Internal medicine shelf exam

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lemonpeel

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Hi:
I just took my internal medicine shelf exam and was wondering if anyone out there knows the grading system for the exam? Does the score you get back reflect the actual number of question you get right or is it curved? How does the grade correlate with # question right if it is curved? Does anyone know the maximum score one can get on the exam? Thanks for your input in advance.

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What's needed to do well on the exam? Blueprints and....? Please PM me. Thanks!
 
To answer the original poster's question, you get a 2 digit score back from the folks at NBME. According to gossip/legend, a score of 59 is something like 3rd percentile, and >80 is 95+ percentile. Apparently it's a pretty narrow distribution. I'm not sure how it correlates with the fraction of correct answers on the exam. At our school we are also issued a letter grade for the exam; I'm not sure if this is institutional or if the grade is given out by the NBME.

As far as how one should prepare... I read Blueprints cover to cover twice in the course of two months. In addition to knowing your patients' ailments inside and out, I think that this is all that someone can reasonably accomplish in a two month Medicine rotation. Know Blueprints well, and you'll do fine.

Good luck,

doepug
MS III, Johns Hopkins
 
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I just walked out of the shelf exam... I was able to answer 5 or 6 of the "out there" questions by doing the question in Pretest. It also served as a good review of more common testable conditions. Otherwise, I tried to follow a wide variety of patients on wards, and read up their conditions. Dz is much easier to memorize when you can associate it with a patient.

Blueprints was scant, but had decent coverage of the zebras like Wegeners, PAN, Takayasus (however you spell that), etc...
 
Definitely, the best way to prepare is to read up on your patients while you're on the wards, like shag and doepug said. As William Osler once explained, "In what may be called the natural method of teaching, the student begins with the patient, continues with the patient, and ends his studies with the patient, using books and lectures as tools, as means to an end." Reading up on my patients is the only thing that will stick well long-term for me.

And I'd like to reiterate that Pre-Test Medicine is an excellent resource for the NBME. There were at least a few questions that they almost cut and paste from Pre-Test. The book covered all the salient and often-tested points about the major diseases well.
 
I just took this test today and got my a@@ kicked. I thought that my school was going to give us 3 hrs (like they did for our ob/gyn shelf), but found out 1.5 hrs into the exam that we only were only given 2 hrs for the test. This left me less then half an hour to do the last 20 questions, with those last 10 taking forever to do. As far as how to study for the test, I would also recommend doing questions from pre-test and blueprints questions. I wouldn't waste too much time reading blueprints cover to cover if I were you though. If you're like me, you will focus too much on learning the "big picture" of every disease out there, which is not helpful at all for the test. Most of the questions were questions that would have been very difficult to study for, you either saw it in your rotation or read it about it in Harrison's (or preferrably Current Medical diagnosis) while you were reading up on your patient, or you did not learn about it at all. And make sure that you have ~30 minutes to do the last 10 questions, they take forever to answer.
 
Originally posted by Burton
Definitely, the best way to prepare is to read up on your patients while you're on the wards, like shag and doepug said. As William Osler once explained, "In what may be called the natural method of teaching, the student begins with the patient, continues with the patient, and ends his studies with the patient, using books and lectures as tools, as means to an end." Reading up on my patients is the only thing that will stick well long-term for me.

And I'd like to reiterate that Pre-Test Medicine is an excellent resource for the NBME. There were at least a few questions that they almost cut and paste from Pre-Test. The book covered all the salient and often-tested points about the major diseases well.

I think reading about patients is the best way to LEARN in real life, but not the best way to PREPARE for a shelf exam. The best way to prepare for a shelf is to pick a good review book and read it cover-to-cover during your rotation while reading about your patients in more detail from a good reference book. The shelf isn't going to be about "Bob's patients," and it's unlikely that you've seen all the obscure stuff that will be on the test.

mike
 
I think it CAN be applicable, but especially if you have been following the patient from admission to discharge. A lot of the shelf exams I've taken thus far have asked a lot of scenarios that were similar to doing consults...pt sx, hx, etc. etc. and then they want your dx, or take it that 'one step further' and ask for treatment, pathobio, etc. If you've followed seen a CVA, get the normal workup done, and then follow the treatment...you'll get a pretty good basic knowledge of CVAs (enough to get you through). But if you just get the patients dumped on you...I find it hard to really 'learn' something from the patient that becomes applicable towards the shelf. Especially ICU patients....:p
 
I just got through taking the IM shelf exam as well and I thought that "NMS medicine" was very good. Seems like it is a little bit more in depth than some of the other review books and has lots of practice ?'s as well. Its pretty long but I was able to get through it easily in a month.


Also, of course you should read about your patients but that is not going to prepare you well for a shelf exam. I have taken all of them now and maybe on average I have seen 25-50% of the material tested during the rotation.
 
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