What was the surgery core like?
My friends we are half way done with third year of medical school after the completion of our 12 week surgery core rotation. This included 8 weeks on the hospital floor with the residents and 4 weeks of electives. My electives included neurosurgery and plastic surgery.
The 8 weeks on the floors started at 5:00/5:30 am everyday. This included coming in for one weekend day each weekend to round. We also had two full weekend days 6:00 am- 6:00 pm during the 8 weeks on floors. Once-twice a week your team would be on call and stay until 6 pm. The 8 weeks included one full week (6 nights) of night shift from 6:00 pm to 6:00 am.
At 5:00/5:30 am we would come in and review charts for our patient list. At 6:30 am we would round with our residents and present whichever patients we saw that day (usually 1-3 patients). Surgery presentations are done differently than in internal medicine which took some getting used to. During internal we presented more in an H&P format and in surgery it was a SOAP note format.
During the remainder of the day, we would go to resident or student lectures and attend surgeries that we signed up for the day before. There was 4 teams that the residents and students were split into- red, blue, green and gold. I was on blue (general surgery) and gold (trauma surgery). Red was focused on cardiothoracic surgery.
For the 4 weeks I was on blue team I saw many general surgeries including cholecystectomy, appendectomy, and several bowel surgeries. For one week of the four I had the pleasure of working with an attending one-on-one who. That week included attending all of the attendings surgeries and clinic hours.
For the 4 weeks I was on trauma surgery, I was mostly responding to the few traumas our hospital received and learning from the patients on the floor. Most of the traumas our hospital gets are hip fractures, falls and motor vehicle accidents. I had a lot of time to study during these four weeks and also had my week of nights.
My electives were my favorite time during the rotation: I learned a lot and had a lot of interaction with the attendings directly. Neurosurgery exposed me to many spinal surgeries and chronic back pain patients. Plastics was my absolute favorite! I got to see several hand surgeries, skin grafts and some breast surgeries.
Denzel really enjoyed surgery. Since he wants to be an anesthesiologist, being in the OR appeals to him. I enjoyed my plastic surgery elective, but overall surgery wasn’t for me.
How we studied for the internal medicine shelf.
The resources we used for the surgery shelf included UWorld, Online Med Ed and the Emma Holliday YouTube video. We also purchased all 4 surgery NBME shelf exams and took them on timed mode.
The shelf exam was 110 MCQs with 3 hours to complete it and no scheduled breaks. This exam did not have any fill in the blank questions. I found it to be of medium difficulty, it was not as hard as the internal medicine shelf in my opinion. The majority of questions were about imaging modality and next steps. It was pretty repetitive when compared to the UWorld questions and the NBME practice exams.
I would suggest starting the UWorld questions in slow increments since there isn’t many and really focusing on reading each question since they are so repetitive. Then, I would re-do your incorrect surgery questions after you complete the 300+ MCQs available. At first, I was doing both internal medicine and surgery MCQs, but then I started focusing on surgery which paid off for me come test day. I watched both surgery topic videos on Online Med Ed and took notes one time through. The last 4 weeks before the test, I watched Emma Holliday video 2-3 times and rewrote her entire presentation once. This is where the majority of my knowledge came from. I took one practice shelf each week before the exam.
Some topics I recommend mastering before taking the exam include and are certainly not limited to: imaging modality of choice for each body part, when to do an exploratory lap, hip fractures and hip pain in children, and perioperative care and evaluation. Check out the Emma Holliday video I linked, it covered all the major topics I was tested on!
Comment below or reach out to me if you have gone through the surgery core rotation and have anything to add to this post.