Let’s get straight to the point, shall we? How do you get honors in your pediatrics rotation? What resources should you use to study for the pediatric shelf exam?
In this blog post, I’ll answer those questions and more! I’ve also graded each resource I used to indicate its value and utility for the ward and the pediatric shelf exam!
Enjoy! (If you want to read about tips on doing well on the pediatric rotation, click here.)
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What Is The Pediatric Rotation?
The pediatric rotation is typically taken during the third year of med school where you’ll undergo both inpatient and outpatient rotations.
During the inpatient rotation you will be exposed to various principles of inpatient management as you actively participate in the care of children with chronic or acute conditions.
(This is probably the most heart-breaking yet fulfilling aspect of this rotation and you can tell why.)
As with most rotations, you will be part of a medical team consisting of pediatric residents, interns and attendings. You will also be expected to write daily notes, physicals and histories, and orders co-signed by your residents.
Of course, the inpatient rotation experience wouldn’t be complete without the oral presentations conducted on rounds. Expect to do this 3-5 times on the evening.
Now, the outpatient rotation is a bit less distressing because you’ll deal with children with better conditions as inpatient ones most of the time.
However, you’ll still be responsible for the outpatient management of children with acute illnesses as well as conduct preventative medicine.
Again, you’ll be working with an integrated team and perform physicals and history of your patients in the clinic. Then, you’ll have to present your findings of therapeutic plan to your clinic attending.
If your school’s pediatric program has it, you might also spend some days in the nursery during the outpatient pediatric rotation (which by the way, is an awesome experience 😊.)
The Pediatric Shelf Exam
After the pediatrics clerkship comes the pediatric end of rotation exam. The Pediatric Shelf Exam assesses a med student’s ability to determine and administer care to children, infants and adolescents.
The NBME Pediatrics Shelf exam is not a requirement for all med students in the US. However, your med school probably requires the clerkship like many others and the most common way of testing you is NBME’s Clinical Pediatrics Exam.
You can take the test on campus, at the Prometic Test Centers, or in any other authorized testing locations.
The way that the pediatrics shelf exam is formatted is so much like the step 1 exams. It’s an online test with 110 questions which you have to answer within 165 minutes. Each question is a hypothetical clinical scenario. Here’s an example:
A 2-month old breastfed male is evaluated for blood streaked stool. He was born at 38 weeks’ gestation and delivery was uncomplicated. He was discharged 30 hours after birth and has been gaining weight appropriately. Exam is unremarkable. You suspect allergic enterocolitis. Which of the following is true? Allergic enterocolitis is rare in breastfed babies.
A. In most patients with allergic enterocolitis, radioallergosorbent tests are positive.
B. The prevalence of cow’s milk protein induced enteropathy is increasing in developed countries.
C. Soy formulas should be recommended, as they are hypoallergenic.
D. Cow’s milk protein allergy is the most common cause of chronic diarrhea in children 6 months to two years.
(You can check for the answer here!)
Passing the clerkship will depend on your medical school’s requirements, but the shelf is graded on a national level. The more answers you get correctly, the higher your percentile will be.
Now, how do you prepare for the pediatrics shelf exam? Essentially, it starts during your pediatrics rotation.
For now, I want to show you the top resources that you should use to honor your pediatric rotation and to study for the shelf exam. Read on!
UWORLD for Step 2: A+:
Regardless of who you ask, practice questions are important for your clinical rotations.
You won’t remember everything you read, and you also won’t see a patient with everything you’re expected to know.
Thus a resource as solid as UWORLD for Step 2 is a must. For the pediatrics rotation, there are about under 400 questions in UWORLD.
To get the most out of the questions, I recommend you start as soon as the rotation starts. Even doing just 10-20 questions a night is enough time to complete the questions within a few weeks.
This gives you enough time to review weaker points as well as attack other questions later on.
The UWORLD questions, in my opinion, are not all you’ll need for the test. Thus, it is yet to become the best pediatric board review question bank.
The real thing is 110 questions long, so you’re bound to see things on the test that are not in UWORLD.
Regardless, the question bank serves as a great resource with high yield material for everything pediatrics. They also do a good job of mimicking the style and length of many questions that you’ll see on the shelf.
I do wish I had started doing random questions earlier. This is not because it would have helped me on the shelf (it may have).
Instead, I think I would have seemed more knowledgeable in front of my attendings. Many of the questions attending physicians asks are high-yield topics that you need to know.
Yes, some seem to come out of nowhere, but most questions could have been answered if I had done my UWORLD earlier on.
Pre-Test is a book with 500 sample questions covering both high-yield and tiny minutiae.
This wide array of questions can make the difference between passing and honoring the rotation. It also helps with the pediatric shelf exam.
I loved this book!
My only regret about Pre-Test is not starting it sooner.
I rushed the last few days to complete all the questions, but they’re a great source of practice after you complete UWORLD.
I would recommend doing these questions towards the end of the rotation. Ideally, you have finished the UWORLD questions two weeks before your shelf.
The last few weeks would be great to just spend your time doing questions. The only caveat I would add is to also do these questions while you’re on a sub-specialty service.
My school’s pediatrics rotation had us each spend two weeks on a subspecialty service – mine was Hem/Onc. These questions were great prep for me when I was asked a question during rounds.
I also recommend buying the physical book. I had an electronic copy and wished I had the paperback to study when I had some downtime during the day.
You can find and learn more about the book here.
BRS Pediatrics: A:
BRS Pediatrics is commonly said to be comparable to first aid for Step 1. It’s a 600 + page textbook with high-yield info on every thing pediatrics.
BRS Pediatrics is broken into major pediatric topics (Development, Cardio, GI, Infections,) and has questions at the end of each chapter.
The two common complaints about BRS Pediatrics, and the reason I gave it just an A is that it’s long and therefore tough to get through during your rotation.
It is, however, very doable. I designated this as my text of choice and split each chapter over the first four weeks of the rotation.
This gave me enough time to focus on doing questions for the remaining two weeks.
There is also a test at the end of BRS Peds which you can turn to during your last few days of prep.
Similar to First Aid for step 1, if you know BRS Pediatrics well then you’ll do just fine on your pediatric shelf exam.
Click here to find out more about BRS Pediatrics on Amazon.
I was introduced to OnlineMed Ed videos by several friends during my rotation.
The videos are brief, high-yield, and free!!
This is a great resource to spend your time early during your rotation if you just want to learn the basics of everything.
The fourth year students have told me that they only used the videos and UWORLD to study for their shelf.
So if you’re pressed for time or are too lazy to study after a long day, these videos are golden. The pediatric section has 7 hours of content so that should be easy to split over your rotation.
Here is a link to the OnlineMedEd website.
It’s my favorite resource for rotations. If you want to know more, check out my OnlineMedEd Review here!
NBME Practice Exams: A
While questions from UWORLD, Pre-Test, and BRS are great, you want to see what the real pediatric shelf exam will be like.
This is where the NBME Pediatrics practice exams come in.
They are designed to look and feel like the real thing. This in itself can make a huge difference on test day, especially if you’ve never seen a shelf exam before (like me).
Being familiar with question lengths and styles is a huge advantage.
Also, it’s wise to take a practice exam with one week to spare. This will help identify any glaring weakness and give you an idea of what score to predict.
I had enough time to take all three, and every single one of them under-predicted my score by at least 8 points. It may be different for you.
If you can’t find the time or money to take them all, definitely try to take at least one before you sit for the actual test.
I was quite nervous during the exam and would have been an even bigger mess had I not done a practice exam before.
There was always one thing I always had to look up for my kiddos, their vital ranges.
Kids have blood pressures, heart rates, and respiration rates that are much different than adults.
Thus, I bought a small reference card to add to my ID badge which nicely broke down the vital ranges for different age ranges in kids.
This was a great resource to know if the daily vitals of my patients were concerning or normal. You can find a link to the cheap badge ($2) here.
Case Files for Pediatrics: B
I admit I didn’t get through the whole book so take my review with a grain of salt.
I find that those who don’t use BRS as their text of choice tend to use Case Files.
On a superficial level Case File looks shorter and feels simpler than the mammoth that is BRS.
Case Files are broken into cases (duh) for the top topics in pediatrics.
The answers to the case questions are short but informative. Overall, this is a good resource for someone pressed for time or one who refuses to study extensively when they get home.
The biggest drawback for Case Files for me was the lack and strength of questions at the end of each case.
Often the questions were not something you could answer by reading the text and would require some outside knowledge.
Still, the questions and text serve as a quick and good learning tool for the shelf. So if you want simple and quick, Case Files may be for you!
Check out Case Files here.
While you can’t grade stickers (they get an A++), they will make life much easier for you in your rotation.
Most of your patients will be very manageable. But other times you will have kids who are unexaminable with their tears and crying.
Here are the ones I picked out.
So there you have it for the top resources to honor your pediatrics rotation!
Hope you enjoyed the top resources for the pediatrics rotation.
If you’re interested in how I studied as well as other tips I have for the rotation, check out my tips for the pediatric rotation post here!
You can also find my study schedule for the pediatric shelf exam here.
Again, if you want to learn more about my favorite resource for rotations, check out my OnlineMedEd Review here!
Check out similar tips for other rotations below!
You may also enjoy the following posts!
Working with Cancer Patients (Pediatric Hematology/Oncology)
How to Study For Rotations In Medical School (Step-By-Step Method)
Top 7 Tips For Third Year Of Med School (How To Do Well)
How to Present Your Patients in Medical School:
How to Study for Clinical Rotations in Medical School:
How to Write Notes in Medical School (Step-by-Step method):
How to Build Strong Relationships with Your Patients:
You will also be getting a free step-by-step video course and guide on how I studied in med school less than 5 hours a day!
Check out the course and guide here!
Finally, if you’re struggling with your clinical rotation but wants to crush it so bad, my Crushing Clinicals course can help you out!
Hope to talk to you soon!
Until next time my friends…