Gross NBME vs. Gross Class

[MilkmanAl]

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I took the gross NBME (shelf) yesterday, and it was absolutely nothing like the tests I had for class. Our tests were almost exclusively over relationships between structures rather than the clinical stuff the NBME has. Mostly, I'm just curious if anyone else has experience this massive disconnect between the NBME having almost exclusively clinical questions and class having things taught from a purely anatomical perspective. I suspect the difference is more noticeable for me than most since Dr. Tank is my professor, but it was still (pleasantly) surprising how different the testing styles were. Anyone else go through something similar?

 

[badasshairday]

So are you saying we should really read all the blue boxes in Moore to be ready for Step 1 anatomy?

 

[bodonid]

Our school gives us access to old exams- back to the late 90s. I'll just say that we have gone from mostly structural questions with a few clinical to mostly clinical and a few structural. Many of our in class questions were based solely on the blue boxes in Moore. And many of the structural questions were in vignette form. Just my 2c.

 

[KnuxNole]

I take it on Friday, and I guess I should be relieved that it is mostly clinical applications. I pretty much read over all the pink BRS boxes for each chapter...do you think all of those are sufficient to pass?

I heard pelvis and abdomen were the most high yield on most shelf exams too, was this the case with that one?

 

[MilkmanAl]

So are you saying we should really read all the blue boxes in Moore to be ready for Step 1 anatomy?

No idea about Step 1, but it'd sure work for the gross shelf. I used the BRS red boxes and practice questions and read the High Yield, and I think I crushed it. I'd recommend the same to anyone

I heard pelvis and abdomen were the most high yield on most shelf exams too, was this the case with that one?

Pelvis was reasonably high-yield, I think, and there were definitely lots of abdomen questions. LOTS of abdomen questions. There was less upper limb than I was expecting and a lot less lower limb. There was a bunch of head and neck, but it was probably represented less than it was in class.

 

[Jolie South]

anatomy was built into our whole block exams, but I still felt most of our questions were clinical. Even our practicals weren't strictly limited to "what is this structure and innervation?" but "what would be a clinical sign of an injury here?"

I always read the clinical correlations boxes in Gray's to prepare.

 

[MediumDef]

Our prof's philosophy was basically that if he cared whether or not you knew a structure he'd tag it on the practical. Written was basically all clinical, occasionally an anatomical relationship couched in a clinically based question.

 

[HPSPpayissues]

Think of it this way: most of your step 1 questions are going to be clinical - many clinical vignettes. You are getting a good practice of what is to come. Now, you have a better idea how to prepare for it then those that never took shelf exams.
Also, most questions are not going to be basic-science based. There is not going to be what enzyme does this, how many ATP is produced, what is the function of amygdala, how does the vagus control blood pressure. Those are basic science that you MUST know, and I am pretty sure most people even knew that since undergrad.
Some people are not good at applying. Well, if you did well enough in the MCAT to get accepted to a med school, you should have enough application and critical thinking skills to get through the USMLEs. Good luck.

 

[HPSPpayissues]

Also, some schools have practical exams and wrriten exams. For the practical one, they usually show you something like a pec minor and ask you what the insertion and function of the tagged item are. For the written, they ask you questions that are more like the blue box of Moore's

 

[drizzt3117]

our multiple choice tests were extremely clinical, but our practicals were ID only.

 

[Igor4sugry]

From my impression of Gross NBME shelf, the test is designed to test your anatomy knowledge, not whether you memorized the clinical boxes. Most of the questions on there I have never seen in the clinical boxes, and I had to rely on clues from the text on what was being asked.
So I think if you have a solid grasp of anatomy, the test should be doable.

 

[coldweatherblue]

in like two weeks we take an in-house cumulative final and the NBME Gross shelf back to back so I'll let you know then how they compare lol..

 

[Jolie South]

From my impression of Gross NBME shelf, the test is designed to test your anatomy knowledge, not whether you memorized the clinical boxes. Most of the questions on there I have never seen in the clinical boxes, and I had to rely on clues from the text on what was being asked.
So I think if you have a solid grasp of anatomy, the test should be doable.

obviously, memorizing clinical boxes isn't going to get you anything if you aren't familiar with the basic anatomy to begin with. i used them to help me think about anatomy clinically as opposed to "a this is lateral to that is innervated by x and does this" kind of mindset.

 

[SoCuteMD]

Think of it this way: most of your step 1 questions are going to be clinical - many clinical vignettes. You are getting a good practice of what is to come. Now, you have a better idea how to prepare for it then those that never took shelf exams.
Also, most questions are not going to be basic-science based. There is not going to be what enzyme does this, how many ATP is produced, what is the function of amygdala, how does the vagus control blood pressure. Those are basic science that you MUST know, and I am pretty sure most people even knew that since undergrad.
Some people are not good at applying. Well, if you did well enough in the MCAT to get accepted to a med school, you should have enough application and critical thinking skills to get through the USMLEs. Good luck.

See, I really didn't feel this way at all when I took Step 1. I felt like they were trying to make the questions seem "clinical" but the truth was that they were definitely basic science from a clinical perspective, not *actual* clinical questions.

 

[VoiceofReason]

obviously, memorizing clinical boxes isn't going to get you anything if you aren't familiar with the basic anatomy to begin with. i used them to help me think about anatomy clinically as opposed to "a this is lateral to that is innervated by x and does this" kind of mindset.

yeah thats what you should have done.

For the people asking what to do, I can tell you that I read all the blue boxes (because thats all i had time for) and I scored more than one STD above the mean. The blue boxes are great if you use them to highlight clinically relevant anatomical relationships in the greater milieu of the gross anatomy. Its been 4 months since I took it though so tahts about all I can remember.

 

[ChiDO]

our multiple choice tests were extremely clinical, but our practicals were ID only.

This is how our exams were. Practicals usually had ID and then a followup MC question (ex: you ID "left coronary artery"..followup question "was which chamber does this artery/vein supply/drain blood to/from")

The shelf was pretty hard, but my class did above the nat. avg. A score of 600 gave you a 90% as your test grade.

The national average of the exam is 500 with a standard deviation of 100pts.
Class average of 532 and SD of 87
High Score: 790 (~10 people scored over 700)

 

[KnuxNole]

Took the shelf today and felt like it was fair(but SOOOO tiring)

I think as long as you drill BRS and Michigan questions, you are guaranteed to pass. There were some long vignettes, but they gave one or two clues that basically turn the question into a simple recall question.

And to be quite honest, I have to agree with the poster who said the pink boxes were not where most of the questions came from. YES, they were clinically related, but as long as you know your muscles, innervation, vasculature, etc., you'll be good to go 😎

 

[HPSPpayissues]

There is no pass/Fail for shelf exams. It is either you did well or poor. Anything above the SD of national average is good, and anything below the mean = poor.

 

[AFDOCtobe]

I think the BRS is great for getting ready for the shelf exam! It is much more clinical which I really liked. I think its also important to realize the shelf test may not emphasize what your course did (eg my school hit cranial nerves super hard and the shelf asked maybe 3 easy questions!).

 

[MilkmanAl]

I have to agree with the poster who said the pink boxes were not where most of the questions came from. YES, they were clinically related, but as long as you know your muscles, innervation, vasculature, etc., you'll be good to go

I agree. However, I found the BRS practice questions extremely useful. Definitely do those. All of them.

 

[phospho]

I'm sorry, but I have a random question for you med students. I didn't want to open another thread just for it.

When you were taking anatomy in M1, at your lab practical, were you required to write out the answers, or did they give you the full list of terminology and you just chose something from the list? I hope this makes sense.

I have a practical tomorrow, and they're going to give us a sheet that has all the terms on it. We go from one bench to another, look at where the pin is on the structure, we find the name on that list, and we right down the number beside the name as our answer. Is medical school like that?

🙂🙂🙂

 

[badasshairday]

I have a practical tomorrow, and they're going to give us a sheet that has all the terms on it. We go from one bench to another, look at where the pin is on the structure, we find the name on that list, and we right down the number beside the name as our answer. Is medical school like that?

🙂🙂🙂

It probably depends on the school, but my school did exactly what you are describing.

 

[Jolie South]

When you were taking anatomy in M1, at your lab practical, were you required to write out the answers, or did they give you the full list of terminology and you just chose something from the list? I hope this makes sense.

I have a practical tomorrow, and they're going to give us a sheet that has all the terms on it. We go from one bench to another, look at where the pin is on the structure, we find the name on that list, and we right down the number beside the name as our answer. Is medical school like that?

🙂🙂🙂

My school is not like that. We had to come up with all the answers on our own.

 

[MilkmanAl]

Yep, we did too. Most of our practical questions were just simple identification, but there were always a few tricky questions - 3-4 per exam - that required more thought.

 

[phospho]

Cool, thanks for the responses... I'm getting a little worried now, but i guess i'll figure it out eventually.

 

[TMP-SMX]

Our practicals were 100 questions and multiple choice. I forgot the breakdown since it was 1.5 years ago but I think it was about 30% ID and the rest were relationships and thinking.

 

[Jolie South]

We had 40 questions and 1 minute at each specimen.

 

[phospho]

We had 40 questions and 1 minute at each specimen.

so you had to memorize the whole name, along with its spelling so you can write it down? that's crazy though! what about the muscles? 😱

 

[phospho]

Our practicals were 100 questions and multiple choice. I forgot the breakdown since it was 1.5 years ago but I think it was about 30% ID and the rest were relationships and thinking.

yeah, that's essentially what we have right now... gosh, i hope it stays like this in medical school...

 

[Jolie South]

so you had to memorize the whole name, along with its spelling so you can write it down? that's crazy though! what about the muscles? 😱

yep, all the muscles plus spinal roots, innervations, and functions.

 

[phospho]

yep, all the muscles plus spinal roots, innervations, and functions.

man, this is going to royally suck... i have to do the muscles tomorrow. Never mind the names, I can't even tell the dam difference between each one of them on that freakin' cadaever 😡

 

[badasshairday]

I'm a terrible speller. Good thing we had the list and number thing for anatomy. Maybe you will too. Pectoralis Major. Lattisimus(spelled wrong?) Dorsi... lol

 

[coldweatherblue]

yeah we had to know the names (no cheat sheet) of all muscles, nerves, osteology items (tuberosities etc), arteries, some veins (although these are mostly torn out), plexuses, random parts (lung lobules, etc), ligaments, spaces, basically anything with a latin name.

what usually got me is when they dissected something from a different angle, like when we did throat we dissected CN IX anteriorly, but on the practical they showed it from a posterior dissection and it looks completely different. Practicals are pretty easy points as far as anatomy goes though..

 

[0Complications]

so you had to memorize the whole name, along with its spelling so you can write it down? that's crazy though! what about the muscles? 😱

You are so lucky!!! At my school we had to know names, structures, functions, origins, insertions, etc.

Not to mention the whole exam was only 25 questions!!! So they were worth 4 points each. I missed one, because I accidentally added in a "d" that didn't belong. If you are given a list you should be set.

 

[phospho]

I'm a terrible speller. Good thing we had the list and number thing for anatomy. Maybe you will too. Pectoralis Major. Lattisimus(spelled wrong?) Dorsi... lol

lol, you just made me laugh... that's exactly what we're doing right now:

1. Trapezius
2. Levator scapulae
3. Latissimus dorsi
4. Splenius capitis
5. Rhomboid major
6. Rhomboid minor

You are so lucky!!! At my school we had to know names, structures, functions, origins, insertions, etc.

Not to mention the whole exam was only 25 questions!!! So they were worth 5 points each. I missed one, because I accidentally added in a "d" that didn't belong. If you are given a list you should be set.

yeah, I nailed the first practical, 78/80... but that first practical was only bones... now this next one that i'm studying for is only muscles. I have never been this confused when i look at something. You can't tell the difference.

 

[0Complications]

lol, you just made me laugh... that's exactly what we're doing right now:

1. Trapezius
2. Levator scapulae
3. Latissimus dorsi
4. Splenius capitis
5. Rhomboid major
6. Rhomboid minor

yeah, I nailed the first practical, 78/80... but that first practical was only bones... now this next one that i'm studying for is only muscles. I have never been this confused when i look at something. You can't tell the difference.

Nice work on your first one! It just takes time. That scan/whiteout/scan/fill-in method I told you about before works wonders.

(oh by the way, I meant 4 pts in my previous post 😳)

 

[phospho]

Nice work on your first one! It just takes time. That scan/whiteout/scan/fill-in method I told you about before works wonders.

(oh by the way, I meant 4 pts in my previous post 😳)

oh, that's right, i wanted to thank you for that heads up, because I've been doing it ever since you told me about it. It does work wonders. It saved my ass with bones. Now I just need to figure out a way to see the differences between each muscle. I might have to go and spend the day tomorrow in the lab and try to do things on my own i guess. I'm fine with memorizing, but it seems that each cadaever (sp) looks so different from the other that it seems that you can never pin point the same part on each one.

 

[MilkmanAl]

I'm with the "I had to know everything" crowd. No lists of structures or any help at all for us. Still, like someone said, practicals for us were FAR easier than the written exams.

 

[Jolie South]

I'm with the "I had to know everything" crowd. No lists of structures or any help at all for us. Still, like someone said, practicals for us were FAR easier than the written exams.

our practicals were pretty hard. they happened after the written exams so it was usually a demoralizing blow if you didn't feel great about your performance on the written.

 

[0Complications]

oh, that's right, i wanted to thank you for that heads up, because I've been doing it ever since you told me about it. It does work wonders. It saved my ass with bones. Now I just need to figure out a way to see the differences between each muscle. I might have to go and spend the day tomorrow in the lab and try to do things on my own i guess. I'm fine with memorizing, but it seems that each cadaever (sp) looks so different from the other that it seems that you can never pin point the same part on each one.

Nice! I'm glad it's working for you! Good luck on your exam.

 

[MilkmanAl]

our practicals were pretty hard. they happened after the written exams so it was usually a demoralizing blow if you didn't feel great about your performance on the written.

Same for us.

 

[bodonid]

our practicals were pretty hard. they happened after the written exams so it was usually a demoralizing blow if you didn't feel great about your performance on the written.

same for us, except the written was usually the monster- it was pretty easy to get a low B on the practical but near impossible for an A.

 

[HPSPpayissues]

My school is not like that. We had to come up with all the answers on our own.

Ditto.
It is very hard to get an A in any med school course, but B is pretty easy. For an A, many factors play a role: luck, hard-work, good test-taking ability, memorization AND application skills, time management, subjects you are good at, took a similar course as an undergrad, etc

 

[HPSPpayissues]

man, this is going to royally suck... i have to do the muscles tomorrow. Never mind the names, I can't even tell the dam difference between each one of them on that freakin' cadaever 😡

Go get Netter's and Rohen's or Rohan's whatever that was called.

 

[phospho]

Go get Netter's and Rohen's or Rohan's whatever that was called.

Are they really that worth it? we're using a book by Moore called Essential Clinical Anatomy. It's not bad I guess, but I've never really used another anatomy book to compare it to.

 

[badasshairday]

Are they really that worth it? we're using a book by Moore called Essential Clinical Anatomy. It's not bad I guess, but I've never really used another anatomy book to compare it to.

Well Rohan's and Netter's are not textbooks, they serve as atlas. You are going buy either one when you get to med school anyways.

 

[MilkmanAl]

Personally, I think I'd get both.

 

[badasshairday]

Personally, I think I'd get both.

I agree. But it gets expensive so I got a Rohen and my roommate got a Netter, so I'd use his or just use a library copy + we had a dirty Netter for our lab group donated by an upperclassman.