I took the medicine shelf on Friday so I can't definitely say if my plan worked until I receive my scores in January. Still, I know I answered more correct answers compared to my USMLE Step 1 (241/97). Then again, I might have just had an easy test form with a high raw score average.
From my analysis, everytime I knew I answered a question correctly there were at least 2 or more clues in the passage. This means that you have to know the physical diagnosis clues COLD!!! For example Charcot's Triad to distinguish choledocholethias vs cholecystitis vs cholangitis. All three present with RUQ pain..... blah, blah, blah....i.e similarly. Still, I would miss the question if I picked choledocholethias based solely on sclera icterus since cholecystitis doesn't present with jaundice. Never pick an answer based on one physical finding!! It is usually a red herring.
Here are my suggestions.
1. Cecil's Essentials or Harrison's to learn everything about your patient's presenting illness. Know how to diagnose, workup, risk stratify, and treat your patients. Don't worry there are only around 10 Major Concepts in Internal Medicine that just keeps recurring such as CHF, Anemia, COPD, Diabetes, Hypertension, Asthma, etc. So you won't read that much of Harrison's or Cecil's. If you read Cecil's or Harrison's you will get a strong grade for fund of knowlege because your knowledge will be evident in your assessment and plan + you will be able to answer the pimp questions on your patients.
2. Use Step Up to Medicine for Shelf Exam Prep. Try to read this book slowly one time through.
4. Do as many questions that you have time to do in MKSAP2 (~400Q) and MKSAP1(~400 Q). MKSAP 1 is a book published in 2001. MKSAP 2 is the sequel. They have completely different questions.
Good Luck