High Yield Topics
Half of the family medicine shelf is management and health maintenance, at ~30% and ~20%, respectively. Pathophysiology is less than 10% of the family medicine shelf, and establishing a diagnosis is about one-third of the exam.
The highest yield topics are cardiology, pulmonary, and GI. Relatively low yield topics include immunology, hematology, obstetrics and dermatology. The vast majority of the questions deal with the general adult population. Pediatric populations account for approximately one-quarter of the questions, geriatrics is little over 10% of the exam.
High Yield Resources
- United States Preventive Services Task Force guidelines
- IM Essentials
United States Preventive Services Task Force Guidelines
The best resources for the Family Medicine shelf in my opinion, were medicine questions in UWorld, and the United States Preventive Services Task Force guidelines. There weren’t too many of these questions on my shelf, but studying the guidelines ensures that any questions that do come up are quick and easy. In particular, I would recommend studying the USPSTF A and B recommendations, as these are only the guidelines with sufficient evidence to show up on your shelf.
Purpose: NBME style practice questions
The Family Medicine shelf is a pretty random exam, with an eclectic array of questions from different disciplines, including OB/Gyn. In general, your best resource will be UWorld, with its 1000+ questions. As with all the other shelves, it’s important to get bogged down in trying to utilize too many resources. Another good resource for building a foundation before UWorld, is IM Essentials. I would recommend simply doing the practice questions in IM Essentials and reading the key points from the explanations, rather than reading the actual text. Step Up to Medicine seemed like a good resource, but it was too long and required too much of a time commitment for me to ever really use it. That said, it’s a good reference if you are looking for a textbook to refer to.
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 never managed 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 wariness 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.