At the end of the family medicine rotation, my classmates and I took the shelf exam, a standardized subject exam written by the NBME to assess our learning during the clerkship. Starting with the family med clerkship felt like a great introduction to clinical medicine, but I had heard that the shelf exam was a bear. The family medicine exam, my 4th year friends said, could cover anything, encompassing basically all of medicine, from obstetrics and gynecology, to pediatrics, to dermatology, and even a little surgery.
Fortunately, I felt that the practice where I worked prepared me well for these challenges. The practice had many residents, and because they need to have training in obstetrics and gynecology, I saw quite a few routine obstetric patients and I even got to see my first delivery! I was also lucky to assist with many well child checks, from newborn visits, to high school and college students. I even got to see some textbook rashes, including erythema chronicum migrans, and pityriasis rosea, and watch a punch biopsy. Some other students did not have such varied experiences and were caught a little off guard by the shelf exam. Although I found the exam to be difficult, I felt like it was littered with concepts that I knew and could reason my way through.
In terms of actual study materials, I did buy a book of cases but never really got a chance to use it. We were required to do a certain number of virtual cases online, with the encouragement that the more cases we completed the better we would do on the shelf exam. This was borne out in my case, since I did most of the cases and did pretty well on the shelf! During the first two years of medical school, I was pretty resistant to studying from textbooks and tended to eschew them in favor of lecture notes and flashcards. Slowly, though, I’ve started to come around. The virtual cases were a great resource for me during family medicine, and I felt that I learned a lot simply during my daily work in the clinic. For other rotations though I may need to open up to using additional resources and that process will start with adding more books to my shelf!