Medicine Shelf Difficulty

Started by AlexRusso
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AlexRusso

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is it just me or was the medicine shelf the hardest exam you ever had to take. I did well in the first two years of med school honoring almost every course and did very well on my Step 1 so I figure I am a descent test taker. IM was my first clerkship and that exam absolutely rocked me. I blindly bubbled in the last 12-15 questions and read about 1 or 2 words at most from the 15-20 or so questions before those. Even the questions I read in full I dont think I got right?

I'd rather take the Step 1 5 times than sit through that shelf again.

Am I alone in this? what the hell was wrong with this test (or me)?

Sorry....just venting
 
Alex,

Did you do MKSAP? I found MKSAP to be extremely helpful. I had time (after doing the looooooooooooooooooong questions in MKSAP) to go back and re-read 20 questions that I wasn't sure on.

But, of course, I could be way off and I'll post when I get my score back.
 
AlexRusso said:
is it just me or was the medicine shelf the hardest exam you ever had to take. I did well in the first two years of med school honoring almost every course and did very well on my Step 1 so I figure I am a descent test taker. IM was my first clerkship and that exam absolutely rocked me. I blindly bubbled in the last 12-15 questions and read about 1 or 2 words at most from the 15-20 or so questions before those. Even the questions I read in full I dont think I got right?

I'd rather take the Step 1 5 times than sit through that shelf again.

Am I alone in this? what the hell was wrong with this test (or me)?

Sorry....just venting
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Just wait until you get to the surgery shelf!
 
AlexRusso said:
is it just me or was the medicine shelf the hardest exam you ever had to take. I did well in the first two years of med school honoring almost every course and did very well on my Step 1 so I figure I am a descent test taker. IM was my first clerkship and that exam absolutely rocked me. I blindly bubbled in the last 12-15 questions and read about 1 or 2 words at most from the 15-20 or so questions before those. Even the questions I read in full I dont think I got right?

I'd rather take the Step 1 5 times than sit through that shelf again.

Am I alone in this? what the hell was wrong with this test (or me)?

Sorry....just venting
Click to expand...

As I stated in another thread, you are not alone. I too blindly bubbled in the last 15 question (85-100) and its a surprise I even passed the darn thing but of course my grade was loooooow. I just knew I was going to honor it.


I finished the MSKAP book and thought those questions were not all that challenging but too bad my prep didn't involve timing myself because sitting through MSKAP under non-timed conditions is a helluva lot different than sitting through the IM medicine exam and having 2 hours to complete it. What was getting under my skin was that it seemed like the more time ticked way, the longer the freaking vignettes got.

I still haven't come up with a strategy for the next shelf. I will vist my academic counselor to check out her recommendations. I got my FM shelf in exactly two weeks and the actual rotation is only 3 1/2 weeks which sucks for preparation.
 
bigfrank said:
Alex,

Did you do MKSAP? I found MKSAP to be extremely helpful. I had time (after doing the looooooooooooooooooong questions in MKSAP) to go back and re-read 20 questions that I wasn't sure on.

But, of course, I could be way off and I'll post when I get my score back.
Click to expand...


I did MKSAP twice. I read FA for IM twice. Did all of Pre-test. Read Blueprints. Read the relavant sections in Pathophys for Sep II and III. Did all the IM questions in Kaplan Qbook timed. Read Kaplan lecture notes for IM. Read Up-to-date on all my patients. Read a considerable portion of Ferri's.


All this to no avail. Now I'm at a real loss as to how to prepare for all other shleves. I thought I went all out on this one. Didn't help.
 
I thought the shelf was difficult, but not impossible. I scored well on the exam and did not feel that I put ridiculous amounts of time into studying. I read blueprints one time only and did the questions in blueprints, blueprints q and a, and blueprints clinical cases (about 385 questions between these 3 books). I did all this over the first 6-7 weeks of the clerkship. The last 5 weeks of the clerkship I spent doing pre-test, mksap 1 and 2, and reading sections in cecil's if I found myself consistently doing poorly on certain sections. Most importantly, I finished all the questions on the exam, but did not have a chance to go back and double check. This strategy worked for me as I scored in the 96th percentile.

IMO, the most important thing to do well is to work briskly and be efficient with your time. Do not dwell on questions that you do not know the answer to (guess and move on). Also, read the answer choices before reading the passage because for a few questions (probably less than 5), the question can be answered with one or two facts from the passage. For example (this specific one wasnt on the shelf but was in mksap...the shelf had similar scenarios), they may give you a big long history of someone with CHF. They will tell you all of their signs and symptoms (orthopnea, swelling, sob, cough, s3, jvd with hjr, pitting edema, and so on and so on) and all of their labs. But the question is what drug has been shown to decrease mortality in this pt. You would pick the ace inhibitor and move on. You do not need the entire h and p to answer this question. If you do not do the last 10 questions and guess on all of them, you may get 2 or 3 right. If someone else reads through all 10 and gets 7-8 right, the extra 6 correct answers would be a difference of about 30 percentile points. So work quick and make sure you do not dwell on questions that are ridiculously hard. There are about 10 experimental questions on their that arent even graded so if a question seems vague or poorly worded or beyond your level of education, it probably isnt even a graded question.
 
I thought the IM shelf was hard, but definately doable.

I used only MKSAP (made through once) and just read a medicine clerkship guide over the 8 weeks. that's it. I got over the 90% percentile. I thought MKSAP was really all you needed. that was the consensus at my school at least.

good luck on the rest,

later
 
AlexRusso said:
I did MKSAP twice. I read FA for IM twice. Did all of Pre-test. Read Blueprints. Read the relavant sections in Pathophys for Sep II and III. Did all the IM questions in Kaplan Qbook timed. Read Kaplan lecture notes for IM. Read Up-to-date on all my patients. Read a considerable portion of Ferri's.


All this to no avail. Now I'm at a real loss as to how to prepare for all other shleves. I thought I went all out on this one. Didn't help.
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Wow Alex, you did tremendously more than me and virtually everybody at my school. I'm sure you did better than you thought.

Best
 
geez, now u guys got me scared ****.....

how are the question lengths compared to kaplans...because i am barely completing 50q med blocks/hr.

i just hope finish
 
p.s. big frank...i think you need to update your footnote...things seem to have changed at the polls

bigfrank said:
"Are you really surprised that Bush is pounding Kerry in the polls and will do so on Election Day?"
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As always Scholes, a class act. Still jealous? :laugh:

scholes said:
Please God do not tell me that you truly do not see anything strange about a man wiping his pee hole. Why don't we just eliminate the urinal and we can all just sit and pee? And then we can all wear pink scrub pants with scrub tops that have hearts and puppy dogs on them.

I for one choose pee spot!
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Thank you for your continual insight!
 
In my opinion, the most difficult thing about the third year shelf exams is the increased length of the questions. There is so much fluff added to each question it's almost exhausting to have to read through it 100 times on a given exam. "A patient presents with butt pain. Lungs clear to auscultation bilaterally. Resonant to percussion in all four quadrants. Normal tactile fremitus in all four quadrants. No egophony present. Bowel sounds present. No bruits heard. No masses palpated." Yada, yada, yada. Blah blah blah.

You have to get in the habit of reading through of each question and underlining anything that's abnormal or that sounds like a buzzword, and then ignoring all the normal fluff they throw in there for "completeness". If labs are given, there's a ~80% chance that you'll need them to answer the question correctly (unless the question deals with renal or acid-base, in which every freakin' question seems to have the same standard lab values given). If you can get used to this, you can make it to where you'll only have to read a question through once, get the drift, and then make a solid choice. If you're unsure of your decision, you can always mark it and come back. This can save a bunch of time.

And while I'm on the subject, I've noticed two other things about third year shelf exams that differ from first and second year exams (and step 1). 1) Classic presentations don't appear nearly as often and 2) you have to know even the least known "buzz" associations for particular conditions. For example, if I said "chest pain and electrical alternans" and basically nothing else would you know what the most likely answer would be? On second year exams you probably would've seen it with the clue "patient reported in recent past feeling better when he leaned forward" or maybe even pulsus paradoxus, which would then make it absolutely obvious. When I took the medicine shelf I would read through these questions looking for dead giveaways, but I was rarely given any. Most of the time if I got any buzzwords at all, they were things that I may have read but didn't really pay any attention to (as in, surely they won't ask me about THAT aspect). The tests are getting more difficult and the writers DO expect you to know everything about disease if it relates to diagnosis, treatment, or prevention.
 
Yeah, I didn't think the shelf questions were too hard per say, but the time to take the exam sucked. I finished in time with about 8 min to go over stuff which I really didn't cause my brain was gone. I did most of MKSAP and most of Pretest (The profs from my school wrote it). I really didn't feel either of them helped that much. I felt reading about my patients and trying to understand all the patients I saw on rounds (even if I wasn't taking care of them) helped a lot. Oh yeah I also read half of NMS which is useless. Haven't got my score back yet though.... scary, you know how it goes when you think a test is not that hard.
 
you're right on. i had an S1Q3T3 for pulmonary embolus. something that i just happened to remember but nothing i would've paid attention to and tried to learn. it's weird.
 
12R34Y said:
I thought the IM shelf was hard, but definately doable.

I used only MKSAP (made through once) and just read a medicine clerkship guide over the 8 weeks. that's it. I got over the 90% percentile. I thought MKSAP was really all you needed. that was the consensus at my school at least.

good luck on the rest,

later
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I concur. I also got >90%, read NMS medicine once through and most of MKSAP. Personally it seemed like a lot of general knowledge, kinda like step I but only with clinical questions.
 
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