I took the path shelf today and it seemed fair. No questions on glycogen storage disorders or the such. Other than that, though, they really hit about seemingly every organ system and concept with their 125 Qs. A few pictures and they helped. There were a few immuno and micro questions, but not enough in my mind warranting a review beyond that in BRS or Golijan's Rapid Review for Path (do know what is in these sources well, though, especially infections common to an organ system like GI or liver). There were a couple on congenital infections, though, that you had to diagnose pretty much on clinical presentation. A couple of nutritional deficiences. Going over transplant rejection, GVHD, and associated complications/diseases is worth your time. There were a couple of brain neoplasms but they made them really distinguishable (actual buzzword on one). Know about chromosomal disorders and how they might occur. A couple of questions where it helps to know cell molec, and knowing what bcl-2, p53, Rb do will help you out- this stuff is largely covered in First Aid and review books, you don't need to get a cell molec book. Notice how the word "couple" keeps repeating? It really is a broad based test! If you could skimp on learning any organ systems it would be HEENT, muscoskeletal, and skin; cardio, renal, and respiratory are of course popular, with basic path also high yield.
Pathophysiology wasn't really tested, but on a couple of questions I wish I had known Winter's formula or how to properly compensate for an alkalosis or what not (I think you could reason it out, though). No FEV/FVC hints for pulmonary, but I wouldn't be surprised if it showed up on other exams. So just having a basic grasp of pathophys is sufficient, except on endocrine disorders since physio is pretty much intrinsic to stuff like Conn's or pseudohermaphoditism.
Immunopath (i.e. Chiedak Higashi's, Ig deficiences) and vascular disorders like PAN and the such are worth knowing pretty well, but I think I was especially worried about them since I never learned them well. Oh yeah, cystic fibrosis, cystic fibrosis, there'll be a couple on that for sure.
What's kind of funny is that some stuff that seemed pretty hard becomes pretty easy if you know how they ask the question. For example, I had no clue what Wishkott Aldrich or scleroderma was as we were not formally taught it as I could recall, but after doing Robbin's Review Q book and Kaplan, it starts to become a giveaway (at least I think that's what the question was asking about!). I would really recommend going through Robbin's Review book, paying attention to the stems of the question (especially if it's a weird disease).
Once in awhile the shelf gives a pseudo-softball and it's straight up, but usually you have to diagnose it and then you have to know something like the microbiology or prognosis behind the disorder as most already know. They don't ask about lung or pancreatic cancer by giving you a good workup, they ask about stuff around them. The presentation might just be a rare clinical finding. Once in a great awhile you get a buzz word, but I think they like to ask "around" buzzwords, i.e. they don't give you the word but describe it (dilobed nucleus = Reed Sternberg, intracytoplasmic eosinophilic inclusions = Lewy body in Parkinson's). Know the buzzword, but more importantly know how to describe them. Know everything AROUND a common disease like prognosis (lymphocyte depletion in Hodgkin's is BAD) and typical presenting symptoms and WHY they give you that symptom. They can just throw you something like thickened, dark skin on the axillae and you have to immediately think about anthacrosis nigricans = stomach cancer in your differential. Epidemology is also somewhat important (if someone's Asian you have to think of these cancers, if someone went to Africa they might've gotten this infection, if they're a black Ashenkazi Jewish Native American alcoholic who smokes three packs a day, well, they're probably dead by now). Sometimes you get a question and you get miffed because you'd think you'd notice if someone were a certain ethnicity or if they already had cancer or AIDS... but these guys can withhold this info because this is not a test of reality but of something else, I don't know. Robbin's Review is mean but good at simulating that.
Golijan's audio really is awesome. Sometimes you get a question and you're thinking DUH because he really stresses certain clinical presentations. I think this is where BRS path is really lacking. If I could recommend anything, it would be Robbin's Review of Path for questions, Golijan's Rapid Review (annotating it with some histo path findings as it's a little weak on that), and his audio. Rapid Review emphasizes some things in boxes and they're worth remembering; it also does a decent job with integrating some microbio diseases in each organ system, but it's worth annotating them. Kaplan QBank is OK but not as good as Robbin's. BRS is OK and better on some basics of path, but it won't "give away" the answers like Goljan might; if you have it, keep it, annotate with some clinical presentation stuff. It does expound a little more on certain disorders that Goljan does (he might deal with in a chart format). Oh yeah, and if you don't know anything in First Aid, know it first. Appleton and Lange's USMLE Q book is pretty good, their Path Q&A is so-so (I study at bookstores so I just sort of 'browse' these books for a few hours). I didn't like Kaplan Q Book, maybe because I suck at it. A few of my friends also recommended PreTest, but I never really liked their stuff due to its pickiness, just work with something you can somewhat dig and then DO IT. I really wish I had just repeated Robbins Review for questions again and again... oh yeah, the second edition can be a pain as some of the stems are too long (I'm about to return it), the first edition is probably just as good for the path shelf. The end exam is especially killer on the stem length, you may see it on the USMLE but not so much the shelf.
I think this test is doable but part of it is playing the game and knowing what they want to ask and test. They what certain concepts and a few weird disorders to test these concepts. I think this is where good review materials can really build over a solid knowledge base (mine's more of a Jell-O block).
Anyhow, thanks much to everyone else on SDN for their reviews of material and exams in general, I think it really helped me out and I'd like to give back. I don't know if I did well on this exam or not, but I sort of wanted/had to as I was borderline on this course. I'm not really a class goer for a variety of reasons, so that might've hurt/helped. Shelf exams are not my forte, but hopefully this one is different as I studied a lot more for it. I'll update with my score if the exam took me out or if I took it out. If anyone wants more info feel free to ask me. Sorry if this dragged but I want to put this out while it's still fresh, I'm going to get back to killing my brain with beer.
Good luck and God Bless,
Pathophysiology wasn't really tested, but on a couple of questions I wish I had known Winter's formula or how to properly compensate for an alkalosis or what not (I think you could reason it out, though). No FEV/FVC hints for pulmonary, but I wouldn't be surprised if it showed up on other exams. So just having a basic grasp of pathophys is sufficient, except on endocrine disorders since physio is pretty much intrinsic to stuff like Conn's or pseudohermaphoditism.
Immunopath (i.e. Chiedak Higashi's, Ig deficiences) and vascular disorders like PAN and the such are worth knowing pretty well, but I think I was especially worried about them since I never learned them well. Oh yeah, cystic fibrosis, cystic fibrosis, there'll be a couple on that for sure.
What's kind of funny is that some stuff that seemed pretty hard becomes pretty easy if you know how they ask the question. For example, I had no clue what Wishkott Aldrich or scleroderma was as we were not formally taught it as I could recall, but after doing Robbin's Review Q book and Kaplan, it starts to become a giveaway (at least I think that's what the question was asking about!). I would really recommend going through Robbin's Review book, paying attention to the stems of the question (especially if it's a weird disease).
Once in awhile the shelf gives a pseudo-softball and it's straight up, but usually you have to diagnose it and then you have to know something like the microbiology or prognosis behind the disorder as most already know. They don't ask about lung or pancreatic cancer by giving you a good workup, they ask about stuff around them. The presentation might just be a rare clinical finding. Once in a great awhile you get a buzz word, but I think they like to ask "around" buzzwords, i.e. they don't give you the word but describe it (dilobed nucleus = Reed Sternberg, intracytoplasmic eosinophilic inclusions = Lewy body in Parkinson's). Know the buzzword, but more importantly know how to describe them. Know everything AROUND a common disease like prognosis (lymphocyte depletion in Hodgkin's is BAD) and typical presenting symptoms and WHY they give you that symptom. They can just throw you something like thickened, dark skin on the axillae and you have to immediately think about anthacrosis nigricans = stomach cancer in your differential. Epidemology is also somewhat important (if someone's Asian you have to think of these cancers, if someone went to Africa they might've gotten this infection, if they're a black Ashenkazi Jewish Native American alcoholic who smokes three packs a day, well, they're probably dead by now). Sometimes you get a question and you get miffed because you'd think you'd notice if someone were a certain ethnicity or if they already had cancer or AIDS... but these guys can withhold this info because this is not a test of reality but of something else, I don't know. Robbin's Review is mean but good at simulating that.
Golijan's audio really is awesome. Sometimes you get a question and you're thinking DUH because he really stresses certain clinical presentations. I think this is where BRS path is really lacking. If I could recommend anything, it would be Robbin's Review of Path for questions, Golijan's Rapid Review (annotating it with some histo path findings as it's a little weak on that), and his audio. Rapid Review emphasizes some things in boxes and they're worth remembering; it also does a decent job with integrating some microbio diseases in each organ system, but it's worth annotating them. Kaplan QBank is OK but not as good as Robbin's. BRS is OK and better on some basics of path, but it won't "give away" the answers like Goljan might; if you have it, keep it, annotate with some clinical presentation stuff. It does expound a little more on certain disorders that Goljan does (he might deal with in a chart format). Oh yeah, and if you don't know anything in First Aid, know it first. Appleton and Lange's USMLE Q book is pretty good, their Path Q&A is so-so (I study at bookstores so I just sort of 'browse' these books for a few hours). I didn't like Kaplan Q Book, maybe because I suck at it. A few of my friends also recommended PreTest, but I never really liked their stuff due to its pickiness, just work with something you can somewhat dig and then DO IT. I really wish I had just repeated Robbins Review for questions again and again... oh yeah, the second edition can be a pain as some of the stems are too long (I'm about to return it), the first edition is probably just as good for the path shelf. The end exam is especially killer on the stem length, you may see it on the USMLE but not so much the shelf.
I think this test is doable but part of it is playing the game and knowing what they want to ask and test. They what certain concepts and a few weird disorders to test these concepts. I think this is where good review materials can really build over a solid knowledge base (mine's more of a Jell-O block).
Anyhow, thanks much to everyone else on SDN for their reviews of material and exams in general, I think it really helped me out and I'd like to give back. I don't know if I did well on this exam or not, but I sort of wanted/had to as I was borderline on this course. I'm not really a class goer for a variety of reasons, so that might've hurt/helped. Shelf exams are not my forte, but hopefully this one is different as I studied a lot more for it. I'll update with my score if the exam took me out or if I took it out. If anyone wants more info feel free to ask me. Sorry if this dragged but I want to put this out while it's still fresh, I'm going to get back to killing my brain with beer.
Good luck and God Bless,
