Study Tips for NBME Subject Exams
The following are recommendations from our students:
- Start early. Familiarize yourself with new terminology and major topics that are unique to the clerkship, then build on this with more in depth study. Try to read something new or review a topic each day instead of trying to cram hours of studying into the last week.
- Use your time in clinic and on wards as a way to study, but be aware that the test will often cover a broader range of topics than your clinical exposure. Read about the patients your team is taking care of, use that reading as a starting point, and fill in gaps with a review book. In general, an entire textbook is too much information to cover but may be of use as a resource for furthering understanding of a subset of topics/diseases of particular interest. Ask fourth year students or residents for suggestions about helpful review books or textbooks but keep in mind that everyone will have different preferences.
- Use your residents and attendings as resources. Ask them questions and ask to discuss topics with them, as they often know the “bread and butter” topics, “classic” questions, and key information for exams.
- Make sure to do practice questions throughout the clerkship, but don't focus 100% of your efforts on them at the exclusion of reading a text or review book. Use explanations of answers to guide your use of textbooks and other, more detailed, sources. Practice questions will also provide insight into the depth and detail of understanding that will be tested.
- Use what worked in preparing for Step I to maximize pacing and timing on the shelf exams. If doing practice Step I exams was valuable, do at least one or two full-length, practice exams two-four weeks before the shelf exams. These are available in the SASS.
- Make an effort to attend all student lectures, resident lectures, noon conferences, and grand rounds. These lectures often provide important information on many frequently-tested topics.
- Subject exams generally test:
- disease recognition and basic epidemiology/statistics.
- diagnostic tests (expect questions such as "What test would you order next for this patient?")
- "big picture" pathophysiology but not intricate basic science knowledge
- early management of acute diseases
- indications for referral to a specialist, surgery, invasive interventions etc.
- DO NOT expect resident level questions on topics such as how best to perform procedures, what type of sutures to use, drug dosages, etc. While searching out in depth journal articles during your clerkship may help you better understand your patients, and may occasionally be expected of you, shelf exam questions do not test this level of knowledge.