The NBME® Medicine Shelf Exam

What You Need to Know

The NBME Medicine Shelf exam assess a student’s mastery and practical application of general medicine knowledge on adult patients. It is typically taken during the third year of medical school, after the medicine clerkship. It is a particularly intensive and difficult exam that covers a broad range of medical information. With that in mind, students should anticipate dedicating more studying time to this exam compared to other Shelfs.

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How to Study for the Medicine Shelf Exam

  • Try scheduling your Medicine and Surgery exams in succession of each other, if possible, as there tends to be some overlap in the topics covered. Students who take Medicine first do tend to be better prepared for Surgery.
  • Cover as many practice questions and different cases as possible, as the Medicine Shelf (like the discipline itself) is extremely broad.
  • Focus on cardiovascular, respiratory, digestive and endocrine disorders, as they make up almost half of the exam’s topics.
  • Study throughout the course of your entire Medicine rotation and make sure to keep your eyes open on the wards. Knowing how to correctly work-up and manage your patients will be beneficial for when you finally take the exam.
  • Approach questions as real diagnostic dilemmas and practice making differentials.
  • Cover the entire internal spectrum of medicine as you prepare: pay attention to common conditions during your clerkship and use your downtime to focus on the more esoteric diseases that you don’t see on the wards.

Taking the Medicine Shelf Exam

Not all medical students are required to take the NBME Medicine Shelf Exam, and it’s not a required exam for obtaining a U.S. doctor’s license. However, most medical schools have a required medicine clerkship, and the most popular way to test students on this particular rotation is by using the NBME’s official Medicine Subject Examination. The exam can be taken on campus at select medical schools or at authorized testing locations, like Prometric test centers.

The Medicine Shelf exam is formatted as an online test consisting of 110 questions which must be answered in 165 minutes. It shares the same interface as the USMLE Step exams, with each question presented as a hypothetical clinical scenario. The exam is graded on a national average, though whether or not you pass your entire clerkship will depend on your individual medical school’s requirements. More specifically, the number of correct answers you get places you in a percentile, which is then measured across national grades.

The following textbooks and resources have traditionally been very popular when preparing for the shelf:

UWorldStep Up to Medicine, and Case Files Medicine.

However, while informative, they are expansive and unwieldy to use for students short on time. A more unified and condensed solution is available for more streamlined studying.

Try a Different Take on the Medicine Shelf

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