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Official Internal Medicine Shelf Exam Thread

Discussion in 'Clinical Rotations' started by Kluver_Bucy, 11.04.05.

  1. MossPoh

    MossPoh Textures intrigue me

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    Usually, tests for a third year student are created with the goal of identifying the classics and/or big things. They could put some ridiculously complicated EKG on there, but it wouldn't be beneficial for the assessment when a huge percentage of students have to guess. There are always a few of those out there questions, but that is to be expected.
  2. DrPathodifficle

    DrPathodifficle

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    whats a good average on Uworld IM questions? im averaging at around 50% and im worried. what should i be getting in order to pass the shelf? let me know.
  3. sswang00

    sswang00 MS4

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    Also, when doing UWorld what portions of the IM section could be unchecked (for the sake of time). Im assuming the Neuro section? And what about biostats? Optho?
  4. studentdoc911

    studentdoc911

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    Getting every single PEEP, FiO2, respiratory rate question wrong on UW

    So far from what I understand:

    FiO2 is changed for O2 toxicity purposes
    PEEP is increased in ARDS to prevent alveolar collapse
    RR is changed to address acid-base issues
  5. MossPoh

    MossPoh Textures intrigue me

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    Reviewing pulmonary physiology and the section in step up would probably help with that more than anything. Try to think of it from a conceptual standpoint more than a memorization one.
  6. MossPoh

    MossPoh Textures intrigue me

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    Took it today and it was as random and tricky as anticipated. Overall, it felt very uworld-ish in question structure and choices...even had a few scattered peds questions. I never feel good after these exams, so I won't use that gauge anything.

    Best preparation is probably questions, questions and more questions but if I had to do it over again, I might've looked a few more things up in StepUp. Other than that, if I didn't know it or was confused, there wasn't much I could do about it. It was the first test that I was truly rushed at the end. I normally finish with 10-15 minutes left, but I am pretty sure I wasted time on questions and spaced out for part of it.
  7. ericL

    ericL Member

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    ^^^ agree with above

    Just took it today, random, was surprised by the amount of peds and gyn on mine...

    UWorld questions were way closer to the style and content on the test than those in the MKSAP.

    I tried reading Step Up to Medicine... but then I was reminded that review books make me want to hang myself. So most of my studying was done via reading on my patients, and doing most of the UWorld questions.
  8. pitt1166

    pitt1166 New Member

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    u mind explaining why you wished you had read more step up?

    my shelf is a month away. i just finished the usmleworld questions w like 55% correct. not sure where to go from here. im gonna go over the questions i marked on usmleworld, but im not sure if i should read step up again, or do casefiles/mksap 4 or 5.

    part of my concern is that ive gotten so bogged down in details from usmle world questions that i might have forgotten some bread n butter stuff.

    any input is very appreciated.
  9. MossPoh

    MossPoh Textures intrigue me

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    The test felt like it had a lot of diagnosis questions that hinged on a single diagnostic to differentiate between the answers. Usually the subtle stuff one doesn't think of. Step Up is good for that. I really did not read much of any of it. I did all the uworld questions, all mksap 4 and 5, most of mksap 3, Kaplan step 2 Qbook IM questions and a hefty portion of an internal medicine board review Qbook from Kaplan. A little more structure and formal reading probably would've been wise, but we will see in a few days.
  10. perutz

    perutz

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    even if you don't know all the details to differentiate, you'd be better served to err on the side of more benign vs malignant or managing in a less aggressive way vs more aggressive. you'll be right most of the time.
  11. MossPoh

    MossPoh Textures intrigue me

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    Well yea, but when the question is asking for the diagnosis and not management and the diseases are fairly equal in outcomes , that doesn't really matter. :p


    Got my score back the other day. 83 percentile. I'm a little dissapointed, but think I made a bunch of stupid mistakes because of crappy time management. Usually, I have 20 minutes to go back over and reread some of the questions I needed to think over more, but didn't have that chance on this one. I still honored, so I can't be TOO dissapointed.
    Last edited: 03.08.12
  12. wannabedocta

    wannabedocta

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    anyone care to answer this? I've got ~600q's to go in 3 days :scared:
  13. MossPoh

    MossPoh Textures intrigue me

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    I had one biostat question that was really easy. Can't think of any of the others.
  14. SB100

    SB100

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    My IM shelf is in 6 weeks, and currently I'm doing a mix of Step Up To Medicine, UW questions, and SIMPLE cases (required by our clerkship). My clerkship site gave us copies of MKSAP to borrow, but I haven't touched mine yet. Is it worth doing for the extra practice questions, or is there really no good correlation in question style/content between MKSAP and the IM shelf?
  15. CharleyVCU1988

    CharleyVCU1988 Are we having fun yet?

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    From what I've seen there are mixed reviews, some people like MKSAP and some don't. My uncle gave me his copy of MKSAP but I didn't like it as there were some really off the wall questions on it compared to UWorld. The MKSAP usually correlates to the Essentials of Internal Medicine made by CDIM but I get overloaded already with Step Up to Medicine (currently 3/4 of the way through and my shelf is on April 20th) so I'm sticking with UWorld and not MKSAP. Either way you're at least doing some sort of practice.
  16. ArcGurren

    ArcGurren only one will survive

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    MKSAP was better for wards and not necessarily reflective of the shelf exam; I thought UW was more reflective of the topics covered on the shelf and there's a metric ton of questions as well
  17. kaleerkalut

    kaleerkalut

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    So I've med coming up after Step 1 and I was snooping around in this thread. Would somebody mind giving me an update on what things people use most to kill the Medicine shelf (being that this thread extends back about 7 years). Thanks in advance :)
  18. MossPoh

    MossPoh Textures intrigue me

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    Just click through the last few pages and you can get a good idea. Being fresh off step 1 makes it all a little fresher.
  19. FSU2013

    FSU2013

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    I have my shelf two weeks from Friday and I need to know what else I should read.

    So far:
    UWorld Internal Medicine + I redid all missed Qs
    MKSAP
    Select questions from the MKSAP for attendings (my attending picked out questions he thought were particularly good)
    Step Up To Medicine
    Case File: IM
    Selected chapters (about half) from the Washington Manual

    I know I did a lot so far, but based on the importance of IM, my intended specialty, the rough curve at the end of the year and the fact that I'm really OCD.....I need to find something to read.

    I took notes on Step Up and UWorld that I plan on reviewing during the last week. Any other suggestions?

    Cheers
  20. michigator04

    michigator04

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    I did the "questions only" approach to this exam and got my best grade of any shelf yet. 700 or so USMLERx Medicine questions (~70% correct) + about 100-200 MKSAP questions --> ~90th percentile on the shelf.

    Every other student I talked to read Step Up or something similar. I just didn't get around to it and kept plugging away on questions.

    Time management is big time on this test. I am usually a fast test taker. I used 1 hr on the first 30 questions and then had to hustle the rest of the way. I finished with about 10 minutes left, went back and changed 3 answers. Other students I talked to had major time management issues with this one.

    I don't know that I would advise not reading like I did, but definitely don't neglect practice questions on this test, as the UW/Rx questions seemed very high yield.

    Topic wise, I know a lot of people stress out about biostats, but I only had 1 question that was very easy.
  21. peedeeaye

    peedeeaye

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    Seems like consensus believes UW is higher yield thank MKSAP. Anyone have thoughts on redoing marked/incorrect UW vs. starting MKSAP with one week left? Thanks.
  22. Phyozo

    Phyozo

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    redo uw
  23. IsoTemp

    IsoTemp

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    95 scaled on the shelf. I had done surgery, psych, and family before this rotation, shelfs in the high 90s. Knowledge from the surgery shelf is definitely useful for this shelf.

    Resources: Case Files x 2, NMS Casebook Medicine x1 (excellent book), and lightly skimmed Step Up to Medicine (dense and difficult to retain for me personally). Skimmed UpToDate very lightly during the rotation for patients' problems. I watched all of the Kaplan Step 2 internal medicine video lectures as well before the rotation started, and had watched Pestana a while before for surgery. On the whole, very happy with the reading resources I chose.

    Questions: did the Kaplan Internal Medicine Qbank several months before the rotation (69% overall), Pretest Medicine (85% overall), MKSAP 3 (80% overall), MKSAP 4 and 5 (85% overall on both).

    Pretest seemed too easy -- nearly all one step reasoning except for a few gems like the matching section on pleural effusions. MKSAP questions seemed slightly easier than the shelf, though the acid-base and cardiology sections are great review, in my opinion. I didn't use UW -- saving the bank for Step 2 studying. The Kaplan questions range from bad to terrible for preparation, but still better than nothing. (The main Kaplan qbank IM questions are slightly better than their separate IM qbank, but I didn't use the main qbank for my shelf or rotation study)

    Shelf: despite complaints of long stems and answer choices, I found it quite comparable to the surgery and psychiatry shelfs. Content is mostly well-represented by MKSAP and Kaplan, though there are always going to be random questions from other rotations on there, as others have pointed out. Reasonable amount of outpatient internal medicine (screening guidelines, preventative medicine, etc.) so these should be studied even if they are not directly applicable to wards. There are also a very few basic science, Step 1-type questions, generally way out of the left field, that are more or less impossible to study for beforehand.

    On the whole, most of the questions on the shelf were relatively straightforward and still classic presentations and buzzword bingo, but the more challenging questions ask about in-depth management and require some thinking.
    By my estimates of remembered questions that I later looked up and know for certain I got wrong, one can miss at least 10 questions (and likely around 20 or more, by my estimates) and still get my score.
    Last edited: 03.29.12
  24. Mr RADical

    Mr RADical

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    UW higher yield but MKSAP still helpful. MKSAP is pretty quick, I thought it was better to work through than redoing UW. It's always good to see questions from different sources to minimize bias.
  25. RafaTech

    RafaTech

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    Just got my score back: 99 on the shelf.

    Here were my resources:

    1) Step Up to Medicine - read it once through (referenced my First Aid for some pharm stuff)
    2) UWorld Q bank - did all 1400 medicine questions, very high yield (i was averaging around ~72% on each block)
    3) MKSAP questions - did the big systems the day or two before the exam, very high yield (GI, Pulm, Cards, Hem/Onc, Renal)

    If I had to focus on one qbank it would be UWorld, but I'm glad i did those MKSAP questions at the end because the are really quick and high yield. I'm usually a fast shelf taker, but this shelf took me all the way to the end. Its a long one so the more practice questions you do, the better.

    Good luck peeps.
  26. ArcGurren

    ArcGurren only one will survive

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    Beast!!
  27. JasonE

    JasonE

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    pretty new to this so this question might seem stupid, but it seems like everyone does UW questions.

    when do you start doing the questions? where do you develop the knowledge base before attacking the questions? or do you just randomly start doing questions and learn from them
  28. kaleerkalut

    kaleerkalut

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    When people say they did the Kaplan Step 2 Qbook do they mean the one from the video series with the red cover? Thanks
  29. boostta

    boostta

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    Hey guys

    So I know the consensus is Step-up, UW, and MKSAP. Did anyone use Kaplan IM instead of Step-up, any thoughts? I know Step-up seems like the source to use, I was wondering if Kaplan is just as good or not as good...
  30. kaleerkalut

    kaleerkalut

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    Wondering the same thing. Hope someone answers.
  31. kaleerkalut

    kaleerkalut

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    Bump. I'd really appreciate it if somebody could please comment on this. Did anybody use Kaplan IM lecture notes instead of Step Up? What was your experience? Appreciate any input. Thanks :)
  32. Sheldor

    Sheldor

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    Thought I'd give back:

    Studied: MKSAP 4 throughout the rotation
    UWorld: 1200 questions during the last 2.5 weeks of rotation, and redid a few hundred incorrects in the few days leading up to the test.

    Scaled score 93. Not sure what the percentile is, anybody know?

    Anyway, Uworld was amazing prep and my chief resource. I'd highly recommend getting through 1000+ IM questions and then calling it good!
  33. NYCMS2

    NYCMS2

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    Questions about MKSAP:

    What resources of this, exactly, are people using? Books, or digital? I am confused by the availability of what is listed on the ACP website, and when I look at Amazon, I do see books (like 4), but I have no idea what exactly I should buy.

    So what exactly are people using?
  34. Pinworm

    Pinworm

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    I have already read step up, done mksap 4, and uworld questions...wondering what I should do next?

    #1 Reading --> Casefiles vs 4-5 chapters of Step Up (second time)
    #2 Questions --> redo uworld vs MKSAP 5 + Kaplan qbook

    I want to do one thing from #1 and one thing from #2 --> Any suggestions on what would be most helpful/high yield?
  35. coffeebeanjenn

    coffeebeanjenn

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    I used MKSAP 5 online plus the questions. I perused a copy of MKSAP 4 and they were similar. I liked that I had access to the MKSAP book online wherever there was Internet, so I didn't have to carry the book around.
  36. Sheldor

    Sheldor

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    Have you redone all of your wrong questions from U world? If not I HIGHLY recommend that.
  37. Pinworm

    Pinworm

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    No I haven't but I have taken notes off uworld as I went through it. Would you opt for redoing uworld over re-reading 5-6 chapters in step up? My test is next week.

    Thanks for the reply
  38. Sheldor

    Sheldor

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    I didn't read any of Step Up because, lets face it, by this time of the year reading a review book is the worst. I did, however, redo my wrongs in Uworld. Ended up with >90 so I stand by it!
  39. englishpatient

    englishpatient

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    how much neuro is on the exam?

    i notice step up has a huge section on it and there's a ton of questions in UW even if you say you just want IM qs

    thanks
  40. whoknows2012

    whoknows2012

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    Honestly, less than 5 on my test, and the neuro they do ask is pretty basic. My assumption has always been that because there is a shelf dedicated to pure clinical neurology most of the more complicated neuro questions end up on that shelf.
  41. elektroshok

    elektroshok

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    Just took it Friday. Thought it was about as hard and random as uworld questions..

    Sent from my Galaxy Nexus using Tapatalk 2
  42. JasonE

    JasonE

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    are the question stems really long? do people still run out of time?
  43. elektroshok

    elektroshok

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    I thought they were pretty long for the most part... Finished okay timewise, just didn't have enough time to really go through a of my marked ones like I normally do.

    Sent from my AT100 using Tapatalk 2
  44. NewYorkDoctors

    NewYorkDoctors

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    hello everyone:

    99 on the shelf

    I took a different approach:

    Kaplan videos
    first aid for step 2 ck (admittedly not a great book, but I refused to play sheep with Step up to step 2, when no one bothered to use Step up to step 1... sheep syndrome.. i refuse to comply)
    case files
    UCV

    Rx qbank
    Kaplan qbank
    World
    Pretest qbank


    at the end of the day, what I did was totally overkill. there were so many topics not tested on the IM shelf.

    however, the biggest tip i can give everyone is to STAY SHARP. there are many clinical subtleties you should always be aware of.

    moreover, get familiar with geriatrics
  45. kaleerkalut

    kaleerkalut

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    Congrats! Can you please comment on the Kaplan videos? Also which questions did you find the most useful other than UWORLD? Thanks.
  46. kstreet

    kstreet

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    Used uworld, most of step up and studied on the wards. Uworld was definitely the best resource and I would recommend multiple runs through it if possible. Occasional Kaplan vid, but not absolutely necessary imo. This strategy got me a 92.
  47. dude1344

    dude1344

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    This was my first shelf of third year 10 months ago. I basically used UW only and got a 96 on it. I tried to read step up but there was no time.
  48. kaleerkalut

    kaleerkalut

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    What did you get on Step 1? That seems relevant since it was your first rotation and you only used UWORLD. Thanks.
  49. dude1344

    dude1344

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    high 250s
  50. NewYorkDoctors

    NewYorkDoctors

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    do all of the NBME for Step 2 forms. That really helped with the inpatient infection prevention and geriatric themes.

    A little bit of each of the other qbanks helped, but nowhere near in the same vein as UWorld. It is really about diminishing returns I'd have to say. I was just fortunate to have those other qbanks on my ipad which I could do during rotations when things calmed down a bit.

    I also do not think much of MKSAP. Sure the topics they ask about are virtually the same topics as that on the shelf, the MKSAP qusetions are far too simplistic to compare to shelf or board questions

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