How to Study for the Neurology Shelf Exam

For many medical students, the neurology shelf exam is perceived as one of the “easier” shelf exams simply for the reason that it doesn’t cover such a broad range of content in comparison to other subject exams like medicine or surgery. Despite its reputation, “easier” is certainly a relative term and there absolutely are students who find the neurology shelf exam quite challenging. If this sounds like you, or you’re feeling a little anxious with how to adequately prepare for the neurology shelf exam, you’re in luck! We’ve compiled a list of tips from our tutors who achieved honors on the neurology shelf exam to help you get set up for success. In addition, please see our neurology shelf exam tutoring page for a list of situations where a student would be considered at-risk for neurology shelf exam failure and seek help if you fall into one of those categories.

Tip #1: Use the UWorld Step 2 CK QBank as your primary resource

There are slightly under 400 questions on neurology in this resource and they will give you effective preparation both to impress your preceptors in clinical rotations and to improve your score on the shelf. Retrieval-based learning – the type of learning you get from actively attempting to come up with answers as in question banks like this – has been consistently shown to be much more effective than passive learning such as watching videos or reading long book chapters. 

• • Remember when reviewing UWorld questions to only review incorrect answers, and to use the answer choices as a jumping-off point for review of other study materials: for instance in a question on anti-epileptic drugs where the options are A) Topiramate, B) Valproic acid, and so on, be sure to at least briefly review each of the Sketchy Pharm images for all of these medications (assuming you’ve been using SM). 
  • You can create basic flashcard decks with software like Anki if you’d like, but be sure to limit these flashcards to 1-2 basic learning points about the question. Flashcards are an effective resource, but if you find yourself simply rewriting each question in flashcard form then there are better uses of your time. 
  • Over the last year or so, UWorld has rolled out a shelf exam specific division of their Step 2 CK qbank. In the past, students had to filter their qbank to review neurology system questions but now by entering shelf exam prep mode it is already done for you.

Tip #2: Supplement with additional questions from another question bank if you’ve already finished a double pass of UWorld

If you’re going at a pace of even 60 UWorld questions per day, it will not take you very long to get through all the UWorld neurology questions. If you’re still feeling underprepared, it is absolutely appropriate to turn to another qbank (such as Amboss) for more practice questions.

• Amboss currently has about 350 neurology specific qbank questions which are great if you still have extra time and have already gone through the UWorld neurology questions
• If you manage to get through all of UWorld, all of Amboss and STILL want more practice questions, TrueLearn also has a neurology shelf exam “smartbank” where you can find even more practice questions.

Tip #3: Take an NBME practice test about a week before your neurology shelf exam

NBME practice exams are the best predictor of what your performance on your actual neurology shelf exam will be like. This is why its a great idea to sit for one NBME right before your real neurology shelf exam (we recommend the weekend before for Friday exams, for instance). For students who may have a history of poor test taking, we also recommend taking another NBME practice test about two weeks prior.

• If your rotation is 6 weeks or shorter we would not recommend taking more than two or, at most, three total NBMEs as the yield from reviewing these is much lower than UWorld. 

Tip #4: Listen to a passive review on your lunch break

While we never recommend using a passive review resource as a primary resource to study for your shelf exams, listening to a video review series in your down time can be beneficial especially if your nerves are high.

• PreTest Neurology and OnlineMedEd are both excellent resources for passive review. If you have time to watch the OME neurology section before your rotation begins it can give a good foundation for the clinical concepts you will encounter during your clerkship. However, it should not be relied upon for high-yield question review and we would not recommend re-watching the videos multiple times. 
• Sketchy Pharm is useful for the antiepileptic drugs, but Sketchy Path generally tends to be lower-yield for neurologic concepts. 

For students who have failed once

• At this point we do recommend taking all four NBME exams. You can retake NBME exams that you previously took during the rotation as enough time will usually have passed that they will remain useful as assessment and review tools.
• Ensure that you have completed two full UWorld passes. If you had already done this before taking the initial shelf we recommend completing all remaining incorrect questions in UWorld and then moving onto another QBank such as Amboss and/or TrueLearn
• Consider tutoring; many of the concepts in neurology can be “hard to see the forest for the trees” concepts, where students may be overwhelmed with the amount of subject-specific jargon and anatomy. Having a tutor to put this all in a broader context can be extraordinarily helpful. You are welcome to contact us here if you would like more information.