As a medical student in the throes of core clinical clerkship, time is an oh-so-precious resource. How can you make the most of it while also ensuring you are on pace to perform well on the end-of-rotation shelf exams— also referred to as National Board of Medical Examiners (NBME) Subject Exams?
Simone Kantola, MD, is a plastic surgeon and the physician engagement lead for AMBOSS—a medical education reference tool designed to adapt to your learning style and clinical needs, from exams to clerkships, cases and more. The AMA and AMBOSS have teamed up to give medical student AMA members an exclusive 10% discount on the AMBOSS Library and Qbank add-ons.
As medical students navigate clerkship rotations, Dr. Kantola offered test-prep guidance on creating a deliberate shelf-exam study schedule that will help you master the material and walk into test day with confidence. Here are some key tips for medical students to maximize their shelf-exam performance.
Start studying day 1
Shelf exams are tough. Time to prepare for them is tight. Between long days on the wards and the sheer volume of material, it’s easy to fall into the trap of cramming. Considering that, Dr. Kantola said the early days of a rotation are the ones on which you want to begin your shelf-exam prep.
“Ideally, start studying from day one and do a little every day,” Dr. Kantola said. “The only way I know to maintain a sustainable pace during clerkships is to start early and chip away steadily at the material.”
“A common mistake is leaving the bulk of studying until the end of the rotation,” he added. “It’s certainly understandable, given the fast pace and time scarcity of most rotations. But, of course, it’s not helpful because the quality of the studying and the ability to retain information goes down.”
Study what you see
Dr. Kantola advised medical students to reinforce learning by studying conditions they encounter on the wards.
“From the start of your first rotation, whenever you can, link what you’re studying in the evening to what you’re seeing on the wards during the day,” she said. “The clinical knowledge you gain will stick better, and you’ll also be better prepared to take care of that patient—a win-win.”
Dr. Kantola added that students who make note of clinical questions during the day then look up the answers as part of their review process are the ones who tend to succeed.
“That curiosity-driven learning sticks, and it’ll help you on your exams and when you’re making decisions as a physician,” she said.
Make the most of small windows
Even short study sessions add up over a four- to eight-week rotation.
“Even with five–10 minutes, while you’re in between OR cases or you’re waiting in the nurses’ station for your resident to show up, you can do a couple practice questions or review some flash cards,” Dr. Kantola said. “Study conditions may not be ideal but learn to use whatever you’ve got.”
Your bandwidth to study can also differ significantly based on which rotation you are on.
“Finding time to study can be a huge challenge on surgery or ob-gyn rotations,” he said. “In that case, it helps to make use of every little study opportunity during the day, [doing things like] reviewing flashcards or doing five practice questions while in between cases and to be sure to hit the high-yield stuff early on, in case time runs short.”
Practice questions make perfect
Question banks—or Qbanks—are a good barometer of your knowledge and weak spots. They tend to focus on high-yield topics and offer exam style questions. Dr. Kantola highlighted the importance of consulting them daily and reviewing all the explanations, while paying particular attention to the questions you get wrong.
“When it comes to studying for shelf exams, practice questions are your foundation,” Dr. Kantola said. “They not only test your knowledge but also teach you how shelf questions are written and highlight what’s high yield.”
Shift methods as exam day nears
At the start of a rotation, medical students should be in “study mode,” a time during which you review and build foundational knowledge, Dr. Kantola said. As you get closer to test day, flip to “exam mode” to simulate real conditions and doing entire question bank blocks.
“Use that last week to focus on strengthening weak areas and practicing under more test-like conditions with timed blocks of randomized questions,” Dr. Kantola said.
The final week is “also a good time to hit the ‘classic’ high-yield topics one more time—things like diagnostic criteria or management algorithms for commonly tested conditions.”
As part of an exclusive offer, AMA members can save 10% on an AMBOSS Library subscription, which includes unlimited access to high-yield USMLE® content, 50 Qbank questions per month (with an option to upgrade), smart study tools like an Anki add-on, histology images with Smart Zoom and performance analytics.
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