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Mistakes Medical Students Make While Studying for Shelf Exams

A group of medical school students in scrubs studying for their shelf exams while in the hospital for their clinical rotations.


During your first clinical year of medical school, it is easy to feel overwhelmed. You will find yourself taking care of patients, rounding, working in the operating room, reading about your patients’ diseases, creating case presentations, and more, all while studying for your shelf exams. Here, we will discuss the most common mistakes medical students make while studying for shelf exams, and importantly, how to avoid and recover from these mistakes.


1. Starting Studying for Shelf Exams Too Late


By far, the most common mistake students make is starting their shelf exam preparation too late. Most core clerkships range from 4 to 8 weeks in length, which sounds like a lot of time. However, when you have hundreds, if not over 1000, of practice questions to cover, even starting a few days late can make the number of questions you have to complete each day seem daunting. As a rule of thumb, you should try to complete all of your QBank questions about ¾ of the way through your clerkship. For example, try to complete all of your QBank questions by the end of week 6 for an 8-week clerkship. You can determine the number of questions you have to complete by this ¾ benchmark, and calculate the number of questions you need to complete each day. By following this rule, you (1) have a quick and easy schedule to follow to help guide your studying, (2) have a quantitative goal to work towards, and (3) will have sufficient time for reviewing the material before your shelf exam.


2. Starting the Clerkship With No Preparation


At most medical schools, the majority of your clerkship grade will be based on your clinical evaluations. Therefore, it is important to demonstrate your clinical capabilities to your residents, fellows, and attendings from day one. I recommend to my students that they complete some basic review of the clerkship material the week/weekend before starting the new rotation. A great resource to begin with is Online MedEd. These videos are by no means comprehensive for the medical care you will see during your clerkship. Nor are they going to teach you all you need to know for the shelf exam. However, these videos teach you enough so that you will feel relatively comfortable your first day in the clinic or hospital. This small amount of preparation will help you understand what is happening with your patients in real-time, and also familiarize you with the diseases you will encounter. Ideally, this work will make you feel better prepared for the clinic/hospital, so when you get home at night, you can devote more time preparing for your shelf exam instead of just reading about your patients.


3. Using the Wrong Resources for Your Shelf Prep


It is important to recognize that each core clerkship is different and, more importantly, every student is different. Therefore, finding the right resources requires careful consideration of the clerkship and the learner. The resources that you use for your surgery clerkship will differ from those that you use for your medicine clerkship. Be comfortable changing your approach as you progress through your clinical year. However, it is vital that you use a QBank in preparation for every shelf exam, this is by far the best and most necessary resource to succeed on your shelf exam. Additionally, we recommend using NBME practice shelf examinations 1-2 weeks before your exam, as these will reinforce high-yield topics and also provide you with valuable feedback regarding your knowledge base. You will need to explore resources like textbooks, videos, online courses, podcasts, flashcards, cheat sheets, etc. for each clerkship. We encourage you to talk to multiple upperclassmen or meet with a shelf tutor to learn about some of the highest-yield resources for each clerkship.


4. Using Too Many Resources When Studying for Shelf Exams


If you search for “resources to prepare for the ### shelf exam”, you will find more resources than you will need. This amount of choice can be overwhelming and students sometimes feel as though they need to use multiple resources or they will miss out on important information. First, recognize that no resource is comprehensive on its own. I have yet to find a textbook or video series that covers all of the material found on a shelf exam. Most textbooks on the market do a great job of introducing the high-yield points for the most common diseases you will see on your shelf exam. On my shelf exams, I found myself confronting NBME questions about material I have never seen before – this is normal!

Realize that using too many resources often provides diminishing returns. It is advantageous to stick to a few, reliable resources (QBank + NBME practice tests + one or two reference books/video series) rather than a plethora of material. In my experience, students who work through all of the questions in their QBank and through multiple NBMEs know enough information to succeed on their shelf exams, as well as set themselves up for success for Step 2CK. However, many students choose to incorporate either a textbook, videos, or flashcards because this provides some diversity to their day-to-day studying. Remember – pick the right resources, but limit the number of resources you pick.


5. Going Through Preparation Alone and Not Asking for Help


Medicine is hard, you cannot change this fact. However, you can change how you approach mastering the material. While some people view asking for help as a weakness, I view it as a strength – this person recognizes their limitations and seeks out assistance so they can continue to grow. Importantly, asking for help should never be used as a mechanism to avoid working hard. If you feel that you put in significant time and effort to grasp the material on a shelf exam, and you are still not getting the results you desire, you may need help and that is okay! Getting ideas on different study methods or test-taking skills, or working with a classmate/shelf tutor to better understand the material is a much more efficient way to learn and grow. Do not let an ego get in the way of growth – sometimes becoming the best doctor-version of yourself requires the help of others.


I hope this blog post will help you prepare for your clinical year and shelf exams. If you need any help at all, do not hesitate to reach out and contact us with questions or to schedule a complimantery consultation session. Best of luck!

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