The NBME® Psychiatry Shelf Exam

What You Need to Know

The NBME® Psychiatry Shelf exam assesses a student’s ability to diagnose and treat psychiatric illnesses. Success on the exam depends on what is learned during the Psychiatry clerkship in addition to coursework and dedicated study time. It is generally regarded as the least challenging Shelf, though that doesn’t mean students should be sparing with their study time. The exam will incorporate knowledge from other Shelfs, namely Pediatrics, Internal Medicine, OB-GYN, Geriatrics, and Preventive Medicine, and touch on psychiatric medications, adverse medication reactions, mood disorders, and psychoses.

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How to Study for the Psychiatry Shelf Exam

  • Familiarize yourself with the diagnostic criteria and timelines for anxiety, mood disorders, psychoses, and personality disorders. Know how to differentiate between schizophreniform disorder and schizophrenia.
  • The question stems are long, so be wary of drowning in the details. Basic diagnostic skills and the memorization of high-yield pharmacologic side effects will be enough.
  • Learn all of the major side effects for psych drugs (and avoid spending too much time on what’s uncommon or vague).
  • Seeing as the Psychiatry Shelf exam question stems are very long, timing could be your greatest challenge. Skip past the tricky questions and focus on gathering points on the ones you do.
  • Try scheduling your Psychiatry and Neurology exams in succession of each other, if possible, as there tends to be some overlap in the topics covered.

Taking the Psychiatry Shelf Exam

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

The Psychiatry 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:

First Aid for the Psychiatry Clerkship, official NBME practice examinations, and UWorld (both Psychiatry Neurology questions).

However, while informative, these resources may feel disjointed and require cross-referencing for missing information. A single, integrated resource can be a better way to go.

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