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Shelf Exams

How Long Are Shelf Exams and How Can I Study For It

Wondering how long shelf exams are and how to study for them? Get the information you need to excel on your shelf exams and impress your professors.

May 26, 2024

Person Attempting Exam - How Long Are Shelf Exams

Are you preparing for your Shelf Exams, but unsure how long they last? Knowing 'How Long Are Shelf Exams' can help you manage your time and expectations better. In this blog, we’ll go over everything you need to know about the duration of Shelf Exams, so you can study effectively and perform your best. Let’s dive in!

What Are Shelf Exams?

Doctor Testing on Machine - How Long Are Shelf Exams

Shelf exams are standardized tests medical schools use nationwide to assess students' medical knowledge and how they compare with peers. These exams cover many medical topics and often contain "shelved" USMLE questions from past exams. Typically, students are asked about 110 multiple-choice questions that explore a variety of hypothetical medical and surgical scenarios. Due to the vast amount of knowledge required and the necessity to apply this knowledge in clinical situations, many students consider shelf exams challenging. This examination format aims to develop a deeper understanding of medical topics and prepare students for higher-stakes exams like the USMLE Step 1 and 2.

NBME Shelf Exams Overview

The NBME offers different shelf exams covering disciplines such as Biochemistry, Histology, Internal Medicine, and Emergency Medicine. These exams help provide a comprehensive assessment of students' medical knowledge and allow them to identify their strengths and weaknesses. By analyzing the score report, students can focus on areas that need improvement before moving forward to more challenging exams.

Content and Scope of Shelf Exams

Shelf exams draw questions from a wide range of medical topics. The content can range from heart failure, diabetes, and liver disease to movement disorders, multiple sclerosis, and neurological disease processes. The broad scope of this exam format requires students to memorize and understand a wide range of medical concepts and then apply this knowledge to hypothetical clinical scenarios.

While some medical schools may not consider shelf exam scores when grading clerkships, they can still affect a student's acceptance into a residency program. Therefore, doing well on shelf exams is crucial to enhancing a student's chances of securing a desirable residency position.

What Is Tested On Shelf Exams?

Doctor Diagnosing on Machine - How Long Are Shelf Exams

In contrast to the questions on the United States Medical Licensing Exam (USMLE) Step 1, shelf exams focus much more on patient care, including how to diagnose and treat diseases. You should expect to be tested on identifying the next steps in management, utilizing appropriate and cost-effective diagnostic tests, and selecting correct pharmacotherapy.

How does Shelf Exam Content Correlate with USMLE Step 2 CK?

In general, the questions reflect the USMLE Step 2 CK. Many have likened Step 2 CK to a sampling of questions from all the shelf exams consolidated into one test.

What Topics are on a Shelf Exam?

Intuitively, the content of each exam will relate to the field of medicine or surgery you just did a rotation in. For more specific details, the NBME publishes a content outline online that provides a breakdown of the different items tested on each exam. For example, the internal medicine shelf exam outline can be found here.

Cross-Disciplinary Concepts in Shelf Exams

It’s important to understand that material can overlap across multiple shelf exams. An important example is the surgical shelf exam, which tends to focus less on procedures or techniques and more on the medical management of surgical patients (e.g., diagnosing postoperative fever or recognizing peritonitis).

Progressive Familiarity with Shelf Exam Content

Other examples include concepts at the intersection of neurology and psychiatry or internal medicine and pediatrics. This means that, while earlier shelf exams may be inherently more challenging, shelf exams become easier as you see recurring concepts across specialties.

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How Long Are Shelf Exams?

Shelf exams are typically 110 questions long and last 2 hours, 45 minutes (1.5 minutes per question). The only exceptions are the family medicine shelf exams, which lack MSK.

Family Medicine Modular

Core only 90 questions lasting 2 hours, 15 minutes
Core + Chronic Care 100 questions lasting 2 hours, 30 minutes

So, when you are preparing for your Shelf exams, be sure to keep in mind the amount of time you have to answer each question. This can help you manage your time effectively and get through all the questions before the time runs out.

Do Shelf Exams Matter For Residency?

Girl Preparing for Exams - How Long Are Shelf Exams

Your clinical grades matter a great deal for securing the residency program you desire. Even though your USMLE® Step exams, including Step 1 and Step 2 CK, are not reported to residency program directors, your Shelf exam scores could be. The United States Medical Licensing Examination (USMLE) has its own scoring system and does not require students to take Shelf exams.

Many medical schools require their students to take Shelf exams as part of their clinical rotations. A good performance on the Shelf exam can positively impact your clinical grades in the rotation. Conversely, a poor grade on your Shelf exam can negatively impact your final clerkship grade. Your clinical grades in rotations are a key factor for residency programs when considering an applicant.

Are Shelf Exams Harder Than Step 1 or Step 2?

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Shelf exams are generally designed to be of comparable difficulty to those on USMLE® Step 1 and Step 2. Many of the questions are retired from previous Step exams! The NBME® writes both the shelf exams and the Step exams; similar software is used to administer them. The proctoring rules and time constraints are also very similar.

Shelf exams can seem more difficult to many students than Step 1 or 2. This might be because Shelf exams are intended to help you prepare and practice for these subsequent exams, rather than because the tests are designed to be harder. Using the score reports from your shelf exams can help focus your studying on areas of weakness before you take Step 1 or Step 2. If you can improve in these areas, the Step exams may seem easier!

How Many Shelf Exams Are There?

Doctor Reading Reports - How Long Are Shelf Exams

There are 7 core clinical rotations:

Internal medicine
Family medicine
General surgery
Neurology
Pediatrics
OB/GYN
Psychiatry

You will face a shelf exam at the end of each rotation, so expect to have at least 7. While not typical, some schools may require additional core rotations, such as emergency medicine, radiology, or anesthesiology. Depending on your school, it’s possible you will face shelf exams for these rotations as well.

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A wide range of data sources, from bookmarks, tweets, and extensive books to YouTube videos.

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3. Create

Draft outputs using the sources you've collected

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What Time Are Shelf Exams?

Person Writing Exam - How Long Are Shelf Exams

Your clerkship syllabus will specify the time of your Shelf exam. The exam is strictly proctored, timed, and standardized using NBME® software, so there is generally not much flexibility regarding when the exam can be administered. You will need to log into the exam at the same time as the other examinees in your cohort using a password provided by your proctor. During the exam, a proctor will monitor you carefully, who will guide you on how to exit if you need to leave for any reason.

Remote Testing for Shelf Exams

The coronavirus pandemic has led many medical schools to administer Shelf exams remotely, which has benefits and challenges for students. If you are taking the exam remotely, your clerkship director should inform you when to log in to your computer to access your shelf exam and provide any necessary details on virtual proctoring requirements.

How To Prepare For Shelf Exams With These 6 Tips

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1. Starting from Day One

I can't emphasize enough the importance of starting to study for your shelf exam as soon as you start medical school or your clinical rotations. You should start building a strong foundation for your shelf exams from day one by actively learning and taking useful notes. This will help you learn, retain, memorize, and apply knowledge effectively.

2. Taking Good Notes

Ensuring you have superb study materials is essential when preparing for your shelf exams. Implementing active learning techniques and taking effective notes will help cement the knowledge in your brain. Utilizing the Cornell note-taking method can be valuable for organizing key information and concepts, cues, and summaries of what you are learning.

3. Utilizing Study Guides and Resources

Taking advantage of online study guides specifically tailored for the shelf exam can provide invaluable resources. Many other medical students have been in your shoes and have utilized these materials to help them prepare effectively.

4. Testing Yourself

Regularly testing yourself on the material you're learning is crucial to gauge how well you It. Utilize question banks, practice tests, and flashcards to test your recall of the information you've studied. Covering a wide range of practice questions will ensure you are well-prepared for the breadth of material covered in the exam.

5. Breaking Concepts Down

Dividing and conquering vast information is key to successful preparation for your shelf exams. Categorize and organize your notes by subject and discipline to reduce the chaos of memorization and aid in better recall. Focus on studying the subjects that are more heavily covered on the exam to optimize your study efforts.

6. Tying Your Experiences In

Linking your clinical rotation experiences with your shelf exam study material is essential for success. Connecting what you've learned during rotations to theoretical notes will help you remember the information better and demonstrate your ability to apply knowledge to real-world patient cases. By intertwining theory and practice, you'll be better prepared to showcase your understanding of both concepts and clinical practices during the exam.

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How Long Are Shelf Exams and How Can I Study For It

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