Resources
Up To Date
-For your patients-the more you read on your patients the better your overall preparation.
USMLE World Internal Medicine
-The more of the questions you can get through the better. Of all the Usmle world step 2 question banks, this is the most reflective of a shelf and of step 2. Making the question review process an active rather passive experience will yield higher benefits, such as writing out in a word document the explanations provided and how your thought process led you to the correct or incorrect answer.
MKSAP question book.
-extremely high yield. This is available for free via shiffman. Highly recommended as its depth and breadth are wonderful for medicine. The questions are not phrased in step 2 style like usmleworld but it has its own advantage on being more readily accessible. There is a student version that is preferable over the one intended for medicine residents.
Step Up to Medicine
-This is also extremely dense but it is unlikely that the exam will have anything not covered in this book. I preferred the question format of MKSAP and the explanations but for those that want to read a book similar in style to First AID, this is for you.
NMS Medicine Casebook
-while the NMS medicine book companion is great as a reference, this book is more useful as a combination prep for your hospital work, the shelf and step 2. It is still dense but with the time commitment is has a very high yield. One of the best big comprehensive prep books out there after MKSAP and Uworld.
USMLE Secrets Step 2
A useful book to cover very high yield topics when tired. It is in no way comprehensive on any topic but it will point you in the right direction for the topics worth looking into further. However, MKSAP goes into greater depth but Secrets covers all the subspecialties on the exam for a quick read in between usmle world questions.
NBME exam: very helpful, some questions seemed to appear on the shelf however no explanations. Typically people perform much better on the actual exam than the Medicine NBME. This holds true for the STEP 2 NBMEs as well.
Case files Medicine– gives clear cut pictures on basic presentations, no nuance or depth that shelf questions will often probe at. Case files-most normal presentations of the biggest disease, the breadth of coverage is insufficient, also clunky if you wish to reference a specific illness. Not recommended for medicine given the availability of more comprehensive and in depth resources.
Blueprints Medicine: great for a firm basis of pathology and knowledge for reference, not a quick read.
Pretest Internal Medicine-will provide questions on all the areas of medicine but not in SHELF format. Given the availability of USMLE world and MKSAP, not recommended.
Pathoma: worth reading over for the major organ sections at least once since every shelf exam will build on basic pathology knowledge. If you used this during step 1 preparation, reading over it should be more of a review process.
Kaplan Notes Medicine-found online or in the shared dropbox, this is not an adequate depth you need but still valuable.
Goljan Rapid Review Pathology: very useful for quick reference of pathology. Just because it is year 3 does not make this useless! Many of your attendings will ask you basic physiology found in this book.
First Aid for Step 1
-often reviewing your basic pathophysiology will pay dividends on clinical medicine exams.
High Yield Questions
1. I would really really really try to do all the questions in MKSAP in the first month. Then do them again in the second month. As with studying for step 1 and step 2, Medicine scores go up exponentially with the number of questions you do and work out.
2. Interspersed throughout the rotation, do as many USMLE IM questions as you can, there are a ton. Use your downtime on these.
3. The exam itself is a combo of random step 1 questions,
4. a lot of MI/CHF management,
5. GI (always with the scopes and tests),
6. nephro both fluid management,
7. AKI (understand prerenal, intrarenal, postrenal and then the nephrotic/nephritic syndromes (really that section in pathoma is more than enough).
8. Understanding your electrolyte disorders is huge, being able to read lab results is pertinent to at least half the questions. Often you are given more labs than you need so read efficiently and quickly.
a. Hyperkalemia
b. Hypernatremia
c. Acidosis
d. Alkalosis
e. Read an ABG
9. Then most importantly a LOT of rheumatology was on this exam (including bone disorders, LUPUS (everyone has lupus!), sarcoid (all African american women until proven otherwise), RA, osteoarthritis, seronegatives, etc). The rheum question section in MKSAP is one of the longest and now I understand why.
10. This exam more than any features numerous zebras since medicine is so broad. Do as many questions as you can will pay dividends for the shelf and for your step 2 preparation.
11. Pneumonia
12. Pfts
13. Cap vs hcap for abx
14. Heart stuff
15. Basic ekg probably 1-2
16. Heart failure classification drugs and the treatment regiment
17. Mi interventions in short term and long term
18. Differential for chest pain is the most important thing, likely at least 10
19. PE
20. ER
21. Random step 1 type questions, such as hereditary c1esterase deficiency
22. Heart disease and risk factors
23. Hypertensive emergency
24. Hypertension medications
25. Polio, diseases that have been eradicated
26. Shock and different types of shock and management
27. COPD
28. Compare and treat obstructive vs restrictive lung disease patterns
29. CANCER
30. ARDS
31. Colorectal
32. Lung cancer types
33. Pancreatic cancer
34. Alcohol, diabetes, smoking is related to 30 questions on every exam without question.
35. Non surgical gut issues,
36. Inflammatory bowel
37. Liver cancer, cirrhosis
38. Different hepatitis differential
39. Elevated bilirubin differential
40. LFT differential
41. Pancreatitis-acute presentation
42. Rheumatology is very highly yield
43. Headaches
44. Anemia
45. General knowledge of the applicability of Alcohol, Smoking, and Diabetes (the big three of medical school) to the exam in question. Always good for 5-10 questions on the shelf.
Regarding Step 2: the majority of the exam feels like the IM shelf, with some more out patient management, there are no direct family medicine questions since it is covered by studying out patient medicine, pediatrics, and ob/gyn. Once again, using Uworld as your primary resource and one text is wonderful, many re-use step up to medicine, it is superior to step up to 2ck. Neither has biostats which you will find in First Aid for Step 1 done the best combined with the uworld questions. Step 2 takes the pathophysiology of step 1 and then asks, now that we ask you to figure out what it is, what should we do to confirm or treat it!
Up To Date
-For your patients-the more you read on your patients the better your overall preparation.
USMLE World Internal Medicine
-The more of the questions you can get through the better. Of all the Usmle world step 2 question banks, this is the most reflective of a shelf and of step 2. Making the question review process an active rather passive experience will yield higher benefits, such as writing out in a word document the explanations provided and how your thought process led you to the correct or incorrect answer.
MKSAP question book.
-extremely high yield. This is available for free via shiffman. Highly recommended as its depth and breadth are wonderful for medicine. The questions are not phrased in step 2 style like usmleworld but it has its own advantage on being more readily accessible. There is a student version that is preferable over the one intended for medicine residents.
Step Up to Medicine
-This is also extremely dense but it is unlikely that the exam will have anything not covered in this book. I preferred the question format of MKSAP and the explanations but for those that want to read a book similar in style to First AID, this is for you.
NMS Medicine Casebook
-while the NMS medicine book companion is great as a reference, this book is more useful as a combination prep for your hospital work, the shelf and step 2. It is still dense but with the time commitment is has a very high yield. One of the best big comprehensive prep books out there after MKSAP and Uworld.
USMLE Secrets Step 2
A useful book to cover very high yield topics when tired. It is in no way comprehensive on any topic but it will point you in the right direction for the topics worth looking into further. However, MKSAP goes into greater depth but Secrets covers all the subspecialties on the exam for a quick read in between usmle world questions.
NBME exam: very helpful, some questions seemed to appear on the shelf however no explanations. Typically people perform much better on the actual exam than the Medicine NBME. This holds true for the STEP 2 NBMEs as well.
Case files Medicine– gives clear cut pictures on basic presentations, no nuance or depth that shelf questions will often probe at. Case files-most normal presentations of the biggest disease, the breadth of coverage is insufficient, also clunky if you wish to reference a specific illness. Not recommended for medicine given the availability of more comprehensive and in depth resources.
Blueprints Medicine: great for a firm basis of pathology and knowledge for reference, not a quick read.
Pretest Internal Medicine-will provide questions on all the areas of medicine but not in SHELF format. Given the availability of USMLE world and MKSAP, not recommended.
Pathoma: worth reading over for the major organ sections at least once since every shelf exam will build on basic pathology knowledge. If you used this during step 1 preparation, reading over it should be more of a review process.
Kaplan Notes Medicine-found online or in the shared dropbox, this is not an adequate depth you need but still valuable.
Goljan Rapid Review Pathology: very useful for quick reference of pathology. Just because it is year 3 does not make this useless! Many of your attendings will ask you basic physiology found in this book.
First Aid for Step 1
-often reviewing your basic pathophysiology will pay dividends on clinical medicine exams.
High Yield Questions
1. I would really really really try to do all the questions in MKSAP in the first month. Then do them again in the second month. As with studying for step 1 and step 2, Medicine scores go up exponentially with the number of questions you do and work out.
2. Interspersed throughout the rotation, do as many USMLE IM questions as you can, there are a ton. Use your downtime on these.
3. The exam itself is a combo of random step 1 questions,
4. a lot of MI/CHF management,
5. GI (always with the scopes and tests),
6. nephro both fluid management,
7. AKI (understand prerenal, intrarenal, postrenal and then the nephrotic/nephritic syndromes (really that section in pathoma is more than enough).
8. Understanding your electrolyte disorders is huge, being able to read lab results is pertinent to at least half the questions. Often you are given more labs than you need so read efficiently and quickly.
a. Hyperkalemia
b. Hypernatremia
c. Acidosis
d. Alkalosis
e. Read an ABG
9. Then most importantly a LOT of rheumatology was on this exam (including bone disorders, LUPUS (everyone has lupus!), sarcoid (all African american women until proven otherwise), RA, osteoarthritis, seronegatives, etc). The rheum question section in MKSAP is one of the longest and now I understand why.
10. This exam more than any features numerous zebras since medicine is so broad. Do as many questions as you can will pay dividends for the shelf and for your step 2 preparation.
11. Pneumonia
12. Pfts
13. Cap vs hcap for abx
14. Heart stuff
15. Basic ekg probably 1-2
16. Heart failure classification drugs and the treatment regiment
17. Mi interventions in short term and long term
18. Differential for chest pain is the most important thing, likely at least 10
19. PE
20. ER
21. Random step 1 type questions, such as hereditary c1esterase deficiency
22. Heart disease and risk factors
23. Hypertensive emergency
24. Hypertension medications
25. Polio, diseases that have been eradicated
26. Shock and different types of shock and management
27. COPD
28. Compare and treat obstructive vs restrictive lung disease patterns
29. CANCER
30. ARDS
31. Colorectal
32. Lung cancer types
33. Pancreatic cancer
34. Alcohol, diabetes, smoking is related to 30 questions on every exam without question.
35. Non surgical gut issues,
36. Inflammatory bowel
37. Liver cancer, cirrhosis
38. Different hepatitis differential
39. Elevated bilirubin differential
40. LFT differential
41. Pancreatitis-acute presentation
42. Rheumatology is very highly yield
43. Headaches
44. Anemia
45. General knowledge of the applicability of Alcohol, Smoking, and Diabetes (the big three of medical school) to the exam in question. Always good for 5-10 questions on the shelf.
Regarding Step 2: the majority of the exam feels like the IM shelf, with some more out patient management, there are no direct family medicine questions since it is covered by studying out patient medicine, pediatrics, and ob/gyn. Once again, using Uworld as your primary resource and one text is wonderful, many re-use step up to medicine, it is superior to step up to 2ck. Neither has biostats which you will find in First Aid for Step 1 done the best combined with the uworld questions. Step 2 takes the pathophysiology of step 1 and then asks, now that we ask you to figure out what it is, what should we do to confirm or treat it!