How can you prepare for the Family Medicine Shelf Exam?
Many students enter into the family medicine rotation hoping that it will be a bit of a break from the intensity of rotations like surgery and internal medicine. It’s true that this rotation is generally clinic-heavy, with little to no inpatient care or call. At the same time, it’s important not to get complacent on this rotation. A fully-booked clinic day can certainly be stressful, and the variety of different clinical situations that you may encounter on family medicine is huge.
The Family Medicine Shelf Exam presents a unique challenge. The breadth of material that can potentially be covered on this exam is huge. You could have a question about a senior with dementia, followed by a question about a pregnant woman with depression, followed by a question about the vaccination schedule for infants. How can you possibly study for an exam that covers such a diverse range of topics?
While it is a challenge, the breadth of topics on this exam can also be a great opportunity. Studying for the Family Medicine Shelf will be very helpful on Step 2 CK, as you’ll be reviewing and connecting content that you’ve learned in various specialties. Whether you want to honor your family med rotation or simply ensure that you’re prepared for Step 2 CK, the right study plan can help you to do well on the Family Medicine Shelf.
What are the best resources to prepare for the Family Medicine Shelf Exam?
At first, family medicine may seem like an impossibly broad knowledge base. However, keep in mind that you will not be expected to be an expert in every area. The Family Med Shelf will test your ability to differentiate between the problems that a family physician would manage on their own in a clinic setting (such as managing meds for a patient with diabetes and hypertension), and those who would need referral to a specialist. (Basically, you need to be able to manage the horses, and refer the zebras to a specialist.) It will also expect you to be able to recognize an unstable patient who should be transferred to an inpatient setting.
A family physician also focuses on screening and disease prevention. It’s likely that you’ll be asked about vaccine schedules, as well as the current guidelines for screening exams such as colonoscopies and mammograms. You should also have a sense of what lifestyle modifications would be helpful for preventing complications, including guidelines for exercise and nutrition, as well as pharmacologic interventions that are useful for disease prevention.
This is a great site with a series of videos on high-yield topics. To make things a little easier, the videos that are relevant to family medicine are grouped together here. Along with the videos, there are also notes for each one; these are particularly useful for quick review before the exam.
We recommend carrying a book in your bag to study whenever you find downtime in the clinic, and Case Files Family Medicine is a great one. You can use it in the clinic to learn more about your patients’ clinical problems and review information connected to them. This helps you to connect content to experiences, which is very helpful for learning. You’ll also want to read cases related to clinical problems you haven’t encountered, because a few weeks of clinic may not expose you to all of the clinical situations you’ll need to know about.
Although UWorld is helpful for all of the Shelf Exams, it can be a little bit trickier to use for the Family Med Shelf than for some of the others. This is because UWorld doesn’t make it easy to filter for the questions relevant to family medicine. As a result, this is the one Shelf for which UWorld may be more of a challenge to use. One option is to use the pediatrics, ob/gyn, and internal medicine topics, but this could easily be overwhelming to try to get through in the short time that you have. Although UWorld is still helpful, there are two other sources of questions that may be more useful for the Family Med Shelf: PreTest and the AAFP.
PreTest Family Medicine
PreTest is a print book rather than an online resource. This allows you to carry it in your bag to review when you find downtime in the clinic. It contains 500 high-yield questions on ambulatory medicine, so it’s a good question bank for the Family Medicine Shelf Exam. We would definitely recommend getting through all of these at least once before your exam.
AAFP website question bank
The American Academy of Family Physicians, or AAFP, offers a useful Qbank on its site. Though designed for the family medicine boards, it’s also high-yield for the Family Medicine Shelf Exam. If you sign up for a student membership to AAFP (which is free), you have access to this Qbank. This is another great option for getting questions that are similar to what you’ll see on your Family Med Shelf. We’d actually recommend starting with these questions, and going to UWorld later if you have extra time.
Step Up to Medicine
This book is extremely high-yield for the Internal Medicine Shelf. It covers all of general internal medicine, and tends to emphasize inpatient care. However, the section on ambulatory care patients is very relevant to the Family Medicine Shelf. You’ll definitely want this book for both your Internal Medicine and Surgery Shelves, so it’s worth the investment. If you get through the ambulatory care section in Step Up during your family med rotation, you should be well-prepared for the exam.
How can you create a study schedule for the Family Medicine Shelf Exam?
The family med rotation is clinic-heavy; your clinical experiences will take place mostly or entirely in the outpatient setting, generally leaving you with nights and weekends free. This may make it seem like this rotation will be a bit of a break, although it’s important not to underestimate this rotation. You will definitely need to be on your game to do well on family medicine.
Still, although some clinic days are very busy, there also tend to be some slower days in the clinic with more downtime between patients. It’s a great idea to have at least one book in your bag, so that you can study whenever you find yourself with extra time. This will also allow you to read up on the patients that you see, to help you shine in the eyes of your residents and attendings.
Because your schedule is likely to be somewhat more predictable on this rotation, you may find that it’s easier to stick to a study schedule. You’ll want to create a study target; take all of the content you want to get through before your exam, and divide it up so that you know how much you need to complete each day. There may be some days when you can’t meet your target, because your clinical responsibilities end up being more than you imagined. That’s okay; just make up the study time on a different day. You could plan on using a little extra time on the weekends for studying as well. (We also do recommend giving yourself some break time each weekend. Rest is important to avoid burnout!)
Seek help from others
As with all of the exams along the medical journey, from the MCAT through your specialty boards, you aren’t the first one to go through this. Ask people who have recently completed the exam to give you their study tips. Your friends in MS3, as well as MS4s and residents that you meet on your rotation, can be great sources of information.
For those who want some extra help studying for their Shelf Exams or Step 2 CK, you may want to consider hiring a professional tutor. You’ll want to choose someone who has experience in helping students to prepare for their exams, so that you know they’ll be able to give you the best advice. Medlearnity tutors are physicians who performed very highly on their USMLE exams, and they have experience in helping others to perform their best as well. We’re confident that once you experience our services, you’ll see the very high value that we provide. That’s why we offer a one-hour free trial, with no obligation. You can get started here.
We hope that you find your family medicine rotation enjoyable and rewarding.