High Yield Topics
The highest yield topics for the medicine shelf are cardiology and pulmonary. Together, they make up anywhere from 30 to 40% of the exam. Other high yield topics include renal and GI. Gynecology is relatively low yield for the medicine shelf.
Diagnosis is less than 50% of the exam, management and pathophysiology are each as much as 25% of the medicine shelf. Health maintenance is little more than 10% of the exam.
High Yield Resources
- IM Essentials
- Pre-Test Medicine
Purpose: NBME style practice questions
There is little reason to explain the utility of UWorld in studying for shelf exams beyond noting that for the Medicine Shelf, there are well over 1000 questions.
Purpose: building a foundation, primer for UWorld
Due to the plethora of practice questions available in UWorld, I ostensibly wanted to prime myself for those questions and build off of the foundation of medicine I have from my preclinical years. I did not read IM Essentials, but rather used the flashcards as a primer for the practice questions, and then did the practice questions. I took notes from the answer explanations and used this as my primary primer for UWorld, and used my notes as my foundational text for the shelf.
OnlineMedEd offers a large number of lectures for Medicine; I really wanted to use it, but found it to be too time consuming to be valuable for me when in combination with IM Essentials. It was a tough decision for my OCD brain to decide to not use OnlineMedEd for every subject in medicine. However, I did use it for cardiology and pulmonary as these are the highest yield topics for the medicine shelf.
Purpose: reviewing pathology
But I thought Pathoma was only for Step 1! After my surgery shelf, which I felt contained far too many mechanism questions, I decided to buy a three month subscription of Pathoma to review pathology for Step 2 and the medicine shelf. It was a great review, and I watched a few lectures a day while walking on the treadmill in the morning. I opted for this instead of OnlineMedEd, insofar as OnlineMedEd reviewed similar material to that presented in IM Essentials, but Pathoma was a completely different perspective.
Purpose: building a foundation; primer for UWorld
After completing the relevant chapter in IM Essentials, I would complete the related chapter in Pre-Test Medicine as a primer before jumping into UWorld questions. It may not be necessary, but it alleviated my wariness of starting UWorld too early and helped build my foundation. I similarly took notes on the answer explanations, as with IM Essentials.
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.