Managing the clinical rigors of clerkships with the studying needed to excel on a National Board of Medical Examiners Subject Exam—commonly called a shelf exam—is no easy task. AMA Wire® spoke to students and educators to glean tips on how to succeed academically during clinical training. Here are some of their thoughts.
When a rotation allows for schedule flexibility, incremental study can better prepare you for both your shelf exams and clinical interactions.
“If you spread out your shelf-studying over the course of your rotation and tackle your studies little by little each evening, you’re better able to apply the knowledge you gained from your shelf books or practice questions when you’re back on the wards the next day,” said Haig Aintablian, MD, a recent graduate of the University of Arizona College of Medicine.
“It’s a lot better to invest your time studying after each hospital or clinic day because you’re combining your learning from text books and questions to actual encounters in the clinic/ward. You’re more likely to recognize various pathologies or treatment guidelines and reinforce your text-based learning, versus leaving the shelf material to the last week of a rotation and having to cram whatever you possibly can for the shelf exam.”
Identify knowledge gaps
Between question banks, review books and online tools, there’s no shortage of study materials to prep for shelf exams. Practice questions are best used to determine weaknesses in a student’s knowledge.
“The thing we promote that really seems to work quite well for people is to do a certain number of practice questions on a specialty per day,” said Pamela DeVoe, PhD, director of the Office of Academic Resources and Support for undergraduate medical education at the University of New Mexico School of Medicine.
“Students should look closely at each question’s answer explanations and note what the conceptual gap areas are in their knowledge base,” she said. “You might have time one day to do 10 questions, read through five of the answer explanations and write a list of learning issues then you’re busy. When you come back to studying, you do the rest of the answer explanations, then complete your list of gaps in your knowledge. Then target your study to filling in those gaps.
Remember your patients
With each patient encounter, a med student is given an opportunity to learn. If you get to know your patients on a personal level, it might help you remember come exam time.
“Let’s say someone came into the hospital with a case of pneumonia, and you treated it and it improved. One of the best things you can do is get to know that patient, and that way it’s actually a study aid,” said Michael J. Rigby, an MD/PhD student in the University of Wisconsin-Madison Medical Scientist Training Program who just completed his clinical rotations.
“The more you know about that patient, their personal life, who they are, what they do, you are actually going to help yourself root that concept in memory,” Dr. Rigby said. “So getting to know the patients on your team can actually be very helpful for your own academic needs.”
To cram effectively, stick to key concepts
In the midst of a taxing rotation, incremental study might not be possible. Cramming for a shelf exam isn’t advisable. But if you do it, it helps to know the most important focus areas.
“There are high-yield topics,” DeVoe said. “Topics that you better know. Keeping a running list of those through the clerkship is going to be really helpful. ... The concentrated time is on practice questions to show you where you still have gaps in your knowledge and then to be looking at the high yield topics to make sure you understand each one of them.”
If you’re a student looking for resources, the AMA selected Kaplan as a preferred provider to support you in reaching your goal of passing the USMLE® or COMLEX-USA®. AMA members can save 30 percent on access to additional study resources, such as Kaplan’s Qbank and High-yield courses. Learn more.