Official Internal Medicine Shelf Exam Thread

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Ismet said:
It's been great! Not taking the shelf for another month, but the videos are super helpful, especially if you're a visual learner. I'm working my way through the "intern content" this weekend.
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Cool. I have done all of cardio today after reading that section in Step Up. I like these videos much better. That book is hard to read to me and I feel like I am not getting it and having to go over stuff again and again.

I think I will just watch them and do UW.
 
J DUB said:
Cool. I have done all of cardio today after reading that section in Step Up. I like these videos much better. That book is hard to read to me and I feel like I am not getting it and having to go over stuff again and again.

I think I will just watch them and do UW.
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That's my plan as well, but splitting questions between UWorld and MKSAP 5. Tried Step Up and I just don't think it's feasible.
 
Ismet said:
That's my plan as well, but splitting questions between UWorld and MKSAP 5. Tried Step Up and I just don't think it's feasible.
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Yeah, if I get through 1300 something questions in UW. I think and hope that should be enough. lol

I am not a good study person for these shelves.
 
just got my shelf score yesterday: 94
Overall my IM rotation was 12 weeks long and i think the trick to doing well was to start UWORLD from day one!
I used SUTM and stuck with it for the entire rotation. I tried to tackle 10-20pgs a day [depending on how well I knew the subject] and divided the corresponding subjects accordingly, i.e. if rheumatology was 60 pages, I gave myself 3-4days to tackle it.
Before doing uworld I would skim MTB2 [focused mostly on the green boxes and just read it once over for the subject]. I would then do the entire subject on uworld and then I would annotate each and every question...this took the longest. I would do my annotations once I got home each night and then do these annotations for roughly 2hrs and then read SUTM for 1 hr. I did this and it took me roughly 2 months [I had 2 weeks off during christmas holidays but I managed to do neuro and heme/onc during these 2 weeks]. Overally, my entire annotation 'packet' was 200+pgs and once that was done I just went over that packet in detail for the remaining month. About 1 week before the shelf I skimmed MTB2 one more time and did form 1 [predicted 90]. The last few days I just kept going through the packet.
For the actual shelf, it was again a random test, filled with WTF moments. Major emphasis was placed on preventative medicine. I had one biostats question that had a trick with it [asked an easy concept but the numbers that they gave you required some manipulation]. Derm, ENT and rheumatology were very straight forward.
Overall the best source was Uworld. Read SUTM or MTB when you can and read up on your patients before you present and after rounds are done. Hope this helps.
 
Taking this shelf in 2 week and had some questions:

Are there any ambulatory questions on this shelf or is it mainly ward stuff?

Can people who did UWorld and have taken the shelf post what they were averaging for the last 5 or so question sets vs what they got on the shelf? Mainly want to know what I should be getting on UWorld for a shelf equivalent of >90

Thanks!
 
Laplace said:
Taking this shelf in 2 week and had some questions:

Are there any ambulatory questions on this shelf or is it mainly ward stuff?

Can people who did UWorld and have taken the shelf post what they were averaging for the last 5 or so question sets vs what they got on the shelf? Mainly want to know what I should be getting on UWorld for a shelf equivalent of >90

Thanks!
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There's ambulatory stuff, but still mostly ward.

Haven't gotten my score back yet so I can't comment on your second question. I thought the shelf was harder than UWorld though.
 
Laplace said:
Taking this shelf in 2 week and had some questions:

Are there any ambulatory questions on this shelf or is it mainly ward stuff?

Can people who did UWorld and have taken the shelf post what they were averaging for the last 5 or so question sets vs what they got on the shelf? Mainly want to know what I should be getting on UWorld for a shelf equivalent of >90

Thanks!
Click to expand...

I think I was around 80% pretty consistently through the majority of the blocks, got a 94
 
Laplace said:
Taking this shelf in 2 week and had some questions:

Are there any ambulatory questions on this shelf or is it mainly ward stuff?

Can people who did UWorld and have taken the shelf post what they were averaging for the last 5 or so question sets vs what they got on the shelf? Mainly want to know what I should be getting on UWorld for a shelf equivalent of >90

Thanks!
Click to expand...
some ambulatory, most was straight forward
was scoring around 75-85 near the end but TBH the shelf was way more difficult than uworld; there was just simply too many WTF type questions!
 
I'm looking like a boss in front of my attending because of MTW: IM by Conrad Fischer. Other students during morning table rounds were dead silent and I was answering everything. They came up to me and asked how I "know" so much and I told them my secret. Even laughed and said if I were a gunner I wouldn't have told them LOL. Should be good for shelf prep too. I don't even bother carrying the "purple book" around with me anymore.

Doing Uworld and MKSAP 5. Don't think I'll have time to read SUTM.
 
Thanks for the responses! Down to ~400 UWorld questions, you guys think it would be more beneficial to switch over to MKSAP to fill in some holes for the rest of the week or finish UWorld? Haven't used any kind of reading source, just been doing questions, varying between 75-91 on UWorld (wide swing I know)
 
Took this today, overall I think it was the easiest shelf so far but also studied more for this one. I'd say there were 10-15 questions I wasn't sure on, much better than most shelves. Mainly did UWorld which was awesome preparation, will post back with score.

Anyone figure out yet how these shelves are scored? It doesn't seem like 10 wrong = 90 from past experience, the raw score is usually higher than what an absolute percentage would be.
 
Took it today. Just keep in mind, I had family, peds, and surgery before internal.

Felt surprisingly straight forward. Some random diagnoses, but for the most part a lot of pathophys and next best step questions. For example, >75% of the questions required you to recognize a dx then state the next best step or something about the disease process itself (which shouldn't seem too surprising). I've heard comparisions made between the Family Medicine and Internal Medicine shelves, and I can say after taking both that Family was a lot more random with a greater focus on prev med, which I found harder.
Lots of labs too on this one and you definitely have to infer from the info they give. Thought infectious disease was the hardest stuff, while pulm/cv (which are weighted most) were easiest. Go figure 🙂

Books I used, in the following order:

Case Files-->MTB Step 2 CK-->NMS Medicine Casebook

I did all of Pretest Medicine and UW Internal Med and annotated from UW to Step Up To Medicine, which I did use, although I never read straight through. I would just read relevant sections in areas I was struggling with in UW or from questions I missed. I did this bc I plan to just use SUTM with annotations for dedicated Step 2 time.

Good luck! It's not hard but definitely study a little bit each day from day 1-shelf time. Focus on your weaknesses as well!

I will report my score when I get it so others can see if my thoughts and study plan were worth anything 🙂
 
Just took it today.

Background: completed all 3rd year rotations, except surg. Step I 250-260

Study habits: Terrible this rotation, only got through about 700/1400 of uWorld Internal Medicine Q's all in the last 10-days. Studied along with my patient's diseases, worked many 12-hour days, 6-days a week for the entire 12 week rotation. Did two chapters of MKSAP Q's.

Resources:
UWorld = $$$ there were several Q's that were straight repeats off of UWorld. Wish I did the whole thing.
MKSAP = ¢¢¢ it was okay for secondary Q's but UWorld was much much better.
Uptodate = fact check everything
First Aid for Step I = I know where everything is in that damn book

Test itself: VERY long stems, lots of lab values. I'm a quick reader and only had time to recheck 20/100 Q's (I usually go through the test a second time if time allows).
# CV>pulm>renal>GI>autoimmune seemed overrepresented in that order.
# Everything in medicine is fair game.
-Thought it was a very doable test overall with some laughably easy questions (50/100). However there was enough uncertainty on awkwardly phrased questions (10/100), legitimately hard questions (10/100) and moderately tough questions (30/100) to make it a crap shoot when it comes to scoring.
 
"Case Files Cardiology" -- Has anyone read this book? Is it good for the Cardio component of IM or is it perhaps overkill?
 
Iatrike said:
"Case Files Cardiology" -- Has anyone read this book? Is it good for the Cardio component of IM or is it perhaps overkill?
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Definitely overkill for the exam I took, there were very few cardio questions (~10 or so) and they were all extremely straight forward. I'd say even the detail in SUTM is over kill but if you know it, you should have no problems answering cardio questions.
 
didn't think this one was too bad. Very similar to NBME 1. Ended up with a 92 on NBME 1 as well as the real deal.

Used SUTM, Uworld and MKSAP 5. Shelf was pretty straightforward with mostly bread/butter ward stuff, some esoteric **** and a few preventative medicine questions.
 
guitarguy23 said:
Took it today. Just keep in mind, I had family, peds, and surgery before internal.

Felt surprisingly straight forward. Some random diagnoses, but for the most part a lot of pathophys and next best step questions. For example, >75% of the questions required you to recognize a dx then state the next best step or something about the disease process itself (which shouldn't seem too surprising). I've heard comparisions made between the Family Medicine and Internal Medicine shelves, and I can say after taking both that Family was a lot more random with a greater focus on prev med, which I found harder.
Lots of labs too on this one and you definitely have to infer from the info they give. Thought infectious disease was the hardest stuff, while pulm/cv (which are weighted most) were easiest. Go figure 🙂

Books I used, in the following order:

Case Files-->MTB Step 2 CK-->NMS Medicine Casebook

I did all of Pretest Medicine and UW Internal Med and annotated from UW to Step Up To Medicine, which I did use, although I never read straight through. I would just read relevant sections in areas I was struggling with in UW or from questions I missed. I did this bc I plan to just use SUTM with annotations for dedicated Step 2 time.

Good luck! It's not hard but definitely study a little bit each day from day 1-shelf time. Focus on your weaknesses as well!

I will report my score when I get it so others can see if my thoughts and study plan were worth anything 🙂
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Don't know my actual number score, but 93rd percentile nationally, so should lock my A down. I would recommend reading a lot and doing a lot of questions.
 
Laplace said:
Took this today, overall I think it was the easiest shelf so far but also studied more for this one. I'd say there were 10-15 questions I wasn't sure on, much better than most shelves. Mainly did UWorld which was awesome preparation, will post back with score.

Anyone figure out yet how these shelves are scored? It doesn't seem like 10 wrong = 90 from past experience, the raw score is usually higher than what an absolute percentage would be.
Click to expand...

Raw 94. I'd say just doing UWorld is enough, add a text (SUTM) if you want that 99
 
T minus four days (take it this friday)

Should I:
Finished Uworld, and MTB IM...
1. redo my incorrect on Uworld (592 questions = 13 blocks)...took notes the first time thru.
OR​
2. do MKSAP 5...have only done two chapters of it so far.

PLEASE HELP!
 
rcdamania said:
T minus four days (take it this friday)

Should I:
Finished Uworld, and MTB IM...
1. redo my incorrect on Uworld (592 questions = 13 blocks)...took notes the first time thru.
OR​
2. do MKSAP 5...have only done two chapters of it so far.

PLEASE HELP!
Click to expand...

I would redo your Uworld incorrects and just read through the explanations carefully.
 
So, I'm doing UWorld to prep for the shelf and getting absolutely destroyed, hovering around 50%....how similar are the UWorld questions to the shelf exam? I know people say it's the best resource, which is why I'm a bit worried.
 
addy said:
So, I'm doing UWorld to prep for the shelf and getting absolutely destroyed, hovering around 50%....how similar are the UWorld questions to the shelf exam? I know people say it's the best resource, which is why I'm a bit worried.
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MKSAP 16 for students was way closer to what the shelf was like. Uworld is pretty tricky with 2 nearly right answers but one is more right than the other. The real deal was very straight forward.
 
notbobtrustme said:
MKSAP 16 for students was way closer to what the shelf was like. Uworld is pretty tricky with 2 nearly right answers but one is more right than the other. The real deal was very straight forward.
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I thought MKSAP 16 was for internal medicine residents and costs ~$1,000...can you link me to what you're talking about?
 
addy said:
I thought MKSAP 16 was for internal medicine residents and costs ~$1,000...can you link me to what you're talking about?
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my bad, it's called mksap 5 for students and it's reasonably priced at like 50 bucks. Free if you know where to find it on the internet.

yea, mksap 16 is overkill for this, lol.
 
Took this exam recently and got the score back yesterday.

Prep: I did all the UWorld IM questions and the practice NBMEs. I ended up with ~ 80% on UW and 98 on both the NBMEs. The rotation was 8 weeks long, so I spent the first 7 weeks trying to hammer through all the questions (god bless their phone app) and took notes. I reviewed the notes in the last week and did the NBMEs a couple days before the exam.

Score: 99

I know some people advocate using either SUTM or MKSAP 5, but I felt like doing all the UW questions and understanding the concepts was more than enough. There were some stuff on the test that UW didn't cover, but most of the concepts in my exam were touched upon in UW. I felt that it was an even distribution between all the major systems. There were some preventive med questions and a couple questions from other clerkships like psych, surgery and OBGYN, but that's par for the course in all the shelf exams.

Good luck!
 
how on earth are you guys getting 80% on UWorld...what text are you using before doing the questions? or is this stuff you're picking up on the rotations?

I got a 230-240 on step 1 and this is my first rotation and I'm 1/3 done with the IM of UW and only scored at or above average on ~3 test...wtf...
 
addy said:
how on earth are you guys getting 80% on UWorld...what text are you using before doing the questions? or is this stuff you're picking up on the rotations?

I got a 230-240 on step 1 and this is my first rotation and I'm 1/3 done with the IM of UW and only scored at or above average on ~3 test...wtf...
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Bros?


I'm getting slaughtered over here....
 
addy said:
Bros?


I'm getting slaughtered over here....
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I wouldn't let it get to you. Some people read before UWorld, others don't. Makes a huge difference. The percentiles are also way off no matter when you use UWorld, because it's an average of people doing it for the first time (often more unprepared than for Step 1) and those doing it a 2nd time (a much larger population than for Step 1).

For what it's worth, I got 260+ on Step 1, got 80-90's on shelves, and averaged 73% on UWorld first pass. My Ob/Gyn average 1st pass was 57%. I usually did UWorld first or in place of reading. By far, the most important thing for shelf prep is that you thoroughly learn from UWorld. The rest is secondary.
 
kirbymiester said:
I wouldn't let it get to you. Some people read before UWorld, others don't. Makes a huge difference. The percentiles are also way off no matter when you use UWorld, because it's an average of people doing it for the first time (often more unprepared than for Step 1) and those doing it a 2nd time (a much larger population than for Step 1).

For what it's worth, I got 260+ on Step 1, got 80-90's on shelves, and averaged 73% on UWorld first pass. My Ob/Gyn average 1st pass was 57%. I usually did UWorld first or in place of reading. By far, the most important thing for shelf prep is that you thoroughly learn from UWorld. The rest is secondary.
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I guess that's my question. When you say "some people read before UWorld", what are they reading that covers these topics??

I'm averaging 50% right now and I'm sure it's a bit off because I'm doing full blocks after a full day's work so I'm mentally exhausted, but still....
 
addy said:
I guess that's my question. When you say "some people read before UWorld", what are they reading that covers these topics??

I'm averaging 50% right now and I'm sure it's a bit off because I'm doing full blocks after a full day's work so I'm mentally exhausted, but still....
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The corresponding recommended books:
-For IM: SUTM, maybe some MKSAP if you're insane
-For Surgery: Pestana notes/audio
-For every other subject: Blueprints/Case Files/FA for wards...there are one of each of these series for every shelf.
 
sorry if this is a dumb question, but where do we purchase mksap 5? I can't seem to find it for some reason. thanks!
 
zany_brainy said:
Amazon sells it, otherwise you can try the ACP website
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hmm, the ACP website doesn't have it and amazon is only renting it. seems like IM Essentials Questions is the newer version? Does anyone have any experience with it?
 
Just to clarify, you should be looking for the MKSAP for students, which is essentially 500 questions, with explanations, rather than MKSAP for IM boards, which is a 12 volume set of books used to study for your IM board exam after residency.
 
Newyorkgiants said:
copyrighted content removed by moderator
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For the first question the patient has MVP and is symptomatic so I would treat with beta-blocker. If patient has MVP and asymptomatic then it is reassurance but this patient has chest pain. To be honest I would have done cardiac enzymes x 3 (troponins, CK-MB) after the EKG because of the strong family history (dad and uncle were very young when they got MIs)

For the second question this patient has a macrocytic anemia with physical exam signs of cirrhosis/alcoholic withdrawal/hepatic encephalopathy and vital signs indicating tachycardia likely secondary to vomiting. BP takes time to change unless massive fluid loss. He has a beefy red tongue and macrocytic anemia - so answer would be B12-deficiency. The thrombocytosis is caused by dehydration (vomiting) + alcohol - the 3 most common causes of thrombocytosis is (1) dehydration - vomiting, diarrhea (2) pseudothrombytopenia (3) alcohol.
 
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I would second the reassurance and folate deficiency. The body typically has a year or more worth of b12 stored. Folate runs out faster. Also the guy has no neuro signs ( minus the tremulous was, but no evidence of combined subacute degeneration). Not positive but I would go with folate as well.

Of note: With mention of the thrombocytosis, anemia can cause this as well ( reactive thrombocytosis)
 
playingfrombehind said:
For the first question the patient has MVP and is symptomatic so I would treat with beta-blocker. If patient has MVP and asymptomatic then it is reassurance but this patient has chest pain. To be honest I would have done cardiac enzymes x 3 (troponins, CK-MB) after the EKG because of the strong family history (dad and uncle were very young when they got MIs)
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why enzymes x 3? If anything, she should get a cholesterol screen and an echo to r/o inherited hypercholesteremias and HTCM. Since those aren't options, reassurance is best.
 
Is Pretest Medicine recommended for the IM shelf? Or is UWorld the way to go? Any feedback from someone who might have utilized both would be appreciated. Thanks!
 
Has anyone used the student MKSAP Edition 5 lately for extra practice questions?
 
Yeah, I'd like to know if it's worth the time. I have the book and have done UWorld 1x and have 1 out of 2 months completed with the plan to do UWorld once more before the shelf....
 
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