Study Strategies for Rotation/Shelfs

[vicinihil]

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Newb about to start on the wards here and I'm wondering how to study during rotations. I've heard a lot of people saying things like..."make sure you read up on your patient"...."learn from the patients"...didactic sessions from the school, etc, etc. I'm wondering how you guys did it. I'm not asking about recommended books but what sort of studying regimen did you guys use to succeed once you have the books you want for a rotation.

Is it necessary to read a textbook or is Blueprint or an equivalent (Step-up, First AID) sufficient for learning the core knowledge of each rotation?

Doing question banks and case like problems are good prep for the shelf I heard but how did you fit this into your study routine for a shelf? At the beginning? After reading and learning from a text like book like Blueprints, or right before the shelf just to review what you probably already know.

How much studying daily did you do outside the rotation? Since it's not like the classroom portion where 8-10 hours of studying daily is feasible since you have so much time, how did you guys get all the studying in?

Thanks for the advice in advanced!

 

[Guile]

Every rotation is different. I would definitely check the "official" shelf study materials threads for each rotation. The advice varies greatly for each rotation.

As far as "reading on your patient" goes, that can be anything from a very broad range of resources. UpToDate is very popular. I liked reading original literature. You can even read textbooks for the particular specialty. I thought Harrison's was pretty good for medicine, for example. Usually "reading on your patient" means reading about the particular diagnosis so that you are more knowledgeable on its presentation, clinical course, epidemiology, diagnosis, treatment, etc.

 

[faw20]

I agree with Guile. In general, I used some type of text, some source of case-based study, and some question source to study for each clerkship.

I didn't bother preparing for didactic sessions. They were pretty much useless at my school, and we weren't graded on our participation or preparation. You'd want to check your school's specific policies on didactic sessions and grading though, and ask classmates who have already taken what to expect for the didactic sessions.

I used down time in the hospital to read up on my patients, surgeries, prepare for presentations I had to give. That way I could always study, even if I didn't have access to my books. When I got home, then I would study for the shelf.

 

[Jolie South]

I read a text that will prepare me for the shelf (i.e. Blueprints, First Aid, Case Files, etc) and then read up on whatever my patients have (i.e. menorrhagia, Whipple procedure, etc). I think you should be doing a good mix of both everyday. It sucks, but the more repetition, the better. I'd say and hour or two should be sufficient. When you combine that with reading on downtime, you'll get some good studying in.

As far as studying for the shelf goes, study with other folks on your rotation for a couple of weeks before the test. They will focus on crap that you don't think is important. I know I got some shelf questions right simply from other people mentioning stuff to me when studying.

 

[Super Mario]

1) Patient-based learning: the generic adage is to "read up on your patients." A more specific way to learn from your patients in a way that's relevant to your shelf exam would be to read about the diagnosis and management of the disease they present with, how to distinguish your patient's disorder with other similarly presenting conditions, and then read further into the diagnosis and management of the more common similarly presenting conditions. This can be time consuming, but is probably one of the most effective methods to actually learn medicine and can be time-efficient since you can do this during down-time on the wards or on call.
E.g. - Chest pain patient admitted to "rule out ACS"
- Read about distinguishing between the acute coronary syndromes (STEMI, NSTEMI, unstable angina)
- Read about the management of the three types of acute coronary syndromes and their complications
- Understand the differential diagnosis of chest pain
- Read about diagnosis and management of common causes of chest pain (e.g. - cardiac causes like pericarditis and aortic dissection, pulmonary causes like pneumonia and PE, GI causes like nutcracker esophagus).

2) Review book/casebook: no matter how well you read up on your patients, you will likely not see the spectrum of conditions that you will be tested on. Pick a comprehensive review book/casebook and study it well. If something is not particularly clear in the review book, go back to a review article or uptodate and clarify the issue.

3) Questions/cases: Since the shelf exams are all multiple choice, most students generally pick an additional question book/casebook. I would suggest also trying to do some of the questions in timed blocks, since many students find themselves pressed for time during the shelf exams. In terms of questions versus review book first, this varies with the student. As a student, I generally read a review book first (quickly) to get a general understanding of the subject --> then did questions to figure out what I really had not picked up on or where the review book was not sufficient --> then read again.

4) How long to study: very difficult question to answer since everyone is different. While it is true that you will not have 8-10 hours a day to study you certainly should have sufficient time on most rotations (surgery and ob-gyn can be exceptions).

 

[mTOR]

2) Review book/casebook: no matter how well you read up on your patients, you will likely not see the spectrum of conditions that you will be tested on. Pick a comprehensive review book/casebook and study it well. If something is not particularly clear in the review book, go back to a review article or uptodate and clarify the issue.

3) Questions/cases: Since the shelf exams are all multiple choice, most students generally pick an additional question book/casebook. I would suggest also trying to do some of the questions in timed blocks, since many students find themselves pressed for time during the shelf exams. In terms of questions versus review book first, this varies with the student.

Do these.


You can read on your patients if you're interested. And as far as really making things stick and building your clinical PRACTICAL problem-solving skill set this cannot be beat. But as far as shelf exams go, reading on your patients is neither sufficient NOR necessary. At all. One bit. At worse and in excess, it can be grossly inefficient.