Why is the first test the hardest?
The focus of the test is different from all pre-clerkship tests you’ve taken at Einstein up to this point. Don’t let placement of Surgery and Medicine as the first shelf or the last shelf, throw you.
Questions focus less on diagnosis and more on management, but often the answer choices do not reflect what is done in practice. This can be frustrating.
In general, the more patients someone sees or works up, the better you will do on the shelf.
Pace yourself over three weeks at least. Cramming is not possible, especially if you’re on the wards really late for many nights. It’s best if you stay on top of the entire content during rotation.
For each clinical rotation you should purchase a book where you can go to find answers which the summary-type books don’t answer. Otherwise given limited time, it is better to read all of a summary-type book rather than part of an authority-type book. If you have decided that you are going into a particular field, you should invest a little more in books for that area.
Some students like Boards and Wards: A Review for USMLE Steps 2&3: A Practical Guide (Boards and Wards Series) or First Aid for the® Wards: Fourth Edition (First Aid Series). These provide a good brief summary of the diseases that you might see on the rotations. They are good to read before the start or early in the rotation as they give you a general overview.
A central theme for all the rotations is to do questions, questions and more questions for the test at the end of the rotation. The pretest series is great to this end. There are other series which are good also such as Appleton & Lange Review of Surgery of Internal Medicine, etc. Most people get a questions book and a summary-type book for each rotation. What you purchase depends on what you think you can finish before the end of the rotation. Again if it's you’re field of interest, you might buy an authority type book like Harrison's Principles of Internal Medicine, 17th Edition or Cecil Essentials of Medicine for Medicine or ACS Surgery: Principles & Practice, Schwartz's Principles of Surgery, Eighth Edition, Greenfield's Surgery: Scientific Principles and Practice (with Solutions Package) (Mulholland, Greenfield's Surgery) for surgery.
On Rotation: Quick Glance
TIP: Critical to stay on top of content, because of the oral exam at the end.
The unique thing about surgery is that you will work a lot of long hours and you will not have the same time that you have on other rotations, so plan reading carefully.
NMS Surgery Casebook
Casefiles General Surgery: good for recall, prep for those "berating" behaviors, and prep for oral questions.
Kaplan Surgery Notes
Appleton & Lange Review of Surgery: Do as many questions as possible.
Kaplan Q bank Surgery: Do as many questions as possible.
USMLE World Step 2 Question Bank
Surgery Recall: Very good for the wards, not so good for the shelf
You don't need to know how to do Surgery for the shelf exam. The majority of questions are - "What is the best next step?"
Essentials of General Surgery: Excellent text for those who need to read paragraphs, but the only caveat is that you have to actually read the whole book.
TIP: The Medicine shelf is hard, because it's very random and feels like the Boards all over again. It’s important to stay on top of the material.
MKSAP (medical knowledge skill assessment program) twice,
Case Files Internal Medicine: Good during the early weeks for building foundation knowledge, managing a lot of patients and presentations on common management issues.
Kaplan Qbook for Step 2: Good source of practice questions.
Medicine: Pre-Test Self-Assessment & Review: Good question book.
Appleton & Lange Review of Internal Medicine: Good question book.
Harrison’s Principles of Internal Medicine, 17th Ed.: Good reference to keep for surgery.
NMS Medicine (National Medical Series for Independent Study): A summary type book.
Rapid Interpretation of EKG’s, 6th Ed: You need to know EKG’s before medicine. This is a classic book everyone uses to learn EKG’s; clearly the best way to learn.
Pediatrics: Pretest Self-Assessment & Review: Always a good question book.
Blueprints Pediatrics (Blueprints Series): Gives a good overview.
Case Files Pediatrics
Kaplan Book exams in their Step 2 material.
If you’re going into Peds, you might consider: Nelson Essentials of Pediatrics, 5E with STUDENT CONSULT Access 5th Ed.
Pre Test Self-Assessment and Review, 11th Ed., (Pre Test Series) High-Yield Psychiatry (High Yield Series): by Fadem
Case Files Psychiatry, 3rd Ed., (LANGE Case Files): by Debra L. Klamen
Planning to go into Psychiatry BUY, otherwise borrow indefinitely: Kaplan and Sadock’s Comprehensive Textbook of Psychiatry (2 Volume Set). Extremely comprehensive and up to date text containing all you ever wanted to know (plus things you never knew existed) about psychiatry - from its historical roots, biological, psychological and social determinants, medications, psychiatric sub-specialties, plus other detailed information about topics that are often not even mentioned in similar psychiatric texts. Comes with the CD-ROM version with an interface that is very flexible and configurable with a powerful search engine for the complete text, images and medications contained within.
Interview Guide for Evaluating DSM-IV Psychiatric Disorders and the Mental Status Examination (Zimmerman): Little pocket guide especially to specify questions for certain interviewing sessions with clients. Provides a concise review of many diagnoses.
PreTest Self-Assessment and Review, 6th Ed. (Pretest Series): by David Anschel
Medical Student’s Pocket Reference: by Ken, M.D. Bookstein
Emergency Medicine Manual Paperback by O. John Ma
Text: An Introduction to Clinical Emergency Medicine: Guide for Practitioners in the Emergency Department by Swaminatha V. Mahadevan.
Tips: “The most important thing is get as good as you can at your presentations and make them as streamlines as possible. Be enthusiastic and friendly with everyone, including the nursing staff. If someone says ‘do you want to____, your answer should be, Yes, of course.’
There aren't really any secrets or things that medical students don't know to do by the fourth year.”
NMS Clinical Manual of Emergency Medicine: Good if you do the ER rotation in your M3 year by Paul D. Biddinger.
Tips: Family Medicine is the only clerkship that does not use the Shelf exam. The exam will cover material discussed in lectures, so attendance is very important!! It’s also a part of your grade. Questions for the exam are taken from the the PCORE modules and the required readings associated with modules associated with the team based learning sessions.
For rotations, the best advice is to get involved. See a patient, write a note, come up with the best specific plan, and then present it to the doctor with whom you are working. It helps to process protocols and guidelines rather than just memorizing them out of the text. Use the "required 30 diagnoses" from the patient log system as a guide to common problems in the family medical setting.
Caution: Many tend to blow off studying until the last week for this exam. It’s not the most difficult one in 3rd year, but it’s definitely not a cake walk, so pay attention in class, review the lecture slides, and keep up with the reading.
Key testable areas: Clinical practice guidelines, age-related disease and mortality, disease prevention, screening guidelines, and palliative care topics.
Family Medicine PreTest Self Assessment & Review, 2nd Ed., PreTest Clinical Medicine: by Doug Knutson
Case Files Family Medicine (LANGE Review): Good general review book which provides solid foundation, but it’s NOT recommended for the Family Medicine Clerkship exam.
Work your way through several on-line modules of FM Cases.
Swanson’s Family Medicine Review: by Tallia, Scherger and Dickey. Good for the Boards, not for clerkship exam.
Bratton’s Family Medicine Board Review: Paperback by Robert L. Bratton.