How to improve shelf exam scores

[Noemata]

Hey everyone, MS3 here. Did well in preclerkship (Top 7-10% class rank), Step 1 > 80th percentile. But I just can't seem to break the 45-50th percentile on shelf exams. Tried firecracker, UWorld, and pestana for surgery. And then UWorld, case files, USPSTF, Ambulatory chapter of SU2M, OME (96 videos covered) for family medicine. I don't think I could have studied any more but scores remain in the 72-75 range and are preventing me from receiving honors in my clerkships.

Worried that this might affect class rank, residency applications, and possibly translate into a lower Step 2 CK score. Still have four rotations to go, so just wanted to know if you guys have any tips or suggestions. Is it because I'm early in my third year? I am not someone who learns from textbooks so are there any comprehensive resources that are worth trying (such as Amboss, Lecturio, going back to firecracker, etc)?

I know these exams are difficult, but I just want to learn how to improve, so any thoughts are appreciated. Thank you.

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[FreeMedEd]

These exams can be very stressful and medical students are rarely (if ever) taught how to gauge their exam skills and identify pain points to improve on. First, it doesn't seem as if it is the resources that are the issue. You have tried everything under the sun so I would not recommend spending more resources on new materials. Maybe try instead to examine your test-taking strategy and study habits.

Here are some questions that may help to guide you:
What does my daily study routine entail?
Do I study when tired/burnt out or do I schedule breaks to remain fresh?
What do I do when I get a question wrong from an exam (make a note, enter into flashcard deck, etc.)?
How often do I review those difficult topics/questions I keep getting wrong?
What types of exam mistakes am I mostly making (time, knowledge gaps, misreading question/answer options, etc.)?

At this stage in the game, it may seem like cramming in as much material as possible will be helpful, but progress is still generally slow and steady. Don't give up!

P.S. If you want to answer these questions to yourself, that is fine. If you wish to post them to the thread I'll do my best to return and answer to the best of my abilities.

 

[Noemata]

Thank you, that was very helpful. The biggest problem I feel is the breadth of content. In preclerkship, nearly all content for the questions came from our school's lectures and UFAP, but on shelf exams, I'm often lost. The types of questions I struggle with are those on topics that I've not studied about or the answer is too detailed, for instance, patient needs surgery according to a chapter I've read, but the answer choices are five different types of that surgery - this happened to me about 3-4 times on my last shelf. So I feel it's about the volume of content that is testable. If you have more suggestions please let me know. Thanks.

 

[mistafab]

I think the best strategy on the shelf exams is to take as many practice questions as possible that covers the breadth of the content.

With this in mind, I highly recommend uworld + zanki combo for the shelf exams.

 

[Noemata]

That is indeed a great point, thank you.

 

[theonlytycrane]

Also going through the same struggle as OP. > avg years 1&2, but I'm < avg on shelf exams so far, despite doing everything that I can. I feel that the stems are longer, the questions are more vague, and I'm asked more about things I haven't studied/came across. I'm feeling like shelf exams tend to favor better test takers that can maneuver through these murkier conditions. Any advice is appreciated D:

 

[siliso]

Pre test books. 500 shelf relevant practice qs with explanations each. IME they were better than uworld qs in quantity per rotation and closeness to the shelf particularly. There’s one for every core clerkship and you might can borrow them from your school library.

 

[Noemata]

I will certainly look at that resource, thanks

 

[FreeMedEd]

Thank you, that was very helpful. The biggest problem I feel is the breadth of content. In preclerkship, nearly all content for the questions came from our school's lectures and UFAP, but on shelf exams, I'm often lost. The types of questions I struggle with are those on topics that I've not studied about or the answer is too detailed, for instance, patient needs surgery according to a chapter I've read, but the answer choices are five different types of that surgery - this happened to me about 3-4 times on my last shelf. So I feel it's about the volume of content that is testable. If you have more suggestions please let me know. Thanks.

Shelf exams are often not a concern for the pre-clinical curriculum, causing students to feel a bit unfamiliar and overwhelmed by the material. You are NOT alone!

You can get a brief overview by watching video lectures, such as OnlineMedEd. Lectures will give you the basic outline, but are not enough on their own to prepare you for exams. You will definitely need to do practice questions and there is no definitive source for Shelf exam questions that is highly rated (at least more than subjectively).

Also, make sure you are spending your time effectively. We have a podcast that covers study strategies, mnemonics, and cognitive psych of learning so that is a great free resource if you listen to podcasts.

 

[Noemata]

Thank you, that was so helpful! I will certainly focus on some of the skills and strategies you've mentioned in your post.

 

[Noemata]

1-year update: My NBME shelf scores significantly improved over the next few months and throughout the third year. For anyone else experiencing this issue, just remember to stick to 2-3 resources for a particular clerkship, and memorize and know those resources cold. Especially anytime you see the words "risk factor," know it and don't forget it! Reading a book and trying to remember is not good enough. You have to know the details and little factoids by heart if you're wanting to score >85th percentile. The shelf exams have gotten much more difficult over the last year or so, in line with the Step 2 difficulty level as well, so you really have to be able to remember the facts and then comprehend, manipulate, reason, and justify your answer to a question. For specific details, feel free to PM me. Thanks everyone!