Official Pediatrics Shelf Exam Thread

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90 raw, 93 percentile

I had an 8 week rotation
Week 1- 3: - 20 of the 30 CLIPP cases
- Read Case Files
Week 4: UWorld questions
Week 5-6: Read First Aid for Pediatrics (about 20-50 pages a day)
Week7-8: PreTest x 2, UWorld again, and any other questions I could find

I think PreTest and UWorld were probably the most helpful. I felt Blueprints gave a good overview but didn't provide the details that were actually tested on. FA Peds is OK, it's very disjointed, clunky and all the tables suck, but it has the high yield facts scatter in there.
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Can people rank the books from best to worst in terms of being most helpful and representative of the shelf?

Also, can people rank the question sources from best to worst in terms of being most helpful and representative of the shelf?

I am thinking of using Case Files Pediatrics and UWorld (only the pediatrics questions), would that be good enough? I have a little under 5 weeks to study and my schedule is 9am to 6-7pm Monday to Friday.

Anyone?
 
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I just took this shelf about a month ago, here's what I highly recommend:

1. PreTest - going through this once was very high-yield. PreTest is very good for the Pediatrics shelf.
2. USMLE World - about 300 questions, go through these and take notes, and then review the questions block by block the 3-4 days before your exam.


That's all I did, and I earned a raw score of 78, which was much higher than I had expected :) Doing lots of questions for this exam is high yield, since the shelf exam requires that you know the most exacting details to differentiate between the diagnoses. If you are aiming for a very high shelf score, I think reading Blueprints once through in addition to the above (excluding the Chapter 3 - Cardiovascular System, which is awfully written) should be more than adequate.

Good Luck!
 
Took the exam about a month ago. This was my study plan
6 week rotation

Read Case files(Got only through about half) THEN -->
Did PreTest, then Uworld the last 1.5 weeks(Avg untimed sub peds was about 83%). Reviewed the incorrect ones, marked ones. Made sure to know all the metabolic disorders and immune disorders, but still prob got some wrong.

Raw 85
 
hey all - ive been reading different things about how to study for the shelf. mine is coming up in a month, so i was wondering what the best way to study is.i have blue prints, case files and pretest. but, realistically, can't get thru all of that. i'm also going to buy uworld. i was told to skim blue prints, focus on case files and do uworld. is that a good plan?
 
Raw score: 76.

School didn't provide the percentile. The mean of 70 and SD of 8 written on the score report has to be inaccurate since it doesn't add up to the raw scores and percentiles posted on here. I think the percentiles change every few months and you have to ask your school directly for it. Based on the stats listed on this thread, I would guess I was at 70-80th percentile.

This was my first rotation/shelf. I technically didn't do bad, but I definitely wanted to do much better. I think my downfall was not studying until the last few weeks of the rotation. I didn't have time to use a full content study source (like Blueprints or Kaplan notes) and I spent nearly all my time on UW and Kaplan qbanks. For OB next, I'm going to start studying at the beginning of the rotation. That way I can actually do a full content study source (Blueprints) and then do even more qbank questions (UW, UWise, and maybe Kaplan).

Hope this post helps some ppl.

--------------------------------------------------------------------------------------------------------------------------

Took it on 8/3. That **** was harrrrdddd.

Study sources (had 6 weeks to study, but only used the last 3):
- Kaplan Step 2 CK Peds Notes - 100/300 pgs. Pretty good but was too detailed to finish while also doing Qbanks. Would have needed to start it at the beginning of rotation, but I'm honestly glad I didn't b/c I don't think it would have helped much. The small details (like ID) were not covered in it anyway (I tried looking up the tricky ID questions after the test and didn't have any answers)
- Kaplan Step 2 CK Peds Qbank (66% average) - 1x, questions were decent, more clinical than UWorld or Peds shelf.
- UWorld Peds Questions (66% average first time) - 1.5x, best qbank available but still not too similar to real shelf. Probably had 5 UWorld repeats on shelf, which was nice b/c they were vague questions and would not have gotten them on my own.

The shelf was pretty hard, not gonna lie. Much harder than UWorld. The shelf was way less clinical (as in asking for the next step in management) and more straight pathophys (like Step 1). The vignettes were super long. It was full of infectious disease and metabolic panels. Barely any pharm. Not many trigger words, and when there were trigger words they usually just distracted you from the right answer.

The material I studied in this rotation probably only covered half of the questions, while the remaining half felt like I relied solely on leftover Step 1 knowledge. We'll see how the scores are next week...
 
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I had a 4 week Pediatrics rotation followed by the pediatric shelf at the end of the month.

-Case Files Peds 2.5x
-Uworld x1

97 Percentile, school didn't give raw score.

I think the biggest factor that helped me get through this test was my preparedness from USMLE step 1, and a month of internal medicine 2 rotations before. From my test experience, it seemed like I was taking the usmle again except with a focus on peds. That meant that pathophys and any other pathologies that could relate to the children population were fair game. The case files for peds really helped hammer down the high yield peds topics that weren't covered from my knowledge on step 1. Also note, the case files and uworld are not good sources when used alone, but if used together they generally cover all the really high yield peds that was tested on. The rest, unfortunately or fortunately for the reader, was covered from just doing well on the step 1 and being somewhat fresh 3 months out of it. I debated using blue prints pediatrics because I heard it was a good review, but if you're doing well in your classes and on the step 1, it may be overkill.
 
Hey just wondering. Is it USMLEworld step 2 that is recommended for third year clerkship?
Thanks
 
Yeah, USMLEworld step 2 Pediatrics subsection. I also had about 400 IM questions done and OBI gyn done from my previous 2 rotations.
 
Raw 99 / 98th percentile

This was my first rotation so I had no clue how to prepare for a shelf exam. I love doing questions and hate textbooks.

I did:
1x Case Files
2x Pretest
2x USMLEWorld pediatrics questions
1x Kaplan QBank pediatrics questions
2x Kaplan STEP 2 pediatrics videos (There are about 15 hours worth. This was my favorite resource. If you can get a hold of these videos I highly recommend it.)

I tried to read First Aid for Pediatrics but I thought it was way too detailed. The exam had plenty of weird **** I had never heard of before. I know I got quite a few questions wrong. If I had to study anything over again I'd focus on infectious diseases and pathology you'd see in an emergency department (ex. drownings, burns, MVAs, bug bites, other physical trauma).
 
I was looking into the Kaplan Videos myself. I worried the books weren't enough. I acquired the ones that start with Eduardo Pino MD. Are these the latest ones?

Do you think it helped for scoring high on the shelf? How long did they take you, about a week?

Thanks in advance!
 
happyfeet123 said:
I was looking into the Kaplan Videos myself. I worried the books weren't enough. I acquired the ones that start with Eduardo Pino MD. Are these the latest ones?

Do you think it helped for scoring high on the shelf? How long did they take you, about a week?

Thanks in advance!
Click to expand...

Yeah, those are the ones. The videos helped fill in the new pathology that I had never heard of before I started my rotation - like retropharyngeal/peritonsillar abscesses, Wardenberg syndrome, "most common cause of...", etc. as well as the normal variants of infancy and childhood. I had a solid basis from STEP 1 so anything in First Aid I knew cold, so a lot of it was filling in new details on familiar diseases like the best initial treatment, best initial diagnostic test, etc. But really the biggest thing for me is that I learn better from lectures than from reading a textbook.

You could definitely do them in a week at a pace of ~2 hours a day.
 
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Thanks! Watching the videos now. Not bad, but doesnt seem to go much into rationale. I guess this is where Step 1 studying comes in handy.

Anyone know how big the current exam is on vaccines and milestones? These topics seem to be the most miserable memorzing topics in peds lol.

Also, NMS seems to be losing popularity (perhaps due to time), but it seems the few who do use it do very well. I was wondering if anyone could comment on the case studies in the back as well as the practice exam questions?

Thanks!
 
I wouldn't waste any time memorizing vaccination schedules. I would focus more on post exposure protocols.

I think I had maybe 1 milestone question out of 100 questions and it was pretty basic (everything was normal).
 
happyfeet123 said:
Thanks! Watching the videos now. Not bad, but doesnt seem to go much into rationale. I guess this is where Step 1 studying comes in handy.

Anyone know how big the current exam is on vaccines and milestones? These topics seem to be the most miserable memorzing topics in peds lol.

Also, NMS seems to be losing popularity (perhaps due to time), but it seems the few who do use it do very well. I was wondering if anyone could comment on the case studies in the back as well as the practice exam questions?

Thanks!
Click to expand...

There is a fair amount of fluff in NMS, but that along with practice questions from uworld and pretest were the majority of my studying. (Got a 96)
 
I have had a few attendings tell me to constantly review pictures, especially of dermatologic lesions in children, because "pictures are a large portion of the test". Can anyone attest to this being true or not true?
 
Pictures weren't a big part of my exam from what I can remember but I think it's certainly fair game. Definitely be able to recognize the buzz word descriptions of any infectious exanthem or autoimmune exanthem.
 
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Pre-test was enough for me. 99. I'm a big believer in Pre-test in general. It's never done me wrong.

I guess we had to do some of those CLIPPS cases too, but I don't know how much they actually helped.
 
How do some of you guys figure out your percentile on the shelves? We only received our scaled score and they told us a 70 is the 50th percentile with a SD of 8. Do you guys just figure it out based on that?
 
Blue prints or First Aid peds? Which one?
 
For those who did NMS, could you elaborate on which topics were fluff (to avoid or study less)...also what were your study plans like. :thumbup: thanks
 
did case files, pre-test, skimmed through blueprints, and CLIPP cases (all 32 required for clerkship). took the exam yesterday and felt pretty good after finishing the exam. surprised that there were no direct questions on developmental milestones and only one questions on vaccines considering upper years were saying they had multiple on their exam...
 
ijn said:
Yeah, those are the ones. The videos helped fill in the new pathology that I had never heard of before I started my rotation - like retropharyngeal/peritonsillar abscesses, Wardenberg syndrome, "most common cause of...", etc. as well as the normal variants of infancy and childhood. I had a solid basis from STEP 1 so anything in First Aid I knew cold, so a lot of it was filling in new details on familiar diseases like the best initial treatment, best initial diagnostic test, etc. But really the biggest thing for me is that I learn better from lectures than from reading a textbook.

You could definitely do them in a week at a pace of ~2 hours a day.
Click to expand...
Does anyone know if the Kaplan peds videos (the ones you guys mentioned with Dr. Pino) have updates/newer versions out there somewhere? I found 2002 ones that are great, but is there anything more recent?

Thanks.
 
Anyone know where I can find these Kaplan videos online?
 
It doesn't seem anyone has mentioned this recently, but BRS Peds is MONEY for the shelf. Read twice. Do uworld questions if you have them (not terribly useful).
 
Stellar Clouds said:
It doesn't seem anyone has mentioned this recently, but BRS Peds is MONEY for the shelf. Read twice. Do uworld questions if you have them (not terribly useful).
Click to expand...

The 2004 one? I didn't even know they had BRS books for clinical rotations haha
 
Here's what I did:
FA x1 - great for baseline knowledge, more useful for pimping knowledge and sounding smart in clinic but it made me more comfortable with questions.
Case Files x2 -read through one time w/ questions; did just the questions and summaries 2nd time
PreTest x1.2 -wish I could've done it again twice - reviewing is valuble but this took a lot of time.
Uworld - x0.7 -again wish I could've done more and reviewed.
All CLIPP cases -not so useful. Our school has a CLIPP exam for the department and an oral exam which I took a week out of study to prepare for which I feel is a waste of time when prepping for the shelf.
 
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DarthNevus said:
This was my 2nd shelf. I got a 72 score on my NBME report. I didn't get a raw/scaled score or percentile. So what's the deal with the raw score and percentile? How can find these #'s out?

I've never been an allstar med student and I'm frustrated as hell because I feel like I worked harder for this exam and came up short of my goal (>80 on NBME). Believe it or not this rotation was HARDER than my medicine rotation (don't worry, I won't go into it).

Here's what I did:
FA x1 - great for baseline knowledge, more useful for pimping knowledge and sounding smart in clinic but it made me more comfortable with questions.
Case Files x2 -read through one time w/ questions; did just the questions and summaries 2nd time
PreTest x1.2 -wish I could've done it again twice - reviewing is valuble but this took a lot of time.
Uworld - x0.7 -again wish I could've done more and reviewed.
All CLIPP cases -not so useful. Our school has a CLIPP exam for the department and an oral exam which I took a week out of study to prepare for which I feel is a waste of time when prepping for the shelf.
Click to expand...

I'm not sure where the percentile comes from. They aren't listed on the score report, but I know that the percentile is noted on my MSPE...
 
Has anyone found any audio sources to prepare for Peds shelf so I could listen while commuting? (Like podcasts, videos online, etc?)
 
Wow, how do you guys find the time to cover more than 4 sources in a month rotation? That's amazing
 
Few questions off the new practice tests:

1. 38 week AGA neonate with features of Down syndrome, Apgars 6 and 9, AFVSS. Exam reveals hypotonia, pulse ox is 92% on room air. What is the next step?

A) Measure CK and MRI of the brain
B) CXR and blood cultures
C) ECG and karyotype
D) PGE1 and O2 supplementation
E) Surfactant + IV amp/gent

I said D, which was wrong. I figured baby has some kind of cyanotic heart defect, stabilize baby until echo can be done.

2. Previously healthy 2yo boy presents with acute fever and inspiratory stridor. Has had rhinorrhea for the last day. Symptoms improve "when mom took him outside to come to the emergency department" [no idea what that is supposed to mean]. Immunizations UTD, exam significant for retractions and stridor, nothing else.

A) Alveolar atelectasis
B) Edema of the epiglottis
C) Narrowing of moderate-sized airways
D) Pulmonary parenchymal inflammation
E) Subglottic edema

I said B, figuring that was the only one that caused inspiratory stridor. I know epiglottitis is weird in immunized kids, but that was the only answer that fit the signs/symptoms.

Thanks in advance.
 
I haven't taken the peds nbmes because they came out after my rotation but...
VisionaryTics said:
Few questions off the new practice tests:

1. 38 week AGA neonate with features of Down syndrome, Apgars 6 and 9, AFVSS. Exam reveals hypotonia, pulse ox is 92% on room air. What is the next step?

A) Measure CK and MRI of the brain
B) CXR and blood cultures
C) ECG and karyotype
D) PGE1 and O2 supplementation
E) Surfactant + IV amp/gent

I said D, which was wrong. I figured baby has some kind of cyanotic heart defect, stabilize baby until echo can be done.
Click to expand...
SaO2 of 92% is fairly normal for immediately following vaginal delivery. Cite: http://www.ncbi.nlm.nih.gov/pubmed/16737866

I guess they want you to work up why it's hypotonic. Karyotype to confirm down's... if that's negative then go chasing after zebras like spinomuscular atrophies or other weird **** cite: http://www.macpeds.com/documents/Ne...ewoftheFloppyBaby-BrainandDevelopment2003.pdf

It's definitely recommended that Down's babies get ECG & echo prior to discharge. Not sure what kind of conduction defects you're screening for though...

2. Previously healthy 2yo boy presents with acute fever and inspiratory stridor. Has had rhinorrhea for the last day. Symptoms improve "when mom took him outside to come to the emergency department" [no idea what that is supposed to mean]. Immunizations UTD, exam significant for retractions and stridor, nothing else.

A) Alveolar atelectasis
B) Edema of the epiglottis
C) Narrowing of moderate-sized airways
D) Pulmonary parenchymal inflammation
E) Subglottic edema

I said B, figuring that was the only one that caused inspiratory stridor. I know epiglottitis is weird in immunized kids, but that was the only answer that fit the signs/symptoms.

Thanks in advance.
Click to expand...
Cold air can make croup better - presuming it's colder outdoors. That's what they were getting at.

I'd go with subglottic edema which is certainly a radiographic finding w/ laryngotracheobronchitis.

Rhinorrhea is another suggestion this kid is suffering from a viral infection rather than bacterial. H.flu wouldn't have that kind of prodrome before **** hits the fan.
 
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ijn said:
I haven't taken the peds nbmes because they came out after my rotation but...

SaO2 of 92% is fairly normal for immediately following vaginal delivery. Cite: http://www.ncbi.nlm.nih.gov/pubmed/16737866

I guess they want you to work up why it's hypotonic. Karyotype to confirm down's... if that's negative then go chasing after zebras like spinomuscular atrophies or other weird **** cite: http://www.macpeds.com/documents/Ne...ewoftheFloppyBaby-BrainandDevelopment2003.pdf

It's definitely recommended that Down's babies get ECG & echo prior to discharge. Not sure what kind of conduction defects you're screening for though...


Cold air can make croup better - presuming it's colder outdoors. That's what they were getting at.

I'd go with subglottic edema which is certainly a radiographic finding w/ laryngotracheobronchitis.

Rhinorrhea is another suggestion this kid is suffering from a viral infection rather than bacterial. H.flu wouldn't have that kind of prodrome before **** hits the fan.
Click to expand...

Thanks. Still don't like that ECG/karyotype answer...
 
Anyone have any thoughts about Lange Q&A?

I plan on doing casefiles, pretest, uworld.
 
VisionaryTics said:
Thanks. Still don't like that ECG/karyotype answer...
Click to expand...


Board certified pediatrician here (and current PICU fellow)

Some thoughts:
1) A sat of 92% is beyond adequate per NRP

2) Your most common major congenital heart defect in Down Syndrome is AV Canal, which has stereotypic EKG findings (extreme LAD in particular)

3) Depending on the actual anatomy of the AV Canal defect, supplemental O2 may actually worsen the condition - if you have an unbalanced canal with preferential pulmonary blood flow, O2 has a potent pulmonary vasodilator in the neonatal period may lead to overcirculation and associated sequelae.

4) For all board exams, whether it's Step 1, Shelf's, or your specialty boards, they want you do the easy things first. Yes, an echo is what you really want, but in reality, even for me where I can call or text the cardiology fellows personally to get what I want, I'm going to go ahead and get an EKG in the meantime almost every time I want an echo. I feel safe telling you that for any board question, if you're thinking echo, you should have an EKG first.
 
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VisionaryTics said:
2. Previously healthy 2yo boy presents with acute fever and inspiratory stridor. Has had rhinorrhea for the last day. Symptoms improve "when mom took him outside to come to the emergency department" [no idea what that is supposed to mean].
Click to expand...

This should be pathognomonic for croup. About as classic of a sign they come.
 
BigRedBeta said:
This should be pathognomonic for croup. About as classic of a sign they come.
Click to expand...

Thanks for the awesome responses.

Took the shelf Friday - 99 (not sure raw or scaled). Blueprints x1, half of pretest, UWorld peds x2 (have finished whole Qbank by now).

Some random qs, but mostly straightforward. 50% ENT. LOTS of ID and vomiting.
 
VisionaryTics said:
Thanks for the awesome responses.

Took the shelf Friday - 99 (not sure raw or scaled). Blueprints x1, half of pretest, UWorld peds x2 (have finished whole Qbank by now).

Some random qs, but mostly straightforward. 50% ENT. LOTS of ID and vomiting.
Click to expand...

Didn't like pretest or didn't have time?
 
Do you think reading the key points of blue prints is a good review before shelf day I have mine friday. Any other sections stressed you think I should read more, possibly ID? Endocrine?
How much puberty and sexual development is on there?
 
DiGeorge said:
I took the same test today.
1. is C
2. is E like the collegues above said
I got these questions right however I got this one wrong and maybe you could help me or somebody else:
A 10 mo girl brought by parents for well child check up. Parents concerned b/c of recent lazy eye development. Born at 38 wks, following an uncomplicated pregnacy and required Oxygen by Nasal cannula for the first day of life. No hx of serious illnes. Vital signs within normal limitis. Examination of the Left eye shows hyphema and esotropia. Conjuctiva is not injectied and there is no discharge. The left pupil appears white on relex testing. The remainder of the exam shows no abnromailties. What is the most likely cause of these findings?
a) congential cataract
b) glaucoma
C) retinoblastoma
D) Retinopathy of prematurity
E) Retintis pigementosa
I put a b/c this is the most common cause of leukocoria but is it D) ROP b/c she required Oxygen?
Click to expand...

Neither... it's C. You won't get O2 toxicity via nasal canula. ROP comes from high flow/ 100% O2. Cataracts are the most common cause of leukocoria, but hyphema and esotropia in an infant are alarm symptoms for malignancy... in this case, retinoblastoma.
 
DiGeorge said:
I took the same test today.
1. is C
2. is E like the collegues above said
I got these questions right however I got this one wrong and maybe you could help me or somebody else:
A 10 mo girl brought by parents for well child check up. Parents concerned b/c of recent lazy eye development. Born at 38 wks, following an uncomplicated pregnacy and required Oxygen by Nasal cannula for the first day of life. No hx of serious illnes. Vital signs within normal limitis. Examination of the Left eye shows hyphema and esotropia. Conjuctiva is not injectied and there is no discharge. The left pupil appears white on relex testing. The remainder of the exam shows no abnromailties. What is the most likely cause of these findings?
a) congential cataract
b) glaucoma
C) retinoblastoma
D) Retinopathy of prematurity
E) Retintis pigementosa
I put a b/c this is the most common cause of leukocoria but is it D) ROP b/c she required Oxygen?
Click to expand...

Few things - Can't be D b/c this baby is not premature (38 weeks = term). Red Reflex is abnormal with other abnormalities? I always consider that Rb until proven otherwise. Cataracts wouldn't cause lazy eye development (not 100% sure about this). I forget what E is.
 
JRjcu08 said:
You won't get O2 toxicity via nasal canula. ROP comes from high flow/ 100% O2.
Click to expand...

While I guess in a very technical sense, this is correct, it's an inappropriate jump in the understanding of the physiology behind ROP. With long term oxygen toxicity being the most common cause of ROP, you do need higher levels of FiO2 than is typically delivered by a standard nasal cannula, the way you stated your answer is incomplete at best.

An FiO2 of 0.6 is generally considered to be a safe level of oxygen, and via a nasal cannula due to intraining of room air, you simply can't reach that level of inspired oxygen with a standard nasal cannula at 2-4 LPM of 100% O2. But still the point should be (particularly in the NICU when many LBW/VLBW preemies remain intubated for weeks) that it's the oxygen delivered, not the device you use to deliver it.

Additionally, as far as the original question goes, a term infant is at almost no risk of ROP (as the vascularization of the retina is generally complete around 36-37 weeks gestation), which should have been the first clue that ROP was an incorrect answer choice.
 
any other schools have only 4 weeks for this rotation? I worked my ass off and barely hit the average...extremely frustrating
 
I don't have a shelf for this rotation, but I want to be able to hold my own on the wards and have a solid working knowledge of peds while I'm on the rotation. What do you think I should read for this purpose? I have access to CF, BP, FA, and CLIPP. Thanks
 
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