Senior Member
7+ Year Member
15+ Year Member
Oct 6, 2002
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Hi all,

I have gone through four clin rotations now and have received very poor scores on each of the shelves (below average on all); I tried to learn from each one and tried to recognize what the problem was and I have done everything i could but it hasn't worked for me. It feels like my scores are not representative of my medical knowledge as I never feel all that stupid on wards. On the written evals I have received my attendings have written good things about my medical knowledge and clinical abilities but it just bothers me why I can't peform well on the tests and whether I am learning what I should be learning. On my last rotation I received a very good eval from the director but he wrote a sentence commenting on my poor standardized test taking ability which I suppose goes in my dean's letter and I am concerned how that will be perceived by residency directors. I am interested in pursuing IM at an average academic program, with no intentions of going at a top tier program, and my step I score was slightly above average. Anything I could do differently regarding these shelfs as I suppose they reflect somewhat of your step II scores. How important are shelf scores in terms of residency and all; can I make up poor scores by working extra hard on step II and doing well? Thanks


Loving Life
10+ Year Member
Nov 8, 2006
East of the Mississippi
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I'm sorry that you've had trouble with your shelf exams. Doing well on Step II could make up for not honoring your medicine rotation (which is probably the only consequence of your below average shelf score). Residency PDs won't see your shelf exam scores if it isn't included in your Dean's letter.

From experience with interviewing for IM residencies, programs seem to be interested in finding "well-rounded" candidates. A volunteer experience can go a long doesn't have to be extensive or terribly time consuming. Interest/minimal involvement in a research project can help your application as well -- and you don't need to devote 10 hrs a week to it either.


Full Member
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Feb 3, 2007
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Strong letters commenting on your clinical skills will be more important than numbers and could help make up for lower test scores. I can understand your frustration though with having a test constantly bring you down. What are you currently doing to study for the shelf exams? I found first aid and blue prints to be helpful and then ususally did practice questions from Pre-test or MKSAP (IM).


Senior Member
7+ Year Member
15+ Year Member
Dec 5, 2001
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Do you think that part of the problem with your Shelf scores is due to not having time to study due to your clerkship responsibilities? I think that a lot of residency programs know that this is often the case. Try to do well clinically, get good letters of recommendation, and do well on Medicine Sub-I next year. All of this will go a long way in helping you to secure the residency that you want.

Most schools don't even record the Shelf exam scores in your Dean's Letter. Mine just mentioned that I had Passed all of my exams. Good luck!
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