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I started my third year with my surgery rotation. While I knew it was going to be time consuming, I was excited to interact with patients, work in the hospital, and never have to think about glycolysis again (which isn’t entirely true, but that’s a topic for another time). I knew I had a Shelf exam at the end of the rotation, but at that point it was so far away and I was more concerned with succeeding on the wards.  I would cross that bridge when I came to it.  

While I enjoyed my surgery rotation, the time commitment was as intensive as I had expected – and then some. It got to the point when I came home for the day, I was barely able to greet my roommates, cook myself dinner and change out of my scrubs (which was probably the hardest part, because scrubs are basically doctor pajamas.) The thought of doing any studying was laughable. It didn’t help that I would tell myself I actually WAS studying because of what I saw every day. When the exam was one week away, I finally started to actually study... and quickly came to a tough realization of how woefully underprepared I was.

There were many topics I had never seen before, and even the ones I had seen were never in the context of a multiple choice question. The next week was sleepless and long, but I managed to scrape by. However, I did promise myself I would not be caught in this same predicament for the 6 remaining shelf exams I had. This led me to create a “manifesto” of studying for shelf exams that I hope you find as helpful as I did:

Determine the high-yield topics that need to be covered. 

AND make a schedule that covers all of them with at least a couple days before the Shelf exam. I thought the Online MedEd video series was very good for providing an outline of the high-yield topics. Your study time is much more valuable for the Shelf exams, as it is harder to come by, which makes your schedule all that more important.  

Don’t drive yourself crazy with a strict daily schedule.

There are some days you will joyfully skip out of the hospital at 4:45 PM and others you will be scarfing down cafeteria chicken nuggets at 7:00 PM because you are already late for your next case. If you go home on those late days with the feeling that you also need to read 4 chapters of Pestana’s that night, it will cause you undue stress and make you to try to study when you aren’t retaining anything. I recommend creating weekly “tasks” so that those days when you do get home at 4:45 PM, you can do a little extra that night and when you end up leaving at 9:00 PM, you don’t feel obligated to stay up until 1:00 AM.

You will NOT be fully prepared for the Shelf exams by only learning from the patients and cases you see during your days on the wards.

These are certainly important and I do believe that seeing a disease first hand is the best way to learn it, but there is no way you are going to see everything you need to know for Urology AND Ophthalmology AND Surgical Oncology in 8 weeks or less. You need to sit down and read about these topics in order to succeed.   

Like Step 1, don’t overwhelm yourself with the number of resources for each rotation.

There are so many books, flashcard sets (such as Memorang's IM shelf deck), and videos for every single shelf. No matter which rotation it is, it is better to pick a few quality resources and truly go through them then skim a whole bunch of them. 

Don’t marry yourself to one “series” of resource for each rotation (such as Blueprints, First Aid, etc.).

“Case-Files for OB/GYN” was by far my most valuable resource for that rotation.  “Case Files for Internal Medicine” was insufficient for the Shelf exam.  Ask your peers or residents if they have any resources that really helped them prepare for the shelf exam you have coming up. You’ll find as you go along that you will prefer a different resource for each rotation.  

It is OKAY to give up on a resource.

If it is simply not working for you, you don’t know have to keep using it, even if your bestie loved it. While this holds true for Step 1 as well, it becomes a little more urgent for shelf exams because there is less study time to waste on an ineffective resource  


Hopefully, these help.  Study hard for the shelves but keep in mind that if you survived Step 1 you can survive anything. And lastly, enjoy third year if for no other reason than you sometimes get away with wearing doctor pajamas to work.


Like these USMLE Step 2 CK flashcards? Get access to 8,000 more that cover all of UWorld and are authored by our experts at MST. 

Nick Lunig

Nick Lunig

Nick is a newly-minted 4th year medical student at UMass Medical School, pursuing a residency in pediatrics because kids are way cooler than adults. After graduating from Boston College, Nick moved to Houston, Texas where he taught 6th and 8th grade math for three years. He also bought cowboy boots. After teaching, Nick returned to being a student, where he has received high-honors in all of his third year clerkships and excelled on their shelf exams. He is excited to return to the world of teaching and is ready to help his fellow medical students ace their exams.
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