Rotation Specific Overview

The surgical rotation is often physically and mentally demanding, characterized by early mornings, long hours, and high expectations for preparedness. Students must quickly adapt to the operating room environment, balancing technical knowledge of anatomy and procedures with patient management on rounds. A strong focus on efficiency, procedural understanding, perioperative management, and concise presentations will facilitate success. Structuring your study around common surgical conditions, procedures, anatomy, and evidence-based management guidelines is essential.

 

Core Principles and Focus Areas​

• Pre-Operative Evaluation and Risk Stratification

  • Master assessment of surgical risk, including the management of coexisting medical conditions (cardiac, pulmonary, renal).

  • Understand the importance of pre-operative optimization (labs, imaging, medication adjustments, and informed consent).

• Surgical Anatomy and Technique

  • Prioritize clinically relevant surgical anatomy—especially abdominal, vascular, thoracic, and trauma.

  • Learn fundamental procedural skills, sterile technique, and wound closure principles (types of sutures, knot tying, staple placement).

• Post-Operative Care and Complications

  • Identify and manage common post-operative issues, including fever, surgical site infections, bleeding, ileus, electrolyte abnormalities, and DVT prophylaxis.

  • Recognize early signs of serious complications such as sepsis, bowel obstruction, wound dehiscence, and anastomotic leaks.

• Trauma and Emergency Surgery Principles

  • Understand initial management of trauma (ATLS principles), rapid assessment of unstable patients, and indications for immediate surgical intervention.

  • Familiarize yourself with emergent surgical conditions: acute abdomen, bowel obstruction, perforations, and bleeding.

• Fluid and Electrolyte Management

  • Master fluid management (maintenance vs. resuscitation), electrolyte abnormalities, nutritional support (enteral vs. parenteral nutrition), and interpretation of labs relevant to surgical care.

• Surgical Oncology Basics

  • Grasp the fundamentals of surgical oncology, including staging systems, principles of cancer resection, and multidisciplinary management of malignancies.

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Core Resources (Resources, Links, and More Detailed Descriptions Listed Below) 

• UWorld/Amboss Qbanks – The cornerstones of practicing rotation-specific knowledge 

  • Approach questions systematically, identify key phrases and concepts, differentiate critical information from distractors, analyze all answer choices (why they’re right or wrong), and hypothesize how changes in the vignette could alter correct answers.

• Pestana's Surgery Notes 

  • ​Concise summaries with clinical pearls for common surgical conditions. Excellent rapid review before shelf exams.

• De Virgilio's "Surgery: A Case-Based Review"

  • ​Comprehensive, case-based resource highlighting clinical presentations, differential diagnoses, and surgical decision-making processes.

• Surgical Recall

  • Ideal for preparing for OR cases, offers Q&A format that covers common pimping questions, anatomy, and procedural steps.

• NBME Practice Exams 

  • Pivotal for evaluating progress throughout the rotation. Target your first NBME for the mid-point of the rotation followed by a NBME every 1-1.5 weeks following​

 

Maximizing UWorld Effectiveness

• Active Learning: UWorld Notebook

  • Write down one or more key takeaways per question (new fact, forgotten detail, high-yield point).

    • Option: Convert notes into Anki flashcards for spaced repetition.

  • UWorld is for learning, NOT assessment – Read explanations in detail, even for correct answers.

• Question Block Strategies

  • Random Question, Timed Blocks = Best for self-assessment and tracking progress.

  • Subject-Specific, Tutor Mode Blocks = Useful for targeted content mastery. This should be the focus for the majority of your rotation

  • Quality > Quantity – A thoughtful review of a few questions beats rushing through many.

 

General Approach to Studying on the Wards

• Weekly Topics: Divide rotation into weekly sections (e.g., gastrointestinal, trauma, endocrine surgery, vascular surgery, surgical oncology) to systematically address core surgical topics.

• Daily Integration/Practice: Allocate daily review sessions to UWorld practice questions and corresponding Anki reviews for spaced repetition. Recommended to break down the total number of Uworld questions for the rotation and schedule a set number a day that will put you on pace to finish by 1 week before the shelf exam.  

• Pre-Operative Preparation: Before OR days, review relevant surgical anatomy and key procedural steps for cases you’ll attend.

• Post-Op/Clinic Reflection: After clinical experiences, revisit related guidelines or resources to deepen your understanding of real-life applications.