How to study in MS3

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GonefromTX

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Was wondering what the consensus on resources is when it comes to studying for MS3 NBMEs and prepping for Step 2 CK early. Specifically, I was wondering what is the best lecture series to complement First Aid for step 2 CK and the First Aids for specific clerkships (eg psychiatry)

So say I am starting my Psych rotation. If I wanted to get ahead, I would perhaps watch the lecture series while reading First Aid for Psych, and then read the psych section of First Aid for USMLE Step 2 CK. Thereafter, I would do all the questions in the psych section of UWorld.

So my questions are 1) Would you recommend such an approach? and 2) What lecture series would you recommend? Ive heard of DIT and Kaplan.

Thanks in advance!
 
I am a very visual learner and loved online meded. I would go through the videos for whichever rotation I was on usually twice and do their questions as well as combank for the shelfs (shelves?). Then just did uworld for step 2/level 2.

I didn't try dit for step 2. My school payed for Kaplan so I tried it, but was unimpressed.

Notably, we just had to pass our tests, but I was really happy with my step 2 score.
 
For shelf exams, try and find one source and really stick to it. Here's what worked for me:

Qbank: ONLY Uworld for Step 2 CK all year long, and with corresponding clerkships. I also reviewed only Uworld during dedicated Step 2 CK study.

IMED/Surgery (partial): Step Up to Medicine (SUTM) for reference/difficult topics + OnlineMedEd
Psych: OnlineMedEd
OB/GYN: LITERALLY only the uWise question bank from ACOG. Do all the questions twice and take notes, you'll be all set
Family Medicine: The Ambulatory Medicine Chapter of SUTM
Pediatrics (IMO the hardest shelf): I did BRS Peds + OnlineMedEd and passed the stupid thing
Surgery (I'm biased): NMS Surgery textbook (NOT the casebook). Read the most relevant chapters, but do ALL the end-of-chapter questions. Review with Pestana.

BONUS:
For Step 2 CS, if you are a US med student who did well on your OSCE's, just take a week (seriously, 5-7 days is almost TOO long to prep), and read First Aid for CS to learn about the exam format (how to write your notes, etc) and maybe review a few topics that you are unfamiliar with.
 
Was wondering what the consensus on resources is when it comes to studying for MS3 NBMEs and prepping for Step 2 CK early. Specifically, I was wondering what is the best lecture series to complement First Aid for step 2 CK and the First Aids for specific clerkships (eg First Aid for Psychiatry )

So say I am starting my Psych rotation. If I wanted to get ahead, I would perhaps watch the lecture series while reading First Aid for Psych, and then read the psych section of First Aid for USMLE Step 2 CK. Thereafter, I would do all the questions in the psych section of UWorld.

So my questions are 1) Would you recommend such an approach? and 2) What lecture series would you recommend? Ive heard of DIT and Kaplan.

Thanks in advance!

Hey TexasMeds, I'm on my last M3 rotation and am more confident in my approach to shelves now. Studying for CK/shelfs exams is tough because of the infinite number of resources with no clear front-runners and while everyone has their unique approach, I feel like what I'm about to suggest would be the most effective for the majority to do well on Shelf exams and Step 2 CK.

First of all, I want to tear down the main resources you're using (in a nice way). The First Aid series is no longer AS good for exams after Step 1 with the exception of First Aid for Psychiatry where it's a must and Step 2 where CK is a so-so reasonable source.

Plan:

#1 Purchase a 1 year UWorld CK Subscription. It's your #1 tool for Step 2 CK. Use it like a textbook and dig deep into every single question and answer. For Step 2 CK, your first pass should be to complete all the rotation specific questions (ex. surgery Qs on surgery) while you are on that rotation. This will serve as your primary QBank. It won't be enough detail for all your shelf exams, but it is the best overview and this way you're always studying for CK.

#2: Your lecture series is OnlineMedEd by Dr. Dustin Williams. He's extremely organized and lectures to the shelf and the boards (as well as the wards). This lecture series is incredibly high-impact. Again, like UWorld, it may not be as much to get 99 on the shelf, but it will hit all the high yield points which is not to be underestimated (I'll explain later-1).

#3. In the middle of the rotation, do 1 NBME and UptoDate the answers or look somewhere for the answers and take notes.

#4. Use 1-2 (max.) in-depth sources for each rotation. I've outline my personal favorites below.

OB-GYN: Case Files (get through it): Alternatives are BluePrints. Also UW!

Neurology: BluePrints or Pre-Test (good for less interdisciplinary shelfs, I'll explain later-2). Pick One. Also UW!

Psychiatry: First Aid for Psychiatry and UW. (Also note no OnlineMed videos, but relax, this is the easiest shelf. I didn't even study until the last week and still honored)

Pediatrics: Really any source is good. I recommend Case Files and/or PreTest. BRS is known to be the "Gold-Standard" and it's probably comprehensive BUT IT IS TOO MUCH. Some hard-asses may recommend it but I honored comfortably with just Pretest, Pre-Test, Uworld, and OnlineMedEd which was frankly easier to go through than BRS. Don't forget UW!

Internal Medicine: Very tough shelf to prepare for. The #1 source is UWorld questions. The second source is the OnlineMedEd videos. I would not use any books for this. I know there's a book out there "Step Up the Medicine" which is probably the "gold standard" for IM. The issue with this is that like BRS it is too long to read. I tried and wasted a lot of time and ended finishing Uworld but half-assing it and ended up missing the IM cut-off by 2 points. I can't remember a single question on the IM shelf where I was like, oh yeah, this is from SUTM. If your IM rotation is two months of shorter, I highly recommend skipping Step Up To Medicine and really using UWorld (1300 questions IM/2400 total) and using OnlineMedEd (10+ hrs of content split into 50+ videos) as well. It's an intense rotation and really dig deep into those UWorld questions.

Surgery: At my school, this rotation is tough because we have an oral and written exam that are made by the clerkship directors that have minutiae so I have to read Surgical Recall and Devirgilio. If you want to honor the surgical shelf, use Pestana's Surgery Notes, UWorld, SUTM (yeah i know...) GI Section-only, OnlineMedEd, and DeVirgilio (this is the detailed text and will take a long time to read). Beware, on this shelf, there are NO details about the actual process of the surgery. Instead, the shelf tests whether or not it's appropriate to go to surgery vs. medical management. A lot of people say this is a medicine exam but often the answer is medical management which you will have to pick (i.e. get a CT vs. do U/S or IV normal saline v. IV dextrose...for example for Pyloric Stenosis, before you operate, you get a electrolyte profile and correct electrolyte abnormalities). As you can see, I gave you 5 sources to use here.

Family Medicine: Notorious for being broad. I had it after medicine. There's no Uworld or OnlineMedEd for this. Resources are: In-House Exam PDFs (4 200 Q exams with explanations), Family Case Files (best case files book in my opinion), Pediatrics MedBullets (free website, look up pediatric rashes, etc. esp. if you haven't had Pediatrics), and SUTM (again, I know) with only the Ambulatory section. Really helped for problems like Rotator cuff tear etc. Then nail down Centor's criteria, Asthma 6-stage therapy guide, HTN JNC-guidelines, and COPD Gold Staging. They'll be in all your sources, but these are especially HY.

*********For What I said I'd explain later*************

#1.) For Shelfs, unlike you were trained to do for classes, knowing the bread and butter diagnoses is VERY IMPORTANT. What is most important is understanding the nuances of case presentations and the next step and the reason. Learning minutaie disease will score you 1-3 points max because those diseases are revealed with a buzz-word that's easier to memorize and there's limited things to ask about them. On Shelves, they try to trick you by throwing very confusing vignettes at you that can be 2-3 different, but common things. However, there will be 1 or 2 clues in there that will make one answer the most likely (for example, Kawasaki's vs. Strep Infections they'll give you a sterile UA or 6 day high non-breaking fever). Also, some diseases have very specific therapies so know those. That's why it's important to know the subtleties of the major diagnoses which most review sources like Uw and OnlineMedEd emphasize which is why you need to them for shelf as well as rotations.

#2. Pre-Test is a 500 question review book where they ask 50O MCQs and then follow up with 500 corresponding explanations similar to UW. It's a great source, but it's strength is recognizing the rare diseases like Prune-Belly Syndrome for example or the fact that anti-aquaporin antibodies are seen in transverse myelitis. You can see how Pre-Test is a great book for shelves where the subject matter is detailed (neuro, peds), but the shelf is less interdisplinary (less medicine, surgery, etc.).
-----------------------------------------------------------------------

Now that you've done all of this, Step 2 CK prep is 100% effort, 0% strategy.

#1. Re-watch OnlineMedEd
#2. Absolutely NAIL down UWORLD CK.

Again, 0% strategy, 100% execution. You've learnt everything you need to do. Now it's time to review the things Step 2 will actually throw at you and if there's minutiae you'll miraculously remember it (notice how this parallels the strategy of how working hard in classes sets you up for Step 1). Lastly, don't waste your time with Kaplan or DIT. Both are trash for Step 2. For one, they are old and re-recorded. Second, they are way longer and less HY than OnlineMedEd. Third is that they'e each like $500 while the rest is free.
 
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Hey TexasMeds, I'm on my last M3 rotation and am more confident in my approach to shelves now. Studying for CK/shelfs exams is tough because of the infinite number of resources with no clear front-runners and while everyone has their unique approach, I feel like what I'm about to suggest would be the most effective for the majority to do well on Shelf exams and Step 2 CK.

First of all, I want to tear down the main resources you're using (in a nice way). The First Aid series is no longer AS good for exams after Step 1 with the exception of First Aid for Psychiatry where it's a must and Step 2 where CK is a so-so reasonable source.

Plan:

#1 Purchase a 1 year UWorld CK Subscription. It's your #1 tool for Step 2 CK. Use it like a textbook and dig deep into every single question and answer. For Step 2 CK, your first pass should be to complete all the rotation specific questions (ex. surgery Qs on surgery) while you are on that rotation. This will serve as your primary QBank. It won't be enough detail for all your shelf exams, but it is the best overview and this way you're always studying for CK.

#2: Your lecture series is OnlineMedEd by Dr. Dustin Williams. He's extremely organized and lectures to the shelf and the boards (as well as the wards). This lecture series is incredibly high-impact. Again, like UWorld, it may not be as much to get 99 on the shelf, but it will hit all the high yield points which is not to be underestimated (I'll explain later-1).

#3. In the middle of the shelf, do 1 NBME and UptoDate the answers or look somewhere for the answers and take notes.

#4. Use 1-2 (max.) in-depth sources for each rotation. I've outline my personal favorites below.

OB-GYN: Case Files (get through it): Alternatives are BluePrints. Also UW!

Neurology: BluePrints or Pre-Test (good for less interdisciplinary shelfs, I'll explain later-2). Pick One. Also UW!

Psychiatry: First Aid for Psychiatry and UW. (Also note no OnlineMed videos, but relax, this is the easiest shelf. I didn't even study until the last week and still honored)

Pediatrics: Really any source is good. I recommend Case Files and/or PreTest. BRS is known to be the "Gold-Standard" and it's probably comprehensive BUT IT IS TOO MUCH. Some hard-asses may recommend it but I honored comfortably with just Pretest, Pre-Test, Uworld, and OnlineMedEd which was frankly easier to go through than BRS. Don't forget UW!

Internal Medicine: Very tough shelf to prepare for. The #1 source is UWorld questions. The second source is the OnlineMedEd videos. I would not use any books for this. I know there's a book out there "Step Up the Medicine" which is probably the "gold standard" for IM. The issue with this is that like BRS it is too long to read. I tried and wasted a lot of time and ended finishing Uworld but half-assing it and ended up missing the IM cut-off by 2 points. I can't remember a single question on the IM shelf where I was like, oh yeah, this is from SUTM. If your IM rotation is two months of shorter, I highly recommend skipping Step Up To Medicine and really using UWorld (1300 questions IM/2400 total) and using OnlineMedEd (10+ hrs of content split into 50+ videos) as well. It's an intense rotation and really dig deep into those UWorld questions.

Surgery: At my school, this rotation is tough because we have an oral and written exam that are made by the clerkship directors that have minutiae so I have to read Surgical Recall and Devirgilio. If you want to honor the surgical shelf, use Pestana's Surgery Notes, UWorld, SUTM (yeah i know...) GI Section-only, OnlineMedEd, and DeVirgilio (this is the detailed text and will take a long time to read). Beware, on this shelf, there are NO details about the actual process of the surgery. Instead, the shelf tests whether or not it's appropriate to go to surgery vs. medical management. A lot of people say this is a medicine exam but often the answer is medical management which you will have to pick (i.e. get a CT vs. do U/S or IV normal saline v. IV dextrose...for example for Pyloric Stenosis, before you operate, you get a electrolyte profile and correct electrolyte abnormalities). As you can see, I gave you 5 sources to use here.

Family Medicine: Notorious for being broad. I had it after medicine. There's no Uworld or OnlineMedEd for this. Resources are: In-House Exam PDFs (4 200 Q exams with explanations), Family Case Files (best case files book in my opinion), Pediatrics MedBullets (free website, look up pediatric rashes, etc. esp. if you haven't had Pediatrics), and SUTM (again, I know) with only the Ambulatory section. Really helped for problems like Rotator cuff tear etc. Then nail down Centor's criteria, Asthma 6-stage therapy guide, HTN JNC-guidelines, and COPD Gold Staging. They'll be in all your sources, but these are especially HY.

*********For What I said I'd explain later*************

#1.) For Shelfs, unlike you were trained to do for classes, knowing the bread and butter diagnoses is VERY IMPORTANT. What is most important is understanding the nuances of case presentations and the next step and the reason. Learning minutaie disease will score you 1-3 points max because those diseases are revealed with a buzz-word that's easier to memorize and there's limited things to ask about them. On Shelves, they try to trick you by throwing very confusing vignettes at you that can be 2-3 different, but common things. However, there will be 1 or 2 clues in there that will make one answer the most likely (for example, Kawasaki's vs. Strep Infections they'll give you a sterile UA or 6 day high non-breaking fever). Also, some diseases have very specific therapies so know those. That's why it's important to know the subtleties of the major diagnoses which most review sources like Uw and OnlineMedEd emphasize which is why you need to them for shelf as well as rotations.

#2. Pre-Test is a 500 question review book where they ask 50O MCQs and then follow up with 500 corresponding explanations similar to UW. It's a great source, but it's strength is recognizing the rare diseases like Prune-Belly Syndrome for example or the fact that anti-aquaporin antibodies are seen in transverse myelitis. You can see how Pre-Test is a great book for shelves where the subject matter is detailed (neuro, peds), but the shelf is less interdisplinary (less medicine, surgery, etc.).
-----------------------------------------------------------------------

Now that you've done all of this, Step 2 CK prep is 100% effort, 0% strategy.

#1. Re-watch OnlineMedEd
#2. Absolutely NAIL down UWORLD CK.

Again, 0% strategy, 100% execution. You've learnt everything you need to do. Now it's time to review the things Step 2 will actually throw at you and if there's minutiae you'll miraculously remember it (notice how this parallels the strategy of how working hard in classes sets you up for Step 1). Lastly, don't waste your time with Kaplan or DIT. Both are trash for Step 2. For one, they are old and re-recorded. Second, they are way longer and less HY than OnlineMedEd. Third is that they'e each like $500 while the rest is free.
Thanks for this amazing guide! Do you think it would be worth doing the questions on AAFP for the FM shelf? Or do the cardio/pulm/GI questions of UW IM? I have 7 more weeks of FM, and I'm just reading Case Files FM and doing Bro's step 2 CK deck and another anki deck daily right now. I'm trying to get Case files done within the next 10 days so I can start doing pre-test and AAFP questions. Any advice you have on my strategy would be greatly appreciated!

I also have 8 weeks IM and 8 weeks surgery back to back right after I'm done with FM.
 
Easily the best resources for m3 are uptodate onlinemeded and uworld. The rest is just supplemental
 
Thanks for this amazing guide! Do you think it would be worth doing the questions on AAFP for the FM shelf? Or do the cardio/pulm/GI questions of UW IM? I have 7 more weeks of FM, and I'm just reading Case Files FM and doing Bro's step 2 CK deck and another anki deck daily right now. I'm trying to get Case files done within the next 10 days so I can start doing pre-test and AAFP questions. Any advice you have on my strategy would be greatly appreciated!

I also have 8 weeks IM and 8 weeks surgery back to back right after I'm done with FM.

You're welcome! I really tried to do a good job so I hope it helps future readers! For FM, I didn't personally do the AAFP, but it does seem to be the consensus QBANK...but these In-House exams are really good. PM me and I can send you the retired In-House exams (2012-2015, 4 exams, 240q/each, great explanations to accompany them). I can see how think doing cardio/pulm/GI questions would help but I think the Case Files book does a really good job for family emphasizing HTN/COPD/Asthma/CHF and their respective stages, therapies, and exacerbations which is the main carry-over from IM. As for Bro's Step 2 CK deck, I want to open up and say that I tried to use Bro's Step 1 deck for a good part of 2nd year. It didn't work. If that's you, you may find it less useful. If it was helpful, maybe it'll be good. I would not encourage doing as many resources as you were doing.

FM is the broadest shelf. A common misconception is IM = Family. It's not because Family is literally superficial knowledge of every rotation you'll do. You pretty much need to know the bread and butter of OB/GYN (Abnormal Uterine Bleeding, Primary/Secondary Amenorrhea, etc.), popular diseases and management for IM (see 1st pp.), when to operate for surgery, the common neurological diseases and stroke management, common psychiatric conditions and their medications, and a TON of pediatrics (sore throat, rashes, and etc.) as well all the preventative medicine/clinic knowledge like JNC-8 guidelines and which anti-hypertensives to use, MSK injuries (ankle only XR if point tender or unable to bear weight whereas swollen knee needs an MRI if it's an MSK thing).

I know the gunner-spirit in you is saying I'm going to honor this shelf no matter what, but understand this is your first shelf. You may very well honor, but trying to cram in the equivalent of studying for 3 shelves you normally have 2 months/each for to study for over a 2 month rotation (i.e. 3-fold efficiency) isn't the best way to do it. You will learn so much over this year and unfortunately, shelves like to ask random detailed questions from other disciplines that you just can't prepare for at this time. The main issue I'm seeing with your plan is too many resources. If you stick to 1.) Case Files. 2.) One QBank 3.) MedBullets for Peds stuff 4.) SUTM for Ambulatory, this is a very rigorous plan which will allow your best on Family. To score the +1SD for Family Shelf which is usually what's required to honor, you need like about an 83 which, if you're a good test-take won't be terribly difficult.
 
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