How to answer a theory question paper: Tips to maximize scoring

Disclaimer: This article is primarily intended for my students, and describes strategies for the Kerala University of Health Sciences (KUHS) Community Medicine theory examination. Nevertheless, many of the strategies might be adapted for use in other subjects/ settings.

I. Before the examination

A. Understand the purpose of the examination

Every examination is conducted with a definite purpose. Some are conducted to determine fitness to progress to the next level/ year of study; others are intended to determine your knowledge/competence at a given point in time (so that corrective measures may be initiated (if required)).

The purpose of the Third MBBS Part 1 examination is to determine fitness to progress to Part 2.

Why is this important? Simply because this means you will be assessed on domains that are described as essential for such progress. Knowing what those domains are (from a reading of the curriculum) will greatly inform examination preparation.

Simply put, if you know what the examiner is looking for, you are more likely to prepare for it, and deliver what is expected.

B. Understand the examination pattern

This is perhaps the most important of examination preparation.

Division of topics: You must be familiar with the syllabus, and division of topics by paper- which topics are included in paper I, and which in paper II.

Relative weightage of each topic: This is available in the topic division, with marks for each topic clearly provided.

Pattern of questions: This includes the following information

Number of questions
Types of questions
Maximum marks for each question

Duration of examination

C. Plan your study

Use the information regarding examination pattern to plan your study.

Spend more time on topics that are more valuable (carry more marks), instead of going by number of pages for the topic in a textbook. Remember, the importance of a topic in an examination need not be reflected by the space given for that topic in a textbook. Some topics may take little space, but may carry more marks than a topic that takes considerably more space in a textbook.

Cover the entire syllabus before the examination. Do not leave large portions for reading at the last minute- especially since questions may be asked from any part of the syllabus (despite the division of topics).

D. Develop a plan of action for the examination

Use the information regarding the examination pattern to prepare a plan of action for the examination.

Plan your time during the examination

Each paper in the Community Medicine theory examination is of 3 hours’ duration; contains 18 questions; and carries a maximum of 60 marks.

From the above, we can estimate the amount of time per question:

Total time: 180 minutes (60 * 3)

Total marks available: 60

Therefore, time per mark: 180/60 = 3 minutes.

For a 10 mark question, one should spend no more than 3* 10= 30 minutes;

For a 5 mark question, the time is 3*5 = 15 minutes

For 4 mark questions, the time is 3*4 = 12 minutes

For 2 mark questions, the time is 3*2 = 6 minutes

In general, one should have attempted questions worth 20 marks in an hour.

The requirement for entering page numbers against question numbers; underlining, etc. means that the actual time available for writing answers will be less than 3 minutes per mark. I recommend assigning 2.5 minutes per mark. Doing so will leave you with 30 minutes for the above tasks, and permit some time leeway as well.

Prepare templates for the answers of major types of questions.

Preparing a template simply means creating a framework for your answer.

For instance, all diseases must be discussed under ‘Agent’, ‘Host’ and ‘Environment’; and all descriptions of prevention must be discussed under ‘Primary Prevention’, ‘Secondary Prevention’, and ‘Tertiary Prevention’.

Familiarize yourself with the templates you have created- using them for the first time without adequate preparation may be disastrous, with you forgetting key elements of the template in the examination.

Sleep well before the examination

Lack of sleep will impair the retrieval of items from memory (recall), and increases the risk of falling asleep during the examination.

In addition, in the event of unexpected questions, a lack of sleep will impair critical and lateral thinking abilities.

II. During the examination

Do not panic

Regardless of the situation, do not panic. Most students have prepared well enough to be able to achieve a pass. Panicking will only cause your mind to go blank, and worsen the sense of ‘impending doom’ you are already experiencing.

Read all questions carefully

This is very important. You must try to understand the real purpose of the question. Sometimes, the wording of a question may seem confusing. Your task is to calmly determine what is actually expected in the answer.

For instance, a question asking the causes of infant death is really asking for causes of infant mortality. You must be able to determine that deaths are also referred to as mortality; and hence, that what is really asked are the causes of infant mortality.

Attempt all questions

Sometimes, a few questions may be out of syllabus, or from the wrong topic. This happens when the question-paper setting team neglects to refer the curriculum and/or conform to guidelines.

In all such instances wherein question(s) were inappropriate, examiners are requested to be generous with marks. In addition, university guidance clearly states that such generosity should be limited to those candidates who attempted the question(s).

Therefore, you must attempt all questions; particularly when some questions are controversial.

Implement your plan of action for the examination

Ensure that you adhere to the time plan for each question. Failure to do so may cost you valuable time, and prevent attempting other questions.

Move to the next question as soon as the time for a question is over. No matter how much you write, you will not receive more than the maximum mark for a question. Therefore, improve your chances of attempting all questions by moving to the next question instead of stubbornly writing all you know of a particular topic.

Employ the answer templates prepared previously.

Help the examiner award you marks

There are several things a candidate can do to help the examiner. The first is to understand the examiner’s state of mind. Typically, examiners are under pressure to complete paper valuation and return to their respective departments. This results in examiners being impatient during valuation. Therefore, examiners usually spend only a short time per answer booklet

To help the examiner, you may:

Write in points– this improves readability of the answer, as it is difficult to rapidly pick the main points from a paragraph
Underline key words in each answer- even if writing point-wise: The examiner is looking for evidence of learning. Key words help indicate the content of the answer in a nutshell. Therefore, even if you are writing in points, it is good practice to underline the key words. Take care to underline such that the key words stand out from the rest of the text.
Number all answers correctly- Failure to do so may result in the examiner awarding a zero based on the relevant question number (unless there is something in common between the question and the supposed answer). On occasion, examiners may realize that the candidate has numbered the answers incorrectly, and award marks accordingly. However, candidates must not assume that this will be the case every time.
Follow a consistent bulleting/ signposting system– Break the answer into distinct sections, and identify them using appropriate labels (headings/sub-headings, etc.). This is called ‘signposting’.
When writing answers, ensure that you employ bullets to identify sub-points. However, you must take care to ensure that the system does not create confusion with the answer numbers.Example of poor practice:
1.(Answer number)
1. (Main point #1)
1. (Sub-point #1)
2. (Sub-point #2)
2. (Main point #2)
1. (Sub-point #1)
2. (Sub-point #2)
2. (Answer number)Example of good practice:
1. (Answer number)
(Introductory statement)

A. (Main point #1)
i. (Sub-point #1)
ii. (Sub-point #2)

B. (Main point #2)
i. (Sub-point #1)
ii. (Sub-point #2)

2. (Answer number)

Notice how the bulleting system in the second example does not create confusion with the answer numbers. Also, observe how spacing has been employed to enhance readability of the points within the answer.
Write the entire answer to a question in the same location– Ideally, the full answer should be located together. However, if you have written parts of the answer in different locations in the answer booklet, indicate the page number of the subsequent part at the end of the first part.Example:
1. (Answer number)
(Introductory statement)A. (Main point #1)
i. (Sub-point #1)
ii. (Sub-point #2)

Note: The rest of the answer is on page #12
Use visuals to communicate your message– This includes graphs, diagrams, flowcharts, etc. Not only do they stand out from the rest of the text, they enable a rapid assessment of content and level of learning.
Ensure that visuals are neatly drawn and appropriately labeled. Avoid drawing with ballpoint pen.
Ensure that every visual is accompanied with explanatory text. Essentially, don’t draw a visual and fail to describe it. At the very least, provide a brief introduction or description, instead of presenting a visual alone as the answer to a question.
Write neatly and legibly– This will make it easy for the examiner to read and grade your answer.
Employ outlines to maximize scoring when short on time– Instead of beginning an answer straightaway, write the outline of the answer first, then proceed to discuss each point. This approach has several advantages:
a. It informs the examiner of the content
b. It helps clarify thoughts (of the candidate)
c. Answers are better organized/ structured
d. In case the candidate is unable to complete the answer, it encourages the examiner to award more marks than otherwise
e. Candidates can return to the answer later and elaborate if time permits.