Official Internal Medicine Shelf Exam Thread

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Hey so I did the practice NBME questions and got 19/20. I totally haven't studied enough during this rotation and I'm a little scared of failing the shelf. My hopes are resting on how I did on the practice q's. I haven't even quite gotten through Step Up, nor touched any qbanks of any sort at all. I did find myself easily and quickly answering the NBME 20 practice q's though. What should I make of my situation? Shelf on Friday.

I feel that I have a relatively strong fund of knowledge, 236 Step I, and good test taking skills in general. A little worried, a little not...basically just can't wait to be done with this rotation.
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Oh, man, I GET IT. BLACK WOMEN GET SARCOIDOSIS. SARCOIDOSIS AFFECTS BLACK WOMEN. WOMEN, WHO ARE BLACK, GET SARCOIDOSIS. SARCOIDOSIS AFFECTS WOMEN WHO ARE BLACK.

Ugh, seriously. How many times does UW think they need to ask me?
 
Just took the practice NBME questions as well. 19/20. Missed the melanoma question (thought it was basal cell). Those questions were seriously a piece of cake. I didn't get all the way through Step Up or Case Files either, but I've done 400+ UW questions and a good chunk of MKSAP3. Shelf is in the morning. Here goes nothing.
 
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2 months is nearly not enough to study for this thing... oh well, at least i get psych next 😎
 
TheProwler said:
Just took the practice NBME questions as well. 19/20. Missed the melanoma question (thought it was basal cell). Those questions were seriously a piece of cake. I didn't get all the way through Step Up or Case Files either, but I've done 400+ UW questions and a good chunk of MKSAP3. Shelf is in the morning. Here goes nothing.
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Yeah the questions were a walk in the park, totally misleading. I got rocked on the shelf this morn, hope I passed 🙁 didn't pace myself well and had to randomly bubble a few at the end
 
yohimbine1 said:
Yeah the questions were a walk in the park, totally misleading. I got rocked on the shelf this morn, hope I passed 🙁 didn't pace myself well and had to randomly bubble a few at the end
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that test felt like a sprint. I didn't have enough time on any question on that test to really think all the way through it. After I read the six-paragraph stem, I had to breeze through the answers and try to pick the right one.
 
Yeah, don't really understand the need for question stems that are ridiculously long only to have one little detail or lab value that gives away the answer... oh well, just kind of gets tiring with NBME reaming you test after test
 
wow... that was one hell of a tough exam. i have no clue how people get fewer than 10 questions wrong on that! pretty mind-boggling... anyone have any idea what the national mean is?

i'm not too thrilled that this counts as 50% of our clerkship grade at my school. woof! 👎
 
medstylee said:
wow... that was one hell of a tough exam. i have no clue how people get fewer than 10 questions wrong on that! pretty mind-boggling... anyone have any idea what the national mean is?

i'm not too thrilled that this counts as 50% of our clerkship grade at my school. woof! 👎
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Our administration changed the clerkship grade weight of the shelf from 15% to 50% less than 1 week into my IM rotation...which was at the county hospital here...stopped counting weekly hours at 84 (worse yet, most was scut) with 3 days off out of 28...literally had zero time to study let alone read on my own patients, until I had a meeting with my resident mid-way through week 3 of a 4 week rotation...then he started limiting my hours to 8 to 10 per day.

Too little, too late for me. I made an educated guess on at least 75% of the shelf questions. Ouch.
 
Were there any items you wish you would've studied more or seemed like they were over represented on the test?
 
laxman310 said:
Were there any items you wish you would've studied more or seemed like they were over represented on the test?
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I wouldn't have prepared any differently than I did. More time would've been nice, but it's like Step 1 - there's so much material that COULD be on there that you have to study everything as much as possible, but there's no way you'll cover it all.
 
laxman310 said:
Were there any items you wish you would've studied more or seemed like they were over represented on the test?
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for my test, i remember a lot more rheumatology than I would have liked to see.

does anyone know what score would be good for 75th percentile?
 
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For those of you who used UWorld Step 2 questions to review for this test, how representative was UWorld topics for topics on the shelf?

At my school neuro is a seperate rotation, but UWorld includes a lot of neuro under internal medicine. Was there any neuro on the shelf that didnt fall under what you would typically see on the medicine wards (i.e. some delirium, mental status changes, DTs, etc)?
 
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To anyone who has taken the shelf exam:

How many questions were on your test?

Added later:

Was there a particular focus on your shelf exam? For example, would you say ambulatory medicine was more frequently tested compared to say hematology?
 
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laxman310 said:
For those of you who used UWorld Step 2 questions to review for this test, how representative was UWorld topics for topics on the shelf?

At my school neuro is a seperate rotation, but UWorld includes a lot of neuro under internal medicine. Was there any neuro on the shelf that didnt fall under what you would typically see on the medicine wards (i.e. some delirium, mental status changes, DTs, etc)?
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I took it on Friday, and no lie, it's already a huge black hole in my mind. The test went so fast that it was hard for me to do anything other than read and fill in the scantron. Stroke questions are definitely fair game.
 
test was a freakin blur...had bout 6 questions i had to randomly fill in without even lookin at the choices cuz i ran out of time cuz i made the mistake of getting bogged down by hard questions and not moving on...just read as fast as you can..test is actually pretty basic...mksap 3 is cash money...i wish i would have done it multiple times...also case files is legit and i wish i had read more of it....i studied for oral exams from pocket medicine and covered the 15 core topics we had to learn for those..it was very good...dont get caught up with numbers and charts...you will never need to know all the components of a Child Score for this test..reading the sections on diagnosis and treatment in pocket medicine is pretty much all you need for this test cuz you should remember the basics from step 1 and you combine that prior knowledge with all this diagnosis and treatment stuff from pocket and then read mksap to fill in the blanks...mksap was good cept for some parts in cardio as well as alkalosis/acidosis crap which was too detailed as you wont have to calculate on this test...but dont sleep on mksap and pocket med..

a lot of people think that your score is the number of questions you get right which is far from the truth...i know from personal experience regarding the number of questions i know for sure i got wrong in addition to the ones i absolutely guessed on...actually i freaked out because i filled in all C's for the final 6 choices and then realized afterwards that they were matching questions and so i missed at least 5 of em for being an idiot 🙁 but thats what you get for basically pulling an all nighter...
 
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scpod said:
According to the report my school furnished us afterward, the national averages are:

Examination National Mean


Internal Medicine 75.2

Obstetrics / Gynecology 72.6

Pediatrics 74.6

Psychiatry 76.3

Family Medicine 72

Surgery 71.8
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O_O I thought the mean for the shelf exams are set at 70 with a std dev of 8. I guess you must be talking about raw scores, and I'm surprised that the raw scores average are so high.
 
Got an 85 (91st percentile) which is good enough to honor the exam component for the clerkship 😀

I read through Step Up which I liked and did MKSAP 3, 5 of the Kaplan Q book medicine tests, and some pre-test. I think Kaplan Q book is probably the best representation of the test from the question sources that I used. And the test is nothing like those free NBME questions online.
 
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obiwan said:
Got an 85 (91st percentile) which is good enough to honor the exam component for our shelf 😀

I read through Step Up which I liked and did MKSAP 3, 5 of the Kaplan Q book medicine tests, and some pre-test. I think Kaplan Q book is probably the best representation of the test from the question sources that I used. And the test is nothing like those free NBME questions online.
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99 here, obviously very happy. However, this was almost my exact experience with respect to Kaplan and NBME free q's. The NBME questions were ridiculously easy and not representative. What a gyp.

Was a hard shelf overall for sure. Definitely lots of ortho/anatomy q's and surgery q's I didn't know (someone with an ileostomy draining blah colored fluid- what electrolyte/molecule is deficient?? hello, when did I ever deal with patients s/p ileostomy?? and no, it wasn't as basic as b12 or standard malabsorption as far as I remember). And a bunch of 'which nerve is affected?'. One neuro stroke localization question. Bunch of step 1-level stuff too.

Fortunately, very little in terms of picky asthma guidelines and minute MKSAP stuff. Very little in terms of the nuances of antibiotic selection in the same MKSAP vein, other than maybe amox allergy, prophylaxis, and coverage for atypicals. I only got one 'complex' acid/base q, and that was a simple ABG and needed you to just use your common sense and calculate the AG. Yeah, no Child-Puigh score or anything like that, but I think I had a Ranson's criteria application q.

100 questions, the last 10 (maybe?) have choices A-M or something ridiculous like that. Some of those last few were 'pairs' with the same answer choices, like variants of a GI bleed and you had to tailor your management options to that particular complication in the question. You can definitely think of the answers before answering though. A lot more 'what is the diagnosis?' than I expected, where I had prepared more for 'what is the next step in the diagnostic workup?' or 'what is the next best step in the management?'

I went in being really afraid for time based on what I read here, so I worked extra fast and read really quickly, and always the last line so that I knew what I was looking for. There's a lot of stupid extraneous stuff, like "She owns two cats" (prob to include cat-scratch??). I finished with 40 minutes to spare, but marked about 7 questions I had to think long+hard about. The EKG's were easy, but very application oriented (like knowing which AV blocks are more benign than others).

EKG: Dubin's (a child molester, but fantastic book!)

Wards: Pocket Medicine (so fantastic)

Shelf: Step Up!! (SO FULL OF MISTAKES/TYPOS and wrong arrows and signs, but definitely on track for 'next step in the management')

Case Files 1x, it was ok. Skimmed NMS very lightly on my weak areas. Pretest (easy, but some wacked out q's), MKSAP 2, 3, 14, Kaplan Step 2 QBook (all 8 tests), Harrison's Qbook, Schreier Casebook, NMS questions (hard! and sometimes stupid!), UWorld IM q's (though I got sick of these since they got so repetitive and didn't finish).

Read the relevant Harrison's chapters on chest pain + diabetes + pulm.

In my opinion, as above, Kaplan was the most like the real thing, though the shelf was harder than that.
 
When you say Kaplan qbook, do you mean the Kaplan Step 2 CK qbook or the qbook specifically for internal medicine? I was thinking of getting that to supplement UWORLD and MKSAP
 
sunshinedoc said:
When you say Kaplan qbook, do you mean the Kaplan Step 2 CK qbook or the qbook specifically for internal medicine? I was thinking of getting that to supplement UWORLD and MKSAP
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I was referring to the step 2 Q book. theres about 15 tests and 8 of them are IM.
 
I am ready to give up. I am getting reamed on these UWorld questions. I REALLY hope the difficulty of these questions arent similar to the real thing.

Are the question stems of the shelf exam similar in length to these?
 
ambiguous said:
I am ready to give up. I am getting reamed on these UWorld questions. I REALLY hope the difficulty of these questions arent similar to the real thing.

Are the question stems of the shelf exam similar in length to these?
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i don't have any experience with the UW questions for medicine but yes, the shelf questions are quite long and difficult. i was pretty exhausted after 100 questions.
 
To the students who took the QBook IM questions, about what percent were you getting correct. I am getting about 60-70. Is that good enough to pull an 80 on the real deal.

Thanks
 
Alex05 said:
To the students who took the QBook IM questions, about what percent were you getting correct. I am getting about 60-70. Is that good enough to pull an 80 on the real deal.

Thanks
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on the same note, is there a thread somewhere that correlates percent correct on UW with actual shelf score? I would be very interested to see where I really stand.
 
ambiguous said:
on the same note, is there a thread somewhere that correlates percent correct on UW with actual shelf score? I would be very interested to see where I really stand.
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i used uw (did about 500 of the IM questions) and mksap (finished most of the book). i was scoring around 60% on uw and i'd say i would usually get 4-5 wrong per question set on mksap and i ended up with a 93 on the shelf. to be honest, i thought the shelf questions were more difficult than both mksap and uw, although i'd say uw comes pretty close. i've been trying to figure out how they grade the exam because i am certain that i did not get 93/100 correct, it's just impossible. anyway, it's a really difficult test and you really need to study and do questions because most of the stuff on the exam is going to be outside the realm of what you actually see on your 8 or 12 weeks of internal medicine. best of luck.
 
Took the exam today. It was a beast. This was the first time I ever ran out of time on a test.

The last set of questions were really really hard. Did not know what to think of them.

I don't think MKSAP helped that much. Step up was okay. I really felt it was like step 1 all over again.

I hope i passed. Let me know if you have any questions.
 
Were the Kaplan qbook questions similar in length to the real test?
 
With respect to content, I think Qbook does a good job. The questions on the real deal are longer. Some questions took up the whole page as they told you everything about the person, his mother and his brother. It was ridiculous.

Good luck
 
Just finished the test . . . it was a beat down. I used case files, step up, uworld, kaplan and mksap; so I don't know what more I could have done. It's just one big blur . . . I barely finished in time.
 
sunshinedoc said:
Just finished the test . . . it was a beat down. I used case files, step up, uworld, kaplan and mksap; so I don't know what more I could have done. It's just one big blur . . . I barely finished in time.
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welcome to the club...
 
I used the actual Kaplan Step 2 CK question book. It has internal medicine tests. I looked at the book you mentioned, but I was worried it would be too in depth since it is for residents. Doing the kaplan tests helped a little; however, the test was still really difficult. Good luck studying.
 
I have to take the SHELF exams for my clinical rotations but they don't impact our grade at all so I was wondering: do you think that if one were to do all of the USMLEworld questions for IM 2 or 3 times that that would be enough to comfortably pass the IM SHELF exam?
 
zoomzoomzoom said:
I have to take the SHELF exams for my clinical rotations but they don't impact our grade at all so I was wondering: do you think that if one were to do all of the USMLEworld questions for IM 2 or 3 times that that would be enough to comfortably pass the IM SHELF exam?
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i've heard that 1500 of the 2000 questions on UW are internal medicine so yeah, i think you could manage passing the shelf with UW.

so why exactly do you have to take the shelf if it doesn't do anything?
 
So I got my grade back, and I actually did pretty well - both nationally and in my class. I don't know if anyone else bothered to use UWorld for the shelf, but I'm sure it helped me out a lot. Step Up was good, but it was a lot to get through, so I didn't use all of it.
 
I did 850 of the 1500 UWorld questions and I'm hoping they helped me . . . I'll have to wait and see.
 
i just took the shelf today. honestly, i thought it was hard but i have no idea how i would have studied or prepared any differently. there were a lot of questions with 'chose the next best step' where i was torn between 2 answers. and i was expecting there to be a lot of renal acid-base disorder calculations (delta/delta and all that crap) and there weren't.

i used MKSAP (seemed easier than the shelf q's), Step Up (ok, but kind of dense, not sure how much it helped), CaseFiles (thought this was really good, at least 40 of the 60 cases directly pertained to a shelf question), and USMLEworld step 2 CK qbank (did about 700 of the IM questions, thought these were more similar in difficulty to the shelf questions than MKSAP).

i am dreading getting my score back, since it counts toward more than half our clerkship grade and i'm pretty sure the only effect its going to have is bring my grade DOWN. ugh.
 
Finally got my score back 88.

Not the greatest, but good enough to matter.

I was getting about 70 on MKSAP and 80 on Qbook.

Good luck to all!
 
Just got my scores back today... did pretty well. The exam is hard, but doable. And I didn't have a ridiculous step 1 score. I read as fast as I possibly could, questions first then passage, and finished with two minutes to go and went back to a couple of questions. If you are not that fast of a reader, you could probably get away with skimming most of the questions. I used the following:

step up (but only a few chapters, it can be tedious)
mksap 3
700Q's from UWorld targeted to the exam breakdown categories posted on their website
conrad fischer's 200 mostly likely diagnoses for step 2
case files

If I had to do it over, I probably would've skipped step up and done more UWorld and finished all of case files. Good luck!
 
Got my scores back and had a got raw score of 86, which means I got honors. I HIGHLY suggest doing as many UWORLD questions and kaplan q-book questions as possible. The Kaplan questions were especially representative of the questions.
 
Got my score back today. I got an 85 which I was very surprised (see previous post about how much I thought the exam sucked!) and happy about because its good enough for Honors!!

I would also suggest the Uworld q's, as they are more like the exam than MKSAP. I didn't use Kaplan qbook, so those might be comparable as well.

CaseFiles + Uworld are my two highest recommendations. Take that as you will 🙂
 
when y'all say kaplan questions..are you referring to the Kaplan Step 2 QBook for CK? or is there a special kaplan qbook for IM? Thanks!
 
It's the Kaplan Step 2 CK question book. It has sets of questions for each rotation (I'm using for my peds rotation right now). It's good to help you with timing.
 
ambiguous said:
on the same note, is there a thread somewhere that correlates percent correct on UW with actual shelf score? I would be very interested to see where I really stand.
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In case anybody else is trying to benchmark using uw, I got a 90 on the shelf and did about 700 UW questions, with an average of 62%.

Resources: -Step Up to Medicine - good but very dense
-"Medicine" by Fishman - well written and manageably sized textbook
-Consult Manual of Internal Medicine - if you can take the weight, it will fit in your whitecoat

I did one test out of Qbook, and while it was OK, it seemed much easier than UW. Probably useful if you have extra time or no UW access, but if possible, I'd focus on UW before going to Qbook.
 
I love it how pretty much everybody thinks that this test was terrible but end up doing really well
 
Just got my NBME shelf exam score back... 83%. I used Kaplan Q-book and Pretest with reference to Step Up for those questions with inadequate explanations (usually pretest did not have adequate explanations... Kaplan has pretty good explanations).
 
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