Revalida Tips:

Foreword:
First of all, I believe that the Revalida is an outdated tradition. Outdated because its all-or-nothing philosophy reminds
me of the atholic church before !atican II: "edieval. I do not believe that a single e#amination, especially one $udged
by % doctors who will have different views and attitudes towards you and the test itself, is an accurate assessment of
what you have learned and more importantly, your effort over the course of & years. I remember once, where a friend of
mine got a case in the pediatrics case in the O'(, randomly pic)ed by a consultant. The case was dermatologic and
difficult, not even the residents or the consultants )new the diagnosis. "y friend was not able to get his honors. *o one
can )now everything. +owever, it is also a tradition, and I believe that traditions are there to institutionali,e something,
to protect a value. It is an advantage to review everything and test yourself for competency, and in this sense, Revalida
is needed. -hen you pass it, it gives you so much sense of fulfillment and confidence. .s such, you may love or hate
Revalida, depending on how you prepare, and who you get as tribunal.
-hat I do not li)e most about Revalida is that some people who do not deserve to fail, fail, while those who deserve to
fail /0 times over, pass. *o matter what becomes of your Revalida, always remember that it is $ust a single test, on a
single day and & years of hard wor), is proof enough to yourself that you made good of what 1od has given you and
what your parents have wor)ed hard for. -e are not born geniuses and we all have our wea)nesses. .s long as we
lived and wor)ed through "ed school with truthful hard wor), bac)ed up by the love of our parents and friends: we
don2t need to prove anything to anyone, because you already have. "edicine is not easy and the fact that you have
made it through & years is proof enough that you2ve done good.
'art /: -ritten Revalida:
3et me $ust say that I told some of you before ta)ing the written Revalida that there was a lot of O4-1yne in our test
and that you should study it. .pparently, it was the same in your case. Implication: O4-1yne is a ma$or force in the
56T academic institution. .nyway, I didn2t get to study for that, we didn2t have a day off before or after that e#am and to
a sense, I never really crammed a day before it. -hy7 4ecause you can2t8 +owever, the only thing that I remember
studying for that day was a few hours before the e#am: O4 oc oc notes, because that was my wea)ness when I was a
cler), and luc)ily it paid off somewhat. Implication: the written Revalida has given you a taste of the )nowledge base
you must )now or more importantly, the )nowledge base you are deficient in. Tip: concentrate on your wea)nesses.
The written Revalida is nothing li)e the oral, but it gives you it is an aptitude to tell you where you suc).
'art 9: Oral Revalida
6ection/: "echanics
Oral Revalida is supposed to be a practical test to assess what you have learned over the last & years in medical
school. :ou will be grouped into % cler)s and with % corresponding consultants grouped as a tribunal. ler)s are
grouped alphabetically, and consultants, usually still have the same grouping as last year, unless they failed someone,
sometimes, they are disseminated. The pic)ing of the tribunal is probably the scariest part because as you may )now,
Revalida is somewhat tribe dependent. I )now of some people who cried and cried after having their pic), and some
celebrated as if they had already passed. -ell, after pic)ing your tribunal, you have to ma)e a courtesy call to each of
them, usually the senior of the tribe first. +e or she will have the final say when the actual Revalida will ta)e place, and
the venue. I suggest you do this as soon as possible, because their schedules are not very easy to follow. I also advise
that during this courtesy call, stic) to the definition: ;have courtesy.; I remember someone who, as the courtesy call
was about to be finished blurted out: ;(oc, do you have any tips for Revalida7; and the doctor said: ;Tips7 Tips7 -hat
Tips7 -hen I was a cler) I didn2t have any tips8 .nd If you don2t )now anything come Revalida time, then you deserve
to fail8; :es, $ust be nice to them and try not to as) any favors. Oh, and when doing the courtesy call, bring the
document that the tribe has to sign confirming the schedule. I remember some of my friends who forgot to bring it and
the doctor said< ;-ell, where is it7 =silence>well, get out of here and get it8; hehe, $ust be nice and responsible.
The Revalida consists of % parts, namely the basics, the clinical and the emergencies. In the 4asics part, you go into
the room while the other 9 stay outside, usually the se?uence is alphabetical. The tribunal will as) you anything under
the sun on a list of topics that will be given to them: namely, all the systems of the body, and the basic sub$ects. For
instance, they will as) you about the cardiovascular system or they can as) you by sub$ect, li)e certain topics in
pharmacology. -hen you pass, they will tell you. -hen you fail, they will tell you, and you have to leave. 6ome fail in
the first step.
The second step is the clinicals. -hen you2re done with the basics, you go bac) to the dean2s office to pic) a case
from the hands of (ra. (a)is @well, during our time it was herA. 6he will spread out a bunch of envelopes for you and
you will pic). They say, pic) the ones on the e#treme ends, since mga O'( cases daw yun. 4ut I have yet to find
conclusive and consistent evidence that this is as such. In any case, suwertihan talaga. Once you2ve ta)en your
envelope and sealed your fate, you will go either to the ward or the O'( to have your e#amination. .nd you will be
tested on the whole shebang, much li)e "3B step 9: patient-physician relationship history ta)ing and 'B. :ou have to
be ?uic) since they will give you only /0-/C mins for everything. 4ring a scratch and pen. 4e nice. 5sually, one
consultant per cler) will accompany to the O'( or the wards. Often, the consultant will observe you while doing your
history and 'B. Once you are done with this, you go bac) to the ;room; and whoever gets bac) there first, is the one
who will usually go in first @usuallyA. Then the test: if you fail, they tell you. .nd if you pass, you go straight to the
emergencies.
In the emergencies, they have a bingo bottle where they have a bunch of numbers, and those numbers correspond
to specific emergencies. :ou will pic) three bingo numbers and from those, you will select one which you will discuss.
.fter this step, you go out and then they call you in the room for the final $udgment. Then you ta)e a picture with them if
you2re happy @optionalA.
6ection 9 4asics:
3uc)ily, I never had to ta)e this test because, awa ng (iyos, I passed the written Revalida @this was the ruling in our
time, I don2t )now if this is still yoursA. 4ut I have heard many stories from this part: this is the part that will ma)e or
brea) you. This is also the most difficult part because they can as) you anything, absolutely anything. +ere are some
stories: The tribunal as)s the cler): ;I see you2ve brought many strollers for your pile of boo)s. -hat2s at the bottom of
the pile7 Robbins po (oc. .h, o) tell me something about the pathology of breast cancer.; 6tory 9: First ?uestion:
;-hat are the anti-arrythmic drugs, their "O. and indications7 ; 6tory %: ;what muscle am I moving7 -hat about this
one, and this one7 *erve supply7; 6tory &: ;Tell me the anatomy of the 1IT from mouth to anus and the respective
blood supply.; That2s $ust a fraction of the things I heard, and well, that2s me @usually huli sa tsismisA, and there are
probably more stories that are a lot worse. 6o, if you want to study for something, this is it. Once again it is a very
daunting tas) but my advice: focus on your wea)nesses. If you suc) in .natomy, then study anatomy. In my opinion,
the most important basic sub$ects are the ff: 'hysiology, .natomy, 'haramacology. 4iochem is impossible, but usually,
the consultants don2t as) much of it, unless biochem ang tribe mo. . seemingly constant feature though is the
biochemistry of digestion, and metabolic integration: study that.
-hich brings me to another advice: regardless of what they have advised the consultants in the tribe, they will as) you
about their specialties and this is where you should focus your studying also. If you have a surgeon in your tribe, they
will as) you on anatomy. If you have a pulmonologist in your tribe, he will as) you about lung physiology. If you have an
obstetrician in your tribe, she will as) you on the menstrual cycle and the stages of labor. If you have a pharmacologist
in your tribe, she will as) you about antimicrobials. If you have a radiologist, he will center on anatomy. If you have a
nuclear physician, he will center on physiology. In my e#perience, the most difficult specialties to have in your tribunal
are the following: 6urgeons @it2s a one-two punch with anatomy and surgery: blood supply of this and thatA,
Obstetricians @O4-1yne and BthicsA, and probably the most feared, 'harmacologists @anything under the sun, and
most of them are very good too, I had two pharmacologists in my tribe: nerve rac)ingA.
.s mentioned, the style of as)ing will depend on the tribe. 6ome follow the script, and they go through all the systems.
6ome $ust as) you to say something about physiology in general. 6ome will actually prepare their own ?uestions at
home8 The secret in this part, is to $ust )eep tal)ing and tal)ing about things that you )now. . tip from (r. 1o ;If there
was no cardiologist in your tribe, and they as) you to tal) about physiology, concentrate on cardiac physio and say a
lot. (on2t stop tal)ing, but be sure you )now what you2re tal)ing about.; 1reat advice right there. ontrary to what most
people thin), if you get (r. 1o as tribunal, be than)ful: he as)s ?uestions to lead you to the answer and he is fair. It is
rare that people fail under him unless from his ?uestioning, someone2s true incompetence is unmas)ed. .nd before I
forget, there is one thing you must never forget to study for the Revalida, even in basics: BT+I68 6omeone, has failed
every year, from an ethical issue. It is a consistent pathologic feature of Revalida.
3astly, although it is basicsDthey will always as) you something clinical about it, especially anatomy. 4asics to
consultants may be boring, unless you connect it with clinical applications.
Recommended resources: handouts during the medschool will do. 'ersonally, I never really studied my handouts
because ma$ority of them are lost and I2m a boo) guy. I2m also not oc oc enough to ta)e notes. 4asically, read
something that you2ve read before so that it really becomes a review. (o not read something new. I read my boo)s, so I
$ust reread the highlights for study. Otherwise, these are pretty good resources: .natomy: 6nell, esp clinical notes,
'hysiology: 4R6, the best. 'atho 4R6 is very good. The must )now boo) isDwell, must )now. 6tudy that too.
linicals:
This part is easier than the basics, in my opinion. :ou can actually study for this, because, patients will be chosen by
each department and they will submit this to the dean2s office, so you can study these cases nights before the actual
Revalida. 6ome services li)e 'ediatrics, B*T and possibly 6urgery will tell you the cases for the clinicals: but
remember, it changes every day. 6ome services, li)e medicine, will not tell you and you have to study all of the
patients. -ell, that2s if ward ang na)uha mo. If O'(, you cannot study for this, unless O4 ang na)uha mo because
they usually only give first pre-natal chec)-up.
In the actual test, you have to do history and 'B ?uic)ly. Tips: remember to ta)e the general data. It is a big mista)e to
forget to as) the patient2s name8 I remember when I had my Revalida, (r. 4aro?ue tal)ed to the patient in private and
as)ed if I as)ed the patient2s name. In his words ;Bstablishing rapport is halfway in curing the patient.; .nd I believe
that. In fact, it is probably the best lesson I had from Revalida. .nyway, after the general data, you will have to do
history and 'B very ?uic)ly and very smart. 6ome general tips on history ta)ing: /.A 'eople often focus too much on
the +'I and forget the past medical, personal social and if femaleDmenstrual and obstetric history. 9.A (o some of
your RO6 while ta)ing the +'I %.A .fter +'I, complete your RO6 by system &.A "a)e sure you have a diagnosis at the
end of +'I palang: 'B is confirmatory of your hunch. If you do not have a diagnosis at the end of your history, ta)e a
gamble of ta)ing more time with +'I since 'B is $ust confirmatory.
*ow to the physical e#am: /.A .lways ta)e the !6 first8 9.A If your patient is pediatric, fat or pregnant, ta)e the height
and weight %.A (o a focused 'B. .s mentioned earlier, I believe that the 'B in this case where there is time constraint,
is merely confirmatory of your impression by history. 6ome will advise you to do a complete 'B. I agree that you must
do a complete 'B, but it will depend on your definition of complete. If your patient is 9& yrs old complaining about
dysuria, is stable and your impression by history is cystitis, do you need to measure the E!', assess splenic si,e, test
all the refle#es in the body and test for dysmetria and nystagmus7 I advise a focused 'B. (o the tests that will confirm
you impression in addition to a basic 'B. I thin) that the word basic is more appropriate than complete. &.A +owever,
there is always the sometimes, outrageous concept of having to do (RB in every patient. It is part of the 'B, but you
always have to as) the patient first if he wants a (RB. If he declines, then good. If not, you will have to do it, unless the
consultant tells you that it is not needed. C.A -hen doing an abdominal e#am, never forget to stand at the right side of
the patient8 6ome consultants are particular about this, especially gastroenterologists . There is only one other instance
when you will stand at the left of the patient and that is when you want to accurately e#amine the pelvis, li)e in
3eopold2s &th maneuver. F.A 'ractice your *eurologic B#amination. It is time consuming and if you are not adept in it, it
will )ill you. 3earn how to illicit the refle#es without fail @there are certain techni?uesA. 4ring a )ey for the babis)i. (on2t
waste your time if on Oppenheim, haddoc) and 1ordon if the babins)i is positive @there are about &0 variations of the
babin)si last I chec)ed, and they2re all saying the same thingA. +ave the patient wal), and if he wal)s straight, then
there is probably no problem with coordination. If he2s bedridden, then you have to do the cerebellar tests. *ever forget
to assess the patient2s mental status and orientation.
6pecial situations: If you get a pediatric case, good luc). 'ediatric history and 'B are very time consuming and while
you really have to have composure and smarts to get it done. To#ic. In ta)ing the history, you will often have to
interview the mother, but never forget to tal) to the )id8 +istory is to#ic because of the peri-natal, immuni,ation,
nutritional, family etc: 6o do it fast. 'hysical e#am is even worse: weigh the patient, with the clothes off, ta)e the
height, calculate the -F., +F., -F+, listen to the lungs and heart with the clothes off, and have the patient wal) to
?uic)ly assess neurologic status. 4ut that2s not the main problem. The main problem is having the patient cooperate8 If
your patient is crying from the onset, good luc). The dictum in pediatrics holds true, do the most invasive e#aminations
last. The problem here is that the whole flow of the 'B is ruined and people tend to miss out important parts, li)e the
abdominal e#am. 'ractice pedia history and 'B ta)ing. 6pecial situation no. 9: O4-1yne. To the men, never forget to
have a female accompany you while you do your e#amination. *ever forget that. -eight the patient and ta)e the
height. 4ring a good stethoscope to hear the fetal sounds. O4 rotation should have prepared you more than enough for
this. 6pecial situation no.%: B*T, ma)e sure you )now how to use the different instruments.
.fter the visit to the ward or the O'(, you will be as)ed to report to the tribunal your findings, diagnosis and
management. This is where you shine or tarnish. In reporting here are some tips: /.A Bven if you )now the diagnosis of
the patient because you2ve studied this case the night before, or you are the I of this patient, never ever have a very
specific clinical impression. For e#ample, never say that your clinical impression for a &0 yr old man coming in with a 9
year history of swelling or mass at the region of the parotid gland is a pleomorphic adenoma. That is a pathologic
diagnosis. -hen reporting, do it with sense: as an approach8 In (r. 4aro?ue2s words: ;4efore you can appreciate the
trees, you must first appreciate the forest.; 1o from general to specific. One could have said, ;because of the patient2s
profile, the location of the mass, chronically progressive e#pansion of the mass, symptoms of dryness of the mouth and
associated finding of facial wea)ness in the post-parotid distribution of the facial nerve, the patient most probably has a
*eoplasm of the 'arotid 1land. The most common histologic subtype is a plemorphic adenoma, and the patient fits
this profile of a benign tumor. +owever, since I was able to palpate lymph nodes from sites draining the area with the
mass, there is a possibility that it could be malignant.; Remember, trees before the forest. 9.A .lways have a differential
diagnosis. It may also become very obvious that you $ust memori,ed this patient2s case the night before the Revalida if
you do not have a substantial amount of differentials, meaning that you have a one trac) mind. %.A +ave a good
)nowledge of clinical pathology and radiology. It helps to )now what tests and imaging you want to re?uest. &.A
orrelate the clinicals with the basics: consultants love this because they )now you aren2t $ust memori,ing. I advise this
aspect for those running for honors.
+ow to prepare for the clinicals7 /.A .s I mentioned earlier, $oin the endorsement rounds of the residents in each of the
services, including medicine. .lthough medicine will not tell you who is for Revalida the ne#t day, the endorsement
rounds may be useful for you to remember the patients. In any case, if you2re really up to it study as many cases as
possible in the hospital a few days before the Revalida @(ra. 'unsalan )new every single patient in the hospital when
she studied for the RevalidaA. 9.A 6tart studying now for high yield topics. +ere are some in my opinion: 6urgery-
holelithia sis, holedocholithiasis , Thyroid, +ernia, +emorrhoids, 4reast ancer, olon ancer, 4'+ and 'rostate
cancer, 5rolithiasis, Fractures. "edicine: "I, 'neumonia, T4, .sthma, 'leural Bffusion, Renal Failure, 5TI, '5(,
irrhosis, +epatitis, Thyroid, (iabetes, (engue, Typhoid, ellulitis and yes, 63B. :es, they give 3upus in Revalida and
it2s actually not that bad because all you need to do is memori,e the criteria, )now how the ancillary labs and steroid
treatment. -hat ma)es 63B patients in the ward difficult come Revalida time are the comorbidities: pleural effusion,
infections, complications of steroid treatment etc. That2s where it hurts. 6ystemic talaga. 6pecial mention: they will not
give cases at 90% because isolation ward yun, which is good because those cases are really difficult. 'ediatrics:
Typhoid fever, (engue, 'neumonia, .sthma, (iarrhea, 'ost-infectious 1lomerulonephritis, 'yelonephritis, and yes,
3eu)emia. They do give cases of .33 or ."3 once in a while. I don2t )now if they give Gawasa)i though, I have a
feeling they might. O4: 're-eclampsia, 1(", +!(. 1yne: O*1, "yoma 5teri. B*T: Thyroid @yes, tatlong beses na
lumabas ang salitang thyroid, aralin ninyoA, hronic Otitis "edia. *eurology: Ischemic and +emorrhagic stro)e,
+ypo)alemic periodic paralysis. %.A 'repare a speech. If you get a case of hronic Otitis "edia, you should have a
ready discussion so that if the tribe as)s you to discuss, tuloy tuloy )a lang.
6ection %: Bmergencies
If there is anything that will save you from a mediocre performance: this is it. This is the only sure way that you can
assure yourself some points because you can study this8 :ou have a handboo) of emergencies and you will later be
given a list of emergencies @by the (ean2s officeA that will be included in the Revalida. They often add and subtract
topics from the previous year2s topics but not much will change. This year, ewan )o lang since supposedly you had a
new boo) published, they might include everything. 6o I suggest that you get a copy of that boo) and study everything8
.nd I mean, everything8 6tart with those included in last year2s Revalida and then brose through the others. There have
been some tribes who as) about emergencies that were not listed, but this is in the minority, if not a rarity. 6tudy
everything because you may have the fate of pic)ing % numbers from the bingo bottleDwhich you )now nothing of8 I
have had not one, not two, but many friends who did not )now any of the emergencies that they had pic)ed. "inalas
lang talaga sila na nabunot nila yung hindi nila naaral at pinansin. 6tart now8 .nd I would advise that you pass by the
BR when you get the chance, loo) around for emergencies and observe @that2s why I always loiter around the BR, it2s a
habit I still do until todayA. It is the best, if not the only sure way to remember the things you read in the boo). I don2t
have very good memory and so I have to do it by what I call ;learning by trauma.; 6ee it, get shoc)ed, go home, study
it and you wont forget. I lost my list of emergencies included but during our time, nearly all the pediatric and medical
emergencies were included. I adivse begin with the easy ones and master it, because emergencies is a game of
volume. The more emergencies you )now, the higher the li)elihood that you will pic) something you )now. Its nominal.
.nd so when people as) me for advice on how to study for Revalida, start with emergencies now8 It may be your
saving grace.
'art %: The Tribunal
:es, the tribunal is a big part of what will happen to you on Revalida day. -hich is why bunot-day is probably the
most nerve-rac)ing day of all. Tip: loo) for the intern who had that same tribunal as you and as) tips from them, even if
they are in another hospital. I believe many of them are willing to help @it wor)ed for my friendA. The other tip is
concentrate on studying the basics related to their specialties, as I have mentioned earlier. The last tip is this: *o
matter what they say, totoo ang phenomenon ng top /0 na nangbabagsa) sa Revalida. Gnow who these people are
and prepare if you get to pic) them for your tribe. For security purposes, I cannot list down the top /0, but as) around:
it2s common )nowledge.
In any case, I believe that the tribunal is a big chun), but it is only as big as your chun). /H is up to you, the other
/H to the tribe, the rest is up to 1od.
'art &: +onorables
For those running for honors, your tas) is difficult. :ou are out there not only to pass, but to impress and I therefore
advise you to practice tal)ing li)e you want to impress. I )now of someone who was aiming for big time honors and
was not able to get hisIher honors because he failed to impress by delivery. One of the sure ways to impress your tribe
is by correlating basics to clinicals. It shows them that you are not $ust memori,ing guidelines and you )now what you
are tal)ing about. 6econd, be evidence based. ite studies, critici,e them and draw conclusions. Third, tal) li)e a
lecturer and bring a bottle of water. I remember coughing my throat off when I was doing my clinicals since the aircon
was aimed straight at me. 6till, you may fall into the trap of tal)ing too much and wandering off to something you don2t
)now. *ever tal) about anything you are not sure of. Remember, you are there to impress and pass. Eust thin), what if
you pic)ed a case of impacted cerumen7 +ow are you going to get a meritisimus from that7 I thought of that when I
was a cler), and so I prepared a ready speech in case I got such a case, complete with epidemiology, pathophysiology
and latest clinical trials on how to get that crap out of your ear.
There is some controversy on whether to tell the tribunal if you are running for honors or not. There have been a
substantial amount of people over the years who have failed to get their honors because the tribunal didn2t )now that
he or she was running and when the tribunal found out, they regretted it since they would have given the cler) a better
grade. It is indeed a gamble because you are treading the line between honor and )a)apalan ng mu)ha. I suppose it
will depend on the vibes between you and your tribe. If you thin) they are approachable, then perhaps you may want to
attempt to inform them. If not, don2t ta)e the chance, they might fail you from the outset. 5sually, doctors will as) you if
you are running during the courtesy call and by all means, say yes8 Otherwise, it2s still your call. I have no sound
opinion on this issue. 'erhaps, informing them if what you have discussed was ade?uate enough, in order to hint to
them that you are aiming to please them so that you may get an B from them. I suggest that if ever you are going to do
this, do not do it at the outset.

'art C: 'eers
I have said it time and again, you have to have good friends for Revalida time. Friendships will be tested and the
true stuff of people will show. "araming manlalamang at marami ang mag-aabsent. I have seen it at it2s worse and I
must tell you, friendship is a valuable thing, do not brea) the trust of your friends. .yusin ninyo ang mga schedule
ninyo so that hindi sabay sabay )ayo mag-absent: )awawa ang mga naiwan na cler)s and interns and residents and
most of all, the patients. 6ome patients deteriorated because sobrang )ulang ang mga cler)s, some of whom had the
nerve to be absent after passing Revalida in order to party. (ear 1od, for your sa)es huwag )ayong manlalamang sa
isa2t isa. "an does not live on bread alone. +elp each other pass, do not compete and do not be selfish.
'art F: -a)ing up to Revalida
Tip: do not cram the night before the test. 1et some sleep: a ,ombie brain, is a dead brain and a dead cler). 4rain
cells fatigue @too much discharging and intracellular calcium e#ceeds regulatory levels causing cellular dysfunctionA . I
have also come across a study that says that e#cess cortisol is to#ic to hippocampal cellsDso don2t stress yourself too
much that your biologic cloc) goes haywire. 4e fresh and have a good brea)fast. Eust right, not too much and not too
little. "ahirap maging gutom at sinisi)mura sa Revalida. In con$unction with that: tumae )a the night before or in the
morning: masmahirap umeba) sa )aba sa Revalida. .nd most importantly, rela#. *ervousness will )ill you. I )now of
people who on the morning of Revalida were vomiting on the way to school from an#iety. I assure you, if you are a
nervous wrec), it will wor) against you. One of the things tribes hate is if you are too nervous to say anything or thin)
and end up crying during the test. I personally )now of two accounts where the cler) failed because iya) ng iya) or
walang sinasabi sa )aba @ang masa)lap pa, mabait ang tribe niyaA.
'art J: The most important thing
' R . :. There is a 1od and +e will be there to help you if you as) and if you prove yourself to +im.
"iracles happen and I have witnessed this on a personal level. There is a 1od. I cannot emphasi,e it more, hanapin
mo ang panginoon sa buhay mo at ialay mo ang pagsisi)ap mo sa Revalida sa )anya. .nd whatever happens, count
your blessings and than) +im.