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2026年全國(guó)醫(yī)學(xué)英語(yǔ)水平考試（METS四級(jí)）精選模擬試題及答案三
1). Why and When to Consider Taking a Family Medicine Board Review Course■As with most medical specialties， there has been controversy over the past decade regarding changes to the maintenance of certification process for board-certified family medicine physicians (MC-FP) and， in particular， changes to the American Board of Family Medicine′s high stakes board exam process.Beginning in 2006， the ABF：■·Computerized and began offering its exam at an increased number of locations and times than in the past； this essentially required a major transition in the underlying testing theory and scoring process as well as an expansion in the exam′s question bank to enable the auto-generation of different exam versions that would be both secure and consistent in terms of knowledge-assessment integrity.■·Undertook a major overhaul of its exam blueprint， expanding from eight topic areas to 14， including population-based care and patient-based systems， plus eight additional modules from which test takers may choose the two they believe most salient to their clinical experience.■These changes were followed by a deep， yet short-lived decline in exam pass rates.And， while the decline was attributed ultimately to a different cause一namely the ABFM′s 2007 extension of board certification tenure from seven to 10 years (with conditions) - other trends have helped to perpetuate the idea that the exam process has become increasingly challenging for family medicine physicians.For example， the evolving structure of care delivery一in particular the dramatic increase in hospitalists as well as strong， steady growth in rates at which primary care physicians refer patients to specialists for clinical diagnosis and treatment - has reduced family medicine physicians′direct exposure to wider varieties of clinical cases， increasing the challenges of staying current with medical knowledge compared with physicians practicing in narrower specialty areas.■Family medicine physicians also practice in a much wider variety of clinical settings.For example， a PCP working for a large group practice in a wealthy suburb that encompasses separate OB， pediatric， and other subspecialties， might have a much narrower breadth of direct clinical experience from which to build new medical knowledge over time.They may also be less consistently exposed to cases more typically seen in poor， more ethnically diverse inner-city settings.Meanwhile， a PCP working for10 years in a rural private practice might see a greater variety of cases， but would be less likely to be in regular communication and sharing with other physicians and specialists.■While the addition of selectable exam modules seems intended to address real-world variability in family medicine practice， FM physicians are still challenged to keep up with ever expanding and changing arrays of medical knowledge across 14 specialty areas，quite a number of which they may never touch in daily practice.So， given these added challenges for family medicine physicians， what is the best way to go about preparing for the high -stakes ABFM recertification exam?■Top Advice for ABFM Exam Prep■Preparation leads to confidence， and confidence leads to success， says Dr.Mark Nadeau， a clinical professor and residency director in the Department of Family and Community Medicine at the University of Texas Health Science Center San Antonio，who has passed the ABFM exam on five separate occasions over the course of his career and now serves also as a senior reviewer with NEJM Knowledge+ Family Medicine Board Review.(For the full story of how Dr.Nadeau has learned to approach successful board- exam preparation， check out ABFM Exam Prep： Make Time and Make a Plan.)■Question banks (both online and print) have also become hugely popular， especially among younger physicians， because the activity of answering questions is often supported by mobile technology and can be worked into small increments of spare time during each day.In choosing question banks， focus on ones that offer plenty of practice answering clinically focused， exam-style questions that require high-level cognitive tasks such as application， analysis， and strategy versus just definition or understanding.Consider also taking advantage of adaptive learning technology (utilized by platforms such as NEJM Knowledge+) to zero in rapidly on weak spots.And be sure to complete practice questions in roughly the same distribution as the exam blueprint， as this will help in pinpointing specific knowledge gaps and directing more focused follow-up study for family physicians with major time constraints.■When to Consider Taking a Family Medicine Board Review Course■Materials set forth by board review course providers - including location-based，CD/DVD， and online- only programs一suggest that broad family medicine review courses might be best suited for physicians who：■·Have left exam prep until very late in their recertification cycles■·Are not especially disciplined about studying independently■·Are not typically strong test takers■·Have yet to experience computer-based versions of the exam■·Do not make a regular habit of keeping current with general medical knowledge via journals， conferences， peer networking， question banks， self-assessment tools， and so forth■·Have daily responsibilities such as child or elder care that can make it difficult to carve out.focused time for self directed study■·Practice family medicine in relative isolation (rural， private practice) or among patient populations lacking in ethnic， age， economic， or other forms of diversity■·Show downwardly trending test scores over time (a function of distance from academic settings and regular study)■·Have taken practice tests or utilized question banks and have performed poorly across the board (versus in just a few specific areas)■Choose Carefully■Board prep tools have weak and strong contenders， so careful research is always needed in deciding how to invest one′s time and money on specific board-review offerings.■Many review courses and other resources can be purchased conveniently online， but checking original publication dates for content as well as content revision frequencies is a must to ensure they are up to date with advances in medical knowledge (but not so u-to-date， that it overshoots the exam revision cycle) and up to date with changes in how the ABFM structures its exam to assesses knowledge.■While it is a reasonable assumption that family medicine board review courses have been developed using the ABFM exam blueprint 一meaning they portion course time appropriately across the breadth of subject areas covered in the exam一this is not a given and should always be verified when weighing family medicine board review course options.■A big positive for many family medicine board review courses is that一in addition to medical knowledge一they teach specific test.taking strategies， including how to rapidly deconstruct and decode exam questions.Family medicine review courses may also provide key insights into how questions are developed for the exam， how the exam is structured and scored， why it is important to answer every question (even by guessing)，and specific strategies for making best-possible guesses.■Family medicine board review courses may also train physicians to work more effectively in timed and computer based testing environments.When taking the actual exam， one has approximately 60 seconds to read， digest and answer each question； due to exam scoring methods， it is always best to answer every question.Practicing questions repeatedly within realistic time constraints can go a long way to relieving test-takers′anxiety.■While many family medicine review courses offer money-back guarantees， they are not as fail-safe as exam pass rates suggest.At the end of the day， each family medicine physician must make a clear and honest assessment of his or her own learning styles，capacities for retaining information and testing， and career -path priorities.■Please join our ongoing conversation about best practices for family medicine board exam review by sharing your own experiences with review courses in the comments below.The reform of the exam has led to a significant increase in its passing rate.( )
A.True
B.False
C.Not mentioned

正確答案：B
2). Hepatology Service Rotation Curriculum■Hepatologists： Hugo R.Rosen， MD； Gregory T.Everson， MD； Lisa M.Forman，MD； James“Jay”Burton， Jr.MD■Educational Purpose and Goals■The hepatology rotation allows residents and fellows to refine history and physical exam skills， develop experience in management of a variety of hepatological diseases.The hepatology inpatient service will consist of a Physician′s Assistant， a Hepatology Intern， a Hepatology Fellow and a Hepatology Attending.Most months a resident will be part of the team as well，■Principal Teaching Methods■A.Supervised Direct Patient Care： Residents encounter patients admitted to the hepatology service at University of Colorado Hospital and are responsible for admitting patients to the service between the hours of 8 a.m.to 5 p.m.， M- F.In addition to supervising the residents and caring for patients on the hepatology service， fellows are responsible for managing post transplant patients on the surgical service.■B.Required Conferences： In addition to the required general medicine conferences(and GI conferences for fellows) the hepatology team members must attend Patient Selection Committee， Thursdays 7 a.m， Liver Pathology Conference， Thursday， 8 a.m.and Hepatobiliary Conference， Friday Noon.■C.Didactic Sessions： We hold twice weekly on- service teaching seminars， which are taught by the fellows or attendings.Potential topics are the items listed in sectionⅢ.A.as well as transplantation issues for internists， liver disease in pregnancy and evaluation of hepatic mass.■Educational Content■A.Mix of Diseases： Encountered patients have a variety of hepatological disorders which may include the following： Asymptomatic elevation in LFTs，NASH， alcoholic hepatitis， acute hepatitis， fulminant hepatic failure， chronic hepatitis (HCV， HBV， AlCAH， Drug induced， Wilson′s Disease)，hemochromatosis， PBC/PSC， and cirrhosis.■B.Patient Characteristics： Pre and post transplant patients are either managed primarily by the hepatologists or referred from other gastroenterologists (quaternary referrals).■C.Learning Venues： Inpatient setting at the University of Colorado Health Sciences Center.■D.Procedures： Certain procedures will be performed by the intern under supervision of resident/hepatology fellow and attending.These include： IV access， paracentesis，thoracentesis， NG tube placement， and flexible sigmoidoscopy.All GI procedures including EGD， colonoscopy and liver biopsy will be done by the hepatology fellow under the supervision of the hepatology attending.■Principal Ancillary Educational Materials■A.All fellows are provided with the Fellowship Handbook including the fellows curriculum and learning objectives for each rotation prior to the start of fellowship.The hepatology curriculum and learning objectives are distributed to each fellow and resident prior to the start of the hepatology rotation.■B.Residents and fellows are provided with additional targeted reading materials specifically chosen by the hepatology attendings.The set of articles includes key information about the diagnosis， treatment and management of hepatological diseases and is reviewed annually to ensure it is up to date.■C.Computer based resources are available to residents and fellows at the University of Colorado Hospital to facilitate patient care， education and communication.■Methods of Evaluation■A.Resident Performance： Residents are evaluated by attendings via New Innovations at the end of the rotation.It is expected that the residents receive ongoing verbal feedback from both the hepatology fellows and attendings throughout the rotation.The evaluation form centers around the 6 ACGME competencies and completed evaluations are available to the residents online at any time.■B.Program and Faculty Performance： The residents and fellows evaluate attendings at the end of the hepatology rotation.These evaluations are anonymous to ensure the residents/ fellows can be completely open.The evaluations are held from the faculty until sufficient evaluations are completed as to further guarantee anonymity.These evaluations are tools used by the Division Head when conducting annual performance reviews.Attendings will instruct and evaluate the residents′ performances.( )
A.True
B.False
C.Not mentioned

正確答案：A