Consistently poor shelf scores

[lilkiwi]

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I just got out of taking my third shelf of the year, out of 6...and I left 10 questions unanswered, down from 20 on my first shelf. With half of third year over already, I should at least be able to FINISH a shelf exam, right? 😕

At first I thought it was because I hadn't studied enough, but I have been progressively more organized and diligent (I think) about my studying over the past few rotations. My scores have NOT improved. I'm not sure if it's just a time issue or if there is something fundamentally wrong with the way I approach these exams. Maybe I'm used to focusing on the pathophysiology, rather than learning treatment algorithms... In the past, I have performed decently on standardized tests, including Step 1.

Here's how I studied for my exams:
Medicine: I was ridiculously underprepared for this one. Did MKSAP once and flipped through some of Case Files and Step Up.
Neuro: Tried a little harder...Case Files x1, Pretest x1, UWorld x1. Didn't get a chance to review any of the reading or questions I'd done, so I experienced a lot of "this seems vaguely familiar, but I don't know enough to answer the questions" on the shelf.
Peds: Blueprints x1, Pretest x1, UWorld x1. Made sure to review the key tables in Blueprints in the few days before the shelf. Still did poorly.

Shelf-spankers...I'd love to hear your suggestions!

 

[blight]

ugh, I just took my peds shelf today too and left around the same number unanswered!! i have never had trouble finishing exams before, it's so frustrating. how many can we get wrong and still pass? i'm really nervous.
And I am in the same situation as you..i've always done fine before, but for some reason i suck at shelf exams and feel like i tried everything this time to improve

I just got out of taking my third shelf of the year, out of 6...and I left 10 questions unanswered, down from 20 on my first shelf. With half of third year over already, I should at least be able to FINISH a shelf exam, right? 😕

At first I thought it was because I hadn't studied enough, but I have been progressively more organized and diligent (I think) about my studying over the past few rotations. My scores have NOT improved. I'm not sure if it's just a time issue or if there is something fundamentally wrong with the way I approach these exams. Maybe I'm used to focusing on the pathophysiology, rather than learning treatment algorithms... In the past, I have performed decently on standardized tests, including Step 1.

Here's how I studied for my exams:
Medicine: I was ridiculously underprepared for this one. Did MKSAP once and flipped through some of Case Files and Step Up.
Neuro: Tried a little harder...Case Files x1, Pretest x1, UWorld x1. Didn't get a chance to review any of the reading or questions I'd done, so I experienced a lot of "this seems vaguely familiar, but I don't know enough to answer the questions" on the shelf.
Peds: Blueprints x1, Pretest x1, UWorld x1. Made sure to review the key tables in Blueprints in the few days before the shelf. Still did poorly.

Shelf-spankers...I'd love to hear your suggestions!

 

[jsong812]

Something I've found to be extremely helpful with time management is to read the question with purpose. And the way to do this is to read the first line of the question, then the question stem itself, and finally the answer choices. By doing this, you already have an idea of what the answer should or can be and so you actual reading of the question will be much more focused. I've been doing this for the last 3 shelves and I've always managed to finish with at least 30 minutes to spare.

 

[sprinkibrio]

I would love to hear studying strategies as well.

I always finish, but I don't get the score I want. I did really well 1st and 2nd year because all of our test questions HAD to be from the syllabus. This year, I could study every resource out there and still see some topics I didn't study (mostly because they are medicine topics that I don't remember). Unfortunately for me I think the shelves test long term memory.

 

[IM Substance P]

For your time management during the actual shelf, here are the key things I've found helpful:

1. Always start by reading the question. Seriously, it's old advice but works.

2. Realize that shelf exams don't test critical thinking. Instead, they test pattern recognition and intuition.

3. As you scan (don't read!) the question stem, circle/underline the key facts that will help you arrive at the answer. I would focus on the first couple sentences of the history and the vital signs. Most of the other information is extraneous.

4. Strike out any bad choices from the response list as you go through the stem. If the patient is not a smoker, then they don't have lung cancer -- cross it out. If the EKG is normal, it's not an MI -- cross it out. If there is no mention of AIDS or cat feces, it's not toxoplasmosis -- cross it out. If the patient has been depressed for only three days, it's not a major depressive episode -- cross it out.

5. Never skip a question, and don't dawdle over it; commit to answer on first read and move on! If you happen to have time at the end, come back to it.

I did really well on my shelf exams and found that a "scan and jump to conclusions" approach is actually the most effective.

 

[rockinthemullet]

For your time management during the actual shelf, here are the key things I've found helpful:

1. Always start by reading the question. Seriously, it's old advice but works.

2. Realize that shelf exams don't test critical thinking. Instead, they test pattern recognition and intuition.

3. As you scan (don't read!) the question stem, circle/underline the key facts that will help you arrive at the answer. I would focus on the first couple sentences of the history and the vital signs. Most of the other information is extraneous.

4. Strike out any bad choices from the response list as you go through the stem. If the patient is not a smoker, then they don't have lung cancer -- cross it out. If the EKG is normal, it's not an MI -- cross it out. If there is no mention of AIDS or cat feces, it's not toxoplasmosis -- cross it out. If the patient has been depressed for only three days, it's not a major depressive episode -- cross it out.

5. Never skip a question, and don't dawdle over it; commit to answer on first read and move on! If you happen to have time at the end, come back to it.

I did really well on my shelf exams and found that a "scan and jump to conclusions" approach is actually the most effective.

That is awesome advice! I have also really been struggling with not finishing my exams... which is not a problem I have ever had to deal with before. I have taken 4 exams and only finished 1 (and that one was right at the buzzer), but have definitely been reading every word on the test and not just "scanning." Also, I need to start reading the question 1st. I know that I generally have a good handle on the material and have just been missing the proper test taking strategy. Good luck to everyone on the stupid shelf exams throughout the rest of the year!

 

[kdburton]

Do as many practice questions as you can (from sources that are highly recommended for whatever clerkship you're on). If you're leaving 10-20 questions blank at the end then you're automatically losing 10-20% of the possible points. No matter how much you know from studying, if you can't finish a bunch of questions then you're not going to score well. I suggest timing yourself doing the questions and TRY finishing a set of questions with an average of 1 minute/question. If you get used to shooting for that as a goal then even if you're doing 1.2 minutes/question you'll still finish on time on the real deal...