Shelf Exams

[jmdeer]

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100 questions- 2hrs and 10 mins

I finished w 20 mins left, lots of people had a hard time finishing though

know your congenital heart defects and murmurs
know your ID
know your GI

i read blueprints once and did pretest once and scored pretty well-84 percentile

you do not need to read echos. if there are pics their are derm pics. their will also be Chest X rays. Know Diaphragmatic Hernia CXR

 

[kinetic]

Remember that kids aren't little adults. BWAH HA HA HA! OK, OK, I'm sorry.

 

[phoenixsupra]

Any last minute suggestions? Any HY things? I did read the previous posts that were on SDN via the search, but was wondering if anyone encountered anything 'new'.

Also how many ?s and how much time do we get?

Thanks !!

Hey 007, would you mind giving some feedback on what your shelf was like. I've got peds up next after the Chrisma-hana-whatsitsface break.

 

[phoenixsupra]

Yeah. that's great. Just suck up the advice and Pi$s off. Don't bother about giving back.

 

[ThinkFast007]

Yeah. that's great. Just suck up the advice and Pi$s off. Don't bother about giving back.

hey there phoenix...i dont know if that above statement was intended towards me..nevertheless, it's cool, i undestand.

I've just been real busy study for another shelf which i have tommorrow.

my advice for peds....and PM me if you want more...

All I can say is I did ok (didnt honor or anything). As I said I didnt finish about 8-10 q's. I thought it was tough because it's basically a step 1 test all over again. I used Appleton and Lange (it's a real good source, wish I had actually finished it....I didnt have time to...but I actually say verbatim q's from it). A lot of stuff I got right cuz I saw it in my rotation (ie meckels, crohns, and many other GI things...know GI). BUT BY FAR, the most important thing is ID. Know it cold. By that I mean, you should know the differentials for every ID thing. THe hardest thing for me was trying to differentiate b/w items. Know your URI stuff good. Seriously there are soo many diseases in ID that can manifest very similarly so know how to tell them apart. I must say that my test did not have ANY milestones stuff (i was sorta pist since I knew it cold)...nor did it have any thing on vaccinations.

The stuff I used to study from....
Appleton and Lang
First aid for peds
kaplan peds


hope that helps and sorry I couldnt get back to you. Wish me luck on my shelf tommorrow

 

[phoenixsupra]

Thanks ThinkFast007. Appreciate it.

 

[kinetic]

Yeah. that's great. Just suck up the advice and Pi$s off. Don't bother about giving back.

 

[Espion]

Do PreTest. Then find some more questions. Do those. Do as many questions as you can. I tend to remember stuff more easily if I'm forced to think about it in a question format. How else will I remember that galactosemia is associated with E. coli infections and a complication of S. aureus pneumonia is pneumothorax?

I finished the test with, seriously, about 30-40 minutes to spare. Why? Because I did a jillion questions.

That being said, I have no idea how I actually did, but for right now, I can't think of anything better than doing questions.

 

[snowinter]

HI guys,

I took the IM NBME on friday. I dont' know what to think of the test; but I did MKSAP II and pretest .. and I wonder if they really helped? It's not that the questions were so hard or even that long.. (after doing MKSAP) but that ..they didn't ask the same concepts that MKSAP II and pretest were asking; it reminded me more of Step I? Sometimes the questions were just a bit VAGUE?? i left with a bad feeling ... but maybe it waasn't as bad as i thought; anyway MKSAP is awesome just for your own knowledge -- i really understood a lot more of what was going on on the wards cuz of that book and i'm glad i did it. i'm going to miss internal medicine rotation; i really felt comfortable there. and I had a lot of fun!

on another note, I'm sure we all do it-- take a test and then 2 hours after the test a question comes racing back to your mind and you think why am I such an idiot? I do that quite often -- in fact tests don't seem to reflect my knowledge BECAUSE I do that. I have no remedy or cure for my problem; it has improved overthe past 2 -3 years of medical school.. but I still screw myself on easy questions on a regular basis. ive noticed some ppl either knowthe answer or they dont .. so they aren't as upset when they miss a question they know -- just b/c they were thinking of it in a different. way. any thoughts?

take care!!

 

[mpp]

I also took medicine shelf on Friday and felt the questions were a bit vague. Definitely a much harder test than the surgery shelf. To me there were very few 'gimmee' questions. And I hate it when the first few questions on the test are very difficult...it's throws the whole feel of the test for me.

Afterwards we have an OSCE and those things really suck to me...fewer things can make you feel stupider. I don't know why but perhaps to me physical exam skills can be quite subjective and yet the thing is graded in an objective way. The worst is when you put down findings that are not really there. I'm all for having clinical exams in medical school, I just don't like taking them.

 

[snowinter]

hey I felt the same way -- IM seemed harder than surgery shelf!? Although some my classmates didn't seem to think so. Maybe the questions address how different people think differently--

good luck with your OSCE!

 

[phoenixsupra]

*Bump* Peds is coming up in a few days for me.

 

[MissMedicine]

Hi guys

do you all know if there is a way to get a detailed report of our NBME cllinical shelf exams. All i know is a two digit score with no idea what they mean, strengths and weaknesses.

If such a report is available, would I have to get it from the NBME or from the clerkship director?

thanks for the info

 

[MissMedicine]

also what is MKSAP???? What are THE medicine books to get??

 

[bigfrank]

Big Frank

how do you know your precentile for the shelf. Is the precentile the 2 digit score they give us? I dont think thats precentile is it? because I heard they scale it with 70 as the national average.. therefore really a 70 is around 50percentile. so the two digit score doesnt correspond to a percentile?? anyway, just confused as to what our scores mean.

I saw the form that my school received about me. My raw score was a "90" and my %ile was reported as (99th percentile). Your raw score is NOT your percentile. I seem to recall that the mean = 70 and SD = 7-9 for most Shelf exams.

 

[ultane123]

hey - just wanted to get an idea of how you go about stuyding for shelf examsm (aside from clinical exposure). i know there are differnt books for various rotations, but i'm curious how you pace yourself (weekday evenings; just weekends; no reading; just do questions, etc)
thanks
u

 

[p20s02u]

I just found out that my class will be the first to take the Family Medicine Shelf Board, and I have heard nothing about this exam in the past. Any advice on what reading materials our helpful for this exam would be appreciated. I just finished up with IM...should I use the same materials that I used for that exam (MKSAP, Blueprints, FA for Step2)? Thanks for the help.

 

[Scooby Moo]

The Family Medicine shelf is quite similar to the IM shelf...just with some OB-GYN, Peds, and very basic surgery thrown in. IMHO, the books you mentioned are good preparation. I used those in addition to NMS Q&A Family Medicine and was happy with the results.

 

[Trisomy13]

hey - just wanted to get an idea of how you go about stuyding for shelf examsm (aside from clinical exposure). i know there are differnt books for various rotations, but i'm curious how you pace yourself (weekday evenings; just weekends; no reading; just do questions, etc)
thanks
u

chill the first 3 weeks. drink heavily, and often. (showing up to work hungover is acceptable if you can still be sharp enough to handle getting pimped, and is actually respected in some rotations *cough* surgery *cough*)

week 4 you want to start thinking about reading a high yield book like blueprints or current clinical strategies. but just *think* about it. don't really start reading til thursday or so. be a good bookworm on the weekend between 4 and 5. you should still be at least buzzed most nights on week 4.

week 5 you should probably put the bottle down a couple of nights and actually read a few chapters. if you're a chump.

week 6 you read high yield books at the nurses station while patients wonder where you are, and try to pound out about 300 practice questions each night.




seriously.. the shelf exams are standardized. they aren't that hard if you keep your ears open during rotations and set aside a day or two each week for serious study, and casual reading when you can on other days. focus on the obvious high yield areas, e.g. schizophrenia for psych, GI for surgery, etc. this won't get you a 100, but you will pass.

if you want a 100 you need to follow the original guidelines above






(psych, family, surgery ==> DONE. please challenge me NBME.)

 

[p20s02u]

Any ideas where I can get the NMS Family Med Q+A and/or Samson's family med review? Thanks again for the help.

 

[Gibby Haynes]

You might try asking some FP residents or your classman if they have a copy. Some of my classmates that were on different rotations split the cost b/t them.

 

[Vriesea]

For questions, I used A&L and also breezed quickly thru Pretest the week of and scored in the 99th percentile. I thought A&L questions were around the same length and difficulty level while Pretest was a little simplified.

 

[snowinter]

READ THE LAST LINE. you said you don't like doing it -- but it saves you time which may have been part of what you were missing on the nbme;

I try to read the first line and skim down to the last line to see what exactly they are asking : diagnosis, next best treatmnet, etc, then go back and read the middle junk .. cuz then you know what to focus on .. do you really need to read all those lab values or not, etc.

try doing that on practice q's .. if you aren't buying the concept; it may make it easier to do on the real test? i don't usually do it on practice q's just the real deal...

good luck!

 

[Espion]

Do PreTest. Then find some more questions. Do those. Do as many questions as you can. I tend to remember stuff more easily if I'm forced to think about it in a question format. How else will I remember that galactosemia is associated with E. coli infections and a complication of S. aureus pneumonia is pneumothorax?

I finished the test with, seriously, about 30-40 minutes to spare. Why? Because I did a jillion questions.

That being said, I have no idea how I actually did, but for right now, I can't think of anything better than doing questions.

TRUTH.

I made a ** (good grade). Did a million questions. (From PreTest (essential), and Step II question books...most have indexes that break down "Internal Medicine", "Peds", etc.) And I read the blue boxes in BluePrints for the subspecialty stuff (Ortho, Oncology, etc.) Saved mah rear.


** Sorry. Had my grade on there, but I couldn't handle it. I really hate it when people shout out their grades, because they only do that if they did well. So we'll just leave it at, "I did well".

And people are going to take offense at that. I'm not implying anyone on here, because I don't know any of you. I'm happy for people who consistently do well (I'm not one of those), but its hard to get out of my head the two or three people I know that are infuriatingly pretentious about it. Heh. If you have ever set foot in a medical school, I'm sure you understand.

 

[Neuronix]

Since Penn does that 1 1/2 year basic science thing, I'm on my first rotation, Neurology. For the first time ever, Penn has decided to start administering the Neurology shelf for our three week course. Now, while supposedly 75% of our grade is our evulation, we must get minimum grades on the shelf for our HPs and Hs, which are actually pretty high scores. I'm worried. The clerkship director was very much against the shelf exam, since we have to compete with 4-week students, many of them fourth years at other institutions. To make matters worse, I elected to do my Neurology rotation at the pediatric hospital, which means I'm seeing all pediatric Neurology, a small proportion of exam questions. As a precedent, the first time the school administered the Peds shelf a few years ago, several students bombed it and had to repeat the exam. That was even before the administration raised the P/HP/H standards more recently!

I'm through one week of Neurology and I'm realizing that what we're being taught and what I'm seeing in the clinics is very minimal compared to the amount of detail tested by books like Pre-test Neurology. The clerkship director is adament about "don't worry about the shelf, don't buy any books, etc..." but the administration is becoming increasingly strict lately about grading schemes.

So my question is: are the types of questions and obscure trivia tested by the review books like Pre-test a true representation of the Neuro shelf? If so, I've got alot of work to do...

 

[syrinx]

So my question is: are the types of questions and obscure trivia tested by the review books like Pre-test a true representation of the Neuro shelf? If so, I've got alot of work to do...

Not to worry. It is not a difficult exam. Blueprints Neurology is decent and covers most of the high yield topics. Do the 50 questions at the end. PreTest was OK. It has some esoteric questions but also a good concentration of bread and butter, high-yield topics. I also used Secrets in Neurology. I thought it was great but may be too much to get through in 3 weeks.

Make sure you look over basic neuroanatomy and the neuro exam. It will serve you well on the large number of questions asking you to identify the location of the lesion or the nerve root affected. Pick the brains of the adult neuro residents rotating at CHOP. They are your best resource. There are a few peds neuro questions (DDx of floppy baby, genetic disorders, etc) but don't spend much time on this. High yield topics are neurological emergencies, seizure, stroke, headache, CSF analysis, demyelination, neuromuscular, back pain, and brachial plexus injuries.

 

[Neuronix]

Thanks a ton!

 

[Spang]

Not to worry. It is not a difficult exam.

Be sure and let us know if you agree, Neuronix. I doubt you will

 

[syrinx]

Any ideas where I can get the NMS Family Med Q+A and/or Samson's family med review? Thanks again for the help.

NMS Family Medicine is a pretty bad question book. I used it for a bit and gave up because the questions were so OFF. Samson's Family Med Review? Do you mean Swanson's? It was OK but not not great for the shelf. Unfortunately I didn't find the perfect book.

 

[p20s02u]

NMS Family Medicine is a pretty bad question book. I used it for a bit and gave up because the questions were so OFF. Samson's Family Med Review? Do you mean Swanson's? It was OK but not not great for the shelf. Unfortunately I didn't find the perfect book.

Great...I just bought NMS Family Medicine Q+A yesterday. What do you mean that it was OFF? Any other suggested book(s)? I already had Medicine so hopefully that helps.

 

[Neuronix]

Be sure and let us know if you agree, Neuronix. I doubt you will

Well I took the shelf last week. I do think it was pretty challenging, but from what I understand, it's the usual difficulty of a shelf. I finished just in the time allotted, but I was the only one. Others in my group were expecting more of a time warning, and so some were only 1/2 - 3/4 of the way finished. Also, the course director was set on saying things like "Don't worry about the shelf! Don't waste your money on books!" and everyone who heeded this advice now is a little dissatisfied. In the end, I think grades are going to be much more evaluation dependant. The problem is that the administration here has gotten much much less warm and fuzzy over the past few years, and I'm afraid that the people who don't meet at least the 25th percentile will fail. We'll see how the dust settles...

My advice to anyone who has to take the shelf in the future and doesn't know what to expect: PACE YOURSELF! The vignettes are long, and many questions towards the end have alot of answer choices. Remember that you only have like 1 min 10 secs per question, so if you don't know, guess and move on. Blueprints was not detailed enough, while Pretest had alot of obscure stuff that I don't think will ever show up on the shelf. Between the two, you should be well prepared in the middle somewhere

 

[bigfrank]

I just took the Peds shelf yesterday and I thought it was surprisingly difficult. After completing both medicine and surgery, I thought Peds would be a breeze. After the exam, the questions were every bit as long and challenging as medicine but MUCH more difficult than the surgery questions.

I used Blueprints, PreTest, and the A&L question book for review. I was happy with them. Some bits of advice I wish I'd have known:

• Be sure to know the presentation of intussusception. There were at least 5 questions where this diagnosis was a distinct possibility
• Know the distinction among different URIs very well and how they differ in presentation/management of asthma.
• Know your congenital heart defects COLD
• Know your "child has a limp" scenarios. Pat attention to age clues (6 yom following URI vs. obese adolescent male, etc.)

 

[Resident Alien]

Peds was my firs shelf, so I naturally found it hard too. Ended up doing fine on the shelf (atleast for our school's cutoff). Agree with bf's post, except that you didnt need to know a single congenital heart defect for my version of the shelf .....

 

[Lara]

I took mine second and did find quite a bit of cardio - enough to lower my score since it wasn't my strong point. I don't think they were all straightforward "name that CHD", some may have asked to anticipate physical findings...so you really have to both understand the defect and know how it'll present (what kind of heart sounds, etc...cyanotic or not isn't enough!)

I'd also agree with bigfrank's other points - I know I missed some "limp" questions too because I reviewed that part too quickly and didn't know it cold enough.

The shelf is doable (I got an average score) but it definitely takes a lot of studying for.

PS - don't forget with intussuseption you can have periods where the child appears fine and is acting normally! But intermittent crying or just not seeming right (a mother's instinct can be key here) is a red flag. And of course there's the currant jelly stools, but ideally you catch it before that happens...

 

[Mage]

Has anyone used the NMS Peds book for this? I asked in the shelf books thread over a week ago, but no bites. I'm taking the shelf in about 12 days, so I'm hoping its adequate. I can still go out and get blueprints and probably cover it all within a week. I'm also doing a steady pace of questions from A&L (albeit a 13 yr old copy) and a 2004 pretest, though with my extremely old A&L and apparently overly pedantic pretest, I'm wondering if they're worthwhile, too.

 

[Espion]

I did very well on the Peds exam. My strategy was questions, questions, questions. (Which I've posted before.)

Pretest is essential for Peds, I also used NMS (for the questions, heh), as well as various other Step II question books. Then I read the blue boxes for specialties in Blueprints (ortho, onco, etc). A lot of people used CaseFiles, but I can't comment since I've never used the book in any rotation (yet).

All advice above definitely holds. I would also add ID to the list of "things to know".


...
And shigella can present with seizures.

 

[aprilpremed]

Hi,
I have a question on shelf exam timing. When given a shelf exam that is 2 hours and ten minutes, does the time start when you break the test seal or before that when the proctor passes out the tests and reads the instructions.

We had a shelf today in which the time started when the tests were administered and we had to wait 15 minutes while instructions were given before were could break the seal. We all just assumed we had two hours and 10 minutes from the time we were allowed to open the test booklets. We were all pretty surprised when it was announced we had 30 minutes left - when we all assumed we had 45 minutes left.

Is this the way these exams are supposed to be timed?

 

[doc05]

obviously your test was not administered correctly. any idiot knows that the instructions don't count toward test time. I guess your proctor was even dumber than the proctors at my school.

 

[scootad.]

LOL!

 

[EM Junkie]

Is it possible you could have shifted your answer choices up or down one on the answer sheet? I would think it would be pretty hard to get the 1%ile.

I reccommend Case Files: Ob/Gyn by Toy. If it is not at your bookstore, get it at Amazon. Questions, questions, and more questions are definitely key in any exam, but especially the Ob/Gyn shelf.

I also agree with the previous posters, take it at the earlier date!

Good luck!
-Scott

 

[bigfrank]

I don't know. At my school, they assume 20 minutes for drive time, 5 minutes for walking to the testing location, 15 minutes for instructions, and they subtract 5 minutes for a bathroom break!! That's like 45 minutes off the testing time!!!!!!

 

[ThinkFast007]

yah i dotn get it ...some schools get >3 hrs for their shelf exams. We only get 2 hr 10min. Thats such BS that some places get more time. I mean half the time those ppl that failed probably failed by 1 or 2 pts which may have been acquired if they had more time to actually get to q's and not randomly bubble in.

So much for standardization across the country...

 

[tigershark]

yah i dotn get it ...some schools get >3 hrs for their shelf exams. We only get 2 hr 10min. Thats such BS that some places get more time. I mean half the time those ppl that failed probably failed by 1 or 2 pts which may have been acquired if they had more time to actually get to q's and not randomly bubble in.

So much for standardization across the country...

It is standardized, you're only compared to those who had the same amount of time. Besides that, from what we've been told there is not much difference in score when people are given the max amount of time versus the minimum.

 

[jennie 21]

Yeah, I'm thinking you may have somehow mis-bubbled your answer sheet. Especially since you say you studied pretty hard and it sounds like you felt going into the exam that you knew your stuff and felt okay about the exam until you got your grade back. It's pretty hard to get in the 1% percentile if you study. As far as when to re-take it or how to study, I can't advise you being that I'm only a second year and not doing my clinical rotations yet...but I wanted to add a word of encouragement anyway. It must be incredibly frustrating to work so hard and then find out that you did so poorly anyway. Don't get down on yourself...it seems very likely that you either mis-bubbled the answer sheet, or there was a mistake in grading it. You're still a capable student, and you will do much better when you re-take the test!

 

[monstermatch]

Yeah, i bet you just mis-bubbled the scantron - I caught myself doing that on more than one occasion - was always terrified that I'd done it again when I took a shelf and didn't have time to go back and recheck that my bubbles were in order!

OB is such a pain anyhow. Too bad you can't put it behind you - best of luck.

 

[roady]

Thanks a lot for the feedback, all of you who were generous enough to write in and prop my sad butt up...And you were very kind and generous in your comments too. You know, I'm like 2 sheets to the wind with this stuff...one minute I'm convinced that I really lulled myself into some false sense of complacency with my detailed read of Blue Prints and other stuff I did with the Secrets book and some limited Q&A with Appleton and Lange in depth--the next, I'm convinced that there was some mis-bubble fiasco at play.

After reading the comments here, I was CONVINCED that it's a misbubbling error...and then I talk to my roommate here and I wonder again how I could have mis-bubbled but still completed everything--and I think it's me again. I just assume that I'll never have closure on this, and will have to study like a demon to make sure it wasn't actually me. I think the raw score was like 45 out of 100...What the hell is that!!!??? I don't think I've scored that low on one solitary test since I started med school, let alone one I prepared hard for...and yet, maybe it was a constellation of hard questions (for me) on subjects I was unprepared for--there were *A LOT* of infectious dz & breast questions, which I wasn't so sharp on...

I'll just have to study like a demon. DAMNIT! Will med school ever get sane for me??? I guess not; maybe it will just end eventually, and I'll take that too.

Thanks again for the thoughts; I'll likely go with Case Files and Beckman for questions. Any alternate ideas??

Thank you!

 

[laurachon]

Hi. Does anyone know if old shelf exams are available anywhere? I am specifically looking for old path shelf exams.
Thanks!

 

[ericdamiansean]

this sounds stupid, but wat's misbubbled?

 

[bigfrank]

I just took the Peds shelf yesterday and I thought it was surprisingly difficult. After completing both medicine and surgery, I thought Peds would be a breeze. After the exam, the questions were every bit as long and challenging as medicine but MUCH more difficult than the surgery questions.

I used Blueprints, PreTest, and the A&L question book for review. I was happy with them. Some bits of advice I wish I'd have known:

• Be sure to know the presentation of intussusception. There were at least 5 questions where this diagnosis was a distinct possibility
• Know the distinction among different URIs very well and how they differ in presentation/management of asthma.
• Know your congenital heart defects COLD
• Know your "child has a limp" scenarios. Pay attention to age clues (6 yom following URI vs. obese adolescent male, etc.)

Well, I got my Peds Shelf exam score back today and got a "99" raw score, which was reported as the "100th percentile." Needless to say, I believe the 3 [above] books I used to review were excellent resources. Good luck to all.

 

[scootad.]

congrats. if your posts are to be believed, you'll be AOA for sure.