AIIMS May 2016 Rituraj Upadhyay
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1AIIMS MAY 20162
3AIIMS MAY 2016
Rituraj Upadhyay MBBS Junior Resident (Radiation Oncology) All India Institute of Medical Sciences New Delhi, India
4
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AIIMS May 2016
First Edition: 2016
9789385999062
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Disclaimer
This is just a recall-based paper, and the actual options may be different. I have tried to provide the questions, options and answers to the best of my knowledge and after consultation with multiple books and research papers. You may find a research paper supporting a different answer but the actual answers are based on a meta-analysis of a lot of research work.
5Preface
‘You must be the change you wish to see in this world’
Mahatma Gandhi
I would like to thank all the readers of my previous books for the overwhelming regards and wishes. It has pushed me into following-up with this idea with AIIMS May 2016 exam. I have tried to do my best to match-up with your expectations and provide the best, correct solutions to the questions. Hope you will find this book handy and helpful till the final moments of your preparation for the next AIIMS PG entrance examination.
While studying for my own PG entrance examinations, I rea-lized the need of a book containing model questions asked in the previous year papers containing the exact set of questions that came in the examinations. I had been preparing for the exams for a couple of years and by interacting with my seniors and fellows, I realized what psychology the students have when they take the AIIMS entrance exams. It is everyone's dream to crack this prestigious exam and be a part of the Institute and I wish to help you achieve this.
There are always a given number of questions that are directly repeated in an AIIMS entrance examination from previous year papers, especially from the last couple of papers. There are many more indirect repeats, i.e. from the same topics as previously asked. Hence, it is very important to solve the latest papers well in time so that the students become aware of the current topics and prepare for the next exam based on it.
While writing down the explanations, I have tried to be to-the-point, because nobody has time to read through unnecessary additional information, at the same time, I have tried to include useful tables and contents from which questions are being asked repeatedly. I have provided all authentic references mostly from standard textbooks, especially for controversial questions. I have been in touch with consultants from various departments of AIIMS to come-up with the best answers.6
Multiple revisions have been made to minimize the chances of errors but still some mistakes might be there which should be brought to my notice through e-mail. You can also e-mail me any doubts regarding the questions, or if you need further explanation of the answer.
I have added a few pages entailing a strategy to prepare for the exams. It is a pleasure to provide all PG aspirants with this book and as soon after the exam as possible because time is the essence. I hope it meets your demands. Wishing you all the best and looking forward for your feedback and suggestions...
rituraj.game@gmail.com
Rituraj Upadhyay
7Review Board
Anatomy
Rajesh K Kaushal
Physiology
Soumen Manna
Biochemistry
Rebecca James
Pathology
Ramadas Nayak
Pharmacology
Prasan Bhandari
Microbiology
Apurba Sankar Sastry
Forensic Medicine and Toxicology
Soumendranaryan Maitra
Orthopedics
Apurv Mehra
Ophthalmology
Sudha Seetharam
Preventive and Social Medicine
Mukhmohit Singh
Surgery
Manoj Middha
Pediatrics
Meenakshi Bothra
Obstetrics and Gynecology
Richa Saxena
Dermatology
Soumendranaryan Maitra
Anesthesia
Saurabh Taneja
Radiology and Radiotherapy
Rajat Jain
Psychiatry
Praveen Tripathi8
9Acknowledgments
I would like to express my gratitude to the people who have helped and supported me throughout the project.
I wish to thank my parents, for I owe my everything in life to them, who inspired me and encouraged me to do what I felt right and take my own decisions.
Most importantly I would like to thank Dr Zainab Vora (Rank 1 AIIMS PG May 2015), Dr Ravi Sharma (Rank 2 AIIMS PG Nov 2014) and Dr Siddharth Jain (Rank 1 AIIMS PG Nov 2014), my fellow interns and not only my good friends but study partners also. This book could not be written without your support and ideas. They helped me wherever I was stuck.
I am also grateful to all my teachers at All India Institute of Medical Sciences for the wonderful five years worth of information, which no book can ever compete.
I am grateful to all my Senior and Junior Residents as well as all the consultants from the Department of Radiation Oncology, AIIMS. I really admire the helping nature of everyone and thank them for sparing me the time to be involved with this book.
And finally I wish to express my sincere thanks to all my friends and colleagues Dr Sachit Anand, Dr Deepika Kainth, Dr Arshi Singh, Dr Saurabh Bhatia, Dr. Divya and many others, it is their constant nagging to do something good that lead me to this.
I would also like to thank all my seniors and juniors, including Dr Divya Aggarwal, Dr Kartik Gupta, Dr Lokesh Aggarwal, Dr Ajit, Dr Anupam Gupta, and all others, who have helped me in this task. I am grateful to you guys for keeping me awake at nights and never letting me give up on myself.
I convey my sincere thanks to Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India for their efforts and suggestions, especially Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President), Ms Chetna Vohra (Associate Director), and Ms Payal Bharti (Project Manager) for helping me through my idea.10
11Preparation Tips
How to Prepare for Aiims Pg Entrance Examination?
‘Winners don't do different things, they do things differently’
The secret of success in PG entrance examinations is perseverance, a clear mind set and a passion to achieve what you want, no matter how many obstacles come in your path. And starting a bit early always helps.
Defining Your Goal
It is useful to define your own performance goal before starting the preparation—What do I really want? Your style and intensity of preparation can then be matched to your preparations, especially if you have already decided what subject do you want.
Timeline for Study
Make a Schedule
Map out a schedule which is consistent with your goals, daily time available for study and duration left before your exams. And make it realistic, with achievable small targets, you should never procrastinate.
Another important consideration is when you should study each subject. You should never leave a weak subject for last.
Year(s) Prior
I used to be regular in my studies since 6th semester (pre-final year). And by regular, I do not mean I would sit all day cramming up books, no I kept everything balanced. Securing a good rank in PG is important but that is not the be-all and end-all of life. You ought to be a good doctor first, and that is not defined by your ranks.
Attending regular subject classes in a coaching institute is a good idea. Which Institute does not matter, what matters is whether you are attentive during classes and revise the stuff you have been taught or not. It is very important to revise everything you have been taught at least once, within that same week. If not revised, the classes will be up to no good.12
Month(s) Prior
You should start practicing tests to sharpen your question solving skills. Attending a test and discussion is a good idea. After solving tests, you should work on your mistakes and figure out your weak areas. This will constantly improve your performance every next time.
One Week Prior
You should have identified the hot topics from which questions are frequently asked by now, and perhaps would have made some notes as well. This is the time to stop reading anything new and consolidate what you already know. Revise all your notes and the commonly asked questions. Revising repeats is always a good idea even at this time.
The Exam Day Strategy
You need to calm yourself just before taking the test.
The plan should be to attempt as many questions as possible by eliminating the options based on collateral knowledge. Other than the repeats, questions are usually not asked directly from books and can be answered from the background knowledge of the subject. If you can eliminate two options you should mark the question. It is necessary to attempt enough questions because many answers you are sure about are also going to end-up wrong. This strategy is especially for the AIIMS examination as the pattern is changing from straight cramming based questions to more of applied knowledge and USMLE types questions.
Duration of Study
Initially about 4–5 hours of regular focussed study is enough but in the last 6 months or so around 10–12 hours a day is necessary. Even in the last month, it is useful to take a break for sometimes, watch some movies or something, that is all right as long as you are studying seriously for the rest of the time.
If You Think You cannot Do It
Well this question should never arise anywhere during your preparation and especially while giving the exam. Exams are no rocket science. And even if you doubt yourself clearing a PG exam is not everything in life. It is no doubt a highly competitive and difficult exam, you are not only competing with people of your batch from all over the country but also with many who have been taking this exam for years. So many doubts arise but you just keep up with your time schedule without worrying about the rest of the world.13
During exam, if you find the very difficult question, you must not panic at all. It is this thing which distinguishes the people who get selected and those who miss out by a fraction. Because if you panic you may make silly mistakes even in some pretty easy questions. Keeping yourself calm is, hence, of the utmost importance.
Study Materials
Standard textbooks like Harrisons, Robbins and Park must be read as far as possible. For other subjects what you have read during MBBS should suffice.
Textbooks for Reference
Basic Review Books
Practicing questions from these books is much more important than reading the text alone. You should always follow reading up text by doing questions, it helps to consolidate the topic you have read and helps filter out important content.
Coaching Notes
Self-made notes are always the best. It is of no use getting the notes photocopied from someone and reading. If you have made your own notes, you can revise in much lesser time and understand better. If you do not have the time to do it now, it is better to study from books rather than reading up notes.
Focus Subjects
Ophthalmology, Pathology, Pharmacology and PSM are the four most important subjects for AIIMS PG entrance exams. Read from textbooks if time permits.
Skin, Anesthesia, Radiology, Psychiatry and Forensic medicine are almost equally important, they will help you perform in case of a very difficult paper. You must be thorough with the frequently asked topics of these subjects.
And Microbiology and Obstetric Gynecology are the least productive subjects. You can read it once or twice, that should suffice.
Test-Taking Strategies
These skills are equally important as your fund of knowledge on the day of exam. These skills are learnt by practice overtime and must be perfected so that you can concentrate on the exam itself that day.
Pacing
You have three hours to complete 200 questions. This works out about to 54 seconds per question. Note that time is not an issue for most exam takers. However, pacing errors have in the past been detrimental to the performance of even highly prepared examinees. The bottom line is to keep one eye on the clock at all times!
Dealing with Each Question
There are several established techniques for efficiently approaching multiple choice questions; see what works for you. One technique begins with identifying each question as easy, workable, or impossible. Your goal should be to answer all easy 15questions, resolve all workable questions in a reasonable amount of time, and make quick and intelligent guesses on all impossible questions. Most students read the stem, think of the answer, and turn immediately to the choices. A second technique is to first skim the answer choices and the last sentence of the question and then read through the passage quickly, extracting only relevant information to answer the question. Try a variety of techniques on practice exams and see what works best for you.
Difficult Questions
Because of the exam's clinical emphasis these days, you may find that many of the questions appear workable but take more time than is available to you. It can be tempting to dwell on such questions because you feel you are on the verge of 'figuring it out,' but resist this temptation and budget your time. Answer difficult questions with your best guess, mark them for review, and come back to them only if you have time after you have completed the rest of the questions. This will keep you from inadvertently leaving any questions blank in your efforts to ‘beat the clock’.
Another reason for not dwelling too long on any one question is that certain questions maybe experimental or maybe incorrectly phrased, so the answer would depend on the examiner only and it is no use spending excess time on it.
Changing Your Answer
The conventional wisdom is not to change answers that you have already marked unless there is a convincing and logical reason to do so—in other words, go with your ‘first hunch’. However, studies show that if you change your answer, you are twice as likely to change it from an incorrect answer to a correct one than vice versa. So, if you have a strong 'second hunch,' go for it!
Too Difficult Paper
If your knowledge is going tangentially, i.e. you know the topic well but cannot guess the answer, do not worry. Wait for easier questions. And even if they do not come, it is okay, the paper is going to be difficult for everyone. Never give up. If you begin to feel frustrated, try taking a 30-second breather and then continue.
Clinical Question Strategies
In recent years, the AIIMS paper has become increasingly clinically-oriented. This change mirrors the trend in medical education toward introducing students to clinical problem-solving during the basic science years.16
Remember these clinical questions usually describe diseases or disorders in their most classic presentation. So, look for buzzwords or cardinal signs (e.g. malar rash for SLE or nuchal rigidity for meningitis) in the narrative history. Be aware, however, that the question may contain classic signs and symptoms instead of mere buzzwords. Sometimes the data from labs and the physical exam will help you confirm or reject possible diagnoses, thereby helping you rule answer choices in or out. In some cases, they will be a dead give away for the diagnosis.
Making a diagnosis from the history and data is often not the final answer. Not infrequently, the diagnosis is divulged at the end of the question, after you have just struggled through the narrative to come-up with a diagnosis of your own. The question might then ask about a related aspect of the diagnosed disease.
One strategy that many students suggest is to skim the questions and answer choices before reading the question, especially if it is lengthy. This focuses your attention on the relevant information and reduces the time spent on reading it. Sometimes you may not need much of the information given to answer the questions.
Image Based Questions
No need to prepare especially for these questions. I believe it is like finding a needle in a haystack. If you have been regular in your MBBS, you can easily solve the question based on the clinical vignette given along with the image. A sound reading of Robbins in your 2nd year will also help.
A Last Advice for Everyone
If you have the passion to do something, then working hard for it would not really feel like 'work' to you, it would be like a walk in the park. It is necessary to keep yourself calm during preparation, but just like Frank Starling law, an increase in tension will improve your performance until a certain limit. You need to attain that right amount of high to excel.
Again, cracking PG exams does not mean everything. First be a good doctor. Add a bit of hard work and a PG seat will follow surely.
17Dr Zainab Abbas Vora Rank 1 AIIMS PG May 2015
Let me introduce myself first. I am from Rajkot, Gujarat. I did my schooling from SNK school, one of the best ICSE schools in our country. I give a lot of credit to what I am today, to those 15 years of being an SNKian. I then did my MBBS from AIIMS. The place that makes you believe in your abilities to make your every dream come true. I obtained first ranks in AIIMS PG entrance May 2015. This was my second attempt. I also obtained first rank in NIMHANS PG entrance this year.
There is no secret of my success. I have read the same books as people all over India have. My parents and friends have prayed for me and supported me just as all the parents and friends in the world do. What makes the difference in the end, I believe is the conviction and passion to see your dream through. I had a poster ’Stop Wishing Start Doing’ as my phone wallpaper. It helped in getting over those innumerable bouts of random thoughts you have with books in front of you.
My Preparation Strategy
Well internship in AIIMS has the advantage that you do not have such hectic work hours as our colleagues in other parts of the nation do. It has its disadvantages also where our clinical skill or speed is concerned, but you do get almost half an year of free time for PG preparation. Having said that, I believe I studied the best during my OBGY/Casualty postings (quite heavy) when I had no more than 3–4 hours to spare a day—since you concentrate all your energy to study when there is a pressure of time. My strategy for the bulk of the year, that is from Jan/Feb– Aug was 18to follow the test and discussion schedule (any coaching will do) and study accordingly. I used to try and finish the subject (or whatever I could manage) in 4–5 days and then take the test. And then complete the remaining subject with the revision of the class notes in 1–2 days after. This ensures you go through the entire syllabus in a subjectwise manner.
Then comes the most important part which is completing all subjects in the remaining two months. Where I went through the important topics of all subjects with T and D notes and previous years questions.
I had a subjectwise approach to my preparation. I used to do the last 5 years questions for that subject before starting preparation so that I got an idea of the important topics for each subject. I focused more on reading the theory portion of the subjectwise guides than doing the MCQs, it saves time since most of those MCQs are framed from that matter only. It also reduced the matter that you need to revise to almost half the size of the book.
Revision is the most important part. So, keep filtering matter everytime, give a reading and you are left with almost enough matter for that quick revision right before the exam.
Taking Notes
I have a habit of keeping a tiny notepad where I used to jot down points which needed revision like numbers/syndromes. They were quite useful since you can have them in your pocket and have a quick glance while you are in the middle of some boring rounds or waiting in the labor room for the baby's head to pop out! Also helps for that last week preparation since I used to write down points that needs to go in your short-term memory, stuff that you can never ever manage to get past your hippocampus into the neocortex.
Facebook
I have to admit I did not have the self-control to stop myself from logging into facebook at least twice or thrice a day. But if you are a part of those PG preparation forums, it does help. There are quite a few updates that are posted and can be really helpful if used correctly. At the same time it is important not to lose yourself amongst such forums since there are hundreds of questions being 19posted everyday and if you keep trying to find your answers to them, you might lose important time of revising stuff that should rather be done.
Classroom Coaching
I attended DAMS in my 6–7th semester. I did not study much during these years. It is useful to have a set of handwritten class notes for each subject over which you can compile and consolidate whatever you read for those subjects. These notes are very handy and are helpful for your main preparation during internship. Since you remember your own notes the best compared to any other book.
I attended Bhatia TND classes in my internship. It will be very useful to you since it streamlines your preparation by providing a proper schedule as to how you can go about your subjects. Also giving the test after preparing gives you a heads-up as to where you stand as far as your own preparation is concerned and what you need to for that subject. Also the questions in the T and D are quite relevant and are from the recent years, so revising these notes is also not a bad idea.
I also used to give Grand tests from Bhatia, DAMS and IAMS every month starting from internship. Apart from giving you a good idea of where you stand, these tests are quite relevant to the current trend. And you can always pick out 8–10 topics from each test and try to revise them from standard textbooks. That way you cover some very important topics in detail as you move along.
Books for Theory
Anatomy
– BD Chaurasia
Physiology
– Ganong
Biochemistry
– Harper
Pathology
– Robbins
Microbiology
– Ananthanarayan
Pharmacology
– KDT
Forensic Medicine
– Sumit Seth
ENT
– Dhingra
Ophthalmology
– Khurana
SPM
– Park20
Medicine
– Harrison
Surgery
– Bailey and Love
Orthopedics
– Apurv Mehra
Paediatrics
– Ghai
OBG
– Dutta's Obs & Gynae
Anaesthesia
– Ajay Yadav
Dermatology
– Neena Khanna
Psychiatry
– Niraj Ahuja
Exam Specific Books
I read my good friend Dr Rituraj's book for AIIMS November 2014. It is a very well written and structured book. I admire the dedication of this guy, he himself cross checked each and every reference from multiple sources and I have faith in the authenticity of the answers.
Pritesh Singh vol 1 (2014–2011)
STEP 1 FIRST AID- It is one of my favorite books.
Subjectwise Books
1st Year
Anatomy, Biochemistry, Physiology – ACROSS
2nd Year
Pathology – Gobind Garg and Sparsh Gupta
Pharmacology – Gobind Garg and Sparsh Gupta
Microbiology – Rachna Chaurasia
Forensic Medicine – Sumit Seth
3rd Year
ENT- Coaching Notes (DAMS)
Orthopedics – Apurv Mehra summary
Ophthalmology – Ruchi Rai plus IAMS module
SPM- Vivek Jain
Final year
Radiology – Dr Sumer Sethi's book21
Exam Day Strategy
I learnt a lot from my mistakes. When I went in for writing the AIIMS exam in November 2014, I felt like I had taken undue pressure about the paper—which resulted in me taking a lot of time reading questions in the first-half of paper being over-cautious. I tried to overread each question—which meant I messed up the second-half of my paper due to time constraint. I was quite disheartened after the result although it was not that bad a rank (98) obviously but it could not get me the branches that I wanted. So, when I went in for my AIPGMEE, I was out of touch from preparation since a month (that is after AIIMS exam), but I decided to trust my concepts, read every question (more importantly every option) carefully, solved each question by eliminating options and manage time better and the strategy worked. I got a good rank in the exam where the result was as unpredictable as the questions in the exam were.
And then I appeared in the AIIMS May exam with a similar attitude, better prepared, without any stress, and voila, Rank 1.
I appeared in the exam with a predecided approach that I have to attempt the complete paper, since it is very important that if you want a good rank, you need to attempt 95% plus questions for any exam. That is another thing I learnt from my AIIMS Nov 2014 exam. Apart from that, I tried to get all the easy and relevant questions correct after the first read. I kept the twisted ones and the ones where I thought I was second-guessing the answer, for review. Try and eliminate options for every question.
Give your 100% for that exam duration and I am sure everyone will come out with flying colors!
All the best!!22