Psych Shelf Exam

[Freddie Mercury]

First Aid Psych 2x
Lange Q&A 1x
UWorld, only did 1 block of this (44Q)
~100 PRITE (psych boards qbank) questions done with the residents through the rotation.
Previous rotations: Medicine, surgery, neurology

Score: 93

Lange Q&A was really good and mirrored the test very well, if I could go back I would probably do it 1.5x (repeat the Q's I missed mainly).

Know depression vs adjustment disorder vs "adjustment disorder w/depressed mood" and variants like that, very well. Had a lot of that on my exam, in addition to the other stuff mentioned in previous posts.

Good luck!

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[zany_brainy]

Is the legal and ethics chapter in lange worth doing?

nope, I skipped it. Ethics is pretty much a crapshoot on exams. I think I had 1-2 on my exam that weren't too hard

 

[DrShazam]

I will echo other sentiments here in that the psych shelf was harder than expected, but definitely not the hardest shelf so far (FM takes the cake for that by a mile; that shelf was just ). The oddball questions were those that were not related to psych i.e. pediatric genetics (definitely read up on those!). I would also recommend skimming over all the posts in this forum because I got the exact question somebody mentioned here! As for the bread and butter, I had a lot of MDD versus adjustment, social phobia versus panic versus GAD versus PTSD, delirium, and OCD. Some other topics tested were NMS, hypertensive crisis, PMDD, porphyria, MS, hepatic encepahlopathy, RLS, somatoform disorders, REM sleep disorder, AN/BN, nightmare d/o, and intoxication/ withdrawal syndromes (but not as many as I had expected, though harder than expected). DO NOT waste time on the theories because none of it was tested, and looking at previous posts, that's always been the trend. My test was not pharm heavy, maybe 10 questions at max.

What I did to prepare:
FA X3 (highly recommended)
Lange 598 questions (highly recommended)
Pre-Test 350 questions (not necessary, but I just wanted more questions)
HY Psych ppt x1 (highly recommended because she covered a lot of the pediatric syndromes)
NBME 1: 98
NBME 2: 64 (great confidence booster)
I have no idea how this went. This is a hard shelf not only because of the content, but also because the curve sucks.

Final grade: 87 --> 84th percentile, which is enough for an A

 

[tantacles]

I used uworld, case files, and first aid x1 exclusively and ended up with an 82, which is just enough for an A at my institution. Lots of sleep questions, oddly.

 

[J ROD]

based on dsm 4 or 5?

 

[notbobtrustme]

based on dsm 4 or 5?

don't think it mattered.

For the most part, guidelines are more important during the rotation. Shelves have been more about diagnosis and management and pathophysiology. Very rarely does a question come up that requires up to date information about 1st line treatments or treatment algorithms.

 

[Fatalis]

Second. Onlinemeded.org has non-updated videos for DSM 5, but classmates are still rocking the socks off the shelf. I told my roommate about it (shes a 3, im a 4) and she ANNIHILATED the psych shelf using OME.

on every thread you mention using OME and ANNIHILATING shelf exams... lol

 

[guitarguy23]

How do people feel about the NBMEs? Are the representative of the real thing? For those who took them, do you feel like the score you got on the practice NBMEs correlated with your actual score?

 

[Apoplexy__]

How do people feel about the NBMEs? Are the representative of the real thing?

Yes, definitely.

For those who took them, do you feel like the score you got on the practice NBMEs correlated with your actual score?

Not at all.

 

[Kaustikos]

based on dsm 4 or 5?

This is kinda important because I took the nbme and it had questions that were "experimental" regarding dsm5 criteria. I think they're making a change soon. Ask the admins and see what they say.

 

[J ROD]

This is kinda important because I took the nbme and it had questions that were "experimental" regarding dsm5 criteria. I think they're making a change soon. Ask the admins and see what they say.

Mine have no clue. I am learning it all anyway since I plan to go into Psychiatry. Either way I know both for the most part.

 

[Kaustikos]

Mine have no clue. I am learning it all anyway since I plan to go into Psychiatry. Either way I know both for the most part.

I agree. It makes sense in that regard. But it's hard to digest new data when we're being tested on the old. Sadly

 

[J ROD]

for anyone that has taken the test recently.....I noticed in Lange how they had several questions on different types of tests that could be done to assess different conditions. Most were obvious but I was curious if this stuff is still showing up on the test because it was most of the stuff I did not know for sure on the 1st practice test. Thanks.

 

[guitarguy23]

So 10-15% is Neuro. Just study the HY neuro stuff? Anything in particular that shows up on the psych exam for neuro?

 

[J ROD]

I felt the test was very similar to the practice NBMEs. Basic psy stuff. Some were really worded where you could consider 2 answers.

Most Neuro involved obvious stuff. I think there was only 1 or 2 I was not sure about.

Some of the child development stuff and disorders like Downs, Fragile X, and Prader Willy..lol

Wish I would have read over that more. Knew most but would have preferred to been a little fresher on that material.

Also, really know the substance intox/detox.

Easy one I have taken thus far. But I expect a harsh curve.

 

[HCTZ1221]

I've taken almost all the shelf exams now, and I think this was one of the harder ones. I studied quite a bit, too. Lots of vague questions, lots of distractors, and some presentations of illnesses that weren't exactly classic. And so much erectile dysfunction, who knew?

 

[J ROD]

I think I had 2 ED questions but they were not bad. I guess that's why I plan on going into Psy. I get this material and not other stuff.

 

[DunKno]

94 on the shelf

FA X1 - would have done this again if more time
Uworld - get this out of the way earlier, teaches basics but not difficult so no use using it at the end
Lange - all questions once, reviewed 3/4 of the notes I took
Pretest - all questions once, reviewed 1/2 of the notes I took
Anki of certain things along the way

 

[bearboots]

Can anyone please tell me if the Lange 9th edition is much different than the latest 10th edition? Would Pretest be a good or better substitute? I'll be using UW for psych but seems another question source helps?

 

[Ost3oclast]

I did FA 2x, all of Pre-test and all of Lange Q&A, also did both NBME practice exams

Score: 99

Honestly, I felt that you really had to know your stuff during the test. During pre-clinical years, it seemed like all of my tests on psych topics were straight forward and could be answered just by reading the first sentence. That wasn't the case with this. There were many times on the test where one sentence buried deep down in the question stem changed the answer entirely. I did finish the test with about an hour left and went over the entire thing again in detail which helped me catch some mistakes. Overall, I think FA twice was a good idea. I also think that Pre-test was better than Lange (just my opinion here). The NBME's were nice but they didn't reflect my score at all....one said I was going to get a 68%?? Not sure where that came from as I was nailing everything else I was doing.

 

[Viola05]

I did FA 1x, NBME both exams (85, 98)-one 2 weeks prior/second the week prior, Qbank questions, combined notes with DSM V with my notes from First Aid, and did some Lange questions.

Score:99

Honestly, I never felt like any of the question banks were very good. Qbank gives better answer explanations than questions, Lange just felt frustrating sifting through the clearly BS questions. Mainly I went through each First Aid chapter and combined it with the DSM V criteria, then reviewed those notes leading up to the exam. I also found a website that had a listing of all the DSM V diagnoses and just went through each group of diagnoses so I knew I didn't miss an esoteric one (nightmare disorder is a good example of one that showed up a couple times on the shelf for some reason). It was also my first rotation, and I had previously had psych right before it in M2 so that helped.

 

[Newyorkgiants]

A girl presents with all these symptoms that seem like GAD (I don't remember how long they were present for) including anxiety about having to look good. Her BMI was 17.

Would you answer GAD or Anorexia for this question?

 

[Viola05]

A girl presents with all these symptoms that seem like GAD (I don't remember how long they were present for) including anxiety about having to look good. Her BMI was 17.

Would you answer GAD or Anorexia for this question?

Can't tell if trolling or not, but need a lot more information to answer a question like this

 

[Laplace]

Skimmed around in FA thoughout the rotation, probably got through it once. Lange x 1 except for the psych testing chapter.

Score: 99

I would emphasize knowing the congenital and medical conditions that lead to psychosis/delirium/mental ******ation.

 

[Kingella]

Scored in high 90s, Lange Q&A 1X (-the legal and ethics chapters), 2.5X through FA for psych, there's a decent amount of neuro overlap but it shouldn't be a problem if you've had neuro before or you're relatively fresh from step. know drugs, know IM meds that cause NMS, Parkinsonism, Serotonin syndrome etc. MPTP poisoning, Know which opioids are known to cause serotonin syndrome. Know the general psych stuff. Mostly DSM 4 but nothing that expected you to differentiate between 4 and 5 stuff anyway.

 

[asdfTT123]

Question to those who've taken the psych shelf. I just started doing the Lange Q&A 10th edition and I'm getting destroyed on the child psych questions (about 80% on the first 75 Q's) which a lot of the stuff can't be found in FA psych. Is it important to learn the stuff that's in Lange but not in Q&A? Also, what's up with the nitpicky epidemiology/comorbidity percentage questions?

Also, are the shelf questions supposed to be similar length/difficulty to Lange Q&A?

So far I read through FA psych and Case Files and test is in ~2 weeks.

Thanks!

 

[Kingella]

Question to those who've taken the psych shelf. I just started doing the Lange Q&A 10th edition and I'm getting destroyed on the child psych questions (about 80% on the first 75 Q's) which a lot of the stuff can't be found in FA psych. Is it important to learn the stuff that's in Lange but not in Q&A? Also, what's up with the nitpicky epidemiology/comorbidity percentage questions?

Also, are the shelf questions supposed to be similar length/difficulty to Lange Q&A?

So far I read through FA psych and Case Files and test is in ~2 weeks.

Thanks!

Don't worry about the percentages of the lange Q&A too much, especially if the info wasn't in FA for psych. There are no epidemiology questions (X percent of this have bla ) on the shelf. The shelf exam is almost identical in difficulty to the 2 NBME practice exams online. Unlike lange, the stems are very long, there is a good amount of neuro (10%) on the exam. There's also some medicine stuff (~5% of the exam). Do the lange questions mostly for the explanations, and there were 2-3 very similar questions on the shelf. The important thing is not to read FA X number of times, but to know most of the topics pretty well. Obviously you can't know every single detail but know as much of it as possible.
Know when it's appropriate to restrain a patient. Know when you should give haldol, and benzos.

 

[psylocke]

Psych is my first rotation...
So far I have Lange Q&A, Pre-test and FA as resources. Is UW essential? I have a subscription but I'm not sure if I should keep those questions to use closer to Step 2 or use them during the rotation.

 

[rottweiler225]

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[Bru]

#2 is d (meets MDD criteria)
#3 is a (typo in what your copied. no other psychotic symptoms)

 

[asdfTT123]

Thanks for the responses to both of you. I can confirm A is incorrect for #2 (I marked this and got it wrong). However, I'm not seeing the MDD criteria being met here? I see insomnia, wt change, anhedonia (not being social with friends), and lack of energy. What am I missing here? Are we supposed to assume his irritability = depressed mood or diminished concentration?

 

[rottweiler225]

Thanks for the responses to both of you. I can confirm A is incorrect for #2 (I marked this and got it wrong). However, I'm not seeing the MDD criteria being met here? I see insomnia, wt change, anhedonia (not being social with friends), and lack of energy. What am I missing here? Are we supposed to assume his irritability = depressed mood or diminished concentration?

my bad I got #2 right too but I forgot what I put. now that I have thought about it again, yes, escitalopram is correct since he meets MDD criteria.
- decreased sleep
- decreased appetite
- anhedonia
- decreased energy
- decreased concentration (he can't remember as well)
dont forget to use "SIGECAPS!"

 

[sliceofbread136]

Just got owned by this stupid test. Oh well

 

[fssca20]

Took it recently. Mainly just used Case Files, but I had a pretty good learning experience during the rotation as well. Only previous rotation was OB/GYN. Week before the exam I did all the Rx questions - 85%, then the Uworld questions - 91%. Both QBanks are VERY easy compared to the actual exam which was not nearly as straightforward as I was expecting. I walked out feeling pretty crappy about this exam, and it was the first time in med school I can remember almost running out of time on a test. Ended up with an 87 and was completely shocked. Also for what it's worth, there was a note on my score report that said the scale had changed and that scores were not comparable to anything prior to August 2015. avg 77, sd 8. Good luck.

 

[Leopoldovich1]

#2 is d (meets MDD criteria)
#3 is a (typo in what your copied. no other psychotic symptoms)

Can someone explain why #3 is A? I don't get that since her functioning is affected. It seems like Schizophreniform to me

Or maybe Schizophrenia paranoid type

EDIT: it's supposed to be "MSE shows NO incoherence, hallucinations, or loose associations.

Answer is: Delusional Disorder, A.

 

[Bru]

Should be:
1-5 (no psychosis)
2-5 propranolol sfx.
3-3 has enough for MDD
7-2 go with atpyical to avoid TD
8-1 pt still in w/d.

 

[Leopoldovich1]

Should be:
1-5 (no psychosis)
2-5 propranolol sfx.
3-3 has enough for MDD
7-2 go with atpyical to avoid TD
8-1 pt still in w/d.

For #8, wouldnt flumazenil exacervate the withdrawal by Antagonizing the benzos? I was between adding more benzos since the intubation and mechanical ventilation can make up for dec respiratory effort, and haloperidol since first aid paych mentions it in tx of sever agitation in alcohol withdrawal

 

[asdfTT123]

Though they administered diazepam, her agitation here necessitates haloperidol. Someone correct me if I'm wrong, I haven't done form 1 yet.

The answer is more diazepam. I can confirm this as I've done this form. It's a really tricky question but administering haloperidol is not the tx of choice for EtOH withdrawal because it can lower the seizure threshold (like all other antipsychotics). Answer is definitely not flumazenil either for those wondering b/c that lowers the seizure threshold as well and the pt has recovered from respiratory depression. Even though she needed intubation for her prior OD of diazepam, the best thing to control her agitation is still more diazepam.

 

[psylocke]

The answer is more diazepam. I can confirm this as I've done this form. It's a really tricky question but administering haloperidol is not the tx of choice for EtOH withdrawal because it can lower the seizure threshold (like all other antipsychotics). Answer is definitely not flumazenil either for those wondering b/c that lowers the seizure threshold as well and the pt has recovered from respiratory depression. Even though she needed intubation for her prior OD of diazepam, the best thing to control her agitation is still more diazepam.

Thank you for the explanation. Yeah, I sat the form yesterday and chose haloperidol then when I saw it was listed as incorrect I was so perplexed as to which was the right answer. Definitely the trickiest question I found on the form.

 

[vskv]

Got a 67 on this test I listened to the kaplan high yeild videos like 4-5 times on my drives which go along with the master the boards (MTB) book. Went through the 30 pages in MTB once. Did all the questions in uworld about 100 of them redid the ones I got wrong. went through about 160 pre test questions. I took a practice NBME one week out got a 74 on it.

 

[Leopoldovich1]

For anyone that has used the First Aid Psych Clerkship book, specifically the 3rd edition, have any of you guys noticed any mistakes in that book?
I'm pretty sure i've found several, but First Aid doesn't seem to have an errata for this line of books and I don't want to needlessly mark my book without atleast getting some confirmation of the errors.

 

[nontradst]

Got my results today: 81

I used FA, Uworld, Lange questions and both NBME practice tests. I thought the shelf was a little easier than either of the NBMEs, which surprised me and my classmates, who took it on the same day. I'd recommend starting with Uworld 1st , because it is easier, then moving on to Lange or Pretest questions.

 

[Thyroid_Storm]

Got my results today: 81

I used FA, Uworld, Lange questions and both NBME practice tests. I thought the shelf was a little easier than either of the NBMEs, which surprised me and my classmates, who took it on the same day. I'd recommend starting with Uworld 1st , because it is easier, then moving on to Lange or Pretest questions.

If you don't mind me asking, what percentile did this equate to? I just got my score back, too (84 for total equated % correct) and according to the sheet with scores and corresponding percentiles from 2013-2014 that my school is using to determine our percentiles/grades, this amounted to the 62nd percentile. This was my first shelf, and I haven't figured out how the grading works yet...I knew this shelf would have a brutal curve, but damn. Also, I have a statement on my score report that says "equated percent correct scores can't be compared to scores reported prior to August 2015 which were on a different score scale." Should my school not be using the 2013-2014 data then?

 

[nontradst]

Correction. My school some how scaled the shelf wrong and my score actually ended up being an 85. Not sure about percentile. The emailed grade I got from the NBME said that the national mean was 77 and the SD was 7 points.

 

[Bru]

If you don't mind me asking, what percentile did this equate to? I just got my score back, too (84 for total equated % correct) and according to the sheet with scores and corresponding percentiles from 2013-2014 that my school is using to determine our percentiles/grades, this amounted to the 62nd percentile. This was my first shelf, and I haven't figured out how the grading works yet...I knew this shelf would have a brutal curve, but damn. Also, I have a statement on my score report that says "equated percent correct scores can't be compared to scores reported prior to August 2015 which were on a different score scale." Should my school not be using the 2013-2014 data then?

Something similar happened at my school. Might be worth investigating. I believe ended up using the newer scale.

 

[Trousseau]

I thought the test wasn't too bad, I think I got somewhere in the 80s. It felt easier than the NBME Exams. I'm not sure if feeling confident means I'm going to fail, but we'll see.

 

[Trousseau]

Scored a 90. If anyone wants to know my preparation.

Week 1: Only read Case Files.

Week 2: Only read Case Files.

Week 3: Read First Aid and did some UWorld Practice Questions.

Week 4: To be honest, this week had long hours and I felt lazy so I didn't do anything.

Week 5: At the start, I took the first NBME. Reviewed incorrects and then I did Pre-Test practice questions. Case Files and First Aid reading to supplement difficult points.

Week 6: At the start I took the second NBME. Reviewed incorrects, and did another detailed pass through First Aid. The day before the test, I drilled some high-yield Neuro points on stuff like NTs, delirium, dementia, seizures, etc. That's gonna come up on test day.

 

[Ismet]

This is a reminder to please refrain from posting full questions from NBME forms or other copyrighted material. If you need to ask a question about something, paraphrase to the best of your ability without recreating the question. Abbreviating words and removing a couple extraneous words is not paraphrasing.

 

[johnwalldance]

I have some questions on some specific questions on the NBME psychiatry form 2. Is there anyone I could PM to discuss these questions? Have the shelf tomorrow, lol

 

[psylocke]

I sat the exam this past week... I finished Lange 2 weeks into the clerkship, I found the questions to be pretty straight forward. What was most valuable were the practice tests which I saved for the week before the exam. I did FA(1x), Pretest (2x), Lange (2x)...Case files was very well written, I mainly used it to clarify disorders that I needed more background on in terms of presentation and treatment.

Doing questions for me was more helpful than going through FA. In terms of questions on the shelf, Pretest prepared me better than Lange did. The stems were long! I didn't have time to check back on all my marked answers, which was very upsetting.