I have been doing really poorly on shelf exams so far, ranging from 3rd percentile to 20th percentile, most commonly at 10th percentile. I feel so frustrated because I failed one shelf (surgery) and had to retake it, and did not honor all the other clerkships solely due to a low shelf score. Clerkships in my school have a cut-off of the lowest shelf score that you need in order to honor.
I have been studying pretty hard for the shelf exams. Used but sometimes did not finish the regular books that people here recommended like blueprints, BRS, SUTM, Pestana, watched all OME videos, and did all the questions in UWorld, pretest, Rx, Lange Q&A for psych etc (on average > 500-1000 questions per clerkship).
I never had problems with standardized exams or exams in general before M3. Took MCAT once and got 99th percentile. Scored in high 230s in step 1, 1st attempt. I was in top 1/3 in M1-M2. Preclinical years were P/F but have internal numerical grades. I go to a top 20 school if that matters. I do believe people in my school perform below national average on the shelf exams. I am currently at the bottom of my class in terms of shelf exams.
I feel I have exhausted my resources and could not figure what had I done wrong. I am so terrified of failing the shelf every time I take it.
Help!!!
That high of an MCAT and doing well on standardized tests before that indicates that you probably have a high IQ. Getting only in the 230s on STEP1 and doing poorly on shelf exams means your memory is what holds you back.
Most med students have great memories. The field selects for that, so IQ actually is where many hit their ceiling. A few, and I am one of them, don't have the IQ ceiling affect them nearly as much the memory ceiling. Yes, memory is a component of IQ, so I recognize the confounding in this argument. Well recognized international tests btw try to eliminate this component by only trying to test for fluid over crystallized intellect. Granted, one in part begets the other and stuff like digit span is memory but once again there is confounding because that type of short term instant recall won't correlate perfectly to med school style brute force need to just know specific sets of thousands of words for several weeks at a time. Long story short, I think people like ourselves generally have very good fluid intelligence but lack the discipline and memory component of IQ to do well just from reading a lot of books and doing questions.
We have to hammer facts via space repetition. Getting Zanki down is perfect or even using an entity like firecracker. You have to know tons of facts and clinical scenarios cold. I went from the bottom quarter of my med school class to the top fifth in terms of STEP1 scores, and I've honored all my shelf exams so far. I literally stopped trying to understand deeply stuff I liked reading about and went for breadth over depth. I wanted to be able to recognize every disease, when I saw it and know the treatment right away. Perhaps, know a tiny bit of mechanism but nothing beyond that. I essentially tailored my studying more to the style of the exams and became more practical. You have to do the same thing.
There are other more fluid intelligence fields, where you have prospered a lot easier and better. But you are in med school now, so you have to do what you need to do to succeed. Coming here was a good first step. I did the same thing. Now just implement some of this advice. Also, you don't need more than 1 qbank. Maybe 2 max. Also take notes on any immediate fact you didn't know off the top of your head in the explanations. And also make DDX tables with weird facts that can help you pick out diseases easily (triads and such or like pale skin for Chediak Higashi or frontal balding for myotonic muscular dystrophy).
You have to remember that medicine is actually a glorified vocational school. Clerkships are the beginning of your apprenticeship, when you just entered the workshop and do either nothing or just usually hinder the speed of work. Residency is more when you are an effective apprentice. The key is to know the pragmatic stuff well. For example, stuff like vitamin deficiencies, poisons of all kinds, drug adverse effects that are reversible, and things that cause a lot of mortality are tested a lot.
Also, this is very key (and a nuance to the breadth vs. depth principle I stated earlier):
The weird manifestations of common diseases have a higher incidence than the common manifestations of weird diseases. Hence, the former is tested a lot more than the latter. Know the living **** out of ischemic heart disease, cerebral vascular accident, cancers (especially lung, colon, breast, prostate, and melanoma), diabetes, TB, AIDs, staph, strep, E. coli, and pseudomonas. That type of stuff shows up on every test.
Don't stress about cat scratch disease affecting the pulvinar and learning all the mechanisms about that. It's inefficient. Know that type of stuff superficially. 
