I FEEL A NEED 4 SPEED
Join Date: Jul 2005
Thanks Cat for the 411!
Actually, on my medicine shelf exam there were some surgery concepts. Triple AAA rupture into the retroperiotenum, criteria for endotrachael intubation, herniated disk, volvulus, head trauma (without battle sign), and the famous surgery mnemonic "water, wind, walk, wound, and weird drugs" netted me a couple points.
I'm starting to think that each NBME Shelf exam has 10-15% cumulative material of the other rotations. For example, I even had a psych and pediatric question on my medicine shelf. The answer to the Psych question was the antidepressant amtryptiline. The pediatric question boiled down to whether you could distinguish tetraology of fallot, ASD, PDA, VSD from the clinical presentation. Come to think of it, I even had a OB/GYN question of a woman that had pain in the RLQ. The answer choices were appendicitis, pelvic inflammatory disease, kidney stone, or ruptured ovarian cyst.
Originally Posted by TheCat
I just took the shelf today and overall thought it was not bad and I have not taken medicine yet however I did study a ton of medicine during 2nd year and learned things quite well. Well I too had no idea why the so called surgery shelf was apparently "all medicine" but like DW said-after taking surgery and seeing what its all about and even flipping through different surgery texts like sabistons etc- I quickly realized all surgery is, is medicine with the extra step of fixing something instead of refferring out to get fixed. ie. pt gives signs, symptoms etc. You have to diagnose. Then you have to know which studies, scans, tests to confirm diagnosis. Normally medicine would stop here. Surgery goes further to know which procedure you perform and do it. However for the shelf you do not need to know what procedures to perform so basically its is medicine. However I would say 70 percent is stuff about medicine that gen surgery deals with-GI, liver, gallbladder, pancreas, breast,thyroid, hernias. I would say 20 percent was trauma-pt comes in after a MVA-what do you do next, what test do you order etc. 10 percent. Maybe 20, was stuff that a subspecialist would cover-ie vascular/heart pathology, bone/muscskel path.
In all honesty I am a text book person. I had sabistons and compared it to harrisons or any medicine text and 90 percent was teh same. Any good medicine book will discuss surgical options as well.
How i prepared- I read the GI, Liver/biliary, pancreas, ano-rectal and endocrine sections of harrisons. (this is only because I like the book and am familar with it.) I would say reading those topics alone from any medicine book would give you 60 percent of the shelf. I read the first 10 chapters in the Lawrence book on stuff like fluids, nutrition, trauma, etc. Then to cover the subspecialty stuff on heart/vascular, urology etc. I read the lawrence subspeciality book.
Best advice is to take medicine first. I dont konw how else to explain but a common question is any GI related thing like-lower abd pain, increased bilirubin, scleral icturs- what test do you want to order? or whats the diagnosis? Every question except trauma was like that. My advice if you cant take medicine first. Read the GI, liver, biliary, pancreas, breast and endocrine( which are major gen surgery diseases) in a good medicine book that you like. I find lawrence and some of the surgery review texts to do a poor job of these. Then read any surgery text/review book for trauma knowledge. Then use lawrence subspecialty for the remainder. Its not that it is that great, and honestly theoretically if you could read a medicine text/book about hearts, vascular probslems, urological/kidney problems, that woudl be better, however it takes too long and the lawrence does sum the basics up. IMO recall was not great for the shelf-great for pimping sessions though.
Question books-appelton lange i actually thought was worthwhile doing for the trauma questions and the subspeciality questions. I did not use pretest so cannot comment. FA, NMS, Blueprints all seemed terrible. Everyone else that took it with me used one of those and felt the test murdered them. I felt I aced the test and felt well prepared. good luck