Basic and Clinical Medical Sciences: Internal Medicine, Surgery, Pediatrics, Obstetrics and Gynecology
What candidates must know
This domain tests integrated clinical reasoning across four disciplines. In internal medicine, be confident with the diagnostic approach to chest pain, dyspnea, and edema; the classification of diabetes and hypertension; and the recognition of acute coronary syndrome, stroke, and diabetic ketoacidosis. In surgery, know the acute abdomen (appendicitis, cholecystitis, perforated ulcer, bowel obstruction), wound classification, and the principles of preoperative assessment and postoperative complications. Pediatrics requires growth and development milestones, dehydration grading in children, immunization-linked disease presentations, and neonatal jaundice. Obstetrics and gynecology covers normal pregnancy physiology, antenatal care schedules, preeclampsia recognition, postpartum hemorrhage, and common gynecologic infections.
Traps in questions
Questions often present a classic triad and ask for the single most likely diagnosis, or invert the logic and ask which finding is least consistent. Watch for distractors that describe a complication rather than the primary condition. Pediatric doses and fluid volumes are frequent traps: read whether the stem asks per kilogram or total. In obstetrics, distinguish preeclampsia from eclampsia and gestational hypertension by the presence of proteinuria and seizures. Surgical stems may ask for the next best step, where resuscitation precedes imaging.
Worked example: rule of thumb
A 58-year-old with crushing substernal pain, diaphoresis, and ST elevation in two contiguous leads: the answer is immediate reperfusion, not waiting for troponin. Rule of thumb: treat the patient, not the lab - in emergencies, the ECG and clinical picture drive action before biomarkers return. For pediatric dehydration, use the 5-10-20 rule: 5% deficit for mild, 10% for moderate, 20% for severe, and calculate replacement over 24 hours with half in the first 8 hours.