Advice on shelf exams

[pangoro25]

I've been doing well on my clinical evaluations so far but the shelf exams always seem to be bringing down my final grade. I've been a studious browser of the forums in terms of finding appropriate resources to study for each shelf, and I've been pretty diligent in terms of budgeting time to study every day (generally an hour or 2 on work days, 6+ on days off).

However, despite going through a lot of the recommended study resources, I'm still struggling to score above the 70th percentile. Maybe I'm just a bad test taker? Have anybody else had a similar issue? What would be your advice?

obgyn shelf:
did uworld once, took notes on incorrect answers
did extra qbank once (APGO), took notes on incorrect answers
read case files and did all questions
watched all relevant online med-ed videos
Reviewed all notes a few days prior
Score = 78 raw, 53 percentile

IM
read all of im essentials, did all questions, took notes on incorrect answers
finished 80% of uworld once (did not finish all of neurology), took notes on incorrect answers
read 50% of step up 2 medicine
watched 50% of relevant online med-ed videos
Reviewed all notes the week prior
Score - 72 raw, 38 percentile

I wonder what objective things I could improve on (besides study habits, etc.) Perhaps going through more resources? Or more repetitions? Something is off and I would appreciate any advice from you guys for improvement on my future exams.

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[Amygdarya]

First off, what's your Step 1 score? You don't need to answer here; my point is, this may be where you are in terms of your test taking skills. Also, plenty of shelf questions build on Step 1 knowledge.

Second, try figuring out why you miss questions. Based on the resources you listed and the effort you put into studying them, it doesn't appear that your problem insufficient resources. (Also, shelves and Step 2 appear to be more about reasoning than memorization.) Could it be your test taking approach? Timing? Focusing on the wrong info in the stem? Missing the point of the question.
I suggest you to analyze the kind of mistakes you make on UWORLD questions. Also, have you been doing NBME practice tests? They were very useful for me and highly predictive of my shelf scores. You can analyze what kind of mistakes you make on NBME questions as well.

 

[pangoro25]

Thanks Amygdarya, I appreciate the suggestions. I haven't tried analyzing in depth why I get certain questions wrong, but it seems be a mix of focusing on the wrong info in the stem or not being able to decide between the best and 2nd best choices.

Your suggestion to take NBME practice exams is well noted. Do the NBME practice exams give you the correct answers? Or do they only tell you if you got a question right or wrong?

With regards to your question about Step 1, I took that about 6 years ago, and while I didn't do stellar (215) I felt at the time it was more due to inadequate preparation as I had not gone through all the resources available to me. To be honest, most of my Step 1 knowledge had evaporated by the time I returned to clinics. This may or may not be a common theme for returning MD/PhD students, but your point is well taken, I will have to make up for that gap by doing extra preparation for the shelfs and Step 2.

 

[Anicetus]

I've been doing well on my clinical evaluations so far but the shelf exams always seem to be bringing down my final grade. I've been a studious browser of the forums in terms of finding appropriate resources to study for each shelf, and I've been pretty diligent in terms of budgeting time to study every day (generally an hour or 2 on work days, 6+ on days off).

However, despite going through a lot of the recommended study resources, I'm still struggling to score above the 70th percentile. Maybe I'm just a bad test taker? Have anybody else had a similar issue? What would be your advice?

obgyn shelf:
did uworld once, took notes on incorrect answers
did extra qbank once (APGO), took notes on incorrect answers
read case files and did all questions
watched all relevant online med-ed videos
Reviewed all notes a few days prior
Score = 78 raw, 53 percentile

IM
read all of im essentials, did all questions, took notes on incorrect answers
finished 80% of uworld once (did not finish all of neurology), took notes on incorrect answers
read 50% of step up 2 medicine
watched 50% of relevant online med-ed videos
Reviewed all notes the week prior
Score - 72 raw, 38 percentile

I wonder what objective things I could improve on (besides study habits, etc.) Perhaps going through more resources? Or more repetitions? Something is off and I would appreciate any advice from you guys for improvement on my future exams.

This may not be something you wanna hear.

I started getting honors after studying on rounds instead of paying attention. I would study uworld and notes from online Meded DURING floor time and during the lunch conferences and bs grand rounds. I saw ZERO change in my eval score and as much as residents and attendings on here like to think they notice and think they make a difference, they really dont. It's sad that it comes down to the shelf. Don't offer to stay late. An hour or two a day isn't nearly enough time studying. Bump that up to 4-5hours a day after shift, but then again you'll have to find ways to fall through the cracks and study instead of coming back to check on patients etc.

Half the students on here are geniuses who remember every detail from uworld by going through it once and will tell you and me that 1-2 hours a day is enough or that you really don't need to study that much for a shelf. They haven't figured out that human brains actually have variability (surprising I know). You just require more studying time and I'm the same way. You just need to figure out a way to maximize that and I've unfortunately have had to sacrifice the offering extra help etc on the floors and "escape unnoticed" when you know the residents don't care or simply assume you're with with another resident.

They don't actually all gather around and go "oh is med student #4 with you? Oh they went missing at 2:30pm?? They weren't with so-and-so??? So that must either mean they were with the intern or ditching." And if they look into it and go that far and waste that much more time looking into it, just say you had a meeting. That doesn't work? Say you vomited in the bathroom and had to sit down but feel better today. The possibilities are endless especially if the extra Bs they are keeping you on the floors for like watching them do a consult for pain is gonna take up 2 more hours that could be spent studying for the shelf.

 

[Redpancreas]

I went from not almost failing my first shelf (OB), barely missing honors on my next 3, and then honoring my latest one (family) by 12 points. I was actually at home w/ my parents for my family month and while I was continually irritated at all the distractions, I somehow did very well. I think getting proper sleep 1-2 weeks before the exam makes a huge difference.

 

[pangoro25]

I went from not almost failing my first shelf (OB), barely missing honors on my next 3, and then honoring my latest one (family) by 12 points. I was actually at home w/ my parents for my family month and while I was continually irritated at all the distractions, I somehow did very well. I think getting proper sleep 1-2 weeks before the exam makes a huge difference.

That's encouraging to hear! Keep up the success! Staying home with family has its pros and cons; it is quite hard to deal with all the distractions sometimes.

 

[wegh]

You don't need to study 4-5 hours a day imo. You can't be a terrible test taker because you made it to medical school. Chances are you will benefit from a few things.

1) if you change your answers, I would recommend either practicing at home to see if you change them to incorrect more often than not. I stopped reviewing questions I marked. My grades have gone up

2) analyze how you approach questions when you do practice questions at home. the question has to give you enough information to rule out all of the answers but one. if you aren't comfortable ruling out 75% of the answers on average, your knowledge base is deficient

3) try reducing your sources. you may be spreading yourself too thin by reviewing multiple sources, when you could be reviewing 1 or 2 ad nauseam

4) some people like taking notes. I don't bother. I never really have the time to review notes, so basically I'm spending extra time writing crap down when I could be doing more questions or more reading

5) if it was earlier on, I would have said tried firecracker. It basically makes books obsolete for me

 

[padfoot777]

This may not be something you wanna hear.

I started getting honors after studying on rounds instead of paying attention. I would study uworld and notes from online Meded DURING floor time and during the lunch conferences and bs grand rounds. I saw ZERO change in my eval score and as much as residents and attendings on here like to think they notice and think they make a difference, they really dont. It's sad that it comes down to the shelf. Don't offer to stay late. An hour or two a day isn't nearly enough time studying. Bump that up to 4-5hours a day after shift, but then again you'll have to find ways to fall through the cracks and study instead of coming back to check on patients etc.

Half the students on here are geniuses who remember every detail from uworld by going through it once and will tell you and me that 1-2 hours a day is enough or that you really don't need to study that much for a shelf. They haven't figured out that human brains actually have variability (surprising I know). You just require more studying time and I'm the same way. You just need to figure out a way to maximize that and I've unfortunately have had to sacrifice the offering extra help etc on the floors and "escape unnoticed" when you know the residents don't care or simply assume you're with with another resident.

They don't actually all gather around and go "oh is med student #4 with you? Oh they went missing at 2:30pm?? They weren't with so-and-so??? So that must either mean they were with the intern or ditching." And if they look into it and go that far and waste that much more time looking into it, just say you had a meeting. That doesn't work? Say you vomited in the bathroom and had to sit down but feel better today. The possibilities are endless especially if the extra Bs they are keeping you on the floors for like watching them do a consult for pain is gonna take up 2 more hours that could be spent studying for the shelf.

could not agree anymore with this advice

 

[Anicetus]

You don't need to study 4-5 hours a day imo. You can't be a terrible test taker because you made it to medical school. Chances are you will benefit from a few things.

1) if you change your answers, I would recommend either practicing at home to see if you change them to incorrect more often than not. I stopped reviewing questions I marked. My grades have gone up

2) analyze how you approach questions when you do practice questions at home. the question has to give you enough information to rule out all of the answers but one. if you aren't comfortable ruling out 75% of the answers on average, your knowledge base is deficient

3) try reducing your sources. you may be spreading yourself too thin by reviewing multiple sources, when you could be reviewing 1 or 2 ad nauseam

4) some people like taking notes. I don't bother. I never really have the time to review notes, so basically I'm spending extra time writing crap down when I could be doing more questions or more reading

5) if it was earlier on, I would have said tried firecracker. It basically makes books obsolete for me

Perfect example of a med student assuming that all students "don't need to study that much, after all we all made it to med school so we must all be capable of what I can do." That simply isn't true for everyone in third year. Undergrad and even years 1/2 of med school gave us a lot more time to digest and learn/memorize material. MS3 does not give us that luxury so it ends up unmasking students who aren't "doing it wrong" but may simply need more time to study. This becomes very apparent in time-restricted clerkships like surgery, obgyn, and even IM in some schools especially if they hold you hostage in surgeries or procedures and long rounds from 6am to 6pm. Yes, it is physically, literally, virtually possible that a student may still not have figured out the best way they could learn but SDN likes to just label people as "doing it wrong" way too much if they aren't getting good grades after putting in as much time as they can.

Not everyone is capable of doing well enough for honors using more questions. Not everyone is capable of doing well enough for honors using less sources. If this person has tried most "styles of learning" they may need to step back and find more ways to make MORE time if that's all they are needing.

 

[wegh]

Perfect example of a med student assuming that all students "don't need to study that much, after all we all made it to med school so we must all be capable of what I can do." That simply isn't true for everyone in third year. Undergrad and even years 1/2 of med school gave us a lot more time to digest and learn/memorize material. MS3 does not give us that luxury so it ends up unmasking students who aren't "doing it wrong" but may simply need more time to study. This becomes very apparent in time-restricted clerkships like surgery, obgyn, and even IM in some schools especially if they hold you hostage in surgeries or procedures and long rounds from 6am to 6pm. Yes, it is physically, literally, virtually possible that a student may still not have figured out the best way they could learn but SDN likes to just label people as "doing it wrong" way too much if they aren't getting good grades after putting in as much time as they can.

Not everyone is capable of doing well enough for honors using more questions. Not everyone is capable of doing well enough for honors using less sources. If this person has tried most "styles of learning" they may need to step back and find more ways to make MORE time if that's all they are needing.

Jesus, I said in my opinion. Calm down

Also, give me a break with this 6am to 6pm crap. Plenty of people work those hours and have children. Hell, there are people in medical school who do it. I know i worked plenty of crap jobs before college/medical school working 70-100 hours a week. Medical school isn't THAT bad and it's certainly better than residency

 

[Anicetus]

Jesus, I said in my opinion. Calm down

Also, give me a break with this 6am to 6pm crap. Plenty of people work those hours and have children. Hell, there are people in medical school who do it. I know i worked plenty of crap jobs before college/medical school working 70-100 hours a week. Medical school isn't THAT bad and it's certainly better than residency

You're just perpetuating the same thing that I keep using you as an example of. Cool. You know someone who worked jobs, had kids and got straight A's. I know people who had no kids, worked no jobs, eliminated their fb and had their favorite internet sites blocked and still couldn't pull higher than average. To some people med school IS that bad. Stop assuming everyone is capable of hitting the stars if they "want it badly and work hard enough". Variations in aptitude do exist be it due to reading disability, difference in core interest, memory capability, etc. we can keep this going but just admit that not everyone was made the same way and some people can't succeed at an honors level given a fixed time constraint that is beyond their limit. Some people are just way more gifted than others. I'm willing to understand that some people have a natural ability to remember anything they read and rock AOA in med school. There's no secret memory method to it as much as people waste energy and time pouring over what the "best strategy" is.

 

[wegh]

You're just perpetuating the same thing that I keep using you as an example of. Cool. You know someone who worked jobs, had kids and got straight A's. I know people who had no kids, worked no jobs, eliminated their fb and had their favorite internet sites blocked and still couldn't pull higher than average. To some people med school IS that bad. Stop assuming everyone is capable of hitting the stars if they "want it badly and work hard enough". Variations in aptitude do exist be it due to reading disability, difference in core interest, memory capability, etc. we can keep this going but just admit that not everyone was made the same way and some people can't succeed at an honors level given a fixed time constraint that is beyond their limit. Some people are just way more gifted than others. I'm willing to understand that some people have a natural ability to remember anything they read and rock AOA in med school. There's no secret memory method to it as much as people waste energy and time pouring over what the "best strategy" is.

Spare me the histrionics