Studying for Third Year NBME Shelf Exams

[The original version of this newly updated/revised post was first published way back on August 19, 2012.]

Chances are, your third-year clerkship grades will hinge more on your NBME Shelf exam scores than on your clinical evaluations. The strategy I advocate is to come off of Step 1 strong by immediately shelling out for the UWorld Step 2 question bank for the entire year. Do the questions for each rotation.1 Take your shelf exams, nervously wait 1-3 weeks for your scores to come back, and soldier on. Then at the end of third year, reset it so you can start fresh and use it to study for Step 2 CK. If you’ve studied for and done well on your shelf exams, UW and Wikipedia should basically be sufficient for Step 2 CK, which for at least the near future will be an extremely important non-pass/fail exam. The best way to perform well on Step 2 CK is to also prepare for and do well on your shelf exams.

While UW is, I believe, indispensable for several of the shelf exams, it is not sufficient. (Related: If you’re in the market for an additional question source, I do have some qbank discounts on the support page.) There are also a variety of online-based curriculum replacements that one can use for longitudinal learning during third year. But for book people, here’s how I would approach each clerkship:



First Aid for the Psychiatry Clerkship is your must-read. It’s extremely quick, readable, and hits everything. You can read this book in a day if you want to; it’s that short.

The only book you would need after FA is Case Files Psychiatry. It’s a good volume in the series, and some of the cases do a nice job of distinguishing between adjustment disorder in its many forms (recognizing adjustment disorder versus MDD, GAD, acute stress disorder, and PTSD etc is extremely important for the psychiatry shelf). You don’t need more reading beyond that, just UW. Enjoy the psycation.

More than any other shelf, the psychiatry shelf really stresses adverse effects of its medications. Every important drug has its one or two, and you need to know them cold. All of them.

You also need to pay special attention to medical disorders with psychiatric manifestations (depression and pancreatic cancer, Addison’s disease; pheochromocytoma or carcinoid tumors masquerading as panic disorder; etc).



Case Files Obstetrics and Gynecology is your first book of the rotation. When in doubt, you can always get through a Case Files book quickly and know that it will hit the highlights (i.e. common board/pimping questions). It’s an excellent foundation for your rotation, and you should read it as fast as possible.

Many people advocate Blueprints Obstetrics and Gynecology, as it is quite readable and nearly exhaustive. I would caution you that unless your rotation has light hours, many many students don’t have enough time or energy to slog through it. Many of my peers who started with Blueprints never finished a single book before taking the exam. They just didn’t have time. Finishing a single book is the most important thing; you need to have one cohesive point of view. Even Case Files alone is better than 3/4 of Blueprints. Don’t get yourself in trouble. Most OBGYN clerkships are exhausting.

If your school pays for the ACOG/APGO question bank, great. Definitely use it. If not, I’d just read Case Files again and do UW. Always focus on things that might seem similar and be able to tell them apart (placenta previa vs vasa previa vs abruption). You may benefit from a qbank supplement (or even PreTest) if you have time and no APGO access.



Blueprints Pediatrics is the common favorite (and my wife’s personal favorite as well), and though I personally don’t care for the series, it is certainly sufficient. First Aid is overkill. Case Files Pediatrics (my favorite), patient reading, and UW for me was enough, but if you have the time and drive to read a more thorough text, I think BRS Pediatrics is actually the best.

As far as entries in the series go, Pediatrics PreTest is one of the better ones, and if you need more questions in book format, then it would be a reasonable use of your time (I personally wouldn’t bother).

You probably need two sources. Blueprints or BRS + Case Files is a common combination, if you can stand the cardiology section of BP.

Don’t go overboard on vaccine schedules and developmental milestones. You can sink a lot of time into that for little to no benefit. You should know a couple of big milestones per age group. Know the contraindications for vaccines; don’t learn the actual timelines.



As always, crank through Case Files Surgery as fast you can so you don’t look like an idiot. Crush Step 2 / Step 2 Secrets (essentially the same book in different formats, one of which you’ll probably want/have anyway, I prefer the former) can also help you get a rapid-fire overview of surgery in less than a night (and is also a particularly nice way to quickly learn the very basics of the many surgical subspecialties, which are fair game on the shelf). However, the single best rapid review text is actually Dr. Pestana’s Surgery Notes, written by a now-retired faculty from the University of Texas Health Science Center at San Antonio. For years before the official version, a more informal packet was widely used and beloved by students around the world for being extremely quick and extremely high yield (you can find copies of that old standby pdf online).

Then, before slamming into UWorld with all your might, I’ve classically recommended the NMS Surgery Casebook. This dense book has been an essential read for the clerkship: excellent, organized well, good diagrams, and contains everything you need to know. Note, this is not the NMS Surgery textbook. Don’t bother with that thing. The Casebook is the better resource by far. In recent years, many institutions and students have recommended the newer Surgery: A Case Based Clinical Review, which is also excellent. They are analogous, so just pick one. After that, just do questions. Pay special attention to trauma management, which makes up a lot of the test. Many questions hinge on applying the ABCs properly, often comically obviating the need to know definitive management. If you would do two things simultaneously in real life, never forget that one of them technically comes first based on the ABCs.

Many students use Surgical Recall to help prep for pimping and an overall understanding of the day-to-day business of surgery. Surgery Recall is a good book for reviewing the common questions you are likely to receive/knowledge you need to succeed in-person and on the wards/in the OR. It’s a good book to carry in your white coat and pull out when you have a few minutes of downtime. I would not, however, rely on Recall as a primary studying guide when it comes to the shelf. Details about actual surgeries are not on the exam, but the management of surgical patients is. The portions that do apply to the shelf though are full of rapid-fire high-yield facts.


Internal Medicine

The best way to study for IM is to do all of UW Medicine. This will take several weeks but will be worth it. The second most important thing you can do is pay attention on the wards.

The favorite medicine text nationwide is Step-Up to Medicine, which is the best (and the third edition just came out). It’s a bit long, and you may find yourself dropping it in favor of getting through the question bank. Case Files Internal Medicine is decent (helpful mostly if your background is poor and because it’s shorter). First Aid isn’t worth your time. For practical knowledge on the wards, huge swaths of students swear by Pocket Medicine (formerly “the green book,” it’s been changing colors with each edition), though I personally think UpToDate is more interesting and more complete when a computer is nearby.

If you finish UW, do more UW. Nothing else comes close to being what you need.


Family Medicine

I leave Family Medicine for last because it’s one of the more irritating tests to study for. Take it later in the year, and it will be mostly straightforward. Taking it toward the beginning of your clerkships can make it the hardest test of the year given its broad scope and the handful of seemingly random questions on every test. If you have the choice, doing it toward the end of third year makes the test far more reasonable.

Medical students can become members of the AAFP for free and then use the AAFP question bank. I thought these questions were more resident-level than the real thing and didn’t love them, but they are undeniably a solid resource. You can slog through a ton of UW and that would work, but that’s a daunting task for a shorter rotation. To historically prepare via UW, you would ideally get through the OB, Peds, IM, and preventative sections. That’s a lot. UW recently began offering shelf mode, which includes family medicine, so at least that makes the prospect approachable, but this selection is still more tailored than you’d get from months of organic review. Definitely hit up UVA’s free online mini-qbank, which has 125 high-yield questions.

In the beginning of the year, Case Files Family Medicine would help give you the basics. Later in the year, it will likely just remind you of things you already know quite well. The ambulatory section of Step Up to Medicine is certainly a good idea. Some people use Blueprints FM (breadth but not depth) or Step 2 CK review books (try Crush Step 2, if you must). There just isn’t a great resource geared for the clerkship. That said, some students swear by the use of Swanson’s Family Medicine Review, which is written for the FM boards but has a nice case-based question-heavy format that would likely serve you well. If that seems too daunting, reading the pediatrics and ob/gyn sections of Crush Step 2 will at least help you rapidly hit the highlights.

In the end, family medicine is not a discrete field; it’s a combination of everything else: mostly medicine, a good helping of peds and ob/gyn, and even a bit of psych, surgery, and EM thrown in. My advice is to schedule it for later in the year, especially after medicine, which makes it much more manageable.

Questions, questions, questions.

Elective and sub-I book recommendations are here. Some thoughts on how to approach irritating/difficult clinical science questions can be found toward the bottom of this page. Step 2 resources are detailed here.

Looking for information on the preclinical shelf exams?
Anatomy, physiology, biochemistry, and microbiology are here.
Pathology is here.


MJ 01.10.13 Reply

Helped a lot. Thanks!

Ben 02.14.13 Reply

Agree/disagree regarding NMS. I used the text as primary and Casefiles as secondary. There was a ton left out in the NMS case files that the text filled in. I would suggest, however, to read the text and skip any disease processes that has less than a couple paragraphs on as it gets too detailed. But using those two together was hugely synergistic.

Bosch 05.21.22 Reply

For the Texas Medical Board Jurispuridence exam, Texas now does allow reciprocity between states as of 2022.

Ben 05.22.22

Thanks, planning on the next update soon!

Ben 02.25.13 Reply

Between Pestana, the relevant sections of Crush Step 2, Case Files, the NMS casebook, and UW (in that order), I don’t think I had time for any additional resources during my surgery clerkship. While there may be omissions in the casebook vs the textbook, I had no meaningful gaps in my knowledge for the test with that line-up.

ML 03.28.14 Reply

What do you suggest using for the Neurology clerkship? (assuming you had one)
Great advice otherwise, thank you!

Ben 03.29.14 Reply

For our neurology clerkship, we actually took an exam written by faculty from our school instead of the shelf. That said, I would make sure to focus foremost on UW.

For books, PreTest is a good entry in the series. I would focus on the subjects you feel least comfortable about (e.g. movement disorders), since it’s often difficult to churn through a whole PreTest book. Case Files Neurology is also not bad, but not the best in the series. So Case Files + PreTest is a common combination. The neuro section of Step up to Medicine will also serve you well if you have that volume already. Localizing the lesion is oddly more of a focus on the preclinical neuroscience exams, but for help with that I’ve been a fan of Clinical Neuroanatomy Made Ridiculously Simple.

ML 03.29.14 Reply

Thank you!

ann lockhart 04.14.14 Reply

thanks for your great advice. If I wanted to purchase some of the study guides you have recommended, Where could I find them? Did not have luck at Barnes and Noble. Would really appreciate your advice.


Ben 04.15.14 Reply

No brick and mortar store that I know of has a meaningful selection of medical resources (even the school bookstore is typically overpriced and understocked). The above links are all to, which I use to buy all of my texts. The B&N online store has most as well. A good number of non-Kindle digital versions can be found on iBooks and B&N.

jake 08.23.14 Reply

1) This question is regarding surgery rotation prep. When you did Uworld, did you do only Uworld surgery questions? Or did you do select Medicine topics as well?

2) I’ve been getting mixed reviews of Pretest and Casefiles. Why did you choose to go with Case files(an additional text to pestana and NMS) and not with pretest?

3) I noticed that you recommended step 2 secrets/crush step 2 Surgery reading for the surgery rotation only. You didn’t mention to review either of these books for the other rotations. Is there a specific reason why you’d recommend we do it for surgery?


Ben 08.23.14 Reply

1) Just surgery questions. Most of the “medicine” on surgery is not actually medicine, and it is not really necessary to do the medicine questions in preparation.

2) I read Pestana first, followed by Case Files, followed by NMS. While NMS is excellent, it takes a while to get through. Pestana is great but is less of a book, and I felt Case Files is a good starting book to get the highest yield basics down. NMS then reinforces and supplements. I’m not generally a fan of the PreTest series, and I rarely used them myself as a third year. I found that in order to hit 500 questions per volume there was generally a bit of fluff, a decent number of questions that are not reflective of the exam, and it was a sort’ve numbing experience that sapped my energy. That said, other people like them.

3) I mention Crush 2 specifically for surgery because the other resources don’t really cover surgical subspecialty knowledge very well, which is also fair game on the shelf. Crush’s brief chapters are a nice introduction to the most very basic of ENT, urology, neurosurgery, orthopedics, vascular, ophthalmology, etc. You could read the relevant portions of Crush in 1-2 days easily. ENT, for example, takes up a whopping 6 pages.

In hindsight, I would have actually probably read the relevant portions of Crush before each rotation, just to familiarize myself with the absolute essentials (which is all it contains, really). There is no book faster than Crush for giving yourself a very superficial knowledge of a topic during third year.

AdamF 08.26.14 Reply

Hi Ben, Thanks for writing all of these suggestions out!
Our medical school doesn’t have shelf exams and I am preparing for Step 2CK in the next 3 months. I saw that you mentioned a few review books for Step 2CK (e.g. Master Boards, First Aid, Step up to Medicine). Would it be beneficial to read all of the case-files series for this exam + Usmleworld questions? Or do all the question from the list you made above + Usmleworld? I took a NBME and am somewhat below the passing mark. I passed Step 1 with a 210. Thank you for everything!

Ben 08.29.14 Reply

I think in terms it books it would depend on your foundation in the various core fields how necessary a complete walk-through would be. In this situation, I would say that for Step 2 CK I wouldn’t necessarily pursue an additional question source outside of UW (At least for me, I didn’t think PreTest taught me as well as other sources). My gut is that it might not be time inefficient to do all Case Files either (but likely helpful if there are fields for which you have less of a foundation). I would leave 4 weeks for UW at the minimum. Since this will be your first go through, you may need 6 weeks to give yourself time to do all questions once and then go through the incorrects/marked questions a second time (my personal favorite strategy).

I think book-wise, I would probably read Crush Step 2 in a few days to jog your memory. Then follow it up with MTB or First Aid as is your preference (MTB probably); when you hit topics you feel less comfortable with, you might supplement with further reading then. That would give you 6 weeks of books, not bad in the context of no shelf exams, and then 6 weeks of questions.

jake 09.15.14 Reply

Hey Ben
1) for all your rotations, in particular your surgery rotation, did you do Uworld once or multiple times? Right now I am thinking I should do Uworld at least once during 3rd year and a second time a month or two before my ck. So minimally 2 rounds of world before my step 2 ck.

2) I did poorly on Step 1, although I passed on my first attempt. I really need to do well on Step 2 ck to make up for my poor performance. I know nothing is for certain but based on feedback from other students, as well as your own experience, do you think that following your study plan for each rotation/shelf exam can help me get a 240+ on step 2 ck?

Thanks a lot

jake 09.15.14 Reply

Also for surgery, did you personally read surgical recall?

Ben 09.15.14 Reply

1) I typically did the questions for each section once, marking questions I got wrong or guessed on, and then did only those questions a second time. At the end of the year, when it came time to sit down and study for Step 2 CK, I reset the q-bank and started fresh with the same approach.

2) Focusing on high yield resources and tailoring your time to maximize the benefit from questions/UW is a sensible approach that I’ve frequently advocated for myself, colleagues, and my former students. I’ve certainly seen jumps of 20-30 points from Step 1 to Step 2 CK. Absolute numbers are difficult to say. The magnitude of the change itself would depend a large part on how much one underperforms on Step 1 due to inefficient studying, fixable poor test-taking approaches, and test-day anxiety/personal distractors/etc. I do believe that this sort of preparation is sufficient to maximize one’s individual performance, and I do doubt that adding many more resources, etc would meaningfully change most peoples’ scores. There is definitely a point of diminishing returns.

3) Significant portions (3+ years ago), but not cover to cover.

jake 09.15.14 Reply

Thank you for such a detailed response. It’s very helpful!

jake 09.17.14 Reply

Hey Ben I would like to begin using my Crush Step 2 book for rotations. I’m trying to figure out how to best divide the different chapters of Crush among my core rotations. Is the goal to finish the entire book during rotations or only complete pertinent sections?The chapters in this book are 1)Cardio Medicine 2)Dermatology 3)Ear, Nose, and Throat 4)Emergency Medicine 5)Endocrinology 6)Ethics and Patient Encounters 7)Gastroenterology 8)General Surgery 9)Genetics 10)Geriatrics 11)Gynecology 12)Hematology 13)Immunology 14)Infectious Disease 15)Internal Medicine 16)Laboratory Medicine 17)Nephrology 18)Neurology 19)Neurosurgery 20)Obstetrics 21)Oncology 22)Ophthalmology 23)Orthopedic Surgery 24)Pediatrics 25)Pharmacology 26)Preventative Medicine, Epidemiology, and Biostatistics 27)Psychiatry 28)Pulmonology 29)Radiology 30)Rheumatology 31)Urology 32)Vascular Surgery

I’ve categorized the obvious ones but I am unsure about the rest of the chapters(marked by a ?) Would you be able to please help me out? Thanks.

Surgery rotation: General surgery, Neurosurgery, Orthopedic Surgery, Vascular surgery, Ear nose throat?, Opthalmology?,

OBGYN rotation: Gynecology, Obstetrics,

Psychiatry rotation: Psychiatry, Ethics and patient encounters?,

Family Medicine rotation: Genetics?, Geriatrics?, Pharmacology?, Preventative Medicine, Epidemiology, biostatistics?,

Internal Medicine rotation: Internal medicine, Infectious diseases?, Cardio medicine?, Dermatology?, Emergency medicine?, Endocrinology?, Gastroenterology?, Hematology?, Immunology?, Nephrology?, Neurology?, Oncology?, Pulmonology?, Radiology?, Rheumatology?, Urology?, Laboratory medicine?

Pediatrics rotation: Pediatrics,

Ben 09.21.14 Reply

ENT, Urology, and ophthalmology fit best in surgery, although there are components that fit into medicine as well.

Ethics is broad. While it’s most at home psychiatry, it can also just be squeezed into the beginning of the year. Radiology is also general.

Preventative medicine fits in FM. Genetics, geriatrics, pharm, etc would go either with FM or IM, whichever you do first. These chapters are short, so it’s not too difficult to move them around (i.e. doing ob/gyn during FM is advisable, particularly if you do FM first). If you do FM before IM, the IM chapters in general all apply to FM.

Jolly 10.09.14 Reply

What material should I use to prepare for my upcoming neurology shelf exam?

Ben 10.09.14 Reply

I’ve addressed that question previously in the comments (which are getting somewhat long). You can either scroll up the comments or search for “neurology” to get at the relevant text.

Adil 10.31.14 Reply

Hi Ben,
I am starting Internal Medicine(my first core). My step 1 score was a 203. How should I study for this rotation? You mentioned Uworld internal medicine, Step up to medicine, and case files internal medicine. What did you personally do? Should I go through all three resources since my Step 1 score and background are “poor”? Or should I maybe focus on just two of the three resources e.g. uworld and step up only, or uworld and case files only? How do you feel about MKSAP, a resource that students on student doc seem to be mentioning. Is it worth it?

Now for a general question, for each rotation, should I aim to do multiple readings of the different books that you mentioned? I find it difficult to get through them all a second time. What did you personally do?

Ben 11.01.14 Reply

1) Started with Case Files then went immediately to UW. Used a lot of UpToDate on the wards. I also did Medicine at the end of the year, so I had a foundation. I used SUTM only as a PRN resource (many of my peers read it cover to cover). In the end, with the exception of Crush (which is succint), I read very few of the longer review type books from start to finish. NMS Surgery Casebook and Crush Step 2 are exceptions. Case Files books are brief and varied enough to fit my stamina level. There’s nothing wrong with focusing on just CF and UW if you learn them well. Some students tend to go through resources like a checklist, but I think that largely misses the point. It’s the depth of your understanding of the source material that matters, not the number of sources. Whether or not to pour over SUTM largely depends on how long your rotation is and how long you plan to dedicate to studying. It takes a good chunk of time, and I personally would never pick a book over diligently doing the qbank.

2) MKSAP is a good resource. If I could have finished UW and had more time, then sure. Even with a 12 week rotation, that was not the case for me. Mastery of UW medicine questions is easily enough to perform at the highest level (and I bought the year subscription). You needn’t fear that there’s anything significant missing from UW if that’s your primary question source.

3) I never read anything twice, with the exception of certain passages or chapters for review here and there when it relates to questions I’ve gotten wrong in practice. I personally found that I tend to glaze over books the second time and get very little out of the experience. Books are relatively passive. A second read through is super passive. Doing questions is (more) active.

L.K. 09.25.19 Reply


Currently on surgery. I originally planned to use NMS surgery casebook but recently found out about Divirgilio. Would you recommenced it instead of NMS surgery casebook.


Ben 09.25.19

They’re similar in many ways. Divirgilio is more case-based, NMS more topic-organized. Divirgilio is a little more casually written, which may make it easier to go through. You wouldn’t go wrong with either.

Thomas 04.03.15 Reply

Thank you so much for all your help. Do you have a feeling about MTB 3 vs. MTB 2. I heard to look through each. I was thinking of starting with MTB 3 for CK2, then filling it in with MTB 2 when the new editions comes out@! Thank you!

Ben 04.07.15 Reply

I’ve heard that recommendation as well, though I personally don’t think it’s necessary. Since you’ve studied for your shelves (a steadier more focused year-long review than you had for Step 1), any MTB is just serving as a rapid review of the highest yield stuff before diving into a repeat of UW.

Nas 06.16.15 Reply

Maybe this is more obvious that I am googling, but where can I find the UW resource you have mentioned?

Ben 06.16.15 Reply

For third year, it’d be UWorld Step 2 CK.

India 08.06.15 Reply

I am wondering if you have a good daily schedule for keeping up with the studying.

Ben 08.16.15 Reply

Excellent question. I don’t think a broadly applicable daily schedule is possible given the variability of clerkship length, arduousness, and individual variance. I’ve written up what I think is a good way to divide up your study time. Hope it helps!

Kelly 08.16.15 Reply

Hey Ben! I’ve been following your advice for shelf exams throughout third year, as well as for step 2 ck, and I really appreciate all the help you’ve provided for everyone on this forum! I actually just dropped by to see if you had any advice for step 3? Thanks so much! This site has been incredibly helpful to me throughout med school!

Ben 08.16.15 Reply

I do! “How to Study for the USMLE Step 3” – hope it’s helpful!

Jess 08.20.15 Reply

I am thinking of getting SUTM for my IM shelf, but I am wondering if you think this is also a good resource for the IM portion of Step 2 or if I would need another resource book such as Step up to USMLE step 2.

Ben 08.21.15 Reply

SUTM contains more than the Step 2 review books when it comes to IM. The purpose of the review book is to have something more concise/high-yield/focused/faster to get through than rereading dedicated shelf books. Out of all of subject-specific books, SUTM is probably the best for Step 2 CK (because IM makes up the bulk of the test). My post about studying for Step 2 CK is here, if you haven’t had a chance to read it yet.

Naveera 10.12.15 Reply

Hello Ben!

Which book(s) would you recommend for the ENT/Eye rotation?

Ben 10.13.15 Reply

I wouldn’t claim any special knowledge for ENT or ophtho resources. Most medical students during surgical subspecialities should probably first focus on basic anatomy and bread & butter pathology. The mini section in Crush Step 2 would be a reasonable start for the latter, but you’d probably finish that in a few minutes.

ENT Secrets looks like it’d be a good medical student-level text, but the most recent printing is over 10 years old (though recent reviews remain strong, and the core info is unlikely to have changed significantly since then). For further study, consensus would then point you to Pasha or the Handbook of Otolaryngology (the latter looks better to me FWIW). If I were to buy only one book, I’d go for the Handbook.

For ophtho, start with the free online “OphthoBook”. For the non-ophtho bound, this book is well regarded for students and primary care/ER docs etc. If you decided to pursue an eyeball residency, I’d probably then go for Practical Ophthalmology: A Manual for Beginning Residents.

JJJ 11.02.15 Reply

Hi Ben,

When you redid your marked/wrong UW questions before each shelf exam and when you reset UW right before Step 2 CK, how in depth did you read the question explanations? E.g, just the educational objective, just the bolded terms + edu objective, skimmed everything, or read everything completely?

Thanks so much!

Ben 11.02.15 Reply

Depends on how likely I was to get the question right if I saw it a third time again. If I got the question wrong again on round two, I definitely read the whole thing again.

If I knew the material well the first time but got the question wrong due to a test taking mistake, I at least went over the brief explanation and take home point, with complete reading reserved for if I wanted to review the material again. I also might review a particular answer choice(s) but not the whole set when appropriate. Ditto for questions that I had gotten wrong remotely in the past but since mastered the material. Given the frequency of high yield repeats, this wasn’t uncommon. But the key is that knowing the material “well” means a solid understanding of both the right and the wrong answer choices. If you don’t know them all as you do the question, including what would make the wrong choices correct, then I’d read it all.

Mike 05.24.16 Reply

What are your thoughts on the NBME practice exams you can buy for $20?

Ben 05.24.16 Reply

They’re very popular for Step 1. I’ve never seen anyone actually use them for Step 2, but there’s no reason why you can’t. They don’t have explanations but obviously the questions themselves are spot on. There aren’t any NBMEs for the shelf exams proper as far as I know though.

Kale Hunter 07.04.16 Reply

Hi Ben,
Unfortunately I have the Family Med NBME Shelf Exam for my 1st shelf this year. I have about 4 weeks to study. What do you recommend? My school gives us the AAFP questions, and also the Case Files book for Fam Med. I don’t know which other Qbank to purchase though (UWorld of course, but I have heard it is light on Fam Med). Do you recommend ExamGuru or maybe another source?

Thank you!

Ben 07.05.16 Reply

Case Files is worth it for your first rotation. I’d also read Crush because it, while not thorough, covers a lot of the low-hanging fruit in a very concise way (you can get through the whole thing easily). UW has some material you should get through (mentioned above), but you won’t be able to survey the whole FM relevant material (e.g. all of medicine) in the four weeks you have. I’d probably try ExamGuru in your situation to get a more reasonable amount of question-material (I reviewed it here). BoardVitals also now has a shelf qbank as well but I haven’t had a chance to check its quality.

Alex 08.30.16 Reply

hey Ben! solid post and sorry to bump it. question. I’m 4 weeks in IM and I feel like I’ve done no work. is it possible to do well on the shelf still if I work hard? I’ve done 100+ UW qs but it takes forever. the issue is that I’ve been very lazy after the day is done and I haven’t taken advantage of my days off. how do you suggest going about UW? am I in trouble or do most people procrastinate during their first rotation like me lol?

Ben 08.30.16 Reply

There are a lot of factors at play, not just how much time you have left. (Obviously if you have a 12 week rotation, that will be easier than if you have a eight week one). Either way, you can still get it done.

You can extrapolate how much time you need to give yourself by seeing how long it takes you to get through a question section and multiplying based on the number of questions you have left. Ideally, add another 25% for repeats. Then, make sure you stay on track.

Sam 02.22.17 Reply

Followed your advice and got nearly a perfect score on my surgery shelf, highly impressive and much better than any of my other exams ….. Ben you’re awesome! Plan to take your IM advice, will post to endorse after the shelf in a few months.

Ben 02.22.17 Reply

Good advice notwithstanding, that’s hard work and a great result! Should be proud.

Michael 04.20.17 Reply

This was super helpful for my third year core rotations. I was hoping you could offer some insight on any tips for the NBME Emergency MedicineShelf
so far I have been using Rosh, PreTest, and referring to case files and I still have a subscription to Kaplan which has about 150Qs or so.
Do you have any other recommendations?

Ben 04.20.17 Reply

Sounds like you’ll have it covered. Remember your ABCs!

AG 04.26.17 Reply

What’s your opinion on the onlinemeded website? It seems to have good reviews but at $500 for the year, its a bit steep. Thoughts?

Ben 04.27.17 Reply

It didn’t exist during my era, though I’ve seen that people have given at least the videos favorable reviews. As a personal preference, I have generally almost little interest in watching online videos are a primary learning mechanism. And UW to me is indispensable, so $500 on top of that would have been a dealbreaker for me as well.

KM 12.17.17 Reply

Hey, your step 1 advice was really helpful, and I did pretty well, thank you! I’ve been having much harder luck with the shelves, I can’t tell if they’re just fundamentally harder, or I’m not studying as well due to lack of time, or what. I did above average on family by getting through a lot of IM uworld, but reading most of casefiles and doing all of uworld and a couple practice nbmes still left me below average on peds, psych, and obgyn (much closer to average on this most recent one than the other two). I’ve gotten through the other half of IM uworld on my rotation, but am still getting average scores on the practice nbmes. I figure I’ll just try to repeat incorrects in my worst subjects on uworld with my last two days to study, but anything else I can do or perspective you can share? I feel like I can’t crack these shelf exams, they’re just as hard if not harder than step 1, but you have so much less time and stamina to prepare.

Ben 12.20.17 Reply

It’s the time and stamina for sure. They are definitely just as hard, but the rapid cycle makes it hard to master the material, especially when the clinical experiences don’t match up very well or you’re not give much time to study.

I think the resources above are really totally sufficient for peak performance and others might swear by others, but it sadly comes down more to time and prep than exactly what you do. Some schools make that hard, and sometimes it’s bad luck. Starting early is important. UW is I think key for the IM shelf. That said if you’re guessing a lot consider supplementing a topic here and there when Step up to Medicine or something similar, even if you’re not going to read a book cover to cover. There are some topics that are obscure enough that you won’t see it in real life and 1-3 questions out of 1000+ may be too sporadic to really get a good grounding.

KM 01.06.18

Thanks! Hit the national average in the end, and then a bit worse locally because they compare you to people taking it in the latter part of the year at my school, whose average was a bit better than the national.

Colin Bonnar 05.14.18 Reply

Hey Ben,
Do you have any experience with Toronto Notes while on clerkship? Thanks!

Ben 05.14.18 Reply

Nope, sorry. Just took a peek, looks densely packed but pretty good.

Colin Bonnar 05.15.18

Yeah, I think its more of a Canadian thing for the MCCEE. Thanks for looking into it though!

RAY 11.17.19 Reply

Hi Ben, just stumbled on your website. Very glad you still respond and is active providing very good and honest expertise on things! You mentioned that for CKexam you would likely reset UWStep2 once. So does that mean you would suggest getting the 2 year subscription for Step2UW? Thank you.

I am a lazy med student, if I was to do the bare minimum, which resource would you rank as number 1, 2, and 3 for M3 and M4 year? (I know people love to do all the resources but for me it’s “working stupid” so I rather “work smart”)

Ben 11.17.19 Reply

Yes, definitely UW for the whole year. That’s a #1 resource. While I also liked Crush, there are not other single resources tailored for the whole year that I consider essential, each rotation is different and has its own needs (unless you’re looking for a curriculum replacement tool like OnlineMedEd etc). For M4, basically whatever. I have recs for Sub-I’s if you’re trying to impress someone or prepare for a field of interest:

RAY 11.17.19

Sorry last question, so if I get ONE year for UW then are you alluding that I should take CK within the M3 year? At the end of your cores did you feel that you had all the knowledge to write Step2?

Thanks kindly. R

Ben 11.17.19

Not within, immediately after at the beginning of fourth year. The best prep for Step 2 CK is having studied for and taken all the shelf exams. Follow that with a few weeks of dedicated effort and take the exam. See discussion in

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