Official Internal Medicine Shelf Exam Thread

[kaleerkalut]

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

So you did all of the NBME Step 2 tests? How many are there? It seems like I'd be using up any resources I'd have left for Step 2 studying no? Thanks in advance

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[Aclamity]

This might be a dumb question, but where do you all get the knowledge base/foundation before tackling the rotations and UW questions?

This kind of applies to all rotations actually; none of this seems like step 1 (where the first 2 years formed the knowledge base and FA guided our studying during step 1).

Since we don't really get much formal teaching during 3rd year, how do you all build your foundation for all the "what's next?" type of material? And then when it comes time to study for shelf, what do you use to guide your studying? I understand doing lots and lots of questions is key, but that just seems like such a piecemeal way to learn. I'd love to have a book to read/follow.

 

[secants]

Sorry for bumping this up, but like the above poster, I really want to know as well how people developed their knowledge base. I really hope it isn't going through Harrison's..

 

[JasonE]

it seems like a lot of people read step up to medicine, but i have no idea how anyone can retain information from that book. its like reading list after list

 

[tigress]

I can't afford the year subscription to UW, so I'm trying to figure out how to learn medicine adequately. Both for the shelf, but particularly for my general medical knowledge--I don't want to have too many huge gaps--especially since my whole IM rotation is at a VA hospital, so my patients are pretty much all men over age 50 with CHF, DM2, ESRD, etc. I'm not seeing a lot of variety. (But my cardiology and nephrology knowledge should be pretty good after this rotation!)

What would y'all suggest? My school lent us a copy of MKSAP 5, and I have my own copy of MKSAP 4. I have access to Harrison's online and of course Up To Date and whatever other common school resources there are. What other inexpensive resources are there? I can buy a book, but I don't want to get Step Up because it's from 2008 and the new edition is coming out right after my rotation is over.

 

[tigress]

Anybody? I'm into my second week of my rotation and feeling like I need a resource to study from. There has to be something out there that can help MS3s get a solid knowledge base...

 

[Robot Skeleton]

Anybody? I'm into my second week of my rotation and feeling like I need a resource to study from. There has to be something out there that can help MS3s get a solid knowledge base...

Why are you hesitant to use the 2008 edition of Step-Up? Still seems to be the most widely used resource for IM.

 

[tigress]

Why are you hesitant to use the 2008 edition of Step-Up? Still seems to be the most widely used resource for IM.

I'm more hesitant to spend that much money on a book that will be out of date within a few weeks. I've read that some of the treatment info is out of date, but I have no clue.

Anyway, I think I'm just going to read the major topics in Harrison's, read up on specific patient stuff on Up To Date, and do the MKSAP questions I have. That plus the teaching I'm getting should be enough, I think.

 

[Deceptacon]

96 scaled, 95th percentile. in the 4th quarter anything above 93 is capped at 95th (according to my school).

did about 1500 kaplan internal medicine questions and all of the mksap 4 questions and nothing else.

 

[uva2010]

without re reading pages of this thread, i just wanted to see what you guys thought- MKSAP questions vs. Uworld internal med questions. Uworld seems harder, so ive been doing more of those, but if the shelf questions are more like MKSAP I dont want to waste my time. Any suggestions? I dont want to buy nbme test or anything, like what was discussed above. thanks for your advice!!

 

[VenusinFurs]

I'd say the NBME questions are definitely more like UWorld than MKSAP for students. MKSAP for students is too easy.

 

[NewYorkDoctors]

For reference, I did not use Step Up to Medicine. I used First Aid for Step 2CK

I did peruse through Step Up and based on what I saw, I feel it is a more thorough text than First Aid is for Step 2.


Nevertheless I still scored 99 on the medicine shelf, so the choice of books is really moot. It comes down to doing a lot of questions

 

[PinkLithe]

delete please

 

[JasonE]

took the exam few weeks ago. theres no point in studying for it. they ask tons of random questions. there is no way to prepare for them (i.e. info that is NOT at the level of 3rd year medical students, such as treatments for diseases you never see or are not listed in most books).

the problem with them asking these questions is it comes down to guessing. if the person next to you gets luckier than you, they do better.

 

[CuriousGeorge2]

This might be a dumb question, but where do you all get the knowledge base/foundation before tackling the rotations and UW questions?

This kind of applies to all rotations actually; none of this seems like step 1 (where the first 2 years formed the knowledge base and FA guided our studying during step 1).

Since we don't really get much formal teaching during 3rd year, how do you all build your foundation for all the "what's next?" type of material? And then when it comes time to study for shelf, what do you use to guide your studying? I understand doing lots and lots of questions is key, but that just seems like such a piecemeal way to learn. I'd love to have a book to read/follow.

Great question, would love to hear other people's opinion.

I know the mantra is to read uptodate, but the length of the uptodates articles for many topics are even longer than their corresponding sections in Harrison's. I just don't buy it when people say they learned all of internal medicine just by doing Qbank questions and reading the explanations...

 

[PinkLithe]

====

 

[tigress]

took the exam few weeks ago. theres no point in studying for it. they ask tons of random questions. there is no way to prepare for them (i.e. info that is NOT at the level of 3rd year medical students, such as treatments for diseases you never see or are not listed in most books).

the problem with them asking these questions is it comes down to guessing. if the person next to you gets luckier than you, they do better.

So, I agree that there's no good way to study for this shelf. I disagree that it comes down to guessing, though. Most of what I knew was from random reading over the course of my life. Most of it was not stuff I actually learned during my rotation. Some of the treatments I did learn. I did all of MKSAP 4 and thought it was worthwhile just for general education, though most of it is pretty easy...but it didn't help for the shelf. Regardless, I did quite well and will get honors in the rotation, thankfully.

Step Up was way too basic and not helpful for learning to be a good doctor, in my opinion. The best thing to do is to look up everything about your patients on Up To Date and other resources, read some Harrisons at night, and pay a lot of attention when the residents are talking about tests and treatments.

 

[JasonE]

So, I agree that there's no good way to study for this shelf. I disagree that it comes down to guessing, though. Most of what I knew was from random reading over the course of my life. Most of it was not stuff I actually learned during my rotation. Some of the treatments I did learn. I did all of MKSAP 4 and thought it was worthwhile just for general education, though most of it is pretty easy...but it didn't help for the shelf. Regardless, I did quite well and will get honors in the rotation, thankfully.

Step Up was way too basic and not helpful for learning to be a good doctor, in my opinion. The best thing to do is to look up everything about your patients on Up To Date and other resources, read some Harrisons at night, and pay a lot of attention when the residents are talking about tests and treatments.

reading up on patients does help, but thats only going to pick you up a few questions here or there if any at all. depends on the luck of what you see and whats on the test. most scenerios that were on the exam i did not see in the hospital

 

[tigress]

reading up on patients does help, but thats only going to pick you up a few questions here or there if any at all. depends on the luck of what you see and whats on the test. most scenerios that were on the exam i did not see in the hospital

Nope, won't help much for the test. Will help a lot when it comes to what we're actually trying to do here, which is learning how to be good doctors.

 

[JasonE]

Nope, won't help much for the test. Will help a lot when it comes to what we're actually trying to do here, which is learning how to be good doctors.

this threads about the shelf

 

[tco]

Nope, won't help much for the test. Will help a lot when it comes to what we're actually trying to do here, which is learning how to be good doctors.

What you're saying to do might give you a "slight edge" when starting residency, but that's going to be taken away within the first month...

 

[netminder]

Does anyone have any insight on how reliable a predictor of the difficulty of questions and length of questions stems the 20 practice questions on the NBME Web site are?

Thanks.

 

[elektroshok]

Does anyone have any insight on how reliable a predictor of the difficulty of questions and length of questions stems the 20 practice questions on the NBME Web site are?

Thanks.

not even comparable to real exam. Those twenty questions are gimmies if anything on the real test

Sent from my Galaxy Nexus using Tapatalk 2

 

[netminder]

Thanks.

 

[TheMan21]

two questions

1. kaplan qbank vs uworld...thoughts?

2. would one of the above qbanks + step up to medicine be enough to do well on the shelf? i've heard that step up is lacking when it comes to info on how to treat.

thanks for the help.

 

[disorder]

you all make this shelf sound impossible.

uworld, step up, case files. +/- MKSAP.

that's all you need!

 

[NewYorkDoctors]

two questions

1. kaplan qbank vs uworld...thoughts?

2. would one of the above qbanks + step up to medicine be enough to do well on the shelf? i've heard that step up is lacking when it comes to info on how to treat.

thanks for the help.

UWorld all the way

Kaplan QBank should only be done if you enjoy frustration and anger. It has no place for the shelf exam (though for Step 2, it may... if only to get you accustomed to long vignettes)

 

[NewYorkDoctors]

This might be a dumb question, but where do you all get the knowledge base/foundation before tackling the rotations and UW questions?

This kind of applies to all rotations actually; none of this seems like step 1 (where the first 2 years formed the knowledge base and FA guided our studying during step 1).

Since we don't really get much formal teaching during 3rd year, how do you all build your foundation for all the "what's next?" type of material? And then when it comes time to study for shelf, what do you use to guide your studying? I understand doing lots and lots of questions is key, but that just seems like such a piecemeal way to learn. I'd love to have a book to read/follow.

For me, right after Step 1 I got the Kaplan Step 2CK package.

Schedule psychiatry as my first block (much easier workload) and outpatient family medicine as the second one.

During those blocks i just crammed in all the videos and lecture notes to get my base of knowledge.

Then for each block, read case files and did questions.

Obviously the challenge of this is staggering the videos/notes vs questions during the first couple of blocks. But it gets easier as the year goes on

 

[boaz]

Anyone know of good iphone apps with practice questions for medicine shelf? Besides for Lange.

 

[HTwrestler112]

- Step Up (read it, highlighted it, and quizzed with my brother. Did this about 1.8 times through except I only did part of the ambulatory chapter)
- 1400 UWorld Questions (did the questions, and looked at why I missed the answers, if I thought something was really weird, I would teach it to Rob or Richard or someone else on my team to help it stick, other than that, I didn't have time to go over my missed questions. I averaged 70% overall on all 1400 questions).
- Did the heart, lung, and GI chapters in MKSAP 5, looking at why I missed any answers and then if I thought something was weird, I would teach it to Richard to help it stick.

Using that study method (plus a really good timing strategy on the test...you HAVE to read the question at the end of the vignette first and then read the vignette looking for the information that is pertinent to the question...practice doing all of your practice problems like this) and having a good background from step 1, I made 99 on the shelf with every subcategory score in the above average range. The test is standardized so that 70 is average with a standard deviation of 8.

 

[Aclamity]

- Step Up (read it, highlighted it, and quizzed with my brother. Did this about 1.8 times through except I only did part of the ambulatory chapter)
- 1400 UWorld Questions (did the questions, and looked at why I missed the answers, if I thought something was really weird, I would teach it to Rob or Richard or someone else on my team to help it stick, other than that, I didn't have time to go over my missed questions. I averaged 70% overall on all 1400 questions).
- Did the heart, lung, and GI chapters in MKSAP 5, looking at why I missed any answers and then if I thought something was weird, I would teach it to Richard to help it stick.

Using that study method (plus a really good timing strategy on the test...you HAVE to read the question at the end of the vignette first and then read the vignette looking for the information that is pertinent to the question...practice doing all of your practice problems like this) and having a good background from step 1, I made 99 on the shelf with every subcategory score in the above average range. The test is standardized so that 70 is average with a standard deviation of 8.

Wait, how come you only taught MKSAP to Richard? Didn't Rob feel left out? I think that's kind of unfair, no offense.

 

[NewYorkDoctors]

Btw, there were about 5 questions I was unsure of

Unless I totally lucked out, then it is clear that you don't need to get all 100 questions correct to get a 99

(especially since its not likely that I got all the ones that I was sure of correct)

 

[lrkoehle]

took the exam few weeks ago. theres no point in studying for it. they ask tons of random questions. there is no way to prepare for them (i.e. info that is NOT at the level of 3rd year medical students, such as treatments for diseases you never see or are not listed in most books).

the problem with them asking these questions is it comes down to guessing. if the person next to you gets luckier than you, they do better.

This mirrors my feeling about the IM shelf I took today...felt like I was guessing a lot more than I was comfortable with. I just better have passed that damn thing, so I never have to think about IM again.

 

[secants]

Scored 87th percentile, 92 scaled from school.

Did a combination of Uworld, Kaplan step 2 videos/notes, some SUTP, some casfiles, school Umed cases, and then the daily lectures I had during my rotation. I think the kaplan resources along with Uworld were the most helpful. Most of the questions mirrored Step 2 by asking what the diagnosis was and the next step in management. Had some Xrays, EKGs and derm pictures. Not to much preventive medicine/outpatient stuff. Wasn't as bad as what the thread made it out to be IMO.

 

[tco]

I've strayed from advice on here and have done mostly Step Up and MKSAP-5. Planning on doing USMLEWorld in the week leading up to it. I'm hoping that doesn't bite me in the rear.

 

[osumc2014]

Does the test cover neuro at all? ie should I do neuro questions on uworld or just skip them

 

[secants]

Save the Neuro questions for the Neuro shelf; it's not HY enough for the IM one. The questions I got were fairly basic for Neuro, similar to step 1 stuff and it was maybe 3 questions at most. But I'm sure every test varies a little.

 

[secants]

Just brush up on Delirium and Dementia though

 

[ArcGurren]

Save the Neuro questions for the Neuro shelf; it's not HY enough for the IM one. The questions I got were fairly basic for Neuro, similar to step 1 stuff and it was maybe 3 questions at most. But I'm sure every test varies a little.

Definitely varies. I had one neuro question on some vascular syndrome (i think it was osler-weber-rendu syndrome) and that was about the extent of neuro for me.

 

[BlueElmo]

Hey guys do you think doing reading Blueprints, doing uworld, and mksap 5 are enough to do well on the shelf? I tried reading Step Up but reading that whole thing while working 6 days a week is impossible for me, the book is just too dense.

 

[tco]

Definitely varies. I had one neuro question on some vascular syndrome (i think it was osler-weber-rendu syndrome) and that was about the extent of neuro for me.

That's arguably neuro, even, since it's a systemic disease.

 

[iPodtosis]

Just out of curiosity, any of your school combines internal medicine with some other rotation, for example, psych? Cuz our school did and I found it really hard to focus and study

 

[tco]

I felt terrible when I left that thing. I had to use the bathroom in the middle, so that cost me a good 5 minutes or so, and I ended up guessing on at least 8 questions with barely reading them. Great. We'll see if I passed even, I guess!

 

[Bbon]

Hey guys, I had IM as my first rotation and just finished surgery. My 2 cents: I realize now that I would have easily gotten 90% of the questions I know I missed on the IM shelf had I done my surgery rotation first. If you have extra time and are debating whether you should start doing a 2nd pass of Uworld or something, I'd consider reading the Pestana surgery notes, which you can easily get through in a couple hours, +/- uworld surgery questions if you just happen to have loads of extra time. First priority is obviously Uworld IM questions and Step up +/- MKSAP.

 

[link2swim06]

I felt terrible when I left that thing. I had to use the bathroom in the middle, so that cost me a good 5 minutes or so, and I ended up guessing on at least 8 questions with barely reading them. Great. We'll see if I passed even, I guess!

Better than me...stupid computer semi-froze for 5 seconds so I could even guess on the last 3 questions.

 

[ruiner]

Better than me...stupid computer semi-froze for 5 seconds so I could even guess on the last 3 questions.

i noticed loading the questions took a few seconds more than once. doesn't seem like a big deal, but those seconds do add up. i made it through the whole test so i guess im happy but time was the biggest factor for me. I would say for advice to people taking in the future make sure you know when to move on from a question otherwise you can get stuck and in trouble

 

[tco]

Hey guys, I had IM as my first rotation and just finished surgery. My 2 cents: I realize now that I would have easily gotten 90% of the questions I know I missed on the IM shelf had I done my surgery rotation first. If you have extra time and are debating whether you should start doing a 2nd pass of Uworld or something, I'd consider reading the Pestana surgery notes, which you can easily get through in a couple hours, +/- uworld surgery questions if you just happen to have loads of extra time. First priority is obviously Uworld IM questions and Step up +/- MKSAP.

There's also something about learning in a delayed manner. I don't know what the phenomenon is called, but I know material now from my first rotation that I didn't know on that rotation, and I haven't studied it. There's something about relaxing that makes you remember old material.

 

[amakhosidlo]

Random question: Anybody know what sort of Raw % gets you at or above the mean? I know it's scaled to 70, but how does that correlate to actual % right? What should you be aiming for in Qbank or the like to get above average on the real thing?

 

[tryingtogetby]

Has anyone used Saint Frances Guide to internal medicine? any thoughts on it? Seems way too basic for the NBME shelf. Thanks.

 

[evilbooyaa]

There's also something about learning in a delayed manner. I don't know what the phenomenon is called, but I know material now from my first rotation that I didn't know on that rotation, and I haven't studied it. There's something about relaxing that makes you remember old material.

That plus the questions about whether to put a fracture into a sling/traction/cast that are pretty clearly surgery (or at least family medicine) oriented.

I think the first shelf always sucks. I didn't do great, only 76th percentile, but I at least know a lot more going into my pediatrics shelf this coming week.