Psych Shelf Exam

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Books Preferred for Psych Shelf Exam

  • BRS

    Votes: 2 3.2%

  • Blueprints

    Votes: 15 23.8%

  • Appleton and Lange

    Votes: 16 25.4%

  • Boards and Wards

    Votes: 4 6.3%

  • PreTest

    Votes: 14 22.2%

  • NMS

    Votes: 6 9.5%

  • High Yield

    Votes: 6 9.5%
  • Total voters
    63
  • Poll closed .
skidmark said:
Unlike in A&L, I had absolutely no questions where the answer was a percent (i.e. what percent of schizophrenics commit suicide). A&L was full of those questions so don't worry to much about them.
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Not sure what A&L is, but wondering if people's experience on the shelf is the same? Using Lange and wondering if I should bother committing any of these percentages/statistics to memory?
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My school only offers the 3rd edition First Aid for psychiatry. Should I get the 4th edition in order to do well on the shelf?
 
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xiwang said:
Could use help with questions from the new form 3. Thanks!

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For #1, yeah it's adjustment disorder - he has mood that brightens and isn't quite meeting SIGECAPS + depressed mood to merit SSRI. I put Zolpidem and that was correct.

For #2, I actually think the mom is suffering from bereavement/normal grief. No need for an SSRI, I think First Aid for Psych says you can do Benzos for bereavement if they're having trouble sleeping.
 
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simplicity1 said:
My school only offers the 3rd edition First Aid for psychiatry. Should I get the 4th edition in order to do well on the shelf?
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I only have the 3rd edition for FA for the Psych clerkship as well which is all DSM IV. Anyone have the 4th ed PDF which is updated for DSM V?
Edit: LOL nvm, just saw that the 4th ed isn't being released till June 5th
 
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BlueJay25 said:
I only have the 3rd edition for FA for the Psych clerkship as well which is all DSM IV. Anyone have the 4th ed PDF which is updated for DSM V?
Edit: LOL nvm, just saw that the 4th ed isn't being released till June 5th
Click to expand...
The 4th ed paperback is out.
 
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Anyone take the exam recently? It was trickier than what I expected...but it didn't feel like I could of studied more for it? Felt like a lot of weirdly-written questions that required deciding whether or not something was substance-induced vs medication-induced vs primary disorder based on very little information. However, everything that wasn't tricky like that felt very straightforward compared to other shelves.

Hopefully I did better than I think I did...
 
scruffy821 said:
Anyone take the exam recently? It was trickier than what I expected...but it didn't feel like I could of studied more for it? Felt like a lot of weirdly-written questions that required deciding whether or not something was substance-induced vs medication-induced vs primary disorder based on very little information. However, everything that wasn't tricky like that felt very straightforward compared to other shelves.

Hopefully I did better than I think I did...
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Felt the same. I guess we'll see in a few weeks :/
 
Just got my score back, I ended up doing a lot better than expected! 90% raw score, not sure how that translates to the percentile system (if anyone knows that let me know). Hopefully this is reassuring to anyone who also felt weird after the exam!

For studying, I just went through the psych FA once, UWorld once, did all the questions in PreTest once (but got lazy with reading the explanations for correct answers about halfway through), and in the Lange Q&A book I did the two practice exams and the psychopharmacology chapter. I also did NBME forms 3 and 4 - I would definitely recommend it, because I think that the NBME questions are much more representative of the real exam than the easier questions you see in other sources.
 
Got a 90. Pretty much only used Firecracker. Got through about 20 pages of FA for Psych and the first section of Lange (I think it was child psych). Did NBME 3 and there was 1 repeat... so it's probably worthwhile to do those.
Definitely benefited from having this later during the year and after family medicine rotation.
 
Took the psychiatry shelf exam and recently got the results (100th %-ile; 97 raw)... Would have posted earlier but just now got around to it...

My Impression: I thought the exam was fair for the most part as far as testable content (the breakdown was similar to what is outlined on the NBME website). However, I thought that the questions were incredibly long with some vague descriptions. Some questions required careful re-reading to really understand what was being asked. A few of my classmates were surprised that there were about 8-10 child psych questions (conduct disorder, ODD, ...). There were a few neuro (about 5) questions as well (related to strokes, dementia).

What I used: I used First Aid for Psych (4th edition), uWORLD (about 120 psych questions), and did NBME forms 1 (44/50), 3 (42/50), and 4 (45/50).

I did several passes of FA (my main study resource) and I felt that it had almost all of the basic topics in it. I thought that the questions on uWORLD were very buzzword heavy, but the answer explanations were very detailed and helpful. I thought that the NBME forms were an accurate representation of what the real deal is like (vague question wise...)

My advice: I found it helpful to count the symptoms (SIGECAPS, DIGFAST, and a few other mnemonics from FA) as this would help me narrow down choices (adjustment v. MDD; mania v. hypomania; GAD, ...). I liked the pharm section in FA, but if this is your weak point, you may need an additional resource (especially for common adverse reactions, treatment for EPS symptoms, etc.). I think it would be worthwhile to be mindful of the time frame requirements for each disorder as this helped me narrow a lot of answer choices down. I highly recommend doing at least one of the NBME practice tests as I thought there were a few repeats (not verbatim) on my shelf.

Good luck to all!
 
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This is a reminder to refrain from posting NBME questions or any other copyrighted questions, either in full or partially abbreviated. Doing so is a copyright violation. You may paraphrase questions. Abbreviating words or removing fillers is not paraphrasing.
 
Scored a 92 raw which was at the 99th percentile. Basically followed the advice from this thread for resources. Only used First Aid Psych (2x), Lange Q&A (1x + incorrects again), and Uworld (1x + flagged).

I started reading FA 10 days before the exam and then did a real quick review again starting 3 days before. The second pass goes a lot faster and definitely focus on ALL treatment options, not just first line. Also did Lange (~200/day) starting about 5 days out and then the day before redid all my wrong ones.

I thought the Lange questions were harder than the actual exam and for reference, I was hovering from mid 70's to high 80's on the lange questions by section.

There wasn't a single regarding epidemiology or genetic concordance or psychological testing so I would honestly ignore that stuff in Lange.
 
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This question is for some of the DO students in here. My school gives us the COMAT (basically DO version of shelf). Is it still worth it to take the three NBMEs? I also plan on taking step 2 ck. I am 1 week into my rotation (my very first rotation) and so far I have been reading FA for psych, case files, uptodate, and did some COMBANK questions. I plan on starting UWorld questions from this week. Thanks in advance.
 
ninjaman22 said:
This question is for some of the DO students in here. My school gives us the COMAT (basically DO version of shelf). Is it still worth it to take the three NBMEs? I also plan on taking step 2 ck. I am 1 week into my rotation (my very first rotation) and so far I have been reading FA for psych, case files, uptodate, and did some COMBANK questions. I plan on starting UWorld questions from this week. Thanks in advance.
Click to expand...
All you need is UW and FA for psych. Just those 2 resources got me a 125.
 
Aloha - currently in my final week of the psychiatry clerkship (my first clerkship); have scored a 19 on NBME 1, and a 19 on NBME 3, which correlates with a 73 for each. Is this a decent enough score to head into the shelf exam with? I have zero insight to how this compares with national average, what a passing score is considered, and whether or not I should keep doing what I've been doing or if I should change things. Would appreciate any constructive insight here, thanks so much in advance!
 
Have people encountered EEG strips or Neuroimaging images on the Psychiatry NBME Shelf Exam?
 
Sarvish said:
Is the NBME based on DSM IV or V? I have FA 3rd edition as a PDF but can't find the 4th so wondering if the $50 is worth it
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DSM V for sure and $50 for the FA is definitely worth it.
 
Do people still think NBME 1 is worth it? I was planning to start with 3&4, not sure if I have enough time for all 3
 
Hello,

What are the go to resources to crush the Psych shelf? The majority of my psych grade comes from the shelf so I need to ensure I do very well on it.

Currently I am planning on

FA Psych
uWorld Psych questions
Lange Questions

do i need to add or remove anything? How long does it take to prep for this exam? thanks
 
Qester said:
Hello,

What are the go to resources to crush the Psych shelf? The majority of my psych grade comes from the shelf so I need to ensure I do very well on it.

Currently I am planning on

FA Psych
uWorld Psych questions
Lange Questions

do i need to add or remove anything? How long does it take to prep for this exam? thanks
Click to expand...
Should be more than enough!

Personally I had lots of great lectures from faculty, and on top of that I used "Clinical Psychopharmacology Made Ridiculously Simple" (probably better for residents, but still a fantastic and very brief resources for psych drugs) as well as UWorld+incorrects, and NBME 3+4. I did not use FA or Lange.

Shelf score was 87 (~92nd percentile)
 
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Hey guys, so is it worth getting the 4th edition of FA Psych? Or is the 3rd edition sufficient?
 
Anyone have any thoughts on these

38. A 24-year-old woman reports a 3-week history of recurrent fevers. She has a 4-year history of major depressive disorder. Her temperature is 42°C (107.6°F), pulse is 80/min, respirations are 14/min, and blood pressure is 110/70 mm Hg. Physical examination is otherwise normal. Her leukocyte count is 7500/mm3with a normal differential. Liver function tests and serum creatine kinase activity are normal. Which of the following is the most appropriate next step in patient care?

A. administer broad spectrum abx
B. administer corticosteroids
C. Obtain rectal temperature
D. Order bone marrow biopsy
E. Order CT Scan of abdomen

I ruled out A due to normal temperature and no leukocytosis. C didn't make any sense. I ruled out NMS and 5-HT syndrome from the LFTs and serum CK. I figured it was E, pheochromocytoma, but that was wrong.

40. A 23-year-old man is brought to the physician by his mother because of increasing conflict between the two of them over the past 6 months. She says that he has become more difficult because of his growing concern about neighbors who he believes abuse the welfare system. He says that he has had special abilities to predict the future since the age of 15 years, but no one in his family believes him. His mother says that he has never had many friends and describes him as a loner. He has not used any drugs. He has not felt sad or depressed and has had no recent change in appetite or sleep disturbances. Physical examination shows no abnormalities. His language is vague and stilted. Which of the following is the most likely personality disorder in this patient?

A) Antisocial
B) Avoidant
C) Borderline
D) Histrionic
E) Narcissistic
F) Obsessive-compulsive
G ) Paranoid
H) Schizoid
I) Schizotypal

Is this Schizoid? I put Paranoid (G) but it was wrong.
 
For the first one, I could be totally off, but I think the answer is check a rectal temp. Her physical exam would not be normal if she had a 107.6 temp. Also her labs reveal no infectious process. Rectal temp in office is most accurate so I think that's what you're supposed to do. It's implying she's faking her sx. For the second one I was thinking schizoid but it could be schizotypal because of some of the paranoia/delusional belifs I think.
 
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supermario21 said:
For the first one, I could be totally off, but I think the answer is check a rectal temp. Her physical exam would not be normal if she had a 107.6 temp. Also her labs reveal no infectious process. Rectal temp in office is most accurate so I think that's what you're supposed to do. It's implying she's faking her sx. For the second one I was thinking schizoid but it could be schizotypal because of some of the paranoia/delusional belifs I think.
Click to expand...

I'd lean more towards schizotypal for the second.
 
Any specific tips on how to approach studying for the medicine/neuro questions on this shelf? I haven't had medicine or neuro yet. Is there a specific resource you found helpful for medicine/neuro questions or material review on this shelf? Much appreciated!
 
Equated score: 93

Resources used: NBME 1&2, FA Psych (old edition with DSM IV x1, new edition with DSM Vx2), Lange Questions

Did not study any extra resources for the IM/neurology portions. I felt like there were only a handful of each and you can reason your way through them. I've had the IM rotation already which helped, haven't had neuro yet.
 
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How you guys/gals know your percentile score? My school gives me a raw score and an adjusted score...

Can anyone tell me what percentile an 82 raw score is?

I thought I did better... Oh well!
 
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82 is 75th percentile, according to this link (which has corresponded to all of my shelf scores and percentiles reported by my school)
 
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For personality disorder questions, should I memorize the criteria/at least how many warrants the diagnosis of a particular personality disorder... or is it pretty obvious?
 
apr27 said:
is lange pretty easy to get through?
Click to expand...
Lange is pretty easy to get through in my opinion. The questions are brief (in comparison to UW) and the explanations are medium-length and good. You could easily blow through more than 100 in an hour probably.

chickensoupdr said:
For personality disorder questions, should I memorize the criteria/at least how many warrants the diagnosis of a particular personality disorder... or is it pretty obvious?
Click to expand...
In the DSM-V, you could get really nitty gritty if you want, but if you just memorize the highlights of each personality disorder, they'll jump out at you pretty easily in questions. Just know the difference between some of them that could trip you up like narcissistic vs. histrionic. What I thought was more important is how to differentiate a personality disorder from an entirely different diagnosis like schizotypal vs. schizophrenia, paranoid personality disorder vs. delusional disorder, e.t.c

Shelf Score: 99th percentile
Resources: UW, FA, Lange Q&A, and OME
I answered all the UW and Lange questions once, and then reviewed my quite detailed notes 2-3 times for both. I read FA front to back twice and also referenced it often while on rotation or while reviewing questions. OME listened to while driving 2x, not too great since I felt like it was outdated at the time (they just updated it though)
Tips:
-Do the NBME exams because they use some terminology on them that they replicated on the real shelf (eg, function of nucleus basalis of meynert, I would've missed that question immediately on shelf if I hadn't seen that answer choice on the practice NBME)
-I had quite a few questions asking me to discern between somatic symptom disorder, illness anxiety, factitious, e.t.c (seriously like 7-8)
-Not too much specific neurology related questions on mine; just know your dementias well (had not taken neurology rotation yet)
-Know how to recognize FAS vs. Fragile X syndrome vs. Down syndrome on a baby/child
-Know your drug mechanisms and famous side effects
-Follow the DSM main criteria as precisely as you can (eg, count out how many of SIGECAPS that person fulfills before YOLO putting down MDD as your answer)
-If some dude got placed on a drug recently and now has some mental disorder, don't put down MDD or whatever, the answer is substance-induced mood disorder

Hope this helps!
 
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thanks for the helpful posts. quick question

if someone appears acutely manic to the hospital (bipolar) what is the treatment? On some Q banks it is lithium, on others it is other mood stabilizers, and others it is antipsychotic... what if they are bipolar and come depressed? is it an antipsychotic?
 
I took this about 4 weeks ago, but I have a short break before 4th year starts, so I thought I'd add a few of my shelf experiences from this year.

For resources, I used:
-First aid psychiatry (1 pass, but made Anki cards from it)
-uWorld (1 pass plus incorrects)
-Firecracker
-Online MedEd
-3 practice NBMEs (1 - 48/50, 3 - 50/50, 4 - 49/50)
-Lange questions (fairly low yield in my opinion, but very quick to get through if you have time)

I actually didn't feel fantastic coming out of the test. Some of the questions are oddly worded or more vague than you see in uWorld. However, I did feel like it was one of the "easier" shelf exams, if there is such a thing. I will second what some others said on tips:
-Know your psych meds! Be able to identify what they took based on side effects they had, know mechanisms (particularly antipsychotics), and obviously, know what drugs treat what (and what you use for side effects of antipsychotics).
-Know your toxidromes! Lots of questions on both prescription and illicit drugs.
-The neuro is basic enough that what's in FA will suffice - I had psych before neuro and the small handful of neuro questions on the psych shelf I was able to answer from the dementia chapter (I actually think it was more helpful to have psych first for the neuro shelf)
-Know your DSMV criteria to the extent that you can differentiate things based on number symptoms (do they meet 5 of SIGECAPS?) or timing (brief psychotic vs schizophreniform vs schizophrenia) and normal grief vs depression
-I didn't have many personality disorder questions, but they were all fairly obvious
-Know your not-actually-sick disorders like somatic symptom, factitious, malingering, conversion disorders - the key here is to identify if the person is doing it on purpose and what they are getting out of it

Final score: 97 raw. Our school doesn't issue percentiles but my score report says the recent mean was 80 with an SD of 8.
 
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Dr Blue said:
thanks for the helpful posts. quick question

if someone appears acutely manic to the hospital (bipolar) what is the treatment? On some Q banks it is lithium, on others it is other mood stabilizers, and others it is antipsychotic... what if they are bipolar and come depressed? is it an antipsychotic?
Click to expand...

Way late to the party, but the answer is anti psychotic. Lithium takes time to work. If they are bipolar and depressed depends if they are being admitted or not (SI, unsafe to leave) but the same rules apply
 
doyouhaveaflag said:
I took this about 4 weeks ago, but I have a short break before 4th year starts, so I thought I'd add a few of my shelf experiences from this year.

For resources, I used:
-First aid psychiatry (1 pass, but made Anki cards from it)
-uWorld (1 pass plus incorrects)
-Firecracker
-Online MedEd
-3 practice NBMEs (1 - 48/50, 3 - 50/50, 4 - 49/50)
-Lange questions (fairly low yield in my opinion, but very quick to get through if you have time)

I actually didn't feel fantastic coming out of the test. Some of the questions are oddly worded or more vague than you see in uWorld. However, I did feel like it was one of the "easier" shelf exams, if there is such a thing. I will second what some others said on tips:
-Know your psych meds! Be able to identify what they took based on side effects they had, know mechanisms (particularly antipsychotics), and obviously, know what drugs treat what (and what you use for side effects of antipsychotics).
-Know your toxidromes! Lots of questions on both prescription and illicit drugs.
-The neuro is basic enough that what's in FA will suffice - I had psych before neuro and the small handful of neuro questions on the psych shelf I was able to answer from the dementia chapter (I actually think it was more helpful to have psych first for the neuro shelf)
-Know your DSMV criteria to the extent that you can differentiate things based on number symptoms (do they meet 5 of SIGECAPS?) or timing (brief psychotic vs schizophreniform vs schizophrenia) and normal grief vs depression
-I didn't have many personality disorder questions, but they were all fairly obvious
-Know your not-actually-sick disorders like somatic symptom, factitious, malingering, conversion disorders - the key here is to identify if the person is doing it on purpose and what they are getting out of it

Final score: 97 raw. Our school doesn't issue percentiles but my score report says the recent mean was 80 with an SD of 8.
Click to expand...

93 is a 99th percentile so you would be 100% most likely. Firecracker or FA + uworld is enough for this exam but doing the nbme's can be helpful for sure
 
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I've heard first aid psych + UWorld is enough.. how true is this?
 
chromuffin said:
Psych clerkship or just first aid step 2 CK
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IMO, FA for the Psychiatry Clerkship. That and UWorld are good enough even if you don't get sufficient bread and butter general psych experience from your rotation
 
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