Year 3 and 4 Courses

While the year 3 and 4 clinical years lack the considerable testing demands that are a hallmark of pre-clinical training (and Step 1), exams persist (notably in the form of SHELF assessments and Step 2CK) and resources for new challenges emerge to broaden the trainee toolbox (or academic 'black bag.')

Balancing the development of clinical competencies, with expanding medical knowledge, residency options, and patient-centered care highlight the challenges and rewards of these concluding Undergraduate Medical Education (UME) years.

The resources, information, and C-Q-A recommendations below represent one component of the collective input of staff and preceding classes (check out the Words from the Wise) to help you build the best possible academic 'black bag' for success in the clinical years.  All the best! 


Shelf vs Non-shelf Rotations

Shelf Non-shelf No exam/No Shelf
Int. Med* Peds (CLIPP) Family Med & Com. Health
OB/Gyn Int. Med (EKG) Emergency Med
Neurology Surgery (OSATS)  Surgery
  Psychiatry (Activity)  








Tips and Considerations for Clerkship Exams

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C - Content Resources

Applying the C-Q-A process to your clerkship / Shelf exam preparations, exam Content can vary quite a lot depending on the respective clerkships. Consult the 'Words from the Wise' surveys for specific recommendations and consider the partial listing of resources below.  In general, covering content explanations from UWorld (for 2CK) is a consistently reliable baseline approach - and supplement as needed from that point (depending on the rotation).

  • Online MedEd [general content resource]
  • IM Essentials (Text) [for Medicine 1]
  • Step-up to Medicine [for Medicine 1]
  • Pestana's Surgery Notes [for Surgery]
  • CLIPP cases [for Pediatrics]
  • USMLE for 2CK Secrets [general guide]

*NOTE:  With many clerkships discontinuing the administration of Shelf exams, it will be important to develop your own plan for completing questions in the UWorld (for Step 2CK) q-bank as you progress through year 3 of your training.  While not necessary to complete all of the questions associated with the respective rotations, remaining consistently active will be a key preparation strategy for the 2CK exam that you’ll take in year 4.  Contact staff in the Office of Learner Development if you have questions or would like to discuss planning.

Q - Question Resources

Regarding Question resources for clerkships/Shelf, UWorld is the golden standard (for most of the clerkships - note exceptions below). The general strategy is to complete available questions for the respective rotations while you are completing the rotations (no need to 'save' questions for your later 2CK preparations). The content explanations are considered to be excellent and the question style consistent with what you're likely to see on the exams themselves. While a strong resource, others exist and can be considered as needed.

A - Assessment Resources

Regrettably, there aren't a considerable number of options for the Assessments part of the C-Q-A process for clerkship exams.  Most students appear to rely on performance within each of the UWorld question blocks (and/or through resources provided by respective clerkships sites).  This said, NBME does provide a helpful set of abbreviated assessments under the Clinical Mastery Series heading that should be considered.  Unlike their 'comprehensive' series counterparts, these shortened assessments provide a good insight into the style and content depth expected on Shelf exams.  Assessments are available in each of the major rotation areas (medicine, surgery, psychiatry, neurology, and pediatrics). While you will only need to use those for Shelf exams in IM, Neurology, and OB/G, the others can serve as good preparation for the 2CK exam as well.

UMN Resources / Accommodations

In addition to the resources already noted, you may find the following to be helpful in supporting your success with exams in the clinical years. These include reminders to utilize contacts with the Disability Resource Center (DRC) to update and/or arrange testing accommodations:

Words from the Wise (Surveys)

Each year, peers from preceding years provide insights into helpful resources for your clerkship/Shelf exam preparations. This is compiled into a document titled Words from the Wise: ‘High Yield’ Rotation Resources (includes thoughts for SHELF & 2CK prep).

Please find the 2023 edition here.



Note: Make sure accommodations requests are submitted to site coordinators two weeks prior to your exam date.