How To Read A CARs Passage
On my Tinder bio, I have this written: I’m an English major who got a 132 in CARs. Suffice to say, I’m not getting drunk 3 AM texts from anyone except Canadian Medical Schools, and people only go on dates with me for free tutoring. But you don’t have to be an English major to get a 132 in CARs and recieve these benefits. On the contrary, it might even harm you. Because of my overconfidence, I didn’t start studying CARs until a month before my exam.
I got a 3/7 on my first CARs passage (the infamous Picasso one)
Essays are creative. CARs are not. English majors can synthesize three sources and create a 3000 page treatise that combines Marxism and Newtonian physics to explain why Belle should’ve gotten with Jacob instead of Edward in Twilight. There's a universe of opportunity. CARs, on the other hand, is about taking your universe and cramming it into the 500–700 word box the author hands you.
If you remember nothing else from this, take this: the author is the focus.
The actual passage doesn’t really matter, just what the author is trying to tell you. This is important because, as a physician, a patient will walk into your clinic rambling about their aches and pains and the price of gas and if you'd love them if they were a worm, and your job is to extract the critical details that make the diagnosis click. That’s CARs. The author rambles; you listen. You walk away with their truth, not yours. So, getting a 132 in CARs is all about learning how to eliminate personal biases and stay within the passage.
For that reason, there’s a strategy that I’ve invented called...
Scaffolding
We’ll start with the first paragraph of a passage. You read it first and highlight what you think is important. Press the highlighter and just select the text: it should save. Note, if you're on mobile, you should touch OUTSIDE of the text to deselect after highlighting.
Consider how physicians figure out why a patient came to the hospital or office and how they decide what must be done to treat the patient. First, the physicians probe the patient's problems with questions. Next, they review the patient's hospital admission records (usually written by another physician) to learn what has been written about the patient up to that point. Then, the physician performs a physical examination of the patient. The results of this examination are combined with what the patient has said about the problem(s) to form a particular diagnosis or treatment recommendation. Thus, to determine the most likely diagnosis of a patient's problem, the physician reads, listens, and examines the patient and then attempts to coordinate the information from these various sources of evidence. Reading the summary patient-hospital encounter report is the pivotal task in this scenario. Without written patient reports, it would be much more difficult to keep track of the patients a physician sees. The ability to read and use such materials has direct implications for the quality of patient care.
Think of it like a river. Most students, coming from a science background, get lost in the details — the “pebbles” of the river. You might’ve highlighted “first” and then “then” and tried to map out the path of what a doctor does to diagnose. But CARs isn’t about mapping every step. It’s about watching the current: where the argument starts, where it goes, and where it ends. So, after every paragraph, I ask myself, what is the point of this paragraph? Why did the author write this?
This is what people mean by reading for arguments: the critical truth that the author is seeking to unveil.
Here's what I'd highlight to help reveal these critical truths:
Consider how physicians figure out why a patient came to the hospital or office and how they decide what must be done to treat the patient. First, the physicians probe the patient's problems with questions. Next, they review the patient's hospital admission records (usually written by another physician) to learn what has been written about the patient up to that point. Then, the physician performs a physical examination of the patient. The results of this examination are combined with what the patient has said about the problem(s) to form a particular diagnosis or treatment recommendation. Thus, to determine the most likely diagnosis of a patient's problem, the physician reads, listens, and examines the patient and then attempts to coordinate the information from these various sources of evidence. Reading the summary patient-hospital encounter report is the pivotal task in this scenario. Without written patient reports, it would be much more difficult to keep track of the patients a physician sees. The ability to read and use such materials has direct implications for the quality of patient care.
See what I did there? I skipped all the “first this, then that” fluff and went straight for the big picture. I realized the author wants to say that reading is important, then worked backwards to highlight: physician reads the patient and thus the ability to read affects patient care. The scaffolding strategy is about cutting through the noise, highlighting the essentials, and building a skeleton of the argument. After I read, I summarize like this: The author wrote this paragraph to say reading is critical to patient care. That’s where the river begins. That’s the essential, big picture idea.
Now it’s your time to flex. Here’s the next paragraph. Read and highlight based on the flow of the argument. Remember: focus on the river, not the pebbles.
Despite the medical profession's dependence on the spoken word, a well-developed ability to read is often essential to proficient physician performance. The diagnosis of a patient's problem can require reading and integrating information from a variety of written sources (e.g., hospital patient summary, problem list, nursing notes). The status of patient problems may require monitoring by reading charts, flow sheets, lab reports, and consultants’ notes. By reading and distilling information from journals, physicians maintain currency in their field. Reading and clear writing are necessary to inform others and provide documentation of medical actions taken. Moreover, medical students must read vast amounts of written material to meet course requirements, and failure to develop strong reading skills may hinder their ability to succeed academically and clinically.
You might’ve highlighted information that supports the author’s point that reading is important for doctors. However, did you highlight anything new? A new shift? A new argument? Most likely, the answer is no — you probably highlighted a sentence that re-iterated the point in the first paragraph. Personally, that’ll lead to an overabundance of highlights that loses the initial quality of the highlight. You highlight new arguments or important additions to an argument. If the first paragraph’s purpose is to introduce the idea that a physician must read and it affects quality care, then this paragraph adds that even to succeed in medical school they must read vast amounts of written materials. That’s new, as the author didn’t mention reading in medical education before. Therefore, the river so far is: “Physicians need to read to take care of patients and medical students need to read to do well in medical school. I’ll highlight that. Now, go ahead and do the next three paragraphs.
The usual source of case summaries is the patient's hospital chart. These charts, which often are completed under considerable time pressures, vary widely in the quality and quantity of information they contain. Under the duress of time, the physician dictated or wrote an evolving impression of the patient without any established structure or form. The notes may be disorganized, with the most important patient information embedded at various points in the story and non-essential clues included without organization or guidelines. Physicians must sift through these disorganized accounts to discern critical details, which underscores the importance of reading skills in clinical practice.
Because of the vital importance of reading to the competent practice of clinical medicine, it seems crucial to examine reading processes, materials, and outcomes in medicine. Unfortunately, very little is known about how a medical student learns to understand and use physician-authored texts, nor is there any information from the medical profession on reading itself, aside from studies on reading schedules. The initial studies on physician reading patterns have only a fragmentary resemblance to what cognitive learning theorists now know about how students come to understand science texts and solve problems.
The gap between what current educational and cognitive research says and what is actually done in professional school settings suggests that a more systematic study of reading is warranted. The pedagogy regarding reading in medical school seems to derive more from tradition and folklore than from informed science. Without an empirical base for understanding case-based learning, isolated attempts to improve reading proficiency are unlikely to lead to relevant and effective instructional changes in the medical school curriculum. A focused effort to teach reading as a structured skill—grounded in cognitive science—could significantly enhance both medical education and patient care.
Make sure you don't highlight redundant information. After you're done, compare the above with my highlights:
The usual source of case summaries is the patient's hospital chart. These charts, which often are completed under considerable time pressures, vary widely in the quality and quantity of information they contain. Under the duress of time, the physician dictated or wrote an evolving impression of the patient without any established structure or form. The notes may be disorganized, with the most important patient information embedded at various points in the story and non-essential clues included without organization or guidelines. Physicians must sift through these disorganized accounts to discern critical details, which underscores the importance of reading skills in clinical practice.
Because of the vital importance of reading to the competent practice of clinical medicine, it seems crucial to examine reading processes, materials, and outcomes in medicine. Unfortunately, very little is known about how a medical student learns to understand and use physician-authored texts, nor is there any information from the medical profession on reading itself, aside from studies on reading schedules. The initial studies on physician reading patterns have only a fragmentary resemblance to what cognitive learning theorists now know about how students come to understand science texts and solve problems.
The gap between what current educational and cognitive research says and what is actually done in professional school settings suggests that a more systematic study of reading is warranted. The pedagogy regarding reading in medical school seems to derive more from tradition and folklore than from informed science. Without an empirical base for understanding case-based learning, isolated attempts to improve reading proficiency are unlikely to lead to relevant and effective instructional changes in the medical school curriculum. A focused effort to teach reading as a structured skill—grounded in cognitive science—could significantly enhance both medical education and patient care.
Notice how your highlights look like a sparknotes? Well, you should be able to summarize the entire passage in one clean sentence/two sentences. Something like this:
Physicians and medical students must read to do well in practice and school, such as in the case of hospital charts, but there is little science behind physician reading patterns. Therefore, teaching reading as a structured skill could benefit medical education and patient care.
Boom. You can write that down during learning, paraphrase it, and carry it with you to the questions. Here’s why this is useful: most CARs questions require a very good overall understanding of the passage, although some do expect you to find details (which the scaffold helps with!) but now with your quick summary you can get your critical truth. I like to use critical truth rather than main idea, because it more accurately captures what the author is trying to do: he/she is trying to establish a critical truth, a reality, that changes the worldview of who’s reading it (hence, an argument) and it’s up to YOU to find it. I like to say it like this: if you stand up and walk away, what would the author want you to take away?
So, try that with a MyMCAT passage. Next, in the blog, we’re going to go over how to use a scaffold to answer questions.
Here’s a video of me tackling that godforsaken Picasso passage again: