CARS Lesson 12  —  Focus and flow
Reading the passage

Throughout these lessons, we have been getting stronger in the art of reading critically. There is the art of reading a passage closely. While you are reading a passage, you can already be answering the questions intuitively that the questions will ask you later. What claims are made by the author in their argument? Are the claims logically grounded or justified by evidence? What appeals does it make? What issues does the argument ignore or evade? How is it organized? During reading, a self-aware practice of attention management can make it possible to analyze the structure of passage while still being immersed and engaged in the author's expressive language. We are moving into the next phase of CARS preparation, devoted to practice and full lengths leading up to your exam. Let's get everything working together.

  • Make a clearing

    The CARS section represents a kind of performance in time. It's good to think of reading a passage as if you were clearing a field. You are 'making a clearing', making the passage intelligible in every dimension - the plain reference, the expressive dimension, the reasoning, structure, and evidence. You do your best to exhaust the meaning. Taking the time you can afford, you bring everything you can in the passage to the light. When you move on to the questions, you'll not have found all the things in the passage that the question-writer will have seen. You do your best. The question-writer had a much longer time to spend with it, but you will know what they are up to in the questions. When you're in the zone, there is a sense of confident, engaged immersion.

    Just like clearing a field, sometimes you hit a stump or come upon a dense tangle of thicket. Trust yourself. It's this way in all the sections. In a biology passage, for example, you will run into things you feel practically certain are beyond the scope of undergraduate level MCAT science, maybe a viral coat protein fusion used in a yeast three hybrid assay. You know what this is? It's great if you do, but AAMC wouldn't expect foreknowledge of something that advanced. Maybe you've never come across a viral coat protein used as a tool because of its specific affinity to an RNA sequence. Maybe you've never come across yeast three hybrid assay. Don't stress. It's guaranteed that nine out of ten people on the way to a 130+ in the biology section won't have comfortable foreknowledge of yeast three hybrid assay either. It's graduate level molecular biology. AAMC put it there to see if you can keep your footing. You hit a stump, so you make a fence around it. Turn it into an open question and clear as much as you can. Always reach an accommodation. You can see the rationale for the scientific assay from the context of the passage. The researchers are measuring protein-RNA interactions. That's the purpose of the assay. You have reached an accommodation with it. You have made what's left, what's still uncertain, into a good open question. That what AAMC is interested in seeing you can do. You keep moving. You're in the zone.

    Clearing a passage is a little different in CARS. One difference is that the author of the passage is at least trying their best to communicate. The AAMC writer of the biology passage will stress your comprehension on purpose, trying to produce a strain. The 3rd party author of the CARS passage won't do this on purpose. But it still happens. What difference does it make if it's not on purpose? Why does the intention of the author matter? In a CARS passage, the author is always trying to communicate. No matter who it is, never put the author of a CARS passage on Mount Olympus. They are a person. Imagine the author is right there with you, trying to communicate. If you get confused about something in a passage, ask them, 'What are you trying to say here?' Maybe you stumbled in the reading. Maybe they stumbled in the writing. Imagine how they respond to your question. Often it will come clear, and if it doesn't, then fence it in as an open question. Usually a well managed open question will find its answer later in the passage. What do you think they're trying to say right there? You're probably right. But maybe not. Manage it as an indeterminacy and it will often settle in a few sentences. Now matter what, always reach an accommodation. Never let anything push you out of the world of the passage. You are the one it was written for. You are always a local.

  • Movement and structure

    As the great Swiss linguist, Ferdinand de Saussure, described it, speech possesses an on-line emergent temporality. It flows like a river. In a CARS passage, you start reading a paragraph at the top left. Words follow each other in a sequence. The author is speaking to you. Later on, you will have reached the bottom right of the paragraph, and you are at the end of the last sentence. The paragraph started at 'A' and now you are at 'B'. 'A' preceded 'B' in time. It's in the flow of the language that you find the expressive life of the writing. In reading with the flow of speech you connect to the author's point of view on a human level. That's the power of speech. We are hard-wired to understand it like a kind of telepathy.

    Now that you have reached the end of the paragraph, you can see the whole thing. That's different. You can see 'A' and 'B' together. They are simultaneous now. You can see how the paragraph has a central claim the author supports with logical reasoning and evidence. The paragraph has a structure. It is an intentional composition. The paragraph is not only speech. It's also a piece of writing.

    Additionally, looking at the paragraph after the one that came before it, you can see how the paragraph represents a transition. Maybe the author transitioned from a presentation of a counter-argument to return to directly supporting the main idea of the passage. Something is starting to take shape - your sense of the structure of the passage as a whole.

    We are describing here two fundamental modes of attention to bring to reading critically. In one, your understanding follows along with the linear flow of speech. In the other, you see the paragraph, or the passage as a whole. You step back and see it as a simultaneous structure. We are learning how to be in the zone in a CARS passage. In the zone, you can comfortably shift your attentional focus between these two modes in a disciplined way without losing engagement, immersion, and pace. Practice this! It would be very difficult to learn this way of reading if these two modes of attention weren't already very natural. The difference is the disciplined self-awareness that you are doing it, and that it is happening in the context of a timed performance. You are finding all the meaning. You are clearing the passage and getting to the questions.

The questions

In earlier lessons, we have discussed CARS questions from a variety of perspectives. We have also discussed the art of close, critical reading. You can understand how the question-writers see the passages. You can anticipate many of the questions. At this stage, as we enter the next phase of CARS practice, including full-length practice, a primary challenge is to remember not to forget what you know when the test starts pushing you around.

Any participant in a competitive sport knows how this can happen. You knew beforehand what you were supposed to do going into a tennis match. Serve into his body. Get to the net. It works in the first set, and you come close, losing in a tie-breaker. He's ranked above you. He's tough, but you're giving him a real match. However, halfway into the second set, you get frustrated. For some reason, you start trying to ace him, and instead of getting to the net, you stay back on the baseline slugging away. Before you even realize what's going wrong, the second set is over 6-1. You could have made a real match out of it, but you lost it in straight sets. No other way to put it. You forgot your plan under stress. Remember to remember your plan. Practice remembering your plan.

It's easy for stress and mental fatigue to build during the MCAT. It's an intentional part of the test. An important part of becoming a good doctor is learning how to maintain good quality thought process even when you are stressed and fatigued. You are not superhuman. Rules and checklists help. When the going gets tough, don't let it throw you off your game. Let's summarize a few key things you don't want to forget when answering CARS questions.

  • Don't make the perfect the enemy of the good

    Your score does not depend on a single question. A good score depends on comfortable, steady movement throughout the whole section.

  • Give yourself a half dozen get-out-of-jail-free cards

    Imagine setting a hat in front of you when you start a section. If you feel you are getting stuck on a question, play a card into the hat. Flag the question. Choose the least worst answer, and move on. You can come back at the end of the section. If you don't have time to come back then, it turns out playing the get-out-of-jail-free card was an even better idea.

  • Don't go fishing

    Unless you're going back to the passage to find out or confirm something very specific; you have a good idea of its location; and you can get back out again quickly, don't go back to the passage. If you can avoid it, resist the temptation. People go on fishing expeditions to substitute for thinking things through. It almost never helps the question, and it makes it harder to finish the section.

  • Always read the question stem carefully

    Question stems challenge your focus, perception and mental discipline. There is almost always a wrong answer corresponding to a predictable misreading. Read the question stem as if it were a law trying to send you to jail.

  • Answer the question stem by itself

    If there is enough to go on, try to answer the question stem in your mind as if it were a short answer question before reading the answer choices. Pause a moment to think independently about the question stem. Don't let the test-writer's first wrong answer do the thinking for you.

  • Don't commit too soon

    Give all four answers their chance to speak. Don't make the first good sounding answer the king of the hill.

  • Let a question be easy when it wants to be easy

    It goes without saying that the MCAT is a competitive, difficult exam, but if you've prepared reasonably well, for half of the questions on this exam, in all sections, the biggest challenge will be to believe the question is as easy as it looks. You don't rush. You keep your discipline. You read carefully. You look at all the answer choices, but if you've taken these steps, then let yourself believe it's an easy question.

  • Sometimes you just have to choose the least worst

    In looking for the best answer for a difficult, subtle question, sometimes you find yourself stuck between two choices, and they both look pretty good. Now you go on the attack. One of them has an aspect, intentional on the part of the question-writer, that makes it unsound. Imagine you were the question-writer. Find the weakness. The other one will be impervious to attack. You may not love it, but it's the least worst. That's the one.

Keeping your calm

Studies have demonstrated complicated interactions between circulating glucocorticoid levels and performance in cognitive and memory tasks. These mechanisms are proposed to explain some of Yerkes' and Dodson's observation that for a difficult, complex task such as the CARS section, the optimal performance for an individual will be facilitated by a a moderate-low arousal state. From personal experience, everyone knows that attentional focus is different under sympathetic versus parasympathetic control. During the MCAT, stress threatens to overstimulate the sympathetic pathways. The experience of the test-center is novel. Things are somewhat unpredictable. You don't control what passages are in the exam. As they say in the field of psychology, there is a powerful social evaluative threat. We build this thing up too much.

Cultivate a mindset that is calm and engaged for the test and teach yourself how to nurture this mindset through controlled breathing, muscle relaxation and mindfulness even when the exam is at its most challenging. Simply deciding to calm down doesn't work very well for most people. With biofeedback, however, you can move your autonomic nervous system into a parasympathetic response. When you are breathing steadily and all your muscles are relaxed, everything is fine. Your brain is always looking for cues as to which state it should be promoting. Consciously provide the autonomic centers with parasympathatic responses and they become self-reinforcing. That's biofeedback.

Restructuring your cognitions only goes so far. Use biofeedback. When you get to the test-center, clear your mind and perform what's known as a body-scan meditation. Close your eyes. Start from the very top of your head and visit each part of your body mentally. Tense and then relax muscle groups. Go all the way from your head to your feet and then back up again. Take your time. Set your calm at the beginning of the exam and then nurture this state throughout the test.

  • Reset every 30 minutes

    Reset yourself periodically. In earlier lessons, we talked about "plan A" for time management, the thirty minute unit of flow. For thirty minutes the exam tries to beat you up. Then you come up for air and check your pace, close your eyes and meditate for full thirty seconds. You will get the time back after you start back on the next passages. You will get even more back than the thirty seconds you spent, because it will be like you gained five IQ points. Clear your mind and imagine you are somewhere beautiful. There's a cool breeze. Relax all of your muscles and breathe in deeply. Start at your head go down to your feet. Relax each muscle. Encourage the parasympathetic response. Everything is fine. Completely relax, and then start back into the test.

  • After a hard passage

    It's a very common pattern to see in practice tests. The person is moving along well, on their way to a 130 for the first four passages. Then AAMC takes it up a notch in number five and beats them up a bit. The passage is so dense and difficult they don't even notice that three of the five questions are actually easy. What you have here are three easy questions and two hard questions following a hard passage, but that's not how it feels, so the feeling of dread comes on. They think they're missing questions and the MCAT just stopped being fun. The real problem isn't passage five. The problem is what happens in passage number six because now they are off balance and upset. They start passage six, but they're still thinking about five. The pulse is elevated, and the breathing is shallow. It's like that all the way until the end of the section, and they land at 126 when they were capable of 129 or 130. This is how the MCAT can grab you by the back collar and push you out into the alley like a bouncer giving a bar patron the bum-rush.

    In an earlier lesson, we talked about how it can be for a professional golfer. It happens to the best of them. She hooks the ball into the sandtrap and then overshoots the green. That didn't go so well. A double bogie! That's not good. Now, though, she has the opportunity to use the walk to the next hole to clear her head. She knows her game is good. She uses that walk to the next hole to calm her breathing and meditate. When she arrives at the next hole, she will see the fairway clearly. If a passage on the exam beats you up, don't rush headlong into the next one. That's how the exam rolls you. Close your eyes and breathe deeply for a few seconds. Do a four-four-four breath. Breathe in deeply for four seconds. Totally relax and hold it for four seconds. Breathe out slowly for four seconds. Regain your balance. You'll get that time back. Close your eyes and totally relax. Then start the next passage, and you will see it clearly. This is hard to remember to do, but it's so important.

Let's practice

Continue working through Step 2 and Step 3 of the CARS Diagnostic Tool. Pace yourself to complete the curriculum provided by this resource before module 14.