Congratulations, you have finished Step 1, and you have reached the third year of medical school!! This phase you’re about to enter is a GROWING experience where you transition from studying all day from the books to interacting with patients, learning and studying all day in the hospital AND BOOKS. As a third-year medical student, you will become an integral part of the team, taking histories & physicals from REAL patients, assisting the residents and attendings, and seeing real cases you’ve spent the past few years studying about in real life. Although the third year is a lot of fun, the biggest challenge you may face is your shelf exams. Especially finding the time to study for them while excelling and performing well daily in the hospital.

Today, I share with you some tips and tricks on how to excel for your shelf exams, and in the next few days, we’ll get more specific with each core rotation.

What Are Shelf Exams?

Shelf exams are standardized subject-specific tests administered by the National Board of Medical Examiners (NBME). These exams aim to assess students’ understanding of core clinical concepts and their ability to apply them in clinical scenarios. Shelf exams are essential for evaluating your performance during each rotation, and they contribute significantly to your final clerkship grades. They aid you in preparing for your next board exam – Step 2 CK.

Studying Tips for Shelf Exams

1. Study Plan: Create a study plan that aligns with YOUR rotation schedule and clinical duties, and focus on the core concepts of that specific rotation/specialty.
2. Use Textbooks/Video Resources: Use a textbook (First Aid Step 2 CK, Step Up To Medicine or Master The Boards), whichever book YOU FEEL COMFORTABLE with, and review the SYSTEM as a whole for that core. Utilize Online Med Ed or Boards & Beyond to review and annotate.
3. Practice Questions: Like the first 2 years of medical school, practice questions are here to stay. At the beginning of each rotation, check how many questions the resource has and divide it by the number of days you have left to study. Try your best to stick to your schedule, and if you feel tired after your rotation – try waking up earlier and finishing your questions before rotations. Make sure to take the time to analyze your incorrect answers and identify your knowledge gaps and areas of improvement.
4. Practice Exams: Test yourself with practice exams on NBME.org. They are correlative to your real shelf exam.
5. Clinical Experience: Use your patients as study tools – what does that mean? If you have a patient with Congestive Heart Failure – now is the time to review the pathophysiology of CHF and the treatment for CHF. Associate your patients with diseases to help you remember the treatment plans better. Engage in daily rounds during your clerkships and see how they treat and manage patients. Most questions for Shelf and Step 2 CK are “What is the next best step in management?”.
6. Time Management: Balancing studying for shelf exams, clerkship duties, and maintaining your personal life is challenging. Effective time management is crucial. Stick to number 1, your study plan, to avoid cramming at the end and feeling overwhelmed.
7. Study Partners: Try to study with a friend or keep each other accountable for your study plans. It helps to share and learn from different perspectives.
8. TAKE CARE OF YOURSELF. Prioritize self-care and YOUR well-being during the third year. Try your best to include physical activity, healthy meals, adequate hours of sleep (well, for some rotations), and a healthy mind. The days are tough and long, but remember that you are tougher and this is a season. Some rotations are harder than others; regroup in the ones that you have more time. If you experience a difficult patient or the death of a patient, seek support from your residents, attendings, mentors, fellow students, or counseling if needed.

Conclusion

The third year of medical school is a transformative and challenging time. Embrace the clinical experiences, learn from your mentors, and ENJOY the opportunity to contribute to patient care. With dedication, effective study habits, and a positive mindset, you can conquer shelf exams and excel in your clerkships. Embrace the journey, as each step brings you closer to becoming the compassionate and competent physician you aspire to be. Good luck!