Failed IM shelf by a point :(

[tictac123]

M3 at US MD school here who is not the best test taker...really liked my IM rotation, did well clinically and even got a LOR. Just found out I failed my shelf by a damn point and couldn’t be more frustrated. Finished UW and did a few NBMEs and passed them. On test day, I could easily narrow it down to 2 or 3 answers and then I would just get stuck and so felt rushed towards the end.

Just feeling crappy af and looking for advice for the retake from anyone and everyone! Also feel bad because I think I want to do IM and I’m nervous about the retake. I’m pretty sure I’ll have to retake at end of third year so worried about having to push step 2 back a little and I have to really do well on it due to a poor step 1 score (low 200s). I know doing bad on IM shelf is probably not a good sign for step 2 so just looking for some uplifting words from anyone who has failed a shelf and done well!

Luckily if I pass the retake then it just shows up as a pass on my transcript without mention of the fail but still just feel so crappy. Thanks in advance for anyone who comments or even reads this!

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[Meerkatology]

i dont know what ur goals are in IM. but "normal" IM residencies are really not that hard to get into. people tend to overestimate how competitive they are.

if u are gunning for some top X whatever with a cards/Gi fellowship afterwards, you'll need to stay competitive. but if u just want to be a normal IM physician practicing at a normal place. getting into a reasonable residency is the least of ur worries.

just pass the retake.
u don't need that high of a step score to get into the average IM residency either.

 

[7331poas]

i dont know what ur goals are in IM. but "normal" IM residencies are really not that hard to get into. people tend to overestimate how competitive they are.

if u are gunning for some top X whatever with a cards/Gi fellowship afterwards, you'll need to stay competitive. but if u just want to be a normal IM physician practicing at a normal place. getting into a reasonable residency is the least of ur worries.

just pass the retake.
u don't need that high of a step score to get into the average IM residency either.

Can you (confidently) match a cards/gi fellowship from any IM program or do they need to be "name brand"?

 

[tictac123]

i dont know what ur goals are in IM. but "normal" IM residencies are really not that hard to get into. people tend to overestimate how competitive they are.

if u are gunning for some top X whatever with a cards/Gi fellowship afterwards, you'll need to stay competitive. but if u just want to be a normal IM physician practicing at a normal place. getting into a reasonable residency is the least of ur worries.

just pass the retake.
u don't need that high of a step score to get into the average IM residency either.

I very much want to just be a regular IM practicing physician at a normal place! not really interested in competitive fellowships at the moment...mainly thinking of IM or FM. I know I'm partially overreacting and being the typical neurotic med student lol but worried that im gonna prob need a couple weeks to study for the retake and thatll push back step 2. and ofc the daunting thought of failing the retake or failing another shelf is there right now lol but in all honesty, I appreciate the response! Nice to know (from you plus additional research) that failing a shelf isn't too big of a deal and is easily fixable!

 

[bananafish94]

I'm very sorry to hear that. Does this mean that you fail the clerkship? Make sure you find out exactly what will be reported on your MSPE because any indication that you failed could be bad news (e.g., will it say that you passed outright or say that you passed "with remediation" or something along those lines?) I know that my school makes note of any remediations on your MSPE - no idea if that's the same elsewhere. And failing a clerkship is much more serious than a pre-clinical block. Regardless, I definitely think you're still in the running for IM programs because there are so many of them. You will likely have to apply broadly to a lot of community programs and might not have your pick of location but I don't see a reason why you shouldn't match somewhere. Good luck!

 

[Goro]

M3 at US MD school here who is not the best test taker...really liked my IM rotation, did well clinically and even got a LOR. Just found out I failed my shelf by a damn point and couldn’t be more frustrated. Finished UW and did a few NBMEs and passed them. On test day, I could easily narrow it down to 2 or 3 answers and then I would just get stuck and so felt rushed towards the end.

Just feeling crappy af and looking for advice for the retake from anyone and everyone! Also feel bad because I think I want to do IM and I’m nervous about the retake. I’m pretty sure I’ll have to retake at end of third year so worried about having to push step 2 back a little and I have to really do well on it due to a poor step 1 score (low 200s). I know doing bad on IM shelf is probably not a good sign for step 2 so just looking for some uplifting words from anyone who has failed a shelf and done well!

Luckily if I pass the retake then it just shows up as a pass on my transcript without mention of the fail but still just feel so crappy. Thanks in advance for anyone who comments or even reads this!

Is test taking anxiety an issue?

Do you narrow things down to two choices and then second guess yourself?

 

[tictac123]

I'm very sorry to hear that. Does this mean that you fail the clerkship? Make sure you find out exactly what will be reported on your MSPE because any indication that you failed could be bad news (e.g., will it say that you passed outright or say that you passed "with remediation" or something along those lines?) I know that my school makes note of any remediations on your MSPE - no idea if that's the same elsewhere. And failing a clerkship is much more serious than a pre-clinical block. Regardless, I definitely think you're still in the running for IM programs because there are so many of them. You will likely have to apply broadly to a lot of community programs and might not have your pick of location but I don't see a reason why you shouldn't match somewhere. Good luck!

I am just required to pass the retake after my last block! I have to retake during the couple weeks off between 3rd and 4th year and as long as I pass, there is no mention of fail or remediation on any of my records/documents, which I know is lucky and I shouldn’t be complaining right now! But just such a sucky feeling. If I fail the retake then I fail the clerkship and have to retake the entirety of it.
A reddit user had mentioned to look at it from a positive viewpoint and that taking this again before Step 2 will help me feel more prepared for that so that’s the goal now haha, I appreciate your response!!

 

[tictac123]

Is test taking anxiety an issue?

Do you narrow things down to two choices and then second guess yourself?

Honestly I’m not a very anxious or easily stressed person but I feel like ever since I did poorly on step, I have had some test anxiety! It’s weird bc I don’t feel too anxious during it but so many times, ESPECIALLY this shelf, I can easily cross out 2-3 choices and then I get so stuck on which to pick. And then that makes me feel rushed at the end, which I think played a big factor this time.

 

[Goro]

Honestly I’m not a very anxious or easily stressed person but I feel like ever since I did poorly on step, I have had some test anxiety! It’s weird bc I don’t feel too anxious during it but so many times, ESPECIALLY this shelf, I can easily cross out 2-3 choices and then I get so stuck on which to pick. And then that makes me feel rushed at the end, which I think played a big factor this time.

The anxiety can be fixed, especially now that the stakes are higher. Go visit your school's Office of Student Services, or whatever they're called.

It sounds like you also have a confidence issue. What you nee dot go is once you narrow down your answer, trust your gut and pick one. Then , you need the self-discipline to trust yourself and NOT change an answer. In general, people's first choices are the correct ones.

 

[APA 32]

If you didn’t use online meded please do. On your practice NBMEs dig into the questions you missed by googling or Robins and figure out exactly why you missed or didn’t understand the question. Would also recommend finding the Emma Holiday video’s if you can.

 

[ciestar]

If you didn’t use online meded please do. On your practice NBMEs dig into the questions you missed by googling or Robins and figure out exactly why you missed or didn’t understand the question. Would also recommend finding the Emma Holiday video’s if you can.

Love doctor dustyn 😍

 

[tictac123]

If you didn’t use online meded please do. On your practice NBMEs dig into the questions you missed by googling or Robins and figure out exactly why you missed or didn’t understand the question. Would also recommend finding the Emma Holiday video’s if you can.

Yes I did use OME and Emma holiday! But I definitely didn’t do as much OME as I wanted...I think because there were so many UW Medicine questions, I focused on those more than OME! But that’s certainly a change I will make next time around...I appreciate the response!

 

[Meerkatology]

Can you (confidently) match a cards/gi fellowship from any IM program or do they need to be "name brand"?

not any, and even if u are in a big name prog, there is no guarentee. u simply have better opportunities to get to know the staff/research etc, you'll still have to work for it urself.

for nonacademic programs, opportunities aren't as good but each program is unique. some have better match at certain specialties than others. i went to a community IM program where there were alot of GI/heme onc matches but not so much cards, i think our GI staff have good relationship with a nearby academic center and there are opportunities to do research/get to know their staff and such.

if ur gunning for one of the those, its a good idea to do some simple research prior, just look at their past match rates to those specialties

 

[Sleepingdoc]

M3 at US MD school here who is not the best test taker...really liked my IM rotation, did well clinically and even got a LOR. Just found out I failed my shelf by a damn point and couldn’t be more frustrated. Finished UW and did a few NBMEs and passed them. On test day, I could easily narrow it down to 2 or 3 answers and then I would just get stuck and so felt rushed towards the end.

Just feeling crappy af and looking for advice for the retake from anyone and everyone! Also feel bad because I think I want to do IM and I’m nervous about the retake. I’m pretty sure I’ll have to retake at end of third year so worried about having to push step 2 back a little and I have to really do well on it due to a poor step 1 score (low 200s). I know doing bad on IM shelf is probably not a good sign for step 2 so just looking for some uplifting words from anyone who has failed a shelf and done well!

Luckily if I pass the retake then it just shows up as a pass on my transcript without mention of the fail but still just feel so crappy. Thanks in advance for anyone who comments or even reads this!

Your main goal is to pass the Shelf, study for it . IM is not that competitive so you will be ok.

 

[tictac123]

Your main goal is to pass the Shelf, study for it . IM is not that competitive so you will be ok.

I appreciate the reply! I guess just initially was freaking out and thoughts of self doubt were creeping in...but know I gotta focus on bigger picture and things will be okay! Just gotta pass this shelf and do my best on step 2!

 

[APA 32]

Yes I did use OME and Emma holiday! But I definitely didn’t do as much OME as I wanted...I think because there were so many UW Medicine questions, I focused on those more than OME! But that’s certainly a change I will make next time around...I appreciate the response!

I lived and breathed Emma and OME everyday. I didn’t listen to any music or TV while studying for the shelf. Just constant reinforcement of concepts and questions. By the time I made it to Step 2 I knew what the answer of the question was before I looked at the choices. I’m sure you’ll do fine on your retake. Stay motivated

 

[LutGholein]

I appreciate the reply! I guess just initially was freaking out and thoughts of self doubt were creeping in...but know I gotta focus on bigger picture and things will be okay! Just gotta pass this shelf and do my best on step 2!

You got this! UW IM questions is just massive, especially if you feel like you’re short on time— variable clerkship lengths(6 vs. 8. Vs 12 weeks of IM) but you got this with the second time around! Like others have said OME plus reviewing the UW stuff again will pay dividends!

 

[tictac123]

I lived and breathed Emma and OME everyday. I didn’t listen to any music or TV while studying for the shelf. Just constant reinforcement of concepts and questions. By the time I made it to Step 2 I knew what the answer of the question was before I looked at the choices. I’m sure you’ll do fine on your retake. Stay motivated

You got this! UW IM questions is just massive, especially if you feel like you’re short on time— variable clerkship lengths(6 vs. 8. Vs 12 weeks of IM) but you got this with the second time around! Like others have said OME plus reviewing the UW stuff again will pay dividends!

appreciate the motivating words! Once I figure out with my deans when I have to take it and how much time I’ll have for it (I think couple weeks before step study time?), I’ll make sure to use the time efficiently! Especially with more OME this time around and hammering UW

 

[tictac123]

The way step 2/shelf questions are written, it's normal to be stuck between two answers. I was 90th+ percentile on my shelf exams and I was always debating between two answers on at least 30% of the questions. Step 1 is more "you know it or you don't."

@tictac123 The IM shelf was the hardest shelf because of timing. You need to be systematic. I start by reading the question line and then glance at the answers. If there are labs, see if those point to the answer (they usually give it away; instantly see if calcium needs to be corrected or if there is an anion gap or things like that because it takes 1 sec) and then use the vignette to confirm. If there are no labs, read through the rest of the vignette and justify why each option is wrong.

You should do this with practice questions as well. People who do well understand why options are wrong because then they can answer questions on the topic no matter how it is presented.

Yeah I definitely think it was the timing that got me. Need to not spend as much time debating between 2-3 answers. Just so frustrating it was just one dang point. But I appreciate the reply, thank you!

 

[tictac123]

meant to say this awhile back but i passed the retake with almost a double digit score increase so i appreciate all the advice here! now on to CK planning/studying!