Learning how to read

Do you know how to read a book?  For many, with respect to high stakes exams, the answer is “no”. Perhaps nothing is more critical for long-term multiple choice testing success than learning how to read correctly. This skill is why some people are labelled “good test takers” even if they cannot articulate why this is true. If time is limited (less than 2 weeks), my advice is to focus on quadrant C (described HERE). If an examinee is preparing months in advance, then no topic is more important than learning how to read effectively.

The table above is described in this recent POST. In summary, quadrants B and D reflect significant knowledge gaps. Topics that come up repeatedly in these quadrants require further study. This is the benefit of having question banks and sufficient time to prepare: test takers can prepare both harder (defined HERE) and smarter (described below).

When you think about “reading” what comes to mind? If you are doing it correctly, reading in preparation for a multiple choice exam will feel nothing like reading a book for fun. Perhaps the key difference is how actively engaged you must remain in the process. Reading for fun is being taken on an enjoyable adventure; reading for exams is shoveling manure. Preparation for high stakes exams should only be done with the eye of a critic; you need to become a test writer.

The phrase that should never cross your mind when reading a textbook critically is, “well that all makes sense”. That passive approach to reading, and comprehending, means you are not actively engaged. Test writers are constantly scanning material to see where future test takers could get confused. The authors of medical textbooks may be brilliant doctors, but they are frequently horrible writers. The material presented can be confusing and is often poorly written. Your focus should be to create your own questions as you read the material.  This may feel foreign at first and it will certainly slow you down. That is OK. Reading engagement is far more important than reading speed.

After every few paragraphs you should stop and try to formulate a question. The questions don’t have to be perfect, but they should be the best you can do with the content available. Keeping a notebook with such questions is a great idea. When you combine this practice with reviewing material from available question banks you will start to see how closely your self-generated questions are to those in the question banks.  “Good test takers”, whether they know it or not, are those that can identify material that is likely to be on future exams. The process of becoming a test writer is the fundamental skill one must learn to improve their performance on high-stakes multiple choice exams.  


JAY on TWITTER @JayMacGregorMD







4 responses to “Learning how to read”

  1. Kouros Farro Avatar

    Love it Jay. Nail in the coffin!! “The authors of medical textbooks may be brilliant doctors, but they are frequently horrible writers”. “reading for exams is shoveling manure.” You are a writer for sure Brother. People always made fun of me how good of a test taker I was no matter how much time I had. Great read. Happy Holidays!

    Liked by 1 person

    1. Jay M. MacGregor, MD, FACS Avatar

      Thanks, Kouros! Happy Holidays to you and your family. Hope you are able to make time for your amazing photography!


  2. […] Quadrants “B” and “D” are also of limited value to test takers, especially if the preparation time is limited. (Author’s note: preparation time will always feel limited.) An examinee is unlikely to sufficiently address large knowledge gaps if an exam is imminent. Investing time in quadrants B and D is relatively low-yield.  (Note: If sufficient lead time exists, there are excellent strategies to address both quadrants.  A blog post specifically addressing these quadrants is available HERE.) […]


  3. […] your own questions. How is this accomplished? The first step, reading critically, is discussed HERE.  Once critical reading becomes second-nature, the next step is as simple as it is effective: […]


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