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How to Study for NBME Shelf Exams

by Mohammad Hajighasemi-Ossareh, MD, MBA
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    00:01 Welcome back to the third year of medical school lecture series.

    00:04 Now, today, we're gonna discuss how to study for NMBE, National Board of Medical Examiners, shelf exams while a third year medical student, and this is the challenge. You're not in the classroom anymore and you have to make time to study around your clinical rotations.

    00:20 We?re also gonna discuss balancing out the resources that you will use for each rotation in advance, and we?ll also make sure we obtain guidance from senior students, and lastly we?ll discuss how to simultaneously study for USMLE step two while studying for final exams for each of your clinical rotations.

    00:40 So studying as a third year medical student is a little bit different.

    00:45 You have a lot of experience studying in a classroom setting.

    00:48 In college and in the first two years of medical school, you went to lecture, you went home, you spent most of your time studying, but now you?re in a third year of medical school and they expect you to spend the majority of each day in the hospital, usually six days out of the week when you're on the inpatient rotation, and they want you to study for a shelf exam, are these people nuts? Well, no, it?s actually quite common and you?ll be doing this for the rest of your career, you?ll be working in a clinical setting and expected to study.

    01:15 So the solution for this is really quite simple on how to come out ahead, you simply need to develop new study skills, and these will be the skills that you will need to develop and you?ll build on them, and 'cause you?ll use them for the rest of your medical career.

    01:33 You will no longer be solely in a classroom again, you will always be in some type of clinical setting and you'll always be expected to learn and stay up to date with the material.

    01:44 So let?s go through a typical day of a third year medical student and see how we can effectively develop and implement new study skills.

    01:52 So let?s discuss studying during the third year.

    01:55 Most inpatient rotations require you to be at the hospital before sign out, which is usually at 6:30 AM.

    02:03 And then you stay until the evening sign out which is usually at 6:30 PM.

    02:08 Some days you may get out earlier if the service isn?t busy.

    02:13 So that means you'll be working roughly round 12 hours a day and that obviously makes studying difficult.

    02:20 While you're on the outpatient rotation, you usually don't have to arrive until 7:30 AM, and the day is usually done around 5:30 PM.

    02:29 Also on inpatient rotations, you usually get one day off a week while on outpatient rotations, you usually get two days off a week.

    02:38 Now, whether you're on the inpatient or the outpatient service, there are two techniques to use to make studying easier.

    02:45 Number one, study each patient that you see.

    02:49 You?ve probably heard this before 'cause it?s absolute gold, this is a clinical pearl.

    02:55 Every patient that you see will have multiple medical problems.

    02:59 There?ll be the key problem that they came in for and they can have other chronic problems that you?re also managing.

    03:05 Go through the problems of each patient and look them up.

    03:09 Try to find high yield, shelf relevant resources for you to study for each patient.

    03:15 Studying each patient is also a double benefit, it not only allows you to study for shelf exams and USMLE step two, but also makes you look more knowledgeable about the patient when you're presenting on rounds because you're going home and reading about the patient and getting more detail, the questions you?re gonna get ask are usually testing you on high yield knowledge and if you?re studying for shelf for step two material for each patient, you?re gonna look like a rock star on rounds.

    03:43 Now, the second technique to study during third year is more traditional.

    03:48 Studying each patient is very common but there is a different technique here.

    03:52 So this second technique, when you get home from the hospital you could, that is, work through an organized manner of material for a shelf exam.

    04:02 For example, you may come home every night and watch one or so Lecturio videos about a topic in internal medicine, or you could read about it in a book while watching the video and then this could be related to your schedule, you could be comparing it to patients you?ve read that day or seen, or you can just have a standardized schedule running in the background, and then on your day off, you can review all the material that you learned during the week.

    04:28 In that way, you're reviewing everything you've done on a longer day off.

    04:32 Such a technique requires that you have resources already planned out and scheduled in for your day.

    04:38 So speaking about resources, we need to pick our resources for the third year of medical school.

    04:45 The resources that you will use will vary from rotation to rotation.

    04:49 However, it is vital that you have at least a single resource in the background to cover high yield information for all the subject matters for USMLE step two.

    05:01 Having a question bank is also important.

    05:03 Thus your resources for third year are actually threefold.

    05:09 Now, let?s go through them. First you will need resources for each rotation you're on, there?s no question about that. To obtain these resources for your surgery rotation, medicine rotation, neurology rotation, you should speak with senior medical students or even residents on your service who have taken the rotation before you.

    05:28 They will have numerous recommendations for various text and digital resources that you can study.

    05:34 So, the first one is going to be rotation specific resources.

    05:38 The second resource that you will need is what I call a background full encompassing resource that includes all the rotations and materials for USMLE step two.

    05:49 An example is like a video lecture series. You're watching a Lecturio video right now.

    05:53 Lecturio videos have lectures for USMLE step two and they?re great for this because they?ll contain lectures for all of your clinical content and you can simply watch videos each day as they either relate to the patients that you saw in the hospital or watch them in any organized manner you wish.

    06:10 Also, having a single reference textbook is vital. Multiple resources are available for this, from the step up to medicine series or the first aid series, it?s really nice to have a single book that all-encompassing for USMLE exams in which you can write your notes for each subject as you go through the rotations and as you study other resources.

    06:32 Then, you will look at this book again during your dedicated time for USMLE step two and it will be more familiar to you and it'll have your personalized notes.

    06:42 Third, you will need a question bank. Working on a question bank is best done on your day off since you will have multiple uninterrupted hours to work and focus on doing the questions carefully and reading through the answers.

    06:57 In the previous lectures for the second year of medical school and when we discuss studying for USMLE step one, we discussed not only the importance of question banks but how to effectively use question banks and learn from them.

    07:09 Please refer to those videos if you don't remember why it's important to do question banks in a dedicated uninterrupted time on your day off.

    07:19 Now the benefit of using a question bank during your rotations is that you will go through the questions while you're on your rotation, and then if you use the same good question bank again, when you're studying for your dedicated USMLE step two time, you will see the questions again and the questions are usually very well designed and you will have the opportunity to have space repetitions with great questions from a question bank and that will put you in a really valuable position.

    07:46 When you're studying for USMLE step two, going through the question bank more than once is only an asset.

    07:52 Some students may make the argument, ah, but I?ll memorize the answers, well guess what? That's ok, the question bank isn?t designed to test you for right or wrong, the question bank is simply there to give you a knowledge base and for you to a self-assess.

    08:07 Did I already know that? If you say to yourself hey, I knew the answer from before, good, you remembered, you?re learning, good job.

    08:14 There is no downfall to doing a question bank more than once.

    08:17 Just make sure you're always doing it in an uninterrupted and dedicated manner and you?ll get the most of the Q bank.

    08:23 Now let?s summarize what we talked about, what you need to do isn't just from learning in the classroom setting into the clinical setting.

    08:31 You need to learn how to learn from patients when you go home in the evenings because this is how you will learn for the rest of your career.

    08:39 You need to plan out the resources for each of your rotations and the resources that you want to use for USMLE step two early in your third year.

    08:48 Do this by speaking with senior students on your rotation about specific resources they use for rotation and also resources they used that were all-encompassing resources for USMLE step two.

    09:01 You will wanna use both of these resources simultaneously while studying.

    09:05 You should study from the videos, books, and a question bank throughout your third year.

    09:10 There's no better way to go through learning and preparing for USMLE step two than repetition through resources, you?ll go through them once during your third year rotations, and then you?ll go through them again on dedicated step two study time.

    09:24 Thank you.


    About the Lecture

    The lecture How to Study for NBME Shelf Exams by Mohammad Hajighasemi-Ossareh, MD, MBA is from the course Med School Year 3. It contains the following chapters:

    • How to Study for NBME Shelf Exams
    • Studying as a Third Year Medical Student
    • Studying During Third Year
    • Picking Resources for Third Year
    • Lecture Summary

    Author of lecture How to Study for NBME Shelf Exams

     Mohammad Hajighasemi-Ossareh, MD, MBA

    Mohammad Hajighasemi-Ossareh, MD, MBA


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