problem with shelf exams

[apmanruco]

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Here is my problem.
I think I am a good student with a Step 1 score of 237. Despite this my clinical shelf exam scores (psych, peds, ob/gyn) have been between 70 and 72 (raw score that translates to ~40th precentile) despite the fact that I tried to compensate by progressively spending more time studying for them. The frustration comes from the fact that it does not seem to matter if I take 100 practice questions or 1500. I do not know what is wrong and I am running out of ideas about studying these forsaken tests. Can anyone suggest the proper way to beat them?

 

[Bartelby]

Scores are generally reported in their standardized form-- mean of 70 (nationally) and standard deviation of 8. If that is the case for you then you are doing average to slightly above. Anyway, I guess that isn't so different from slightly below average.

I scored similarly (239) and am hitting 72-76, so similar boat. For me it is definitely about how much importance I placed on each test. The step 1 I considered to be my "grade" for the first two years of med school and I put in the effort accordingly. These shelf exams I consider to be routine, especially when they are a small portion of the grade, and I put in a correspondingly smaller effort. You should do an honest assessment of how hard you tried for the step v. how hard for the shelves.

That said if I wanted stellar shelf scores I would start out each rotation having read a review book about that rotation (maybe first aid or something that you could work through in a weekend). I would then diligently look up everything I encountered on that rotation and try to generally do as much real clinical work as possible (follow more patients, etc). In my study time I would buy and do USMLEWorld's qbank (they were awesome for step 1) and read a review book. I would probably round that out with more questions like pretest.

If the above doesn't work, I don't know what would. If you're like me, though, it's not worth trying that hard.

 

[ACSurgeon]

Here is my problem.
I think I am a good student with a Step 1 score of 237. Despite this my clinical shelf exam scores (psych, peds, ob/gyn) have been between 70 and 72 (raw score that translates to ~40th precentile) despite the fact that I tried to compensate by progressively spending more time studying for them. The frustration comes from the fact that it does not seem to matter if I take 100 practice questions or 1500. I do not know what is wrong and I am running out of ideas about studying these forsaken tests. Can anyone suggest the proper way to beat them?

I did significantly better on my Medicine and Surgery Shelf exams after buying the UW qbank... Also, I thought the OB and psych shelfs were terrible compared to medicine and surgery, possibly because they are more specialized and not something you know a terrible lot about going into the rotation. In other words, you might do better on Medicine and Surgery because you already have a better foundation of general topics covered on these shelfs.

Good luck!

 

[ACSurgeon]

Scores are generally reported in their standardized form-- mean of 70 (nationally) and standard deviation of 8. If that is the case for you then you are doing average to slightly above. Anyway, I guess that isn't so different from slightly below average.

I scored similarly (239) and am hitting 72-76, so similar boat. For me it is definitely about how much importance I placed on each test. The step 1 I considered to be my "grade" for the first two years of med school and I put in the effort accordingly. These shelf exams I consider to be routine, especially when they are a small portion of the grade, and I put in a correspondingly smaller effort. You should do an honest assessment of how hard you tried for the step v. how hard for the shelves.

That said if I wanted stellar shelf scores I would start out each rotation having read a review book about that rotation (maybe first aid or something that you could work through in a weekend). I would then diligently look up everything I encountered on that rotation and try to generally do as much real clinical work as possible (follow more patients, etc). In my study time I would buy and do USMLEWorld's qbank (they were awesome for step 1) and read a review book. I would probably round that out with more questions like pretest.

If the above doesn't work, I don't know what would. If you're like me, though, it's not worth trying that hard.

Well, I thought shelf exam questions were significantly worse than step 1. For starters, many questions had a zillion answer choices, and 2+ would sound equally good to me. Step questions generally give you enough to work with, and are generally more fair. Also, I always ran out of time on shelf exams, but did not on step 1 (or UW step 2) blocks.

So, I would not recommend dedicating a bunch of time to shelf studying at the expense of your clinical grade/comments.... as it might not even pay off. There is only so much "clinical medicine" you can learn from books... the rest needs enough experience to think about questions correctly.

 

[BigRedBeta]

One thing to consider...how many patients are you carrying during your inpatient rotations? There's good evidence out there that the more patients you carry during your clerkship, the higher your shelf score will be. So try to be carrying 4-5 patients per day if possible.

Everyone says "read up on your patients, read up on your patients, read up on your patients". IMHO, that's really NOT the key, the key is trying to make decisions on real life patients. Thinking through the process and solving the day to day issues is what's high yield. The more patients you carry, the more practice you get, the more you get to ask the residents "what do we do here?" and pick their brains and present your own plan for feedback and critiquing, the more you'll learn practical information. You may have some residents who bristle at your persistence, but this is your education and you need to put the effort into it.