realistically, how much studying should i be getting done each day? it just seems like there isn't enough time in the day especially when you get home from 12+ hours in hospital and just want to sleep
Try to do as much reading as possible while you're at the hospital. Depending on the rotation there is more or less free time, but almost every rotation has some down time that you can use as study time. If you can get through 20 pages of a review book each day then you don't really need to study at home! At least that's what I've done, and I think I've been pretty successful on the shelf exams.