You will take the NBME Family Medicine Specialty (Shelf) Examination on the last Friday of the clerkship. Since the examination covers a wide range of topics, you must begin studying on the first day of the clerkship. This section presents some information about the examination, suggests some study resources and strategies, and provides overall tips that will help you perform at your best.

FACTS ABOUT THE SHELF EXAMINATION

Administration Essentials

• Time allowed: Two hours, ten minutes
• Number of items: 100

Examination Focus

• Normal growth and development and general principles of care throughout the lifespan
• Diagnosis and initial management of common life-threatening and debilitating diseases/conditions

Item Information

• Most of the itmes use lengthy patient-based scenarios
• Items contain patient history and physical findings that will help you determine the answer
• Patient information (e.g., gender, age, ethnicity) is often important in answering items
• Most of the items are single-best answer (a-e); extended matching items usually appear at the end of the examination

RECOMMENDED STUDY RESOURCES

• Go here for a listing of suggested resources.

STUDY STRATEGIES

• Study for the examination. To perform well on the examination, read about your patients, study for the examination, and take practice tests.
• Use the textbooks, your patient-based readings, and your didactic sessions as a framework for studying. Focus on the clinical medicine aspects of disease and note the signs and symptoms of diseases as you learn. Compare diseases, making special note of features they share and attributes that permit you to make a differential diagnosis.
• Avoid unfocused reading (e.g., passive reading; not thinking about what you need to learn).
• Prepare condensed study materials on topics that are likely to appear on the examination (e.g., asthma and the causes of acute abdominal pain).
• Review material that you've studied on a regular basis so you don't forget it.

FOLLOW THIS SUGGESTED STUDY SCHEDULE

• Day 1 of the clerkship: Scan your books to familiarize yourself with the content of the discipline and the question formats.
• Days 2-22: Read about your patients, study the suggested text, prepare condensed notes for review, participate in the didactic sessions, and review practice questions to identify your strengths and needs.
• Days 23-25: Review the material that you've already studied.
• Day 26: Take the examination and have a great weekend!

TEST-TAKING TIPS 

• Use a dull #2 pencil to darken in the responses on the answer sheet (saves time).
• Divide the test into quarters and pace yourself to finish a few minutes early. Pacing is important due to the lengthy patient-based scenarios that take time to read.
• Complete the extended matching items first (leave the single-best answers to last because you'll get more correct if you have to guess).
• Eliminate wrong answers by relying on your knowledge and clinical judgment. Even if you don't know the answer to a question, eliminate possible responses that are incorrect to increase your likelihood of correctly answering the item.
• Monitor time carefully - don't spend too much time on any one item.
• Fill-in the answers immediately after finishing an item to save time.
• Darken the answer for each item on the answer sheet as you go - even if you don't know the answer. (This will prevent you from skipping a questions and getting your answers out of order.)
• Designate "unsure"and "no-clue"items. First, come back to the "unsures" then do the "no-clues" if you have the time.   

EXAMINATION CONTENT - as listed on the National Board of Medical Examiner's website

Distribution Across Age Groups: 5% - 15%

• Childhood (5% - 10%)
• Adolescence (65% - 75%)
• Adulthood (5% - 15%)
• Geriatrics

General Principles: 1% - 5%

• Infancy and Childhood (normal growth and development)
• Adolescence (sexuality, separation from parents/autonomy, puberty)
• Senescence (normal physical and mental changes associated with aging)
• Medical Ethics and Jurisprudence

Organ Systems:

• Immunologic Disorders (5% - 10%)
• Diseases of the Blood and Blood-forming Organs (5% - 10%)
• Mental Disorders (5% - 10%)
• Diseases of the Nervous System and Special Senses (5% - 10%)
• Cardiovascular Disorders (10% - 15%)
• Diseases of the Respiratory System (10% - 15%)
• Nutritional and Digestive Disorders (10% - 15%)
• Gynecologic Disorders (5% - 10%)
• Renal, Urinary, and Male Reproductive System (5% - 10%)
• Disorders of Pregnancy, Childbirth and the Puerperium (1% - 5%)
• Disorders of the Skin and Subcutaneous Tissues (1% - 5%)
• Diseases of the Musculoskeletal System and Connective Tissues (5% - 10%)
• Endocrine and Metabolic Disorders (5% - 10%)

Physician Tasks:

• Promoting Health and Health Maintenance (15% - 20%)
• Understanding Mechanisms of Disease (20 % - 25%)
• Establishing a Diagnosis (35% - 40%)
• Applying Principles of Management (20% - 25%)