Sup ya’ll!
So you are looking into taking your internal medicine shelf or COMAT for your third year of medical school. Well, I didn’t do terribly on it but I am definitely a middle of the road type of student. So if you need some advice on just passing, then this is the place for you!
Your internal medicine shelf will be like a mini level 1 or step 1 exam. Internal medicine spans MANY different specialties and is the actual base of the medicine stepping stool. You need to know a lot about a lot for this shelf. So pace yourself a bit because it is a lot of information. Topics they like (at least on my shelf):
- Screening. Know the different indications for this. I.e. colonoscopy, breast cancer screening, AAA screening, vaccinations for adults, etc.
- Cardiac basics. I.e. ACS vs MI vs NSTEMI. How do you diagnose it. What do you order vs next steps. How do you treat?
- Cardiac continued: there are several classifications. I.e. Diamond classification for ACS, CHADS2VASC score for anticoagulation, NYHA for CHF. They will ask questions about these. So will your preceptors, so just be familiar with them.
- INFECTIONS. Oh man I was so mad about this. I’m terrible with infections and antibiotics. They will ask.
- Sepsis is hit or miss. I had a lot of sepsis practice questions but didn’t feel like I had that many on my shelf personally. But either way, it is a big hitter in medicine in general and patients die from it, so understand it and how to treat it.
How I prepped:
My internal medicine rotations were back to back. So I started studying during my first rotation a little bit throughout regardless of if I was in clinic or not to try to get through some of this.
- Online med ED videos and questions. There is a lot, and it can be difficult to get through all of it. I started with one topic and tried to dive into it. Some of it will come back from your first two years. The rest you will see for the first time (or at least your brain will think it has). You will be exposing yourself to a lot, so take it chunk by chunk.
- Case X. Yes, very helpful!
- Aquifer cases: more helpful for screening and outpatient medicine guidelines. Less helpful I thought for inpatient medicine.
- Anki Dorian deck: oh yes. Wish I would have been able to get through more.
- U world and Truelearn questions. Even if I only did 10 at a time, I tried to go through all those incorrect answers. I would pick the topics I was studying from the videos I was on at the time to really drive in the content home in my brain.
- Case files. Helpful, just couldn’t get through that much. A good quick way to see high-yield or common presentations and how to assess them.
On my off days, weekends, or weeks where I was off to do my assignments as I am a hybrid student I tried to do a good mix of my assignments and the above. Weirdly enough my school didn’t require me to watch the OME (online med ed) videos/do questions for internal medicine which I thought was just whack. But I did it anyways, because it was a good source of information/study material for me.
My shelf exams were 125 questions. I think it is around 2 hours for a time limit? For the most part I was able to pace myself. The ending there I was a little peeved because I was worried I would run out of time. Just try not to spend too much time on one question. You can always guess, flag it, and if you have time go back and try to glean a better answer.
Anywho, good luck and cheers!
