Shelf Exam

When Do You Take Shelf Exams? Clinical Clerkship Timeline

Wondering when do you take shelf exams during your clinical clerkships? This timeline tackle these important assessments for medical students.

Jun 20, 2024

Shelf Exam

When Do You Take Shelf Exams? Clinical Clerkship Timeline

Wondering when do you take shelf exams during your clinical clerkships? This timeline tackle these important assessments for medical students.

Jun 20, 2024

Shelf Exam

When Do You Take Shelf Exams? Clinical Clerkship Timeline

Wondering when do you take shelf exams during your clinical clerkships? This timeline tackle these important assessments for medical students.

Jun 20, 2024

person preparing for exams - When Do You Take Shelf Exams
person preparing for exams - When Do You Take Shelf Exams
person preparing for exams - When Do You Take Shelf Exams

Are you wondering when do you take Shelf Exams? Figuring out how long are shelf exams are can be quite a puzzle for many medical students. In this blog, we will delve into the details of the Shelf Exams timeline and offer valuable tips to help you prepare. Whether you are an aspiring doctor getting ready to tackle these exams or a seasoned med student looking for a refresher, this article will guide you through the process.

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Table of Contents

What Are Medical School Shelf Exams?

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Shelf exams are where med students in their MS3 taking clinical rotations get examined and assessed for their mastery and practical application of medical knowledge within the actual clinical setting. It is officially licensed by the National Board of Medical Examiners (NBME), the same body that administers the United States Medical Licensing Exam (USMLE). 

Required rotations include:

  • Internal medicine

  • Family medicine

  • Surgery

  • Neurology

  • Pediatrics

  • OB/GYN

  • Psychiatry

Elective rotations, such as dermatology, do not have shelf exams, as there is not a nationalized, standardized rotation that every medical student is required to take.

Why Are They Called Shelf Exams?

Ever wondered why they're called Shelf exams? It's because the questions in these exams are actually retired USMLE Step 1 and Step 2 CK questions. In other words, they're the USMLE questions that have been shelved by the NBME. This connection underscores the importance of your USMLE preparation for your Shelf exams. 

Given this fact, make sure to pay attention to your USMLEs, as you will see very similar content in your shelf exams. This could also go the same way for Step 2 CK. Hence, never take your shelf exams for granted!

How Many Questions Are Shelf Exams?

A shelf exam for a particular core rotation consists of 110 questions to be answered in an allotted time of 165 minutes. You can expect the questions to be multiple-choice, following hypothetical clinical scenarios employed by USMLE Steps 1 and 2.

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How Many Shelf Exams Are There?

mcq questions on a paper - When Do You Take 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 offer additional core rotations, such as emergency medicine, radiology, or anesthesiology. These rotations provide a unique learning experience, and depending on your school, you may have the opportunity to face shelf exams for these, further enriching your medical education.

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When Do You Take Shelf Exams?

person in his dorm - When Do You Take Shelf Exams

Medical students take shelf exams during clinical rotations during their third year of medical school. Shelf exams often occur between USMLE Step 1, which students take after their second year of medical school, and USMLE Step 2, which students take in their fourth year of medical school.

Focused Exams and Flexible Scheduling

The exams are thoughtfully structured, with each exam focusing on a specific foundational subject. This means you won’t be overwhelmed with multiple exams in a day. Instead, you can pace and take exams as you finish your clinical rotations. For instance, you might take two subject exams in one week; the following week, you might only take one. 

Strategic Studying During Rotations

Typically, you will take the shelf exams on the last day of the corresponding rotation, giving a clear timeline to plan your studies. Given that these tests occur during your rotations, the best way to study for shelf exams is to fit small study sessions into your other medical responsibilities to ensure you’re prepared when test day comes.

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How Do Students Decide The Order Of Rotations?

person working hard on preparation - When Do You Take Shelf Exams

Deciding on the order of rotations is crucial in medical school, where each shelf exam aligns perfectly with a particular rotation. Depending on the school, students may have varying degrees of control over their rotation order. Some institutions allow students to handpick their rotation order, while others may try to accommodate preferences but may not always be able to. On the other hand, some schools completely assign rotations randomly.

Fixed Schedule, Fixed Stakes

Normally, core rotations span 6-12 weeks. Unlike Step 1 and Step 2 exams, where students can choose the date, there isn't much leeway regarding shelf exams. If a student is on a rotation, they are expected to sit the exam at its conclusion. This can challenge students who fail to plan or adequately prepare, as postponing exams isn't an option.

Grading Policies and Focus on Practical Skills

Nonetheless, some schools operate on a pass/fail basis; hence, grades may not be significant. Others adopt a non-grading system to steer students towards concentrating on the practical aspects of the rotation instead of being consumed by a stringent study plan. Performing poorly or failing in any of the shelf exams is never ideal. Hence, it's crucial to delve into preparation and study techniques.

How To Study For Shelf Exams

man in his dorm infront of laptop - When Do You Take Shelf Exams

Create a Schedule Early On and Stick to It

Creating a structured study schedule for each rotation will ensure that you cover the necessary material and practice questions before sitting for the shelf exam. Dividing the study material and practice questions by the available study days will help you manage your time effectively and set daily goals. By acknowledging the days you won’t be able to study and incorporating them into your schedule, you can create a realistic plan to stick to. This will also help you avoid last-minute cramming and unnecessary stress. 

For additional resources, check out:

Make Studying a Daily Habit

Cultivating a daily study habit throughout your clerkship year, even for a short period each day, can benefit you in the long run. Consistency will help you avoid cramming and enable you to understand the content better. Daily study routines will improve shelf exam performance and Step 2 CK scores. Be diligent and strive to study daily, regardless of the available time. Consistency is key!

Focus on High-Yield Information and Study Strategies

Given the limited time to prepare for shelf exams, focusing on high-yield information is crucial. You need to study smarter, not harder, to maximize your results with minimum effort. If you recently completed USMLE Step 1, leverage the material you already know and aim to deepen your understanding rather than starting from scratch. This approach will help you make the most of your study time efficiently.

Decide Which Resources to Use but don't over-resource

While numerous study resources are available, it's essential to commit to a few trusted ones and avoid using too many. Overloading yourself with resources can diminish returns and complicate your studying process. For shelf exam practice questions, UWorld is highly recommended and beneficial for every rotation. Review answer explanations thoroughly, as this is where a significant portion of learning happens. 

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Are Shelf Exams Mandatory?

man reading a book - When Do You Take Shelf Exams

While the shelf exam is not required by all medical school programs, and it’s not a requirement for obtaining a US medical license, shelf exams remain a popular way to test medical students on the knowledge acquired during their clinical rotations. Depending on your medical school program, the results of your shelf exam may or may not determine whether you pass your clinical clerkships.

The Indirect Influence of Shelf Exams

Shelf exam results are also not a required part of your residency application, and the programs you’re applying for will not see your exam results. That being said, your exam results may be considered when grading your overall clinical clerkship results. In the case of failure of a shelf exam, you will be required to retake the exam, and a grade of conditional pass or conditional high pass will appear on your transcript. 

If you fail one of your shelf exams, it could affect your MSPE at the end of your rotation. The final grade of your clinical clerkship is something residency programs will see and may determine whether you are accepted.

Maximizing Residency Applications

So, if your medical school program uses shelf exams, it’s best to get as high a grade on these exams as possible so your final clinical clerkship grade is as high as possible. If you score well on your shelf exams, it can complement your OSCE or NAC OSCE when readying your applications to residencies.

Challenging but Manageable Exam

The exam is graded on a national average, curved to a mean of 70 with a standard deviation of 8, so it is difficult to ace it. The tips you learned for how to study in medical school and the knowledge you gained during your clinical rotations will help you tackle it.

Are Shelf Exams Harder Than Step 1?

woman making notes - When Do You Take Shelf Exams

Shelf exams are a significant milestone in the journey of becoming a physician. They are standardized exams that all medical students take at the end of their clinical rotations. Many consider these exams quite demanding. They cover a broad range of topics across all seven medical school rotations. You must memorize many topics you study during your rotations to pass them. Then, you must apply this knowledge to hypothetical scenarios.

Gauging Shelf Exam Difficulty

Shelf exams are generally designed to be of comparable difficulty to those you will see on USMLE® Step 1 and Step 2; since the shelf exams use very similar questions as USMLE exams, you can assess the difficulty based on your success on USMLE Step 1.

Testing Analytical Skills and Comprehensive Medical Knowledge

The exams require you to analyze and interpret data quickly and accurately to answer questions correctly. You must also be able to recognize symptoms and know how to treat patients based on those symptoms. Due to the broad range of topics, you must grasp all aspects of medicine and make connections between different topics. This is necessary to answer the questions correctly on the exams.

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