkship and internship rotations are strong in the OB part, its quite lacking in
the GYNE part. Even the summary rounds had little to say about gynecologic cases.

High-Yield OB-Gyne
- I read this book ONLY for its sections on GYNE. Like other reviewers in the High-Yield series, it
is both easy on the eyes and easy to understand. It is actually possible to finish this book within
a day. True to its name, it is indeed HIGH YIELD. I would say close to 90% of the Gyne
questions in the exam may be found somewhere in this book.
Internal Med First Aid for the Step 2 CK
- Like other books in the First Aid series, this book has a comprehensive, little-bit-of-everything
approach for each disease. It has something to say on relevant anatomy, epidemiology and
most commons, pathologic findings, gold standards in diagnosis, and different forms of
management. It helps that its concise and to-the-point, with a lot of summary tables.
- IM has, through the years, been known as the most multi-disciplinary of all the subjects. So,
expect to see questions on Physio, Pharma, Patho and Microbio. Remember to cover for these
overlaps.
Legal Medicine Summary of Legal Medicine and Medical Jurisprudence
- This was my primary study material. Some people say it lacks a lot of information, but I
personally think that it has pretty much everything we NEED to know.

Solis Textbooks on Legal Medicine and Medical Jurisprudence
- I tried reading the textbook from cover to cover initially, but abandoned the stupidity after less
than a day. I reserved this book as reference material for conflicting information in the Summary,
for questionable answers in the sample exams, and for questions that I just dont know the
answer to.

Mang Lito Sample Exam
- The ONLY sample exam I studied for the boards after hearing reports that the board exams from
the previous year was almost completely lifted from this set. We all know that Legal Med is one
of the subjects NOTORIOUS for a lot of repeat questions.
- Remember, though, that source sample exams CAN change from year-to-year, so be prepared
for the possibility that a new set of sample exams be used next year. If you are an August taker,
what you can do is ask the February takers about the nature of their exam there is a good
chance of similarities.
Prev Med UE Prev Med Notes
- We all know that we NEVER had any formal Prev Med classes (except for Clinical Epidemiology
back in 1
st
and 2
nd
years). So, honestly, I think any Prev Med reviewer be it UST, UERM or
PLM should be fine. I chose the UE Prev Med Notes because I was able to borrow the
complete set from a blockmate from UERM and because I heard rumors that the Prev Med
exam would be lifted from it (by the way, the rumor turned out FALSE). Had I seen my
blockmate from UST first, I would most likely have studied the UST notes.

Sadly, the UE Notes turned out to be LOW yield because the questions were lifted from the
PreTest book. A good 40+ questions came from PreTest, and about 10+ questions came from the
UE sample exam. I must say that the Prev Med exam, like the Surgery Exam, is notorious for
questions that you just have no idea as to their source/s.