Palestinian Board Part I common mistakes
Palestinian Board Part I · Understand the traps and how to avoid them.
In biostatistics items, calculating the PPV or post-test probability directly from sensitivity and specificity while ignoring disease prevalence in the stem.
Candidates memorise sensitivity and specificity as fixed test properties and treat them as interchangeable with predictive values, because prevalence is often buried mid-paragraph rather than in the final question line.
What to do instead
Before any 2x2 calculation, write the prevalence as an explicit prior and build the full 2x2 table with an assumed cohort of 1,000 patients; only then read PPV/NPV off the table. Practise ten stems where prevalence changes but sensitivity/specificity stay constant, so the divergence becomes intuitive.
Choosing an antibiotic or antihypertensive by drug class name rather than by the specific contraindication or interaction stated in the vignette (e.g., picking a beta-blocker for an asthmatic, or nitrofurantoin in renal impairment).
Time pressure pushes candidates to pattern-match 'urinary tract infection = nitrofurantoin' or 'hypertension = beta-blocker' before reading the comorbidity clause at the end of the stem.
What to do instead
Read the last sentence of the vignette first, then scan for absolute contraindications (asthma, pregnancy, renal function, G6PD, QT prolongation) and strike out any option that violates one. Maintain a one-page contraindication grid per major drug class and review it weekly.
On acid-base and electrolyte items, labelling the disorder from the pH and bicarbonate alone without computing the expected compensation or the anion gap.
Compensation formulas and the anion gap are perceived as optional extras, so candidates stop at 'metabolic acidosis' and miss the mixed disorder or the unmeasured anion that the question is actually testing.
What to do instead
Adopt a fixed four-step ritual for every blood gas: pH direction, primary disorder, expected compensation (Winter's formula, expected pCO2 for metabolic alkalosis), then anion gap with albumin correction. Do twenty practice gases using the ritual until it is automatic.
In emergency and critical care items, selecting the definitive management instead of the immediate next step when the stem describes an unstable patient.
Candidates conflate 'best treatment' with 'first action', and the definitive option is usually the most familiar and attractive distractor.
What to do instead
Apply an ABCDE filter: ask what the patient is dying of in the next five minutes and choose the intervention that addresses airway, breathing, or circulation before any diagnostic or definitive step. Practise ranking options by time-criticality rather than by efficacy.
In anatomy items, answering from a memorised diagram position rather than reasoning about the relations stated in the stem (e.g., which structure lies anterior to a named vessel at a given level).
Surface anatomy is learned visually and rote, so candidates recall a picture but cannot translate a described surgical field into a three-dimensional relation.
What to do instead
Study each region as a cross-section plus a surgical approach: for every named structure, list what lies anterior, posterior, medial, lateral, and the nerve or vessel at risk. Rehearse with 'what is at risk if I cut here' questions rather than labelling diagrams.
In paediatrics, applying adult vital-sign thresholds, adult drug doses, or adult fluid calculations to infants and children.
Adult medicine dominates study time, so weight-based dosing and age-specific normal ranges are under-rehearsed and default to adult values under exam pressure.
What to do instead
Memorise weight-based dosing for the high-yield paediatric drugs (paracetamol, antibiotics, adrenaline, fluid boluses) and age-banded normal ranges for heart and respiratory rate. For every paediatric stem, state the weight and calculate the dose explicitly before looking at the options.
In obstetrics and gynaecology, managing the fetus or the pregnancy without first stabilising the mother, or missing that the correct answer is delivery rather than medical therapy.
Candidates separate obstetric from emergency reasoning and forget that maternal resuscitation precedes fetal assessment, and that in severe pre-eclampsia or HELLP the definitive treatment is delivery.
What to do instead
For every obstetric emergency, run a maternal-first checklist (haemorrhage, hypertension, sepsis, airway) and then ask whether the condition is one where delivery is the treatment. Learn the gestational-age thresholds at which delivery versus expectant management is indicated.
In pathology and microbiology, choosing the organism or lesion by name familiarity rather than matching the described morphology, stain, or culture characteristic in the stem.
Candidates recognise common organisms from prior questions and skip the descriptive clues (Gram stain, catalase, growth on specific media, histology pattern) that distinguish the correct answer from the familiar distractor.
What to do instead
Convert each stem into a feature list before reading options: Gram reaction, shape, oxygen requirement, key biochemical test, and classical clinical syndrome. Build a comparison table for look-alike organisms and lesions and test yourself by features only, with names hidden.
In community medicine and epidemiology, confusing incidence with prevalence, or relative risk with attributable risk, when interpreting the study result given in the stem.
The terms are learned as definitions but not as calculations tied to a study design, so candidates default to whichever measure sounds most familiar.
What to do instead
For each study design, write the measure it yields (cohort: incidence and relative risk; case-control: odds ratio; cross-sectional: prevalence) and compute the measure from the numbers in the stem before interpreting it. Practise converting a stated relative risk into an absolute risk difference to see why both matter.
In ethics and behavioural science items, answering with personal moral preference or the legally safest option rather than the four-principles framework and the patient's expressed autonomy.
Ethics is perceived as subjective, so candidates rely on intuition and miss that the exam rewards a structured principle-based justification, especially in consent, capacity, and confidentiality scenarios.
What to do instead
For each scenario, explicitly identify the conflict (autonomy versus beneficence, confidentiality versus public interest), assess capacity with a standard four-part test, and choose the option that preserves informed consent and the least restrictive action. Review the local legal thresholds for consent and notification so the framework is applied within the correct jurisdiction.