High Yield Topics
Keep in mind that anywhere from 10 to 20% of the psychiatry shelf is actually neurology. About two-thirds of the exam is establishing the diagnosis; management constitutes about one-fifth of the exam. Pathophysiology is little more than 10% of the exam, which makes sense considering how little is known of the molecular mechanisms underlying psychiatric conditions.
High Yield Resources
- First Aid for the Psychiatry Shelf
- Online MedEd
- NBME Practice shelf
- USMLE Rx
Purpose: NBME style practice questions
There is little reason to explain the utility of UWorld in studying for shelf exams. It is an excellent source of practice questions that I found are often good mimics of NBME questions.
First Aid for the Psychiatry Shelf
Purpose: building a foundation
The book provides some relevant details, and I thought it was a great resource to read through at least once before my shelf. I read it for the first time the weekend before my shelf, but if I could do it again, I would read it once while studying, and a second time in the days leading up to the shelf. If I was simply looking to pass the shelf, I would have done either First Aid or OnlineMedEd and then taken a practice shelf to see how I faired with just the one resource.
Purpose: building a foundation
This is perhaps not an absolutely essential resource, but I used it as I sometimes prefer watching lectures to reading. The lectures are freely available online, but if you find even watching them on 2x is too time consuming, I found the notes to be fairly succinct and the practice questions that follow each lecture provide decent practice.
NBME Practice Shelf
Purpose: actual NBME questions; predict your score
I would be remiss not to mention the importance of doing practice tests. There are about four offered for each shelf, and if I had the time, I would try to do all four of them, although I must concede that I have yet to manage to do more than two per rotation.
These are going to be the best representation of the kinds of questions you are going to see on your actual shelf exam, because they are written by the same damn people. In other words, you would be a dumbass not to do any practice tests at all. They are an excellent predictor of how I have performed. I have consistently done better on my actual shelf exams than my practice ones, sometimes by as much as ten points.
The struggle is deciding when to take your first practice shelf exam. Often, there is a sense of weariness about how we will perform that leads us to procrastinate on taking them. At the very least, I aim to do the first one two weeks before my exam, and another one the week before. Remember that each practice test is a little less than half the length of an actual shelf. To simulate the actual exam experience, I might also take two practice shelves consecutively two weeks before, and two consecutively one week before. Each practice shelf is 20 bucks which is a small price to pay for getting an inside look into the actual exam.
And while they claim they don’t reuse questions, I have definitely seen similar questions crop up on actual shelves.
Purpose: an additional source of practice questions
Insofar as UWorld does not offer too many practice questions for Psychiatry, I opted to use USMLE Rx for additional practice questions. While many opine that USMLE Rx for Step 1 is superior to Step 2, I think the questions for Step 2 provide decent practice. One advantage of USMLE Rx is that you have the option to go through the questions from easy to most difficult, that is to create easy, medium, and difficult question sets and subsequently go through them. This offers the opportunity to approach practice questions from a step-up method, but it also gives you the flexibility to only study the most difficult questions if you so choose. In this regard, USMLE Rx can be a great primer for UWorld, if you are weary of “wasting” or “using up” your UWorld questions too early into your studying, and would prefer to “save them” for closer to your exam. Another advantage of USMLE Rx, is that unlike in UWorld, you can delete question sets after you are done, and in this regard, you can ostensibly reset your question bank as many times as you like.