Arab Board Internal Medicine Part 1 common mistakes
Arab Board Internal Medicine Part 1 · Understand the traps and how to avoid them.
Committing to a single diagnosis in a stem with two or more plausible options and never re-reading the stem for the discriminating detail (age, tempo, preceding trigger, drug exposure) before selecting.
Exam pressure and pattern-matching push candidates to the first familiar diagnosis; the stem usually contains one decisive clause that was skipped on the first pass.
What to do instead
Adopt a fixed two-pass routine: on pass one, underline the single discriminating phrase (onset tempo, exposure, key negative); on pass two, eliminate options that contradict that phrase before choosing.
Choosing the answer that is 'most aggressive' or 'most complete' workup rather than the single best next step in a stepwise management question.
Candidates conflate 'what is the diagnosis' with 'what do I do next', and anxiety favours doing more; guidelines are stepwise and examiners test the first step.
What to do instead
Before answering, classify the question as diagnosis, next step, or best initial treatment; for next-step items, reject any option that skips an indicated confirmatory test or stabilising measure.
Applying adult dosing, thresholds, or diagnostic criteria to a stem describing a child, pregnant patient, or elderly patient without adjusting for that population.
Most revision material is adult-general and candidates default to memorised adult numbers; examiners deliberately vary the population to test whether criteria are being applied thoughtfully.
What to do instead
On every stem, note age and pregnancy status in the first five seconds and consciously ask whether a population-specific threshold or contraindication applies before selecting.
Treating a numerical value as diagnostic in isolation (a single potassium, glucose, calcium, or creatinine) without correcting for the clinical context or confirming the abnormality.
Electrolyte and acid-base questions look like arithmetic, so candidates calculate and stop, forgetting that spurious results and compensation are part of the tested concept.
What to do instead
For every electrolyte or acid-base item, first check plausibility and expected compensation, then decide whether the value represents the primary disorder or a secondary/spurious one.
Selecting an antibiotic or antimicrobial regimen without checking the stem for the organism's typical resistance pattern, the patient's allergy, or the site of infection.
Candidates memorise 'drug of choice' lists per organism but not the modifiers (allergy, pregnancy, CNS penetration, local resistance) that examiners attach to the stem.
What to do instead
For each infectious disease item, run a three-question check: does the patient have an allergy or contraindication, does the drug reach the site, and is the organism typically resistant to the option chosen.
Answering haematology questions by recalling a disease name rather than interpreting the given blood count, film description, or coagulation profile.
Anaemia and bleeding questions are often answered from the diagnosis label; candidates skip the derived indices (MCV, reticulocyte count, mixing study) that the question is actually testing.
What to do instead
For every haematology stem, write the key indices in the margin and classify the abnormality (microcytic vs macrocytic, intravascular vs extravascular, intrinsic vs extrinsic pathway) before looking at the options.
Misreading the direction of a biostatistics question (sensitivity vs specificity, positive vs negative predictive value, relative vs absolute risk reduction) and choosing the reciprocal answer.
The terms are visually similar and candidates answer from memory of a definition rather than re-deriving from the 2x2 table implied by the stem.
What to do instead
For every biostatistics item, reconstruct the 2x2 table from the numbers given and compute the requested measure explicitly rather than recalling a definition.
Overlooking a drug as the cause of a new symptom (falls, confusion, hyperkalaemia, hypoglycaemia, cough, arrhythmia) in a stem that lists a medication list.
Candidates focus on the presenting system and treat the medication list as background; pharmacology and geriatric questions frequently hinge on an adverse effect.
What to do instead
Make 'could a listed drug explain this?' a mandatory check on every stem that includes a medication list, and specifically review recently started or recently changed drugs.
Choosing an answer that conflicts with the patient's stated values or the professional obligation (consent, capacity, confidentiality, disclosure) in ethics stems.
Candidates answer clinically when the question is about process, and they default to 'do what the family wants' or 'do what is medically best' without applying capacity and consent principles.
What to do instead
For ethics items, first assess capacity and identify who holds decision-making authority, then select the option that respects autonomy and the least restrictive appropriate action.
Spending disproportionate time on a small number of difficult items and leaving later questions unanswered, or changing answers without a stated reason.
Candidates treat every item as equally weighted and experience anxiety-driven answer changing; time and answer-change behaviour are measurable performance variables.
What to do instead
Set a per-question time budget, flag and move on from any item exceeding it, and only change an answer when a specific new fact from the stem justifies the change.