The internal medicine NBME is said to be one of the most difficult of the clinical clerkship’s shelf examinations. I mean, it’s not hard to wrap your head around the fact that a section of medicine, that deals with; cardiovascular, pulmonary, renal, endocrine, infectious disease, etc., would be difficult. We’re basically covering the whole of medicine and we all remember how annoying pulmonary was during our basic sciences years. Not only do we need to diagnose something based on the bread crumbs we receive in the vignette, we have to do the annoying; “What’s the next best step”, approach to answering the questions.

To help with being able to diagnose, and then manage appropriately diseases based on what’s appropriate now rather than what’s appropriate overall and being able to distinguish between the two when a question is presented to you; difference between ultimate diagnostic tool or the most definitive diagnostic tool, then the following advice will be very helpful to you. I did very well on my Internal Medicine NBME, and actually forgot to post my review and advice, as OBGYN came right afterwards and at that point I was mentally exhausted. But, it is never to late, so if you’re interested in doing well in the internal medicine NBME, then keep reading.

1) Online Med Ed
– Online med ed, is to internal medicine what pathoma is for pathology. He gives you the step by step directions on figuring out what to do next, when a particular question is asked. He basically breaks it down so you know that if A were to happen, then you do B, and if B were to happen, then instead you do C. For example, how to treat an MI by BEMOAN (which you will learn and will help with remembering how to treat it) or when to give what medications to treat congestive heart failure; like everyone gets a beta-blocker and ACEIs, then if there is fluid overload, they get a loop diuretic like furosemide, etc.

Online med ed is free to view the videos but the notes you have to upgrade to a subscription, to get those. If you try hard enough, you could probably find the notes online somewhere but I don’t think they are necessary as the videos are good enough.

2) Firecracker
– I found that Firecracker was really helpful in structuring my studying. It allowed me to spend more time studying, than figuring out how to study. Also, the questions that come with each topics, are pretty good and can definitely stack up the question bank for preparation for the examination.

Only down side is that Firecracker isn’t free and as my school gives it to us for free, it was easily accessible. If it is you have some money lying around and you want to just get that extra question bank or like structure or need structure, then it is worth the subscription.

3) Uworld
– The U-World internal medicine, question bank, is very intense but it is a must do. It covers literally everything that you need to know and more. I did it on tutor mode rather than timed, so I could use it as a way to learn my work rather than just test my knowledge. I did about 10 questions every night and as much as I could on weekends. I did all the system based sections, at least twice. Any question I got wrong, I made sure to go over it again also.

The biggest thing that I could say, again, is to do these questions! U-world questions are harder than the actual NBME questions, so you will actually sail through a lot of questions because you picked up what the disease was, and what should be done next.

So as a recap, I used Online Med Ed for the videos and sometimes for the notes but more for the videos, Firecracker because I like reading sometimes and the structure it gave me, allowed me to focus on studying rather than figuring out how to study and U-world Internal Medicine questions, which I did at least twice.

I looked over Step-Up to medicine and didn’t find it to be very helpful. Yes, it did follow the next step method but it didn’t always clarify on what were the indications and sometimes became confusing at times. So I stopped that and started doing the Online Med Ed and reading their notes more and watching their videos because Dr. Dustyn, does a very good job in making something that seems difficult to grasp, very easy and gets straight to the point. Want to answer questions with much more ease? Look at Online Med Ed.

Finally, as you probably already know and this is just me speaking more for myself than anything; the best way to approach test questions is to read the question first; the last line, and then the options. Sometimes, you’d realize that the question stem will give you all this information and make you feel so overwhelmed by the time you got to the question but when you actually reach the question, you realize everything in the stem was useless. But, by reading the answers first, you start looking for the keywords and actually seeing what the test writer was trying to lead you to thinking, when they actually designed the question. After using this method of reading questions, I have gotten a lot better because I was able to eliminate a lot of my options by the time I finished reading the stem.

So, good luck with your studying. Do those U-world questions because everyone I know who did them, did well and passed and everyone I know who didn’t do all, didn’t do so well or failed.

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