Psych Shelf Exam

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Books Preferred for Psych Shelf Exam

  • BRS

    Votes: 2 3.2%

  • Blueprints

    Votes: 15 23.8%

  • Appleton and Lange

    Votes: 16 25.4%

  • Boards and Wards

    Votes: 4 6.3%

  • PreTest

    Votes: 14 22.2%

  • NMS

    Votes: 6 9.5%

  • High Yield

    Votes: 6 9.5%
  • Total voters
    63
  • Poll closed .
How much child psych is on this bad boy?

My attending was saying as much as 25%.
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Is it recommended to learn when to use which psychotherapy and the exact mechanism of action of each drug (as opposed to the group i.e. SSRI / Antipsychotic)? I'm having a hard time on that stuff! Thanks!!
 
LADO said:
Is it recommended to learn when to use which psychotherapy and the exact mechanism of action of each drug (as opposed to the group i.e. SSRI / Antipsychotic)? I'm having a hard time on that stuff! Thanks!!
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The mechanism of action of SSRIs should be pretty much the same...I wouldn't bother knowing exactly which dopamine receptors/serotonin receptors the new antipsychotics work on. I would perhaps know things like abilify is non-sedating or that zoloft and lexapro have become popular amongst the SSRIs because their fewer reported drug-drug interactions, especially for the elderly (not to mention their producers bombarding us with advertisements, including in NEJM.) I would know welbutrin amongst the antidepressents has some stimulant properties and can help people quit smoking and other addictions supposedly. But really I don't remember their being too much on drugs period on the exam I took. A lot more judgment calls like would you admit against patient's will if they threaten to cut themselves or whatever. Do you hospitalize for suicidal "gestures" like shallow cuts of the wrist.....When do you sedate against the patient's will with ativan, etc. etc. A lot of stuff which doesn't necessarily have a clear cut answer imo. The vignettes were long, as they are on most shelfs.
 
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The drugs are really easy. You only need to know the generic drug names that fall under the categories of SSRI, SNRI (Venlaflaxine), NDRI (Buproprion), and TCA (only things that have "tri" in the name). I don't remember being tested on MOAi's. You don't need to know the differences between the individual drugs within each class (e.g., paroxitine vs sertaline).
 
Thanks! Does anybody know what the standard of care is now for newly diagnosed schizophrenia - for test purposes? At my rotation site, it is the atypical anti-psychotics (zyprexa) are first line treatments but some of the questions I'm doing still say to start with haldol or risperidone :thumbdown:
 
I thought that the standard was to begin with an atypical. I don't remember having any questions that got that picky. More important is to know the side effects of anti-psychotics. Again, everything you need to know is in First Aid for Psychiatry.
 
deuist said:
I thought that the standard was to begin with an atypical. I don't remember having any questions that got that picky. More important is to know the side effects of anti-psychotics. Again, everything you need to know is in First Aid for Psychiatry.
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I think you're right that the standard is atypical... those questions w/ haldol as 1st line are probably old. Thanks for the response :thumbup:
 
People have mentioned knowing the DSM IV criteria cold. I understand that I need to know time durations for various illnesses but does this also mean that I need to know "4 of the following symptoms" and the test gives me 3 or 5? or is it more obvious than one symptom swaying the answer choice?
 
EternalMD said:
People have mentioned knowing the DSM IV criteria cold. I understand that I need to know time durations for various illnesses but does this also mean that I need to know "4 of the following symptoms" and the test gives me 3 or 5? or is it more obvious than one symptom swaying the answer choice?
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I thought the test was very clear in terms of what it was looking for. No need to memorize the DSM IV criteria --- just familiarize yourself with the conditions. The duration of illnesses IS important, though (acute stress vs. PTSD, schizophreniform vs. schizophrenia, dysthymic disorder vs. depression, etc.).
 
EternalMD said:
People have mentioned knowing the DSM IV criteria cold. I understand that I need to know time durations for various illnesses but does this also mean that I need to know "4 of the following symptoms" and the test gives me 3 or 5? or is it more obvious than one symptom swaying the answer choice?
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My test actually had a lot of these types of questions where you needed to really know the number of criteria needed for a certain diagnosis. It was honestly the hardest shelf I've had all year. Also, there were probably 10 questions related to drug intoxication/treatment, so know that stuff well.
 
Bump.

Anyone have new suggestions who recently took the shelf?

How have the child psych questions been?
 
vtucci said:
Bump.

Anyone have new suggestions who recently took the shelf?

How have the child psych questions been?
Click to expand...

There were a LOT of child psych questions on mine. I rotated through child/adolescent psych for three weeks, so they didn't really seem out of the ordinary to me, but a lot of my classmates who only did adult psych were caught off guard by the number of child psych questions on the test. However, I felt like First Aid covered it pretty well.
 
Luckdragon and I had completely different tests... there was very few child psych on there (mostly ADHD, etc).
 
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Don't forget psychiatric effects of non-psych drugs(steroids, benadryl, IFNalpha, etc) and general medical conditions. I also had several questions on personality disorders. You will be able to answer 90% of the questions with First Aid, and its an easy read. I also did part of casefiles- its okay but really doesn't add much if you are already doing FA.
 
would you recommend memorizing FA word for word?

i'm planning on memorizing the duration needed for diagnosis, but like the previous poster asked... would you recommend memorizing the DSMIV criteria in FA in terms of the list of symptoms for the diagnosis and how many are needed for the diagnosis?
 
Starting psych tomorrow, and bumping to see if anyone had any other thoughts on the best books for this rotation/shelf exam.

I've got FA for Psych, and am debating if I need Case Files as well. Thoughts?
 
I felt that the psych shelf was the most difficult of the year. It was tricky.

I spent a good deal of deal studying the details of the DSM-IV and do not think differentiating between the various conditions was the real problem. They had acute stress disorder v. PTSD. A lot of emphasis on panic disorder and possible medical explanations. The scenarios presented did not have many of the classic features.

There were not as many questions on meds as I expected. A few on EPS side effects as mentioned by other posters. Those questions on drugs seemed to be concerned about mechanism of action (i.e., acting on what receptor postsynaptic v. presnaptic etc) and that was like a bad flashback to pharm.

There were more poisonings/toxicology questions than I had expected.

I found that there was an overemphasis on behavioral therapy, cognitive therapy, group therapy etc-probably close to 20 + questions on our test. For many situations, they would ask the treatment of x condition, only to list both the traditional pharmaceutical class/actual drug as well as the type of therapy that may be appropriate for treating that condition. Many of us were discussing which would be done first (other than the child enuresis question, which everyone agreed biofeedback first and then meds).

I was not overwhelmed by the amount of child psych on our test. There was ADD, ODD v. conduct disorder, normal development questions, learning disability, Asperbergers v.Autism.
 
what about questions on piaget, freud, kohut, mahler, erikson, etc? should i even bother memorizing what their schools of thought are with age/staging?!
 
goodies said:
what about questions on piaget, freud, kohut, mahler, erikson, etc? should i even bother memorizing what their schools of thought are with age/staging?!
Click to expand...

I had none of that. There's a whole chapter devoted to it in PreTest that is pretty much a huge waste of time.

vtucci and I must have had completely different exams. I thought it was the easiest shelf of this year. Now the IM shelf was a different story ... :laugh:
 
goodies said:
what about questions on piaget, freud, kohut, mahler, erikson, etc? should i even bother memorizing what their schools of thought are with age/staging?!
Click to expand...

I did not have any questions on these.
 
My exam had a TON of neuro, which I felt was a bit unfair given that I hadn't taken neuro yet. Maybe 15% if not more was neuro. I used Case Files and First Aid and I think these covered the material pretty well.
 
vtucci said:
I found that there was an overemphasis on behavioral therapy, cognitive therapy, group therapy etc-probably close to 20 + questions on our test. For many situations, they would ask the treatment of x condition, only to list both the traditional pharmaceutical class/actual drug as well as the type of therapy that may be appropriate for treating that condition. Many of us were discussing which would be done first (other than the child enuresis question, which everyone agreed biofeedback first and then meds).
Click to expand...

:barf: right when I was about to skip the Psychotherapy chapter in Pretest because it seemed low yield and F'in boring, I see this!! Thanks for the advice though :thumbup:
 
Sorry to be the bearer of bad news.

It worked out okay and was my second highest shelf of the year. I just thought it was trickier than the others I took. I also think a solid foundation in the cognitive behavioral tx etc. can mean the difference in percentiles if your school (like mine) uses national percentiles to determine eligibility for honors grades.

Best wishes all.
 
Forgot to write a reply about this after my exam but I wanted to offer my opinion on the test. It wasn't the walk in the park that I expected it to be as this was the only other exam next to medicine where I almost ran out of time. Usually i have 5-10minutes to spare. The question stems are extremely long with about 4 questions per page with some taking half a page. The usual last 10 questions with A-Z as answer choices of course.

Definitely read up on drug intoxication/withdrawals, time duration for various illnesses moreso than the number of exact criteria (i dont think i really had to count the number of symptoms), mental disorders induced by medications (read up on the FA chapter for psychopharm for this). I had about 5 questions on personality disorders with one or two asking how to treat (kind of annoying). Autism vs Aspergers, read up on somatoform disorders (different types).
 
I agree with EternalMD. There were some personality disorder questions. I had a number including paranoid, OCPD, borderline, antisocial. I also had the autism v. aspergers question. If you know the DSM-IV criteria on that one though, it was not a hard question.

Drug intoxications and poisonings seemed to be high yield on my exam.
 
I used First Aid for Psych clerkship, UW questions, PreTest and took the test yesterday... I'll say I did not pass with 99.99% certainty. That was by far the most difficult exam I've ever taken.

edit: EternalMD's advice is right on, but you just need to know the stuff so cold and be able to read between the B.S. quickly. The passages are really long and a lot of mine had what seemed like several psych issues going on and I was asked what it was/ how to treat it: with only one of the several diseases on the answers, VERY CONFUSING!!!

Update: Got my score, PASSED (phewww)... best advice, know your stuff really well. People said not to worry about DSMIV but I highly disagree if you get a test that resembles mine. I would know the DSM IV criteria well for the high yield stuff and also treatments for multiple d/o that occur simultaneously. Good luck!!!!!
 
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Books: I ended up doing FA psychiatry x 3, CFs once close to exam, USMLEWORLD, QBOOK, and A&L questions.
Score: 90 raw.
Thoughts: I thought it was helpful to go through CFs once as it helped flush out some of the personality disorders and various disorders that are breezed over in FA. Wouldn't do A&L over again, it wasn't bad, but didn't feel like it brought anything additional (that was relevant) to the table. BPs Q&A may be a better option? This shelf seemed like a lot more diagnosis to me then the others and as others have said really liked to focus on subtle differences between PTSD vs. acute stress vs. adjustment disorder, bereavement vs. depression, shizophreniform vs. schizophernia vs. schizoaffective, etc... For me the best way to learn these subtle differences was doing lots of questions. Know which drugs are members of what classes (antidepressants, antipsychotics, mood stabilizers) and interesting side effects (i.e trazodone= sedative or priapism). Didn't test on pharmacologic differences within class or make you choose from multiple different antidepressants. Know FA cold and you'll be good. GL
 
I was wondering when people say they used UWorld to prepare for the shelf, are they referring to the Step 2 question bank?
 
type a said:
I was wondering when people say they used UWorld to prepare for the shelf, are they referring to the Step 2 question bank?
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Yes.


And just to follow up, I did not do well enough to honor with my study technique (above). But partly I think that was due to getting a poor night's sleep the night before, as I only missed it by a couple of points. So I would advise not making that mistake, as the questions are very, very long.

Other advice, really memorize the time limits for each disorder as well as the diagnostic criteria. That will get you a lot of points right there as there were a lot of questions that focused just on that. :)
 
For folks that used FA, did you find it helpful at all to memorize the mnemonics they give to remember criteria for certain disorders, ie "SIG E CAPS", "PANIC", etc.?

I feel like I've got a pretty good "recognize it when I see it" grasp of the disorders, but I keep hearing about questions which required you to know all the criteria for a certain dx exactly to answer the question.
 
i was wondering if anyone can provide feedback on older editions of blueprints (3rd ed.) and pretest (9th ed.)? as a med student on a budget, i happen to have the pdf versions and would rather take a crack at these than buy some new copies, if the information is largely unchanged of course. also have a one year subscription to kaplan step2ck qbank and psychiatry made ridic. simple.. sufficient for shelf or what?

also - all this talk of using FA - referring to FA for psych clerkship or FA step 2ck?
 
Just wrote this test yesterday.

Main resources: Case Files, FA, Uworld, Qbook. I also supplemented a little w/ Boards and Wards, CCS pocketbooks, and Deja Review Step2. Looked at A&L, and Pretest and opted to not use them.

Obviously I haven't gotten a grade yet. Our school just requires us to pass the shelf and I feel reasonably confident I did.

I felt the resources above were plenty of preparation. As others have mentioned on here, the questions on this test are very long - each one is a dense paragraph of maybe ten or more sentences. IMO, time management was probably the most challenging aspect of the test, and none of the question sources out there really reflect this. Even though you might have all the knowledge you need, most questions required you to filter a lot of extraneous and sometimes confusing info to get to the point where you could apply what you know to the question.

I suggest underlining the important details as you skim the paragraph - how many months the sx have been occurring, type of sx, etc as you go through the question so you can quickly refer back if you need to. Also, be prepared for questions to give you multiple timelines - ie this event happened 4 months ago, but this sx started 2 months ago, etc. so make sure you are focusing on the right timeline when you answer a question.

I also suggest marking questions on the test that: 1)you think you nailed - don't even look back at these 2)wtf questions that you could spend all day on and will still end up guessing and 3)those questions that require a bit more time and thought - these are the ones to return to if you have the time. I knew I had to read fast, and I ended up with about 30 minutes to check my answers.

Don't ignore lab values. I had a couple questions that sure sounded psychiatric, but checking a lab value changed my answer.

As with step 1, there were lots of buzzwords on this test, but due to other info in the questions, they often didn't match up to their buzzword answer. Read fast, but beware of jumping on the obvious answer.

Many thanks to all who provided advice on this test.
 
Great advice Dragonwell...except it came a bit late for me my man

To all the readers of this thread. Best advice = 1 question/min speed. YOU MUST, if not then you will not finish the test. Read fast and go with gut answer, DO NOT change answer (I did for a couple and regretted later). Also, whenever you read your FA, think about atypical ways that might fit the DSMIV criteria but would seem weird in reality - NBME loves those to psych you out (can't post examples from the test for obvious reasons).

p.s. Dragonwell, thought you did your psych rotation a while back, but you took shelf later?
 
As the previous posts mentioned, be careful when preparing because this is a very difficult shelf exam. For me personally, I found it to be much more difficult than the previous five I had taken.

The previous posts detailed fairly well the content of the exam. It is critical to pace yourself during this exam and I think the key to that is by doing many, many practice questions. I tend to agree that the PreTest questions while good, are not representative of the actual shelf. I used First Aid and Case Files and in retrospect I think the Case Files was redundant. I feel strongly for the series for other shelf exams, but not psychiatry.

Be sure to review illicit drugs, side effects of the commonly prescribed SSRIs, Aspergers vs. Autism vs. mild MR, criteria for commiting patients, mandatory reporting criteria, and somatoform disorders. I thought the time frame of the various diagnoses was also heavily represented. Also look carefully for medical causes of psychiatric symptoms. It seemed like they had several of these cleverly disguised.

All in all it is a very difficult shelf. I repeat, do not take it lightly.
 
Thanks to all who talked about what resources helped for this exam- it was incredibly helpful. Pretest + First Aid worked out pretty well for me. I did a sprinkling of A+L but the other two were my core resources. Yeah, Pretest questions were not representative of the real deal but they were challenging and I learned a good deal from them as well. First Aid was a great resource and covered virtually all you will need. I didn't study too much as I was still burned out from Step I. Most days after coming home I napped and screwed around. It was a glorious summer. I ended up doing well enough to be eligible for honors in psych, just waiting for the clinical evaluation now.

Like others have said, time is a big issue during this test. I'm a fast test-taker and I was running short on time in this exam. Pace yourself! The stems are very long and there are a lot of red herrings/useless info in the stems. Conversely, they also tuck away important info in the stems too occasionally.

It was my first shelf exam and I was happy with the score- gotta keep rollin now. Hopefully it will be enough to have honored Psych.
 
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I posted this in a different thread a couple weeks ago: I used CF, FA for psych, and UW. I'm not really sure which one was better as they are all pretty much the same info. Using all three probably helped, although the questions on the shelf were significantly longer than UW and that was the primary difficulty. The shelf also purposely throws in symptoms from multiple diagnoses in order to make you second guess yourself. I agree with what the previous poster said. Essentially, the questions weren't all that hard if you had another hour to sit through and look at the criteria, but this was probably the most time pressure to finish a test I have ever felt. Maybe MCAT verbal section because I usually had to race to finish that, but I thought this was much longer for the amount of time than any test I've taken in med school. With the three sources I used, I estimate they probably covered 80-85% of what was on the shelf. For the rest, it was basically just random neuro, or general step 1 info if I was going to get it right.

Just to update, I scored 89 raw, which I was really happy with. I am surprised because I thought the test was difficult as I was going through it, so just really force yourself to go through the test as quickly as you can and try to trust your judgement. I second guessed myself too often on the first 50 questions and almost ran out of time. I probably liked FA the best overall because of the way the info is organized, but CF is nice in that it makes sure you are thinking about the cases and not just letting your mind drift as you try to memorize list after list of symptoms that are in FA. I think using both is definitely advisable.
 
obiwan said:
Does it also include neurology?
Click to expand...

I had very little neuro on my test, all of which was covered by FA or case files. The small amount more or less showed up in the differential for whatever was going on - ie delerium vs dementia vs vascular infarct vs parkinsons, etc.

InternationlDoc said:
...
p.s. Dragonwell, thought you did your psych rotation a while back, but you took shelf later?
Click to expand...

Unfortunately, our school only offers the shelves on five dates during third year, meaning that you have to end up doubling up shelves and studying for tests that aren't your current rotation. I actually finished psych two months ago.
 
Does anyone know about how many you have to get correct to pass? Or, to get national average? I just took the psych shelf yesterday. It was crap.

What is honored pass? I don't guess my school has that.

Thanks!
 
I'm doing the Appleton and Lange Question book and there are a lot of questions asking about prevalences and percentages, do shelf exams test on this kind of stuff? It seems absurd.
 
zoomzoomzoom said:
I'm doing the Appleton and Lange Question book and there are a lot of questions asking about prevalences and percentages, do shelf exams test on this kind of stuff? It seems absurd.
Click to expand...

Not in my experience. Having a ballpark understanding is not bad, but it's far more important to focus on criteria and the subtle differences that distinguish between diagnoses. I've heard people endorse Appleton and Lange and liked it a lot. I used Case Files and First Aid and thought they covered everything well.
 
To follow up, I got my grade back yesterday: 89.

If anyone is curious, I did the Kaplan Qboook Psych sections and got 84% and 86%. Got a cumulative 80% on the Uworld psych questions.
 
Dear God in heaven. I just took the psych shelf today. It made Step 1 seem like a piece of cake. Easily one of the most difficult and time-crunched exams I have ever taken.

Also, after having had computerized exams for the past 2 years, it was very difficult to go back to the #2 pencil-and-paper format. I hate bubbling.

I definitely began to ran out of time and frantically tried to answer a few questions at the end without thoroughly reading the question stem. I managed to fill in all 100 bubbles, though.

I'm praying that I pass. I think I need a 60%. :scared:
 
I also just took this test today. Wow, it was a real time crunch. Of course, I usually take the NBOME tests which have two sentence stems and vague questions. But, I had to really skim the stems in order to finish on time. And, I had no time to go back and review questions that I was unsure about. I was really hoping to honor the rotation since I'm heading into psychiatry next year, but I'm not sure I pulled it off today!
 
Got my score back

79 raw - honestly pretty shocked as I put C's for 8-9 questions because I ran out of time. Good enough to honor due to pretty good clinical evals/grade.

Best advice, I say it again, is to just read fast. thats it. The shelf content itself isn't that bad
 
i am no all-star student but had success on the psych shelf so thought i would add

used FA for psych and annotated a bit with the andreason textbook i had from my 2nd year psych course. did all of case files and annotated FA with that as well. i really liked that case files book, it is a bit mundane and the ?s are easy but if you use it earlier on in the rotation it will help alot with learning. i used it a little too late but still loved it. i did about 1/3 of the PreTest book quickly the night before the shelf, as well as 100 of the apopleton and lange questions. During the rotation I did all the 180 some UWorld questions. There were a lot of needless ethics-type questions, but the actual psych ones i got were good. i had very little hard medicine or neuro, the stuff i had you could usually get with some background knowledge from step 1 or sefcond year.

it was my first rotation, so i had no background in anything but using those books i wound up with a 99 raw, so was incredibly surprised and psyched ;)
 
Read this thread before the test and was wondering if any of the questions banks would be a good predictor of the shelf exam

Thought the advice about knowing your timeframes was very helpful. You don't need to know exact numbers for demographics, but knowing what is more common for a gender/age group is pretty useful.

Anyhoo - I read blueprints first week, thought it was too superficial. First Aid was much better and ended up reading it a few times. Read casefiles, and then did the A&L book. Two best books I thought were 1st aid and A&L.

Questions in the order I took them - Kaplan 85, NBME 100, Kaplan 90, A&L 81, 79

Shelf score - 90. Kaplan seemed the best in terms of simulating difficulty, AL was good for pounding Pharm into your brain.
 
So just took the shelf and didn't think it was terrible. I definitely left the exam feeling better than after the medicine shelf. I think everything is pretty well represented with a good bit of medicine/neurology thrown in to keep you on your feet and some WTF type questions at least on my exam. I read FA about 3 times and did questions from Appleton, Blueprints, and Kaplan Q book. We'll see if that was enough.
 
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