question about wards

[saltbreeze55]

1. Is shelf exam counting 20% considered a lot? How does that shift if a student should prioritize time prepping for shelf exams (which eventually is important for step 2 especially with step 1 P/F) vs putting is extra time/ energy into getting best possible evals? Ideally you do great on both, just wondering what advice you would give to students for prioritization. In era of step 1 P/F, would you suggest taking step as soon as possible and use time to shift prepping for shelf/ step 2? Or just really focus on good step 1 prep and take a regular dedicated for a good foundation going into rotations?

2. I hear a lot of students saying it's better to do the speciality you're interested in later on so you're more prepared, but on the flip side any rotation you do early on is usually good too because expectations are super low. Im not sure how valid this is concern is or if any one else every thinks of this too, but I'm worried if I do the rotation I'm most interested later, I am still going to be an absolute idiot but the bar will be higher. Is this a thing or do most people usually really end up feeling a lot more confident as they go along?

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[IR3A4]

1. Is shelf exam counting 20% considered a lot? How does that shift if a student should prioritize time prepping for shelf exams (which eventually is important for step 2 especially with step 1 P/F) vs putting is extra time/ energy into getting best possible evals? Ideally you do great on both, just wondering what advice you would give to students for prioritization. In era of step 1 P/F, would you suggest taking step as soon as possible and use time to shift prepping for shelf/ step 2? Or just really focus on good step 1 prep and take a regular dedicated for a good foundation going into rotations?

2. I hear a lot of students saying it's better to do the speciality you're interested in later on so you're more prepared, but on the flip side any rotation you do early on is usually good too because expectations are super low. Im not sure how valid this is concern is or if any one else every thinks of this too, but I'm worried if I do the rotation I'm most interested later, I am still going to be an absolute idiot but the bar will be higher. Is this a thing or do most people usually really end up feeling a lot more confident as they go along?

1) I wish it was 80%+ (ours are 25%); Either way just do you, show up, put in good work, actively try to learn, prepare for your shelf exam and it'll all come together

 

[Redpancreas]

1. Is shelf exam counting 20% considered a lot? How does that shift if a student should prioritize time prepping for shelf exams (which eventually is important for step 2 especially with step 1 P/F) vs putting is extra time/ energy into getting best possible evals? Ideally you do great on both, just wondering what advice you would give to students for prioritization. In era of step 1 P/F, would you suggest taking step as soon as possible and use time to shift prepping for shelf/ step 2? Or just really focus on good step 1 prep and take a regular dedicated for a good foundation going into rotations?

2. I hear a lot of students saying it's better to do the speciality you're interested in later on so you're more prepared, but on the flip side any rotation you do early on is usually good too because expectations are super low. Im not sure how valid this is concern is or if any one else every thinks of this too, but I'm worried if I do the rotation I'm most interested later, I am still going to be an absolute idiot but the bar will be higher. Is this a thing or do most people usually really end up feeling a lot more confident as they go along?

You’re basically asking FAQs any M2 transitioning to M3 asks. Definitely have this discussion with your upperclassmen as they’re best geared to give you the best advice.

1.) 20% for the shelf seems fair.
2.) I would first ensure you’re committed to your clinical rotation. When you are there, don’t multitask. Immerse yourself and actually try to follow everything that is happening. Don’t disappear or try to do UWorld. Spend all the time you can considering patients and their care. This is how you learn medicine. Residents may also pick up on it and your knowledge of the patients will be well received/appreciated.
3.) I don’t think a lot of people realize this and sorry to be deterministic, but you aren’t really in that much control of your shelf exams during M3 which is difficult for lots of people to accept coming from M1-2 where the amount you studied resulted in the quality of your grade of formerly meaningful Step 1 score. Your knowledge base comes from M1-2 so hopefully you worked hard at that time. Shelf exams test a lot of that same material again related to the field, not really core areas of the field. It also tests clinical reasoning more so than direct recall (but there definitely is some recall too). The IM shelf won’t be full of COPD exacerbation management but rather questions about ADPCKD which you really learnt about in M1-2 and maybe reviewed once. The surgery shelf won’t have questions about gallbladder anatomy you see daily but acute cholangitis . You shouldn’t be spending hours pouring over study resources. Find ONE review source for each rotation and commit fully to that source and try to get through the UWorld questions for that rotation (more so for Step 2 prep than the shelf). The shelf will have several gimme questions anyone should have known even before the rotation, a handful you learnt on the rotation, maybe a handful you actually studied for, and then the rest will be out of left field/random minutiae from M1-2 and it’s really how you do on those (your ability to reason/intuit) that puts you into honors on the shelf. Some say that you can do millions of practice questions so that stuff you see on exam day won’t be completely new but you’d have to do a in unrealistic number of questions and have to get really lucky for that to make a difference. Therefore, spending the majority of time studying for the shelf IMO is not the best use of time. That’s my rant on that.
3. There’s literally a +/- to every single rotation sequence. I suggest putting what you like in the middle. There’s several threads debating it. The only thing I would say is you’re probably best off not doing what you want to do last because what if you don’t find mentors to write you letters or you don’t like it? You’ll have little time to improvise and would hope your SubI works out. In the beginning is OK too because expectations are low so even though you don’t have much underneath your belt, they’re not expecting much. Midway is perfect IMO so you can get some experience under your belt (not to look good) but mainly so you can engage well with the material and understand what’s going on with your patients instead of focusing on how the EMR/Hospital/Hierarchy works.