Post-Surgery Rotation Update: On Studying and the Shelf

As I mentioned before, I took the NBME Shelf Exam on Friday. I honestly went in not knowing much about the test format, other than the fact that it was going to be multiple choice, Scantron-based, 2 and a half hours long, and most likely a fairly random mix of questions–that is, not just related to surgery.

The test was 100 questions long. 100. With extremely long question stems. I should’ve expected as much after having taken Step 1, but even after having done the surgery questions in the USMLE World Step 2 question bank to prepare, this threw me for a loop. A third year told me to make sure I budgeted my time wisely during the test, but I almost didn’t finish. That was partly because I was exhausted from a ridiculous week (I remember zoning out more than a few times), but I’ll definitely have to do better with that next time. Don’t even get me started on the difficulty of the test; I did the best I could as far as budgeting study time, but I don’t know how well my efforts paid off in the end. I was just glad that I put an answer down for everything!!

Speaking of study time: there wasn’t much of it.  Between getting up before sunrise and often going to bed before sundown, there just weren’t enough hours left.  But I did what I could with my off-days and random downtime in the hospital.  Buying an iPad and downloading PDF versions of the textbooks helped quite a lot with this, as did using the UWorld QBank app on my mobile devices.

Now on to study materials.  Unlike Step 1, for which you can probably get away with studying from one primary book and supplementing that information as needed (what I did, although I wasn’t completely happy with my score in the long run), students often stockpile books for shelf studying and try to get through as many as they deem helpful or reasonable.  The question of how to structure one’s study time, whether to read chunks of multiple books simultaneously, finish one at a time, go by page order, by topic, etc, is up to the student.  I tried multiple methods over 8 weeks and have yet to figure out what works for me in that regard; of course, it might depend on the specialty.

I started back in March with this grand study schedule that listed which books I would finish by which dates, but I quickly realized it was way too ambitious.  After emailing some upperclassmen about what books to acquire for surgery, I decided to use about 5 books.  I only got through two of them completely, and only about two-thirds of the way through another.  In the end, I still covered quite a bit of ground page- and topic-wise, but I’m not sure how efficient that time was (I’ve never felt like I retain that much when I read).  In any case, these are the books I used and what I thought of them:

  • First Aid for Surgery: pretty much a mainstay for this rotation, but it’s an overwhelming amount of information.  Best to start early and take it in small chunks if time allows.
  • Casefiles for Surgery: 56 cases and discussions of workup, labs, and treatment.  People either use this book or NMS Cases (whatever it’s called, I didn’t touch it but maybe I should have), sometimes both, but one of them for sure.  I found Casefiles pretty useful.
  • Surgical Recall: ABSOLUTELY NECESSARY to survive (or thrive, if you’re better at retaining facts than I am) being pimped on the floor and in the OR.  Sometimes I would read the chapter that pertained to a certain operation, minutes before entering the OR, and get questions right because of it.  Its Q&A style makes it a faster read than the other books.  Its utility as a shelf study aid, however, is debatable.  This is the one I didn’t get all the way through; didn’t have time to read the “subspecialty” chapters.
  • I also bought Blueprints for Surgery (a review textbook sort of like First Aid; people don’t think it’s as good for surgery) and PreTest for Surgery (a book of cases/questions), but I didn’t get to either of them.
  • As I stated above, I also used the UWorld QBank.  We were told to get a year subscription to Step 2 CK because it would help in all the clerkships too.  Definitely do this.

I won’t know how well my efforts paid off on the shelf/the rotation for a while; I have no clue when we get evaluations back or how long it takes for all those shelf exam Scantrons to be processed and graded.  Trying not to think about it too much, but you can consider this a disclaimer to take my advice with a grain of salt–or a shaker of salt, as a college roommate and I used to joke.

This concludes my recap of surgery.  Next I’ll be on a 2-week elective before officially starting pediatrics.  I should have a bit more time to study and to live like a normal person, so we’ll see what comes of things.  I’ll keep you all posted!


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