How I Studied for the Shelf Exams and Survived Clinical Year
Published on Feb 21, 2019. Updated on Sep 24, 2020.
To be fair, I offer no magic answers. The clinical year is challenging, both academically and emotionally. You don’t always have time for the gym or watching the latest episode of GoT, and even though sometimes you have the greatest day, other times you just want to curl up in a ball and cry. I have been in both of these scenarios, and I made it through. You can make it through too.
If I were to go back and do it again, these are the high-yield study tips that I would want to know broken down by clerkship.
Questions are key for all clerkships
UWorld Step 2 CK and Amboss. These question banks are essential. Also, at least one week pre-exam for every clerkship I would do an NBME practice exam (or two). Just remember that you are only allowed to see the questions that you get wrong and they don’t give you the correct answers. Therefore, these questions are good to go through with a colleague (less expensive too…).
I felt that this was my toughest shelf exam. If the shelf exam matters a lot for your grade, I wouldn’t do this rotation first. If you’re just trying to learn, do this rotation first!! You learn so, so much. In terms of studying, read Step Up to Medicine and re-read each section as it pertains to the questions that you’re doing. Set a goal of doing at least 500 questions during the rotation (so, at the beginning, break that down into a per-day goal). I do my questions at first by category (for example, all of cardiology, then all of endocrine) so that I can get a handle on a topic.
When I don’t understand a topic, I search for an Osmosis video (then do the flashcards and questions to make sure I’ve really understood the topic) or search for a learning card in Amboss. If you have trouble with recall, I would supplement with Anki (can download pre-made decks from the internet and supplement as needed), but focus primarily on questions.
UWorld and Pre-Test. Again. Do the questions. When you encounter a topic you don’t understand, watch Osmosis videos and do associate flashcards to check understanding (Online MedED also has some good videos on peds topics).
If you watch and know all of the Reproductive & GU Sketchy Medical videos, you will do very well on this shelf. UWorld too.
Osmosis is the best resource for this shelf. Click on the neurology tab and do every topic. There are 151 topics. Do the math and set a daily goal for the number of videos and associated flashcards/questions. Osmosis can actually create a study schedule for you if you’re feeling fancy. If you combine this with UWorld questions, you will ace the shelf.
Read all of Psych First Aid and then watch all of the Sketchy Medical videos in the Neuro/Psych tab under sketchy pharm. Do all of UWorld.
NMS Casebook. Supplement this with UWorld and Osmosis video explanations for any topics you don’t understand. Also, make sure that you have an anatomy book to prep for cases. YouTube is a great resource for watching a case ahead of time, which if you combine this with Surgery Recall you will also impress attendings with your knowledge.
A caveat of all these tips is that even if you do everything right, there is no guarantee of honors. Try to remember that most things are out of your control. What is within your control is the amount that you learn. I found that, ultimately, asking questions and showing that I wanted to learn mattered more than showing the knowledge that I already had. Nobody knows everything. Be as prepared as you can be, but also recognize that everyone (even the most stellar attending) is constantly learning, and this is the gift of medicine.
Don’t forget to have balance in your life too. Reach out to a mental health professional if needed if your stress level is becoming overwhelming (if not for you, for a friend). Keep some hobbies, even if that is going out on a Friday night to party with your long lost college friends. We’re only human.
Good luck! I believe in all of us becoming great future doctors.
Claire Donnelley is a 3rd year medical student at Columbia University in New York.
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