Official Internal Medicine Shelf Exam Thread

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Hi Folks,

I was curious if anyone used any audio lectures to prep for the IM Shelf. I have a short drive to the hospital every day, and I would like to use my time in the car a little more productively than listening to morning sports radio every day (although still productive...). I still have Goljan and was considering going back to those, but I figured I would check in with the collective here to see if there is anything better.

Thanks
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WildernessMed said:
Hi Folks,

I was curious if anyone used any audio lectures to prep for the IM Shelf. I have a short drive to the hospital every day, and I would like to use my time in the car a little more productively than listening to morning sports radio every day (although still productive...). I still have Goljan and was considering going back to those, but I figured I would check in with the collective here to see if there is anything better.

Thanks
Click to expand...

There are Conrad Fischer's internal medicine lectures floating around, he does a lot of work for Kaplan. I couldn't find them by searching but I know they exist. You can also download Mcmumbi's step 2 podcasts, which apparently are not on iTunes at the moment but several people on this forum most certainly have them. There is also something called Gold Standard audio for Step 2, which is basically audio step 2 lectures, though this costs money: http://www.apolloaudiobooks.com/page.php?id=79

If you search "internal medicine" on the podcast section of iTunes, a few options pop up. The "BU General Internal Medicine Grand Rounds" podcast seems like it could be useful for you, plus it is free. Hope this helps.
 
Adelaide Nick said:
There are Conrad Fischer's internal medicine lectures floating around, he does a lot of work for Kaplan. I couldn't find them by searching but I know they exist. You can also download Mcmumbi's step 2 podcasts, which apparently are not on iTunes at the moment but several people on this forum most certainly have them. There is also something called Gold Standard audio for Step 2, which is basically audio step 2 lectures, though this costs money: http://www.apolloaudiobooks.com/page.php?id=79

If you search "internal medicine" on the podcast section of iTunes, a few options pop up. The "BU General Internal Medicine Grand Rounds" podcast seems like it could be useful for you, plus it is free. Hope this helps.
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Thanks! Very helpful
 
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Asp said:
Tier 1 -- Must use
USMLE World

Tier 2 -- Nice, but very much optional
NMS Casebook, USMLE Rx, Paying attention on rotation

Tier 3 -- Highly overrated
Step Up to Medicine, Casefiles, MKSAP3, MKSAP4

-----

I did World at a rate of 22 questions per day, redid the questions I got wrong, and then redid some sections I was weakest in.

I read about ~100 pages (mostly Cardiology) in Casebook. I tried doing some MKSAP 3, but gave up after getting halfway through.

If I did it over again I'd just do World, and read Casebook when a computer wasn't around. Casebook is overkill though, so don't stress the details. Just know the keys to diagnosis, and the cornerstones of treatment (i.e., surgery for Type A aortic aneurysm, beta blockers for Type B), and maybe a few mechanisms.

Having a strong STEP I foundation is very helpful. If you don't, I recommend doing all the Medicine questions in USMLE Rx Step 2 CK.

I got a scaled score of 97, which I'm happy with.

Overall the shelf is very straightforward. You don't need to read any books or have a high level of arcane knowledge. You need to do World intensely (spend about 1-2 good hours on those 22 questions), and test-taking skills. That's all.
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I agree with the above. Just got my score back: scaled score = 92

My prep:
1. UWorld - did all 1500 and marked those that I got right which I wasn't absolutely certain about. Redid those questions that I missed. Then started to redo marked items, but ran out of time long before I completed those.

2. Step-up - read through each chapter 2x on first pass. Didn't make a second pass except for cardiovascular.

3. Had a day-and-a-half off before shelf, so went through MKSAP 3 as much as possible... made it through about 2/3. Thought I wasted my time here... probably would have been better served by going through step up cv, renal, resp, infxs disease again or maybe going through my marked world ?'s.

I would add that the timing on this test is pretty brutal. Knowing that pace was going to be an issue, I emphasized speed on my world question sets... timed 44 questions each set all the way through. My goal was to finish each set with 15 minutes left which was really tough at first, but I got better with practice. If I hadn't practiced my timing, I would have been absolutely ****ed. One of my buddies had 20 items left when time was called which sucked b/c the easiest questions were at the end.

Best of luck to all. :thumbup:
 
I know they increased the amount of time on the shelves, but I am almost positive that they also similarly increased the length of the vignettes (although I have no way of comparing to the old shelves). In any case, you have to be a speed demon to finish. Props to anyone who can finish early.

Still waiting for my score...
 
So took the test today, thought it was hard, but doable,...
That is not to say I did great myself, but I felt like while there were a couple questions I had no idea, for the most part, I felt like the questions were not unreasonable and did not require too many assumptions (ie. give some guy w/ back pain, assume he's taking NSAIDS to cause whatever, in order to answer the question)

I did 90% of the UW IM questions, and used StepUp as a reference (no cover-to-cover, only sections I read every word of were CV, Pulm, GI and Ambulatory). We'll see how this turns out.

As for scoring, does anyone know how the true raw score (# correct/100) correlates to your 2-digit score (which correlates w/ a percentile)? I can't imagine that >94% of the nation gets >63/100 questions right on this...or maybe that's just me. :confused:
 
hey everyone,

this is a stupid question, but i'm not sure how to run through the usmle world questions a second time? is there some way to reset the memory of the questions to allow me to do that? right now, when i try to re-do the questions, it made me a new 44 question test the first time. then when i tried to make a second 44 q test, lots of the questions were repeats from the first 44 q test. i would like to be able to run through all of uworld freshly for a second time...any tips would be very appreciated!
 
How long does it take to get your score back for the IM shelf (or does that depend on the school)?
 
I agree with the majory. USMLE world was awesome, Step Up somewhat useful and MKSAP was useless. The questions were in no way similar to the MKSAP, and I would have been in real trouble if I had relied on it.
 
entranced said:
hey everyone,

this is a stupid question, but i'm not sure how to run through the usmle world questions a second time? is there some way to reset the memory of the questions to allow me to do that? right now, when i try to re-do the questions, it made me a new 44 question test the first time. then when i tried to make a second 44 q test, lots of the questions were repeats from the first 44 q test. i would like to be able to run through all of uworld freshly for a second time...any tips would be very appreciated!
Click to expand...
You can only reset the Qbank if you buy a 6 month or 1 year subscription, and you can only do it once. So, use it wisely. If you want to effectively use the questions twice, flag each question when you go through, and then when you go through it again, create a test with only flagged questions. Also, there are over 1000 medicine questions. How did you see repeated questions after only 1 test? I feel like you're not doing something right.
 
quick questions:
how much time do you have on the test for 100q's? It is in paper and pencil right? thanks!
 
eagle27 said:
quick questions:
how much time do you have on the test for 100q's? It is in paper and pencil right? thanks!
Click to expand...

I took it on Friday and they gave us 2 hrs. 30 min. Which was just enough time for me to finish and review a few, yes it is paper and pencil.
 
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DC DOC said:
I took it on Friday and they gave us 2 hrs. 30 min. Which was just enough time for me to finish and review a few, yes it is paper and pencil.
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You guys are the first to benefit from the time increase. It was 2 hrs 10 minutes until July.
 
DC DOC said:
I took it on Friday and they gave us 2 hrs. 30 min. Which was just enough time for me to finish and review a few, yes it is paper and pencil.
Click to expand...

Thanks! i heard they used to have matching questions. Is that right?
 
eagle27 said:
Thanks! i heard they used to have matching questions. Is that right?
Click to expand...
Yeah there are a few matching questions at the end. They're not really matching in the traditional sense as you usually have A through H or so choices and usually 4 matching questions, but I thought they were easier, so make sure you don't run out of time for those.
 
Guile said:
Yeah there are a few matching questions at the end. They're not really matching in the traditional sense as you usually have A through H or so choices and usually 4 matching questions, but I thought they were easier, so make sure you don't run out of time for those.
Click to expand...

My matching questions actually weren't that easy. I did skip to them first though.
 
Jolie South said:
My matching questions actually weren't that easy. I did skip to them first though.
Click to expand...
Yeah I've heard this from a few other people as well. Mine were and it seems like most people I've talked with had an easier time with the matching (almost everyone gave me the same advice before taking it: make sure you have time for the matching at the end since they're easier).
 
Guile said:
Yeah I've heard this from a few other people as well. Mine were and it seems like most people I've talked with had an easier time with the matching (almost everyone gave me the same advice before taking it: make sure you have time for the matching at the end since they're easier).
Click to expand...

Yea, I was expecting easy, but they just weren't. They were very atypical presentations.
 
I did all of the MKSAP questions, all of the UWORLD questions (once), and read through case files. I had a good feeling when I left the test, but came out with an 84, which was the class average. I should have not spent 80 hours a week working in the hospital during my last rotation, because I thought that it might earn me a good review, but it just got me an average review. Maybe if I completed Step Up to Medicine it would have helped. I don't really know where I went wrong. . .
 
Bear in mind the national average is 70 with a SD of 7-8, so nationally you did quite well.
 
Guile said:
Bear in mind the national average is 70 with a SD of 7-8, so nationally you did quite well.
Click to expand...

Thank you for the encouragement. However, on my transcript I just have a P, so I might have well just barely passed!
 
Asp said:
Tier 1 -- Must use
USMLE World

Tier 2 -- Nice, but very much optional
NMS Casebook, USMLE Rx, Paying attention on rotation

Tier 3 -- Highly overrated
Step Up to Medicine, Casefiles, MKSAP3, MKSAP4

-----

I did World at a rate of 22 questions per day, redid the questions I got wrong, and then redid some sections I was weakest in.

I read about ~100 pages (mostly Cardiology) in Casebook. I tried doing some MKSAP 3, but gave up after getting halfway through.

If I did it over again I'd just do World, and read Casebook when a computer wasn't around. Casebook is overkill though, so don't stress the details. Just know the keys to diagnosis, and the cornerstones of treatment (i.e., surgery for Type A aortic aneurysm, beta blockers for Type B), and maybe a few mechanisms.

Having a strong STEP I foundation is very helpful. If you don't, I recommend doing all the Medicine questions in USMLE Rx Step 2 CK.

I got a scaled score of 97, which I'm happy with.

Overall the shelf is very straightforward. You don't need to read any books or have a high level of arcane knowledge. You need to do World intensely (spend about 1-2 good hours on those 22 questions), and test-taking skills. That's all.
Click to expand...

Great advice. Wish I had stuck to just UWORLD and completed all 1421 questions. I did ~950 q's and wish I finished it, it was sooo useful for the shelf. In the beginning I tried reading Step Up from cover to cover, I tried in the beginning and got through about 120 pages before I realized I hate reading and rather do questions. Took the shelf today, and UWORLD was so freakin helpful, really should have finished it all in hindsight. You need to spend like 2 hours reviewing each block though to extract the most out of UWORLD.

Oh, after I quit the cover to cover mission of Step Up, I just read up on info relevant to my patients in Step Up/Red Book/UpToDate.
 
Real Name said:
Thank you for the encouragement. However, on my transcript I just have a P, so I might have well just barely passed!
Click to expand...
It's a bummer, I know. We have to break 90-92 to get honors. I felt the pain of barely missing the cutoff in another rotation.
 
Got the shelf coming up in two weeks. Can anyone tell me if biostats and/or health maintenance (screening tests) is tested on the shelf? If so, are they high yield to study?
 
I took IM shelf thursday, I had like one biostats question, a couple prevention. I thought step up and uworld were both good, i only made it through like half of the UW q's unfortunately.
 
Did all 1500 Uworld questions, Read Step Up 2-3x, Case Files, and did MKSAP 4 once and then redid questions I missed.


Felt really solid about the shelf exam. I knew I missed around 6-8 questions (they were questions regarding surgical mgt really). On the other hand, I had a few questions that were off my peds and ob shelf so paid off in that way.

Had 1 question on biostats but was really easy. 1 ophtho question. A few derm. 1 EKG to interpret. Heavy on rheum actually. Read the last line of the question first and then the answer choices, and then read throuh the question. The questions are long and you dont want to waste time.

Ended up getting a 92. My clerkship director told me it correlated to 97%ile nationally. Haven't gotten my official score report with the mean/SD but from my past exams that sounds about right with a 70-75 mean and 7-8 SD.

My rotation was 1 month inpt, 1 month out, 1 month inpt. I finished reading Step Up once before the end of my first month and then spent my 2nd month re-reading, doing mksap, and starting uworld.

The single most impt piece was really learning while on the wards and paying attention to all of my patient's issues. My first month was on a crazy service that had about 20-25 patients and we had close to 3-4 new admits a day. The high turnover resulted in us rounding from 6-12 daily and although the long winded discussions got to be old after a while, the bulk of my learning came from this.

Uworld is probably next most impt part. Really helped fill any gaps. I bought a 1 month subscription and started to work on it a month before the shelf and did 50-100 questions daily. Read Case files whenver you get a chance and re-read the summary boxes the day before your exam.

Read Step Up a few times throughout the rotation and you'll be fine. Cheers!
 
alesdu1 said:
Did all 1500 Uworld questions, Read Step Up 2-3x, Case Files, and did MKSAP 4 once and then redid questions I missed.


Felt really solid about the shelf exam. I knew I missed around 6-8 questions (they were questions regarding surgical mgt really). On the other hand, I had a few questions that were off my peds and ob shelf so paid off in that way.

Had 1 question on biostats but was really easy. 1 ophtho question. A few derm. 1 EKG to interpret. Heavy on rheum actually. Read the last line of the question first and then the answer choices, and then read throuh the question. The questions are long and you dont want to waste time.

Ended up getting a 92. My clerkship director told me it correlated to 97%ile nationally. Haven't gotten my official score report with the mean/SD but from my past exams that sounds about right with a 70-75 mean and 7-8 SD.

My rotation was 1 month inpt, 1 month out, 1 month inpt. I finished reading Step Up once before the end of my first month and then spent my 2nd month re-reading, doing mksap, and starting uworld.

The single most impt piece was really learning while on the wards and paying attention to all of my patient's issues. My first month was on a crazy service that had about 20-25 patients and we had close to 3-4 new admits a day. The high turnover resulted in us rounding from 6-12 daily and although the long winded discussions got to be old after a while, the bulk of my learning came from this.

Uworld is probably next most impt part. Really helped fill any gaps. I bought a 1 month subscription and started to work on it a month before the shelf and did 50-100 questions daily. Read Case files whenver you get a chance and re-read the summary boxes the day before your exam.

Read Step Up a few times throughout the rotation and you'll be fine. Cheers!
Click to expand...

That sounds low to me. When I got my score report back it was an average of 70 with an 8 standard deviation, which places a 92 at a 2.75 z-score which, if normal, would be 99.85 percentile.
 
rem6775 said:
That sounds low to me. When I got my score report back it was an average of 70 with an 8 standard deviation, which places a 92 at a 2.75 z-score which, if normal, would be 99.85 percentile.
Click to expand...
There is a little black magic involved in calculating these percentiles. Someone mentioned here or in another shelf thread that this average of 70 and SD of 7-8 was a "representative testing" used to represent a national test administration. So it's not the same mean and SD for each testing. But I agree: something doesn't add up. Maybe someone else can weigh in.
 
Guile said:
There is a little black magic involved in calculating these percentiles. Someone mentioned here or in another shelf thread that this average of 70 and SD of 7-8 was a "representative testing" used to represent a national test administration. So it's not the same mean and SD for each testing. But I agree: something doesn't add up. Maybe someone else can weigh in.
Click to expand...


This is a common misconception with these tests. The NBME website needs to remove the "70 SD 7-8" phrase from their website. I've looked at several of the score reports (from last year when I was an M3). The M3 year is split into four different time periods with %ile adjusted based on how early (or late) you took the shelf during the year. This is based on the presumption that you SHOULD do better as the year progresses. This is so the course directors COULD decide to adjust the raw score a student achieves based on when they took the exam. For example (this is hypothetical), you could get a raw of 80 in August and it be 80th percentile. If you had a raw of 80 in April it could be 70th percentile. From my experience course directors rarely correct the RAW score based on the time period. However, the NBME score report that the course directors receive include this data.

Now, from looking at medicine, peds, others... 70 with SD 7-8 is NOT CORRECT! For example, for my medicine exam the national average was 73.8 (I beleive) with SD of 8.1( or so). This is why posters are having problems calculating their %ile and rectifying it with what their course directors are telling them. The raw score average and SD are ALL around 73-75 ( SD~ 8) or so and when I took psych in the spring the raw natl average was 75.2 (SD ~8). If you really want to know this information ask your course director to look at the sheet the NBME provides them. It's that simple.

That is all
 
What I did to prepare for the shelf:

I stopped relying on books. For this rotation, i just questions. I ended up doing all of usmle world, mksap 3 and 4, as well as the kaplan step 2 qbook (the internal medicine questions). After I finished all the usmle world medicine questions I went back and redid the ones that I missed.

Usmle world and kaplan questions were amazing. Kaplan questions weren't very long, but the concepts were super high yield. Usmle world was amazing overall.

Mksap 3 and 4-complete garbage. I didn't get any questions right thanks to mksap 3 or mksap 4-very very very low yield. You would be better off just redoing the usmle world questions if you have extra time.

Basically my advice-use step up occasionally as a REFERENCE (if you use it at all) . don't study it, just do as many questions as possible. This was the first rotation that i completely stopped relying on books and put ALL of my time into doing questions. Trust me I'm not one of those people who always does well on shelf exams. It was the mass amount of questions I did that made the difference between this and previous shelf exams.

Scaled score=99 :D

Does anyone know what the average/SD for the exam at the end of September was? Our school doesn't give us that info.
 
Last edited:
Just got my score back: 91.

Used MKSAP 4 and did all the UWorld Step 2 CK questions a little each day after work. Read Step Up as a reference prn and when I got tired of doing questions.


Also, to the poster above, the mean is always set at 70 with a standard deviation of 8.
 
I just got my score back as a 93.

I used: 1.) Step Up, 2.) First Aid Step 2 CK Questions ($40), and 3.) MKSAP. I considered using UWorld, but First Aid was cheaper, and I could carry it with me.

I had already done my surgery and psych rotations.
 
We have 12 months of IM, all inpatient. I read Step Up during the rotation, and the last week I read MKSAP4, Case Files, and Pretest. Just got my score back at 96.

Step Up was by far the best for information. Pretest and MKSAP4 tied for questions. Casefiles was a nice review of some of the big concepts (like MI and CHF management) in the week before the shelf.

Good luck!
 
DoctorDreamer said:
We have 12 months of IM, all inpatient. I read Step Up during the rotation, and the last week I read MKSAP4, Case Files, and Pretest. Just got my score back at 96.

Step Up was by far the best for information. Pretest and MKSAP4 tied for questions. Casefiles was a nice review of some of the big concepts (like MI and CHF management) in the week before the shelf.

Good luck!
Click to expand...
12 months of IM? Epic rotation.
 
All you ballers scoring in the 90's, what % were you getting on UWorld questions?
 
I see a lot of people thought MKSAP was a waste. MKSAP 4 was my primary study tool. Other than that, I sped through a few chapters of Step Up. I thought MKSAP was way more useful than Step Up. I did all the sections of MKSAP but did not place too much weight on the general medicine section. I ended up with a raw of 93.
 
rockity said:
I see a lot of people thought MKSAP was a waste. MKSAP 4 was my primary study tool. Other than that, I sped through a few chapters of Step Up. I thought MKSAP was way more useful than Step Up. I did all the sections of MKSAP but did not place too much weight on the general medicine section. I ended up with a raw of 93.
Click to expand...
I have noticed an interesting trend of people saying "MKSAP 4 was a waste of time but I did it" and high scores.
 
I've gotten mixed reviews regarding MKSAP. A good friend said her test was taking questions verbatim from MKSAP (she got >90) and other people on this forum have said MKSAP was a wash.

It seems like quite a few people didn't even use UW on this forum? Hmm. Maybe it depends on which day you're taking the test because it varies?
 
so I bought USMLEWorld last night because of what I have been reading here and so far I find the UWorld questions to be similar in difficulty to MKSAP 4; been getting 70s on both. I hope the 200 bucks I spent on USMLEWorld is gonna buy me honors, but it seems like I could have gotten away with just MKSAP 3-4 after all.
 
myhandsarecold said:
so I bought USMLEWorld last night because of what I have been reading here and so far I find the UWorld questions to be similar in difficulty to MKSAP 4; been getting 70s on both. I hope the 200 bucks I spent on USMLEWorld is gonna buy me honors, but it seems like I could have gotten away with just MKSAP 3-4 after all.
Click to expand...

Well, I mean I did the whole medicine bank, so obviously there's some breadth there that you can't get with MKSAP due to the sheer volume alone.
 
Jolie South said:
Just got my score back: 91.

Used MKSAP 4 and did all the UWorld Step 2 CK questions a little each day after work. Read Step Up as a reference prn and when I got tired of doing questions.


Also, to the poster above, the mean is always set at 70 with a standard deviation of 8.
Click to expand...

:rolleyes: i lol'd a little at this. congrats
 
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