General Approach to Shelf Exams: Please Help

[Bearie]

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Hi All,

I'm midway through my clerkship year and recently recieved the results of my third shelf exam--right at the national mean and (73, Neuro) exactly the score of my second shelf exam (73, OB-GYN) and better than my first (65, Surgery).

What makes me sad is that I've really studied like crazy for the last two--especially the third since I was encouraged by improvement from the first but really wanted to score above average. I've gotten really good comments and did well on other clerkship components, but the shelves have consistently prevented me from getting Honors in 3 rotations.

Can anyone PLEASE offer general advice about how to approach these exams early from the start of a clerkship and how to score well. I tried reading the official text, the study guides (Case Files etc), doing EVERY practice question I could get my hands on (UWorld QBank, Pretest BOTH TWICE, neuroprep.com, AKSAP15 Neuro questions), etc. I really have no idea what more I else I could have done. I also finished all the questions on the exam without feeling too rushed at the end for the first time.

It always seems that as much as I read and as many questions I do, there is a large chunk of material on the shelf I simply haven't seen or there are questions I need to think about but have trained myself to chose an answer and move on so that I can complete the exam. What should I do? Any advice would be greatly appreciated!!

 

[LJB]

Hi Bearie

Before taking anyone’s advice on how to prepare for exams, I always like to know specifically how they’ve performed on those exams. I just finished up my 3rd year and my shelf exam scores (scaled scores) are as follows
OB-99
Psych-96
Peds-95
Medicine-92
Surgery-87

I listed these as most recent to least recent, thus it’s obvious that my scores improved throughout the year. I actually didn’t know you could score over a 95, but you can. At the beginning of the year I focused equally on questions and reading. As time went on, I started becoming overwhelmed by the volume of information I was making myself learn. So I gradually started switching to studying purely by questions. This resulted in a steady improvement in my scores. It’s good that you did the Qbanks you listed. But twice is never enough. Do them as many times as you can. Buy the iphone apps for pre-test for every rotation. You only sometimes are carrying around your book, but you’ll always have your phone. Do this during all down time you have. Pretest apps have consistently 500 questions per area. Do them over and over and over again. You’ll learn something new each time by the explanations. Eventually the questions will all start to run together in that you’ve done so many that you don’t quite remember if you’ve answered that particular question before. But most importantly, you’ll also start grasping the info very well. It’s all about repetition. I too received excellent evaluations. But as the year went by, I realized that I was receiving even better evals with less focus on only my clinical performance. Long story short, spend any extra energy on what you are most in control of..... your shelf score. If someone if going to give you a bad evaluation, it’s going to take way more work than reasonable to change their mind. I hope this info helps. I felt very uncomfortable when I switched my focus of studying to questions only. But if you do those questions enough, then it will definitely pay off in the long run

 

[Valadi]

I imagine you're using the wrong textbooks for each rotation. Case files is pretty weesh and only good for daytime review, not shelf studying. You can search threads for the best rated books to use each rotation.

Also, make sure to read up on each of your patients. You will remember it much better for your shelf if you can associate a face to each problem.

My general strategy was like this: first few days off (optional), read up on my patients every day including the relevant book chapter, tried to have the book finished with 2 weeks to go so I could start reviewing, a block of questions a day or every other day, ramping up to several blocks / day as the shelf approached.

If by reading the "official text" you mean like Harrison's or Schwartz's Surgery, then I'd say abandon that plan quickly and opt for the best reviewed books instead. By midway through the rotation you should know what the big topic items are and should make it a point to learn them cold, pubmedding a review article if you need to. For example, if you have IM and don't know shock, ards, copd, heart disease, electrolytes, and diabetes inside and out then you likely won't break honors.