That thing sucked...alot. I will get my score back tomorrow but it was the hardest shelf yet. I wasn't expecting a ton of micro and got killed by the time (but I am a slow test taker).
In terms of nbme shelf exams for me its been:
Hardest ---- path>physio>micro>biochem>icm>pharm --- Easiest
My study strategy was to memorize the blue column points in golijan...this was not detailed enough. A good chuck of the questions are at the level of the actual text of golijan or are micro questions.
They choose atypical presentations of alot of diseases (not the textbook patient demographics). I did a ton of guessing, but I will update tomorrow after I get my score. I felt confident on 1/3, educated guessed on 1/3, and rushed through the last 1/3 answering obvious questions.
If you basically remember everything in golijan and review micro you will do well...