Psych Shelf Exam

[byaaaaaaah23]

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[Mr. Mojo Risin]

My thoughts in quote, let me know if you agree!

Agreed. That's what I would've put.

 

[purpledragon1]

My thoughts in quote, let me know if you agree!

Agreed. That's what I would've put.

I agree with you both! Thanks for the help.

Also, is there a list of childhood disorders we should know about? It seems like fragile X, fetal alcohol syndrome, and others aren't discussed very much during psych but they seem to come up a lot on the NBME questions. Does anyone have a list of childhood disorders that can show up but aren't discussed in FA?

 

[Mr. Mojo Risin]

I agree with you both! Thanks for the help.

Also, is there a list of childhood disorders we should know about? It seems like fragile X, fetal alcohol syndrome, and others aren't discussed very much during psych but they seem to come up a lot on the NBME questions. Does anyone have a list of childhood disorders that can show up but aren't discussed in FA?

Have you checked out Online Med Ed psychiatry and pediatrics sections yet? I really like his videos and I've been doing well on UWorld so far, with the disclaimer that Psych and Neuro are typically my 2 best subjects. I also read a couple other resources like Boards and Wards and FA Wards. They're quick reads and are good at highlighting the important topics.

 

[Bully Ball]

Didn't try that hard because the shelf is only worth a small percentage at my school and I was fairly certain I did well on the faculty evaluation so I studied for maybe a week before the shelf

Got a 73% equated score

FA: 1/4
OME: 2x
Emma Holliday: 2x
Uworld: 1x
Lange: 1/3

Definitely know your neurology (step 1 is enough) and know pediatric/congenital disorders . MTB2 is definitely NOT enough. I felt that most of the information present in OME/Emma Holliday/Uworld was enough to "pass"

FYI my shelf was still DSMIV (answer choices still had disorganized/catatonic/paranoid/etc schizophrenic) and I took it October 2nd. Good luck to everyone!

 

[Mr. Mojo Risin]

Didn't try that hard because the shelf is only worth a small percentage at my school and I was fairly certain I did well on the faculty evaluation so I studied for maybe a week before the shelf

Got a 73% equated score

FA: 1/4
OME: 2x
Emma Holliday: 2x
Uworld: 1x
Lange: 1/3

Definitely know your neurology (step 1 is enough) and know pediatric/congenital disorders . MTB2 is definitely NOT enough. I felt that most of the information present in OME/Emma Holliday/Uworld was enough to "pass"

FYI my shelf was still DSMIV (answer choices still had disorganized/catatonic/paranoid/etc schizophrenic) and I took it October 2nd. Good luck to everyone!

What was your UWorld % if you don't mind me asking?

 

[Bully Ball]

What was your UWorld % if you don't mind me asking?

87% tutor mode

The questions on my shelf were similar or harder than U-world, but as always, reading and understanding the answers are gold. If you know the answers/OME/Emma Holliday I can't imagine anyone not passing...but for a HP/H you'll likely need to do more if the shelf is heavily weighted at your school

 

[tsx09]

If you know the answers/OME/Emma Holliday I can't imagine anyone not passing...but for a HP/H you'll likely need to do more if the shelf is heavily weighted at your school

I agree with this, what you posted should be enough to pass.

My score: 74 with new scale
-Online Med Ed audio once, did the pharm lecture twice
-Emma Holliday's review (made notes and reviewed those once)
-Lange Q&A first half of the book

So, that's what I would consider the minimal amount of effort and it did get me a score to match.

Be sure to know what's "normal." Is this kid normal or are you going to diagnose them with something? Same thing for normal vs. pathological aging.

Be able to tell acute stress disorder, PTSD, adjustment disorder, bereavement, major depression, and any other similar conditions apart. I feel like I had 10 questions on that alone. All of these people will have some sort of inciting incident, it's not super cut-and-dry.

 

[Apoplexy__]

Answers in blue.

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[Mr. Mojo Risin]

I think the time frame of symptoms is also a bit shorter in duration than what would be expected (and required) for a diagnosis of somatization disorder.

 

[Freddie Mercury]

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Sounds like general anxiety disorder (persistent worry about everything, > 6 months). Since there are no SSRI's on the answer choices, Buspirone would be my guess.

 

[byaaaaaaah23]

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1) amitryptyline for its anticholinergic effects. can precipitate delirium in the elderly
2) need to d/c clozapine due to agranulocytosis
3) propranolol is the go-to for performance anxiety related to specific situations, ie a presentation or a public speaking event. SSRIs are for more general situations (not sure what a good example would be).

 

[blueshockey]

Just took this shelf today. I'm not really sure what to think about it; some questions were pretty much a slam dunk but others I found myself asking "how could you possibly be this picky"? Definitely about 10-15 I wasn't comfortable with and of those I KNOW I got 5-6 wrong, so I'm reaaallllyyy praying that the curve works out in my favor and isn't as harsh as it has been before. I'll update this when I get my score back (which I've heard can take up to a month...lovely). My prep was FA psych, uworld, onlinemeded, and lange Q&A. For the love of god, know your adjustment vs bereavement vs MDD people, it honestly cannot be said enough.

 

[kcuh128]

Took the exam 11/20. Found the exam to be relatively straight forward with your typical handful of off the wall questions. Scaled score was 94

Resources (Order from most helpful to least)

1. Lange Q &A--VERY strong psych pharm section. Skipped the psychology theories (Erickson, etc.). These questions most reflected the NBME style.
2. First Aid for Psychiatry Clerkship--very concise and easy to read. While it written with DSM IV Text Revision, the NBME still uses DSM IV so no worries.
3. Practice NBME's--I feel if you do these before the exam, you are bound to get +/- 2 questions which you wouldn't have otherwise. In particularly it reminded me to know the differences between Adjustment disorder vs. MDD vs. Bereavement, as well as intoxication/withdrawal symptoms.
4. Pretest--I didn't find pretest as helpful as other clerkships.
5. UWorld--too straightforward and not enough intox/withdrawal questions.

 

[seminoma]

2) need to d/c clozapine due to agranulocytosis

You know this for sure? If the diff is normal his ANC is above the 1500 cutoff (1650). Haven't done the NBME yet, but I like add lithium for that question. Lithium has augmenting effects.

 

[DrKhan1]

Also, the one about the first year surgical resident who can't sleep because of anxiety and not reading enough + weight loss, avoiding social activities. I'm confused between starting escitalopram (since his life is being affected by his symptoms) or OTC diphenhydramine. Or possibly reassurance?

 

[dartmed]

You guyz,

So Psych is like next week. I typed out all of FA into my own notes, reviewed it like 3x, doing Uworld, Lange Q and A, reviewing some of the Step I sections in FA. Planning on taking the NBME's. Anything else you would recommend? I don't know if I will have much time to add more resources, tbh.

I really need like at least a 87 to HP at my school. It's worth like 40% of our grade (and that's with H my clinical evals). Bleh.

 

[blueshockey]

Just took this shelf today. I'm not really sure what to think about it; some questions were pretty much a slam dunk but others I found myself asking "how could you possibly be this picky"? Definitely about 10-15 I wasn't comfortable with and of those I KNOW I got 5-6 wrong, so I'm reaaallllyyy praying that the curve works out in my favor and isn't as harsh as it has been before. I'll update this when I get my score back (which I've heard can take up to a month...lovely). My prep was FA psych, uworld, onlinemeded, and lange Q&A. For the love of god, know your adjustment vs bereavement vs MDD people, it honestly cannot be said enough.

You guyz,

So Psych is like next week. I typed out all of FA into my own notes, reviewed it like 3x, doing Uworld, Lange Q and A, reviewing some of the Step I sections in FA. Planning on taking the NBME's. Anything else you would recommend? I don't know if I will have much time to add more resources, tbh.

I really need like at least a 87 to HP at my school. It's worth like 40% of our grade (and that's with H my clinical evals). Bleh.

Got my grade back this week, raw score of 89 which ended up being in the 94th percentile. I ended up doing FA x3, uworld, lange Q and A (ignoring some of the more BS questions), as well as doing both NBMEs, pretty much exactly what you are doing. My advice would be really knowing timelines (i.e. brief psychotic-->schizophreniform-->schizophrenia ect.) as well as MDD vs adjustment vs bereavement and really driving home that there can be organic causes of depression. I actually had a few more neuro-focused questions on my exam than I was expecting (5ish); pretty much the only reason I knew these was because my school does it so you end up taking the psych shelf one day and neuro shelf the next so I was prepared for both. Knowing the dementias would be helpful here (alzheimer's, frontotemporal, etc). The vast majority of it was bread and butter psych but I definitely would recommend reviewing psych drugs in addition to relevant neuro drugs in FA with a lot of emphasis on side effects and knowing what class they're actually in (this seems obvious enough but one of the lesser known typical antipsychotics showed up three different times on my exam and I had completely forgotten about it). I felt like the exam was tough but fair; case in point, if someone only has four of SIGECAPS, the answer won't be MDD, I know I shot myself in the foot a few times. Good luck everyone

 

[byaaaaaaah23]

You know this for sure? If the diff is normal his ANC is above the 1500 cutoff (1650). Haven't done the NBME yet, but I like add lithium for that question. Lithium has augmenting effects.

Pretty sure but can't say for 100% as I took this one a little while ago. The rule of thumb I always used for assessing for agranulocytosis from any drug was really any major drop in white cells and I don't think it ever steered me wrong. Never bothered to learn exact criteria but if he doesn't meet them then

 

[byaaaaaaah23]

You guyz,

So Psych is like next week. I typed out all of FA into my own notes, reviewed it like 3x, doing Uworld, Lange Q and A, reviewing some of the Step I sections in FA. Planning on taking the NBME's. Anything else you would recommend? I don't know if I will have much time to add more resources, tbh.

I really need like at least a 87 to HP at my school. It's worth like 40% of our grade (and that's with H my clinical evals). Bleh.

I thought Lange was the most helpful provided you already know the timelines as someone above said. Definitely wouldn't add any more resources at this point.

 

[dartmed]

@blueshockey @lostintranscrip - thank you so much you guys!!!

Starting my second review of FA tomorrow. What did you guys think about Chapter 4 of Lange? Some said to skip it as it was a lot of...BS along with the legal crap stuff in one of the other chapters. I might do Chapter 4 and skip the legal crap thing.

 

[seminoma]

Pretty sure but can't say for 100% as I took this one a little while ago. The rule of thumb I always used for assessing for agranulocytosis from any drug was really any major drop in white cells and I don't think it ever steered me wrong. Never bothered to learn exact criteria but if he doesn't meet them then

Just did this NBME last night and you're right. Looked up the guidelines and WBC 2000-3000 is indication to dc clozapine until WBC rebounds. Plus this guy has "flu-like" symptoms, concerning for neutropenia.

 

[redfish99]

I think people are sometimes thrown off by how much "medicine" is on this test, I didn't think it was an overwhelming amount but I did think there was some emphasis on more "hard science" type stuff and less psychology.

 

[dartmed]

Ok, someone explain this to me:

One of the questions on the practice NBME was about an alcoholic. They initially gave him diazepam for some tremors (assuming from EtOH withdrawal) but later on patient developed even more tremors. So, the options what do you do next:

1) Haldol
2) Give more diazepam
3) Flumanezil


I chose haldol because patient's an alcoholic and diazepam is metabolized by the liver. I assumed his liver was crap and didn't want to stress out even more. Or do you think it might flumanezil?

 

[dartmed]

Also, my school provided us with a paper NBME. If I missed a total of 5 out of 50, roughly what does that translate to? Anyone have an idea? Love you and thank you all!

 

[byaaaaaaah23]

Just did this NBME last night and you're right. Looked up the guidelines and WBC 2000-3000 is indication to dc clozapine until WBC rebounds. Plus this guy has "flu-like" symptoms, concerning for neutropenia.

Sounds good. Low white count and presenting w/ infection = dc clozapine as first step. Next step would I guess be find another antipsychotic.

 

[dartmed]

Took this beast today. I don't think Psych was easy as most people make it out to be. I found myself counting the criteria more than once, making sure that they fulfilled it for whatever illness. There were MANY tricky questions that were extremely vague and that was the hard part. There were some that you just had to take a guess on that weren't covered in FA or Lange or Uworld, and that's to be expected. A LOT of my peers walked out of the test feeling that they did amazing, and right after they started talking, they realized they didn't notice the timing or the exact criteria for a certain illness, so be VERY careful! I had like 14 mins to spare on the real deal. On practice NBMEs, I usually had about 25 mins to spare.

Definitely do Uworld, Lange, FA (this is the BIBLE). Know the criteria, know the things that would distinguish this illness vs another. Know the pharm how to treat the conditions and the neurotransmitters invovled. Multiple questions on illicit drugs. I wish I had spent far more time on it, but I know I missed two of them here just from like sheer overthinking it. And missed a neurotransmitter question that wasn't really covered in FA or Lange. Know your normal developmental milestones. Do the NBMEs.

My NBME scores: 86 - 94th percentile, 88 - 96th percentile.

I expect to do a little bit lower on the real deal because I know I missed 4 for sure, but hopefully the curve is more lenient.

Good luck!!

 

[seminoma]

Took this beast today. I don't think Psych was easy as most people make it out to be. I found myself counting the criteria more than once, making sure that they fulfilled it for whatever illness. There were MANY tricky questions that were extremely vague and that was the hard part. There were some that you just had to take a guess on that weren't covered in FA or Lange or Uworld, and that's to be expected. A LOT of my peers walked out of the test feeling that they did amazing, and right after they started talking, they realized they didn't notice the timing or the exact criteria for a certain illness, so be VERY careful! I had like 14 mins to spare on the real deal. On practice NBMEs, I usually had about 25 mins to spare.

Definitely do Uworld, Lange, FA (this is the BIBLE). Know the criteria, know the things that would distinguish this illness vs another. Know the pharm how to treat the conditions and the neurotransmitters invovled. Multiple questions on illicit drugs. I wish I had spent far more time on it, but I know I missed two of them here just from like sheer overthinking it. And missed a neurotransmitter question that wasn't really covered in FA or Lange. Know your normal developmental milestones. Do the NBMEs.

My NBME scores: 86 - 94th percentile, 88 - 96th percentile.

I expect to do a little bit lower on the real deal because I know I missed 4 for sure, but hopefully the curve is more lenient.

Good luck!!

Lucky. I was supposed to take it on Friday too but the NBME site crashed.

How did you get those percentiles for the NBME scores? I did both the NBMEs, but didn't get any percentile info.

 

[dartmed]

Lucky. I was supposed to take it on Friday too but the NBME site crashed.

How did you get those percentiles for the NBME scores? I did both the NBMEs, but didn't get any percentile info.

We did too!! We had to wait for almost 2 hours to get our test going! Lol.

I don't know. I am a little nervous about how I did. I know I missed four questions for sure, but I don't know how many more I missed. Here's the link that I found that was pretty accurate.

https://www.ttuhsc.edu/som/documents/policies/SOMOP30.01.A.pdf

 

[blueshockey]

We did too!! We had to wait for almost 2 hours to get our test going! Lol.

I don't know. I am a little nervous about how I did. I know I missed four questions for sure, but I don't know how many more I missed. Here's the link that I found that was pretty accurate.

https://www.ttuhsc.edu/som/documents/policies/SOMOP30.01.A.pdf

Hmmm that's pretty bizarre, I guess different schools use different percentiles for rotations. I had a raw of 89 but scored in the 94th percentile, the lowest percentile on that list is 97th percentile

 

[Wailea]

Just got my score (92). The test had a mix of fairly straightforward questions as well as some that were tricky but not impossible to decipher. Some felt like medicine but I expected that. I also recall some DSM IV diagnoses showed up on my exam. It's important to know what's normal and time periods of conditions.

I went though Lange during the rotation and found it very helpful during the exam. I also read through FA twice which is easy to get through and easy to recall during the exam. My program also provided us with a question bank specific for the psych shelf exam (ExamGuru) which I found to be very reflective of what I got on my exam. They had about 400 questions with thorough explanations. They have free questions on their site and I feel this will become a go to qbank for the shelf.

Overall, it's a fairly straightforward exam if you put in the time. Good luck!

 

[SIGNR1]

Made 86, did all of FA once, reread some tricky parts/margin boxes twice, did UWorld once, did almost all of Lange and about 50 pretest questions before running out of time. Did both NBMEs, first was 80 and second was 73, did them within 3 days of the exam. Best resources to me are FA and NBMEs. Surprisingly my exam had no personality disorders, coping mechanisms or legal stuff. I saw a lot of that in the question banks though.

 

[dartmed]

Got a 78, which is significantly lower than my practice NBMEs, but 1 SD above the mean. No idea what happened on the real deal. I assume I made some stupid mistakes. The highest in our class was 86. I am currently sitting at a 89% in the Psych Clerkship. Hopefully that's a high pass. Oh well, I tried.

 

[Vomero]

You know this for sure? If the diff is normal his ANC is above the 1500 cutoff (1650). Haven't done the NBME yet, but I like add lithium for that question. Lithium has augmenting effects.

ANC =/= WBC, I think you misread it

 

[seminoma]

Got a 78, which is significantly lower than my practice NBMEs, but 1 SD above the mean. No idea what happened on the real deal. I assume I made some stupid mistakes. The highest in our class was 86. I am currently sitting at a 89% in the Psych Clerkship. Hopefully that's a high pass. Oh well, I tried.

I'm looking at the percentile chart and 78 equated percent score is 54th percentile for quarter 2 (52 for q3). 1SD for your class? Or maybe there is an entirely new chart out now.

ANC =/= WBC, I think you misread it

I didn't misread it. ANC <1500 is the cutoff for d/c clozapine. WBC is <3k. If either is too low, then clozapine is discontinued.

 

[Vomero]

I didn't misread it. ANC <1500 is the cutoff for d/c clozapine. WBC is <3k. If either is too low, then clozapine is discontinued.

Agreed, but the question didn't mention anything about ANC.

 

[seminoma]

Agreed, but the question didn't mention anything about ANC.

Right. At the time of my original post I didn't know there was a WBC cutoff for clozaril (I thought it was only ANC). So I assumed they wanted us to calculate ANC based on normal diff, and 60% PMNs in a WBC of 2750 is >1500. Obviously not the right thought process, but that's where I was going.

 

[Vomero]

US IMG, Equated Percent Correct Score = 83.

Can't say I really studied for this exam, and scored high enough to (barely) honor at my school.
Uworldx2, EHx2, ran through both NBMEs, psych section in FA14, and 2 hours before the exam, the entire FApsych on pdf.

I read this thread, and echo most of the sentiment here. In addition to the above, know your learning disabilities (multiple questions), your SNRIs, ALL sleep disorders, and sexual d/o

 

[seminoma]

Scored in the 94th percentile, but I didn't think the exam was "easier" like everyone says. Obviously scores are higher so it's logical to assume the exam is easier, but whatever. My other shelf scores as a point of reference: IM: ~95th, Neuro: ~95th, FM ~85th.

I did all of the UW psych questions, some of the USMLE-Rx psych questions, and most of the Lange questions (didn't do the practice tests or the ethics questions). Did both NBMEs, but didn't have any repeat questions on the shelf (estimated percent score was ~5 points higher than my NBME scores). Lange was probably the most helpful. As for reading, I did most of FA at least once, ~30 cases in Case Files, and the Emma Ramahi PDF. I don't think I learned anything from FA that wasn't also covered in qbanks/Lange/Case Files.

The exam itself was not as pharm-heavy as I was expecting. I don't think I had any pharm questions that weren't obvious (e.g. first line med for PTSD? patient started on haloperidol and develops bradykinesia and masked facies, what is the neurotransmitter derangement?). Majority of my exam was diagnosing mood disorders and general management questions. There were more sexual disorders and eating disorders than I expected, which contributed to the perceived level of difficulty.

Despite what others have said about diagnostic criteria and timelines, my exam often didn't provide enough definitive criteria and the only way to answer was to rule out all the other answer choices (e.g. diagnose MDD in a patient with 5 SIGECAPS for only 8 days and no prior history).

Also this is news to

 

[Roseyyy]

Ya I noticed above too. Pretty pathetic.

 

[sloop]

I'll add my experience with this exam.

According to that percentile chart cited above, my score is in the "100th percentile" which makes no sense anyway, but whatever. Suffice it to say I did very well.

My suggestions for this exam are:

1) Read FA psych as many times as you have time for, but at least 2-3x. Really, this is the meat and potatoes for the exam. I think it was perfect and I can't say much more good about it.
2) Do Lange Q&A questions. I suggest doing these closer to the test. I knocked them out (except for the ethics chapter, which I skipped) in the last two weeks before the shelf. It worked out well. They're great for teaching concepts. Just don't use them to assess your knowledge base—they suck for that. If you're getting reamed by them, that's really totally fine. Most of them are (in my opinion) so minutiae/detail-oriented/tricky that the questions would, for the most part, never be allowed on a shelf exam. The reason for this is that I think if you asked two well-studied psychiatrists some of the questions you might get two different answers in some cases. Particularly, a lot of the management questions might come down to personal style in the real world. Just read the answers and understand what they're trying to explain by it, because that's what's important. One question was basically "Woman comes in, thinks you're awesome, but then you don't do what she wants and she thinks you're terrible."; answer choices include both splitting and devaluation. This type of question is silly, so don't worry about how you answered. Just know the concepts. You can also time yourself to try to get used to the timing. I think this was somewhat helpful for pacing on the shelf, though a complicating factor is that the shelf has none of those "list" type questions where you pick from the answer bank and which take far less time to complete. For reference if you're freaking out about how you're doing on Lange Q&A, I was getting like 70-80% correct on most of the chapters, despite doing very well.
3) UWorld questions are good, but super easy. I recommend doing these earlier in your rotation. The concepts they test are high yield but very uninvolved.
4) I'll echo that sometimes strict criteria won't get you the right answer on this shelf. There's a lot of "choose the best answer" where it is not really important that all the criteria be met.
5) Tricky areas include: Adjustment disorder stuff—I felt like I really knew this cold going in, but a lot of the presentations were very confusing. Telling the difference between an intense but borderline normal reaction to somebody's marriage ending and an adjustment d/o can be very difficult in some of the questions. Also know that bereavement is possible after any significant loss (i.e. not just a death).

 

[sloop]

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1. C for sure. OCPD is the only one of those options that both causes trouble making decisions and is ego-syntonic. People with OCPD sometimes hoard stuff because they are worried about needing it in the future.

3. C. Pretty sure about this. Sleep deprivation can cause a nystagmus if I'm not mistaken.

4. B. I'm pretty sure they're going for drug toxicity—kid is robotripping. I think this one is kinda unfair though. The only reason I'm fairly confident on this one is that examiners like you to be able to identify kids tripping on dextromethorphan. Febrile kids can also be delirious so in real life this is not an easy question (unless the kid is taking an absolute ton of DXM).

5. C, absolutely. If you have any suspicion that a child is being abused, your next step is to contact the state child protective services. The first step is always making sure the child is safe (i.e. CPS). Any evidence gathering or psychiatric assessment comes after that.

 

[gregoryhouse]

1. C for sure. OCPD is the only one of those options that both causes trouble making decisions and is ego-syntonic. People with OCPD sometimes hoard stuff because they are worried about needing it in the future.

3. C. Pretty sure about this. Sleep deprivation can cause a nystagmus if I'm not mistaken.

4. B. I'm pretty sure they're going for drug toxicity—kid is robotripping. I think this one is kinda unfair though. The only reason I'm fairly confident on this one is that examiners like you to be able to identify kids tripping on dextromethorphan. Febrile kids can also be delirious so in real life this is not an easy question (unless the kid is taking an absolute ton of DXM).

5. C, absolutely. If you have any suspicion that a child is being abused, your next step is to contact the state child protective services. The first step is always making sure the child is safe (i.e. CPS). Any evidence gathering or psychiatric assessment comes after that.

Thanks. I had all these questions narrowed down to 2 options and just second guessed myself too much. I am hoping the real thing is similar in difficulty to the NBME, I got a 23 which according to the NBME is 1 SD above the mean so enough for honors at my institution. All I've done so far is Uworld and MTB 2. I'll probably go through FA psych tonight and tomorrow to get me a little farther from borderline honoring though.

 

[feverfemale]

I think people are sometimes thrown off by how much "medicine" is on this test, I didn't think it was an overwhelming amount but I did think there was some emphasis on more "hard science" type stuff and less psychology.

What do you mean "hard Science " stuff... any examples woudl be appreciated!

 

[greatsurg]

if a patient is agitated(in delirium), and we have both Haloperidol and Risperidone in the option which will be d best answer?

 

[sloop]

if a patient is agitated(in delirium), and we have both Haloperidol and Risperidone in the option which will be d best answer?

I think that in real life, both can be good options depending on the patient. On tests, I've generally always put Haldol for any delirious or psychotic patient who is agitated. Haldol tends to be pretty sedating, which helps with agitated patients.

 

[Dires]

Hey just got my score back. I took it last week.
-Uworldx1 maybe 90%
-pretestx2 but didn't do all the chapters.
-NBME test I think I got better than 45/50.

Ended up 90-99 percentile.
The test: I read last sentence of every question first then browsed stem. Rushed through flagging ones I wasn't sure of and spent extra time on those on my review. Ended up catching a lot of simple mistakes

What really helped me was my actual rotation. I dealt with so much delirium, adjustment versus mdd, asd versus ptsd, schizos and drugs that it got drilled into my head. Hope this helps someone

 

[greatsurg]

I think that in real life, both can be good options depending on the patient. On tests, I've generally always put Haldol for any delirious or psychotic patient who is agitated. Haldol tends to be pretty sedating, which helps with agitated patients.

thank you

 

[greatsurg]

Hey just got my score back. I took it last week.
-Uworldx1 maybe 90%
-pretestx2 but didn't do all the chapters.
-NBME test I think I got better than 45/50.

Ended up 90-99 percentile.
The test: I read last sentence of every question first then browsed stem. Rushed through flagging ones I wasn't sure of and spent extra time on those on my review. Ended up catching a lot of simple mistakes

What really helped me was my actual rotation. I dealt with so much delirium, adjustment versus mdd, asd versus ptsd, schizos and drugs that it got drilled into my head. Hope this helps someone

how helpful was pretest compared to the shelf, you didn't use Lange ?

 

[Dires]

how helpful was pretest compared to the shelf, you didn't use Lange ?

I used Lange. I don't know why I typed pretest