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Psych Shelf Exam

Discussion in 'Clinical Rotations' started by utlonghorn50, 10.19.04.

?

Books Preferred for Psych Shelf Exam

Poll closed 03.30.06.
  1. BRS

    2 vote(s)
    3.2%
  2. Blueprints

    15 vote(s)
    23.8%
  3. Appleton and Lange

    16 vote(s)
    25.4%
  4. Boards and Wards

    4 vote(s)
    6.3%
  5. PreTest

    14 vote(s)
    22.2%
  6. NMS

    6 vote(s)
    9.5%
  7. High Yield

    6 vote(s)
    9.5%
  1. California2000

    California2000

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    Last edited: 06.30.13
  2. heroes31

    heroes31

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    Thanks for the advice! I am debating between getting FA 2nd edition or 3rd edition (difference of 30 dollars). My main concern is that there may be new medications in the 3rd edition that I may miss out on. Is this a legitimate concern?
  3. gravitywave

    gravitywave fourth year

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    Used 2nd ed and did quite well on this shelf, no need to buy later editions until the test and prep materials start to move over to DSM 5 criteria, which could be quite a while. Certainly not this year.
  4. happyfeet123

    happyfeet123

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    Would anyone want to share thoughts on the Kaplan Psych vids? Doesnt seem to be much discussion regarding those in these 9 pages of threads. Much appreciated.Thanks!
  5. FlowRate

    FlowRate Pas De Deux

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    Didn't find FA psych to be sufficient. Much harder than UW Step 2 questions. Very difficult exam. Be time efficient. Good luck.
  6. rshroff08

    rshroff08

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    Sorry to hear that. I am a little nervous now considering my exam is in two weeks. Did you try the self assessments? Did you find those in any way similar to your actual exam?

    I understand you can't reveal too much but was it more difficult because of longer stems or lot of details being tested that weren't in FA?
    Last edited: 07.15.13
  7. FlowRate

    FlowRate Pas De Deux

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    Didn't try self assessments aside from UW questions. 2 weeks is a lot of time if you've already been preparing. We only had a month of psych, total.

    Longer stems, details that seemed more Step-1 ish to me, and more "specific" important information. E.g. if I give you a list of 5 "facts" about a patient, 2 of which are distractors, the 3 you read are relevant and you're not wasting much time. Felt like I was given 10 facts and only 1 or 2 will help you differentiate the answer.
  8. primadonna22274

    primadonna22274 Senior Member

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    I found the psych shelf to be a LOT of medicine, some psychotherapy and theories, and a whole lot of pharm! Know drugs of abuse and toxidromes!
    It's not enough to know just first line treatments--many of my questions went for 2nd and 3rd line or required you to know WHY one of 4-5 possible good choices was the BEST.
    I swear many of the questions had 2-3 good answers. I felt like "WTF?!" after that exam then scored very well. One of my buddies felt the same.
    I think if you're psych-minded you will do well. If not, may be a struggle--but a solid IM foundation will help a lot.
    Oh yeah, review peds developmental milestones as well--I had 2-3 questions on this on my psych shelf (nice table in Blueprints psychiatry for this).
  9. rshroff08

    rshroff08

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    Hoping you did well! Students in my class who took it last month said there were extremely long stems with 10 facts and a list of 10-15 very similar disorders to differentiate between :eek: . I am curious if there is any way to study the minute differences between some of these very similar disorders ... :(. They also mentioned pediatric syndromes, neurology.
  10. rshroff08

    rshroff08

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    I felt like that during the medicine shelf where almost half the questions I had to decided between 3 very good answer choices. Did you feel there were than many questions with 2-3 good answers? I took a self assessment over the weekend and it was somewhat easier than UW with no questions in neurology, pediatric or toxidromes whatsoever. I feel they are not representative of the exam at all ...

    Also, we need to know psychology theories? Like Jung, Skinner, Freud? :scared:
    Last edited: 07.16.13
  11. primadonna22274

    primadonna22274 Senior Member

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    I recall about 20 questions were the type that had a few reasonable answers...but obviously one was "best". I must have guessed correctly a lot because I got around a 97. I did NOT expect that at all when I came out of the exam even though I do have a psychiatrically-inclined mind (wait, that could be misconstrued...)
    I think a couple questions on theory. Just know the basics.
  12. rshroff08

    rshroff08

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    Wow, that's phenomenal! I am definitely going to look up the BP table. I wish there was a good table for toxidromes (organophosphates vs lead vs arsenic etc). Thanks for the info!
  13. primadonna22274

    primadonna22274 Senior Member

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    Oops typo 87 not 97...still well above passing and happy.
  14. rshroff08

    rshroff08

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    That's still amazing! I hope I get above 70. My self assessments were 75+ but those seem much easier than what the actual exam might be.
  15. FlowRate

    FlowRate Pas De Deux

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    Congrats!

    I scored approximately the national average. Which means I probably won't get "high honors" in my course (we have to score >75%ile for HH). Glad I didn't tank the exam tho. I was freaking out afterward.

    >I am curious if there is any way to study the minute differences between some of these very similar disorders

    There is. I'll give an example.

    Anxiety disorders:
    GAD: Worrying most days, often, with physical arousal symptoms. My gestalt for GAD is a person who "freaks out" about little things every single day.
    Panic DO: Random, extremely frightening "panic attacks" (physical arousal/anxiety) symptoms, causing the person to fear future PA's. Gestalt being someone who is afraid to leave the home because their panic attacks have been getting worse. No identifiable cause.
    Social AD: Has panic attacks in specific social situations, recognizes that it's related to social situations and that it harms social function. This can be hard to distinguish from panic DO but is most easily done by asking the person what they fear and what causes their panic--the gestalt is someone afraid of looking nervous when they meet new people.

    As you can see, all of these disorders (and there are others in the anxiety spectrum) can be hard to tease apart. Each one, though, has an identifying characteristic GAD = tons of worry PanicDO = random/eventual agoraphobia SocialAD = nervous about looking nervous around new people.

    The minutia there are core beliefs and specific presentation of symptoms. Other diagnostic criteria require differentiating based on how long the disease has been going on (weeks/months/years), how long it took to start, etc.

    This is why I'm now convinced it's far more beneficial to do a Consult-Liaison (CL) rotation if you just want to do well on the shelf--they are the ones who are more concerned with medial aspects and precise DSM criteria. My inpatient locked ward rotation focused on multimodality treatment, treatment alliance, psychoanalytic concerns, why the DSM is unhelpful, etc. Not good for someone about to take the shelf, but excellent for someone interested in psych.
  16. happyfeet123

    happyfeet123

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    Anybody know if there is a downloadable version of the psych practice nbme shelf exams out yet? similar to those with with USMLE? Havent had much luck on google. If you know, PM or paste here please!
  17. waitlist22

    waitlist22

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    Took this thing on Friday. Just a heads up that First Aid doesn't cut it for this shelf, granted I didn't use the newest FA. I can't comment on what would other resources you need but if you are planning on just using FA I would supplement with something else. You can definitely pass with it but if you are looking for a good/great score definitely use an additional resource. Know diagnostic criteria, review not only psych drugs but neuro drugs as well, decently long stems but nothing too crazy, mostly straightforward questions (no wtf questions really).
  18. happyfeet123

    happyfeet123

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    how important would you say legal and ethical issues are for the exam? (theres an entire chapter in lange but doesnt seem to be stressed in my clerkship)
  19. waitlist22

    waitlist22

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    I didn't think it was terribly important from what I can remember, a lot of it common sense. I would probably know criteria for inpatient admission and end of life type situations but really don't recall any specific questions on ethics or legal issues.
  20. soccerboy2288

    soccerboy2288

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    Does anyone know where I can find solutions to the NBME self assessment exams (Specifically form 2)? If not any help would be appreciated for these questions:

    Man comes in at the request of his superiors 1 week after he witnessed a terrorist bombing and 3 of his fellow police officers were killed. Since then, felt emotionally numb, unable to enjoy activities, requested assignments far removed from the site. Has trouble with sleep. He has been drinking 2-3 beers for the past week (usually only 2 nightly). He is irritable and says he is not depressed. He tells the physician "They made me come. I'm not interested in talking with anyone. I just want to spend time with my buddies and be left alone." Most appropriate initial step in management?
    A: encourage Px to discuss the trauma in detail
    B: Provide info about the range of reactions to trauma
    C: Recommend group therapy with other trauma survivors (wrong)
    D: Recommend 1 month medical leave of absence from active duty
    E: Rec. physician-led trauma debriefing series
    F: Recommend a 12step program
    G: Begin clonazepam
    H: Begin Fluoxetine

    Patient basically has Sx of PTSD like above. Her job is in jeopardy because she is required to travel in flights (the trauma was due to a plane crash). He is already on clonazepam and paroxetine. In addition to continuing these drugs, which is the most appropriate next step in management?
    A: Rec. patient switch to a job that doesnt require air travel
    B: Start CBT
    C: Start group therapy (wrong)
    D: Start Psychodynamic psychotherapy
    E: Add quetiapine
  21. soccerboy2288

    soccerboy2288

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    25yo women who is 16weeks gestation has crying epidoes, decreased energy, difficulty sleeping, loss of appetite for the past 6 weeks. Has history of MDD. Family is concerned she might inadvertently harm self or her fetus. Husband says she lost interest in daily activities. No Suicidal thoughts. She is concerned about her ability to take care of a newborn and is questioning her decision not to terminate the pregnancy. Which is the best next step?
    A: Reassurance with return visit in 2 weeks (Thought this was the answer if this is postpartum blue, but wasnt sure since she is still pregnant, and will be pregnant in 2 weeks)
    B: Explain risks and benefits of antidepressant therapy
    C: Explain risk vs benefit of therapeutic abortion
    D: Support group Therapy (Wrong answer)
    E: Admit to hospital
  22. RectalProlapse

    RectalProlapse

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    B: Provide info about the range of reactions to trauma

    B: Start CBT
  23. RectalProlapse

    RectalProlapse

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    B: Explain risks and benefits of antidepressant therapy

    She is past the first trimester so it is appropriate to discuss the risks and benefits of her therapeutic options, because she is obviously depressed, and this could worsen after the baby is born. Abortion is never the answer, and hospitalization is wrong bc she's not actively suicidal. She meets the criteria for MDD so just reassurance may not be enough for this patient.
  24. PinkLithe

    PinkLithe

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    is A&L seriously that good prep for this shelf? I'm doing the pharm section and I'm getting annihilated. It is incredibly nit-picky, asking you to know the different S/E profile of each SSRI, which TCA causes the most orthostatic hypotension, what a neuroleptic's exact receptor actions are etc.

    if this is a good chunk of the shelf I am totally effed
  25. soccerboy2288

    soccerboy2288

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    Thank you for your help!

    What exactly does "Provide info about the range of reactions to trauma" accomplish?? I guess I just don't understand why that is the next best step for PTSD... Is it to convince him that he could be helped/treated? :confused:
    Last edited: 08.04.13
  26. beatsbydre

    beatsbydre

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    is Uworld necessary for this test? I'm just using First Aid/CaseFiles/Lange?
  27. soccerboy2288

    soccerboy2288

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    Also, a few pages back someone said the answer to this is C because they got it correct, but I put C and got it WRONG. I guess you cant give him the diagnosis of delusional disorder because he is/was psychotic (says had a psychotic episode) and because the delusion is bizarre (DSM-4 says delusional d/o = fixed, non-bizarre delusion).

    So I think the answer is D? thats the only one that can have psychotic episodes, besides Bipolar. But there is no clue for manic episodes given. Anyone want to chime in?
  28. thotsaaief

    thotsaaief

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    I put D and it was right.

    NBME 1...real thing can't be that easy, from what everyone's said.
    NBME 2...so screwed if that's similar to the shelf haha.
  29. soccerboy2288

    soccerboy2288

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    Thanks! Didn't do form 1, but yeah screwed if its like form 2. I take my shelf tomorrow so I'll report back
  30. Rebs28

    Rebs28

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    My score on the shelf was definitely lower than my score on NBME 1. The shelf was not as hard as NBME 2, but I thought it was definitely worth it to take this practice exam.

    For future purchasers of the practice NBMEs, go for #2.
  31. waitlist22

    waitlist22

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    Took it a few weeks back. Raw score of 89. Didn't study much for it, used FA and read through it once. The best thing you can do for this shelf is see patients and how they are treated. Didn't have to study much because I basically saw every disorder between inpatient and outpatient and their tx. In addition to psych stuff my shelf had some peds milestones and a fair amount of neuro type stuff.
  32. ScottD

    ScottD

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    Took it last Friday; pumped, got a 99 scaled. Read FA Psych 2.5x, did 400 Lange Q&A questions (75% correct), the 150 UWorld questions and incorrects (86% correct), NBME 2 (82) six days out and NBME 1 three days out (80).

    It helped that I was able to do the majority of the above while at the hospital during the rotation, gradually throughout the 6 weeks. UWorld could've easily been tossed in favor of just doing more Lange questions -- UW didn't add anything IMO.

    Mostly everything was in FA, and I feel that the key to getting many of the Qs right was reading the book with an eye out for the difference between things -- e.g. can you pick out Pick's disease vs vascular dementia vs Alzheimer's, or NMS vs serotonin syndrome vs hypertensive crisis. There was some stuff not in FA, but those questions are essentially intuition-based, and a combination of luck and long term prior knowledge will get those right - probably not studying a bunch of extra peds/neuro/behavioral books in lieu of another skim of FA Psych.
  33. PinkLithe

    PinkLithe

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    Just wrote it today.

    Many questions asking to differentiate major depression vs. GAD vs. adjustment disorder vs. acute stress disorder vs. PTSD. Lots of anxiety as well. Very few pharmacology and substance abuse questions, and most were very straight forward. Some pediatrics -- mostly developmental stuff; a couple genetics questions. Some neurology, but also quite straight forward.

    All in all, I thought it was a fair exam. I used First Aid x 2, UWorld x 1, Lange Q&A (only 3-4 chapters), half of Black and Andreasan text, UWorld neurology chapter. Hopefully did ok!!


    Edit: Score back today. Raw 93. Wrote medicine and surgery before this one. Pretty pleased with score
    Last edited: 08.28.13
  34. change77

    change77

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    Congrats to all the people with high scores! One week into Psych now and am using FA, Lange, and UWorld. Plan on taking the two NBMEs as well when it gets closer. For those of you who just took it, what kind of developmental pediatrics are you talking about? Like behavior developmental issues? (autism spectrum disorders, learning disabilities, etc?) Or more organic developmental issues like genetic and congenital issues? Just trying to figure out what to look over when it comes to that stuff.

    Thanks!
  35. Nasrudin

    Nasrudin Member

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    Yeah you're tracking correctly with the peds material. If you've had peds and neurology like I had you have a advantage on this exam. I would say anything from peds that involves CNS and social functioning is game. From neuro I would look over the pharmacology and anything that might have a behavioral or developmental component. From medicine anything that affects the CNS and anything that might be a psych consult in the hospital ie all the differentials for Altered Mental Status.

    I got at most of this material from the comprehensive psych text I own. Which I feel was the easiest way to get it all in one place. But I'm applying to psych so you don't need to get a textbook, just hit the review book sections from your other shelf exams.

    I honored the shelf and the unit, FWIW. But I didn't get my numerical score back yet.
  36. normtheniner

    normtheniner

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    Took NBME 2 today...

    I'm 2 weeks into the rotation... got a 77 which is lower than my first IM practice shelf... that thing was hard!
  37. FireTop

    FireTop New Member

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    Hey guys

    My plan is going to be Lange, FA Psych, NBME exams.

    I wanted to add one more source, but can't decide between BRS, CaseFiles and Blueprints. I generally like to learn in question format to keep my mind stimulated. Any recommendations for my last resource?? Thanks!
  38. Pompeymagnus

    Pompeymagnus

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    Final scaled percentile was 93

    I would highly recommend Appleton and Lange. UW and FA are good for a foundation. Both of my practice NBME's were in the 80's. PM me with any questions.
  39. Dumb

    Dumb USMLE Tutor - PM me for info

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    First Aid, UWorld, and NBMEs are enough for 90+%ile. I would focus on those rather than spreading yourself thin with more resources.
  40. Lokhtar

    Lokhtar Dreaming about the lions

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    95th percentile. I did case files and pretest questions. Twice. Day before I read the blue boxes in case files and redid the pharm section.
  41. change77

    change77

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    Alright, so here is how it went down. Took it this past Friday. 95th percentile, scaled score of a 96.

    First Aid: This is a MUST. Most of what you need to know is in this book. Really know the pharm section. I think I went through the whole book twice and re-read certain sections maybe up to 5 times. This was my main resource.

    Lange Q &A: Also a MUST. Did all the questions the week before my exam and really made sure I knew the answer choices and why things were wrong or right. To be honest all you need to Lange and FA and you are set.

    UWorld questions: I did these as my first set of practice questions halfway through. Also good, but not enough.

    NBME: Test 1: 93 Test 2: 86 .. I thought they were helpful because I did see some similar questions on the actual shelf.

    So in conclusion if you know FA and the Lange questions really well there is no way you should not do well on this exam. Did not have any WTF questions. The ones I did struggle with were really trying to differentiate between a general medical problem causing a mental disorder or if the mental disorder was there beforehand. (Think psuedodementia vs dementia with a high co-morbid rate of MDD). Treatment and management was straight forward. Know your drugs and know how to treat. There is no reason not to do well on this shelf. PM me if you have any specifics.

    Hope that helped!
  42. sanj238

    sanj238

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    Are there any review books you would recommend? I mean its a month long rotaiton so in addition to the Qbanks is there one book you can recommend to ace the exam (93+)
  43. GoWiththeFlo

    GoWiththeFlo

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    You took the exam on Oct. 4th and got your results on Oct 7th???????
  44. change77

    change77

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    All you need is FA for Psych as a review book. I used it and got a 96. :]

    Yup! We take the exam Friday and on Monday are results are up. I know, super fast! However, our final overall score (Pass versus Honors) is not given to us until about 3-4 weeks later after they have had time to review our comments, evals, exam, etc. For example, I still do not have my final grade, but I am 99.9% sure I am getting Honors. It is very rare for someone with such a high score on the shelf not to Honor unless you are a total d**k to your patients and attending.
  45. 3up3down

    3up3down

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    Took the exam about a week ago. Raw score: 90. 90th Percentile.

    Resources:
    Lange Q&A: A must! Did all of the questions one time, took notes, reviewed notes a few days before the shelf.
    First Aid Psychiatry: Read through one time and took notes. Reviewed notes a few days before the shelf.
    UWorld: Did about 40 questions. More ethics oriented. Did not think it was a good use of study time.
    Took NBME 2 ten days out: Raw score of 74.
  46. normtheniner

    normtheniner

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    Raw score was 95... used FA (read 1.5X) and most of Lange and all of Uworld for psych.... honestly thought the test was fairly tough but ended up doing well.
  47. kagman

    kagman

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    Hey,

    I'm an IMG and have got electives in Inpatient Psychoses Ward and Adolescent Psychiatry... Could you guys guide me to the books I need to read to do well in these clerkships ?
    What i've gathered is I need to read FA Psych clerkship, FA wards, LANGE Q&A... any other suggestions... To be honest tho I love psych.. I'm pretty weak in it....
  48. VCorp

    VCorp Est. 1985

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    Would FA Psych section from Step 1 suffice, or is better to buy the FA: Psych book, instead? My resources include:

    1. UWorld
    2. Kaplan LN
    3. MTB for CK
    4. Kaplan QBank
    5. A&L - will try to download it
    6. NBMEs
  49. predestineddoc9

    predestineddoc9

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    Hey guys, do you think First Aid 2nd edition is still helpful for the shelf or is it outdated by now?

    Thanks for the feedback
  50. Armadillos

    Armadillos

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    Scored in high 90s, I think uworld psych and first aid for psych are all you need.

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