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, enjoying one of your favorite hobbies, or watching the latest episode of The Pitt. 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, here 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 question bank is essential. Also, at least one week pre-exam for every clerkship I would do an NBME practice exam (or two). Use practice exams strategically to identify weak areas and focus your final review.
No matter the rotation, the most effective study workflow was the same: identify a weak topic through questions, learn the concept with Osmosis, reinforce it with flashcards and practice questions, and then return to the question bank. The combination of active learning and spaced repetition helped me retain information far better than passive reading alone.
Internal Medicine
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 a comprehensive internal medicine review resource, such as Step-Up to Medicine or another current clerkship text, 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 start with an Osmosis video to build a strong conceptual foundation, then complete the associated flashcards and practice questions to make sure I can apply what I’ve learned. For more challenging topics, I explore additional references as needed before returning to UWorld. 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.
Pediatrics
UWorld and Osmosis were my primary resources for pediatrics. Again, do the questions. When you encounter a topic you don’t understand, watch the relevant Osmosis video and complete the associated flashcards and practice questions to reinforce understanding. Pediatrics covers a broad range of topics, so having a structured resource to review diseases, developmental milestones, and management strategies can make a huge difference.
OB/GYN
For OB/GYN, focus on mastering high-yield obstetrics, gynecology, reproductive endocrinology, and women’s health topics through Osmosis videos, flashcards, and practice questions. Use UWorld consistently throughout the rotation to apply concepts and identify knowledge gaps.
Neurology
Neurology can feel intimidating because there is so much content, but Osmosis made this shelf exam manageable for me. Work through neurology topics systematically using Osmosis videos, flashcards, and practice questions. Set a realistic daily goal and stick to it throughout the rotation. Combining comprehensive content review with UWorld questions is one of the most effective ways to prepare for this shelf.
Psychiatry
For psychiatry, use Osmosis to build a strong understanding of psychiatric disorders, diagnostic criteria, treatment approaches, and psychopharmacology. Reinforce concepts with flashcards, practice questions, and decision-making trees, then use UWorld to further develop your test-taking skills and clinical reasoning.
Surgery
NMS Casebook. Supplement this with UWorld and Osmosis videos for any surgical, anatomy, or perioperative topics that need reinforcement. Also, make sure that you have an anatomy book to prep for cases. Reviewing anatomy and common procedures before cases can help you better understand what is happening in the operating room and contribute more meaningfully during your rotation. Surgery Recall remains a useful resource for preparing for questions on rounds and in the OR.
Bonus tips
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.
One of the biggest lessons I learned during clinical year is that consistency matters more than perfection. A sustainable daily study routine built around active learning, practice questions, and spaced repetition will take you much farther than cramming right before an exam.
Good luck! I believe in all of us becoming great future doctors.
Key Takeaways
- Consistent use of practice questions is one of the most effective ways to prepare for shelf exams.
- Active learning through videos, flashcards, and question banks improves retention more than passive reading.
- Tailoring study resources and strategies to each clerkship helps maximize efficiency.
- Identifying weak areas early and focusing review around them leads to stronger performance.
- Sustainable study habits, balance, and attention to mental health are critical during clinical year.
About the Author
Claire Donnelley is a 3rd year medical student at Columbia University in New York.
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