Official Surgery Shelf Exam Discussion Thread

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Since Dr. Mom hasn't yet created a sticky for the surgery shelf, this should suffice for now. Anyone have any hints or tips on how to succeed on the surgery shelf besides the standard "study medicine"?

Originally Posted by Pox in a box

Since Dr. Mom hasn't yet created a sticky for the surgery shelf, this should suffice for now. Anyone have any hints or tips on how to succeed on the surgery shelf besides the standard "study medicine"?

I've typed out at least two responses to this subject (and its not "study medicine"). They're somewhere around here...

Originally Posted by Pox in a box

Since Dr. Mom hasn't yet created a sticky for the surgery shelf, this should suffice for now. Anyone have any hints or tips on how to succeed on the surgery shelf besides the standard "study medicine"?

1. Do the last 10 or so Questions first.

2. Know when NOT to operate.

3. Read a good text such as Lawrence and of course do mucho questions.

4. Unless you want to be a surgeon, don't try to live in the OR since this will take away valuable study time.

5. Take most opportunities at the hospital to learn how to read images, especially since managment will most likely to be discussed also.

6. Don't think this is a medicine exam. Many of the cases will have a similar presentation but most questions will involve much more than someone with a low hematocrit and schistocytes and the answer choices are a bit different. The answer choices are what makes the surgery shelf the surgery shelf.

Originally Posted by Cpt.Hook Hamate

1. Do the last 10 or so Questions first.

Why?

Originally Posted by Pox in a box

Why?

Because they are the easiest and the shortsest vignettes to read. Trust me, you don't want to have one minute left on the clock and come across those last ten questions beacuse they don't require as much thought as the earlier questions. So get those give-aways first and if you have to be left with ten questions with one minute on the clock, let it be those longer and tougher vignettes like #60-70 which will probably be a lot more tough to answer correctly anyway even if you had ten minutes to answer them. In other words, go for the money ones right away to rack up quick points.

Originally Posted by Cpt.Hook Hamate

1. Do the last 10 or so Questions first.

2. Know when NOT to operate.

3. Read a good text such as Lawrence and of course do mucho questions.

4. Unless you want to be a surgeon, don't try to live in the OR since this will take away valuable study time.

5. Take most opportunities at the hospital to learn how to read images, especially since managment will most likely to be discussed also.

6. Don't think this is a medicine exam. Many of the cases will have a similar presentation but most questions will involve much more than someone with a low hematocrit and schistocytes and the answer choices are a bit different. The answer choices are what makes the surgery shelf the surgery shelf.

I couldn't disagree more.........I think most people on this board when you look at threads historically agree that the surgery shelf is a disguised medicine exam.

Lots of fluids, electrolytes, nutrition, mostly diagnosing common medical problems like choleycystitis, appendicitis, cardiac tamponade all things covered in medicine. Gi bleeding (again medicine) etc....

hardly any surgery.

study medicine and trauma and you'll be fine.

later

I think what throws most people off is that the IM and Surgery shelf exams are so similar as far a vignette presentations goes. After all, the surgery patient is often the IM patient that needs surgical management but the Surgery shelf is definitely no IM exam with some trauma thrown in. You won’t expect to find a vignette on how to manage a person with breast cancer on a IM exam ( do you do a simple mastectomy, radical mastectomy, simple mastectomy with radiation, observe, etc.,) The same goes with colon polyps and other surgical issues.

I think it would be a huge mistake to study for IM instead for the Surgery exam instead of actual surgery texts such as Lawrence or First Aid for Surgery. Just browse MSkap questions and answer choices and Qbank or Pretest Surgery questions and answers choices and you will see the difference. Of course you have to understand medicine well in order to perform well on the Surgery shelf but medicine is covered in appropriate surgery texts but what to do as a surgeon in such cases won’t be covered in IM texts.

Originally Posted by Cpt.Hook Hamate

I think what throws most people off is that the IM and Surgery shelf exams are so similar as far a vignette presentations goes. After all, the surgery patient is often the IM patient that needs surgical management but the Surgery shelf is definitely no IM exam with some trauma thrown in. You won’t expect to find a vignette on how to manage a person with breast cancer on a IM exam ( do you do a simple mastectomy, radical mastectomy, simple mastectomy with radiation, observe, etc.,) The same goes with colon polyps and other surgical issues.

I think it would be a huge mistake to study for IM instead for the Surgery exam instead of actual surgery texts such as Lawrence or First Aid for Surgery. Just browse MSkap questions and answer choices and Qbank or Pretest Surgery questions and answers choices and you will see the difference. Of course you have to understand medicine well in order to perform well on the Surgery shelf but medicine is covered in appropriate surgery texts but what to do as a surgeon in such cases won’t be covered in IM texts.

I still don't agree totally. I mean do a search on this and since i've been on these boards (years) people almost completely agree that it is more IM than surgery. Very few people hold your viewpoint so for others reading this take it with a grain of salt.

medicine most definately covers simple mastectomy v.s. blah blah blah. It's called medical oncology.

I highly recommend surgery pre-test, it's great. But, look at the book and you'll see it's mostly medicine. chapter titles that are huge are critical care, anesthesiology, fluids electrolytes, trauma, nutrition.

bottom line. I rocked the surgery shelf and the only studying I did for actual surgery was pre-test and attended all of the surgery lectures during my course. Lawrence is notoriously loaded with errors and not a very good text at least by the opinion of our surgeons who teach us at my school.

good luck,

later

just did a quick search and found some threads posted about the surgery shelf that go from now all the way back to 2003.


I thought the surgery shelf was easy, but that's because I had medicine immediately before it. The surgery shelf is basically trauma + medicine. I think you'll be very well prepared with the above.
__________________

I've posted on this before, but make sure you don't neglect thyroid, breast and perioperative care (including pre-operative clearance and ICU-ish (i.e. recognizing PE with blood gas values, ARDS, etc.)


I had surgery first and survived the shelf exam. People told me that it was heavily geared towards medicine, but I couldn't really believe it until I took the exam. Sure enough, a substantial number of questions were seemingly randomly lifted from everything except actual surgery



I mentioned before that the Surgery shelf exam is much more like a Emergency Medicine/Internal Medicine exam than really a surgery exam. I would concentrate on stabilizing a patient after trauma or other event that may require surgery eventually, but will more promptly require fluids, electrolyte replacement, etc. Know the surgically correctable forms of hypertension, how they present, and what diagnostic test you would like to do.


This tends to be a more difficult exam... not necessarily because of the material, but more likely due to the fact that you have no time to study on your surgery rotation, and the test really is more a medicine/EM test than the surgery questions you've been pimped on in the OR.



I took the shelf yesterday. It thoroughly kicked my ass. I thought I knew the stuff pretty well, too. It's too bad there was very little SURGERY on the thing!!!


My exam didn't have any subspecialty stuff. Just medicine, fluid and electrolytes, and trauma.


just thought I would back up what most people are saying about the surgery shelf.

later

Originally Posted by 12R34Y

I still don't agree totally. I mean do a search on this and since i've been on these boards (years) people almost completely agree that it is more IM than surgery. Very few people hold your viewpoint so for others reading this take it with a grain of salt.

medicine most definately covers simple mastectomy v.s. blah blah blah. It's called medical oncology.

I highly recommend surgery pre-test, it's great. But, look at the book and you'll see it's mostly medicine. chapter titles that are huge are critical care, anesthesiology, fluids electrolytes, trauma, nutrition.

bottom line. I rocked the surgery shelf and the only studying I did for actual surgery was pre-test and attended all of the surgery lectures during my course. Lawrence is notoriously loaded with errors and not a very good text at least by the opinion of our surgeons who teach us at my school.

good luck,

later

Let me get this straight......you are advising students to take my suggestion of using surgery texts as their #1 source to study for the surgery shelf and with a grain of salt? And to instead just study for IM?

Well, I did well on the exam and was just trying to help out. You can take my advice with a grain or salt if you want, I definitely won't lose sleep over it. Fine; study for IM and trauma for the shelf if you want. God be with you...

I really don't understand the Lawrence comment since if you visit the Surgery Clerkship FAQS it is frequently recommended. Use what works for you, but for the record, I say use any good surgery text. It doesn't have to be Lawrence but I thought Lawrence with First Aid was great and haven't used any others so I can't comment on them. But I didn't have to be on this board or any other for YEARS to find this out. All I did was put in a search for surgery and read a lot of relevant threads on the issue, some even dating back a few years. So how long one has been a member of this or that particular board is really irrelevant.


Anyway, study your Internal Medicine text instead of a Surgery text for the SURGERY SHELF if you wish but before whoever is thinking about doing this does this, I suggest you tell your Surgery clerkship director about your plans. I won't continue a debate over someone else's exam preparation plans.

There is a Surgery FAQ around here somewhere. Just read it and it will tell you what most students recommend for studying for it. It is true that there is a lot of medicine on the exam and many people claim this but I can't personally recall anyone recommending just studying medicine for the surgery shelf.

Personally I used the Essentials of Surgery by lawrence and did the questions in them and that was about it. I barely passed the damn exam so I won't recommend any thing. If you do use Lawrence, at least use another question book with it. Yeah, there was a lot of medicine and ER stuff in there but that is what surgery is, it is medicine, er, neuro, anesthesia, pediatrics, oncology, and OR stuff. Surgery is every thing.

Originally Posted by Cpt.Hook Hamate

Let me get this straight......you are advising students to take my suggestion of using surgery texts as their #1 source to study for the surgery shelf and with a grain of salt? And too instead just study for IM?

Well, I did well on the exam and was just trying to help out. You can take my advice with agarin or salt if you won't, I definitely won't lose sleep over it. Fine, study for IM and trauma to shelf if you want. God be with you...

I really don't understand the Lawrence comment since if you visit the Surgery Clerkship it is frequently recommended. Use what works for you but, for the record, I say use any good surgery text. It doesn't have to be Lawrence but I thought Lawrence with First Aid was great and haven't used any others so I can't comment on them. But I didn't have to be on this board or any other for YEARS to find this out. All I did was put in a search for surgery and read a lot of relevant threads on the issue, some ven dating back a few years. So how long one has been a member of this or that particular board is really irrelevant.


Anyway, study your Internal Medicine text instead of a Surgery text for the SURGERY SHELF if you wish but before whoever is thinking about doing this, I suggest you tell your Surgery clerkship director about your plans. I won't continue a debate over someone else's exam preparation plans.

I was simply pointing out that most people on these boards do NOT have the same opinion as you do regarding the content of the surgery shelf.

the quotes i posted from different posters was about 1/10 of what i found that all say the same thing........surgery shelf equals Lots and lots of medicine and MANAGEMENT of surgical patients.

just wanting others reading this to know that I think your viewpoint is definately in the minority.

to each his own........

very little for me to add at this point.

good luck to all
later

Originally Posted by 12R34Y

I was simply pointing out that most people on these boards do NOT have the same opinion as you do regarding the content of the surgery shelf.

the quotes i posted from different posters was about 1/10 of what i found that all say the same thing........surgery shelf equals Lots and lots of medicine and MANAGEMENT of surgical patients.

just wanting others reading this to know that I think your viewpoint is definately in the minority.

Whatever, man. But I do think your later comments became more comprehensive than the above initial comment of "just study medicine and trauma and you will be fine." My view may or may not be in the minority but I stand by it and it is okay for you to stand by yours. We all know that Med school is about "whatever works for you." If you rocked the exam without studying surgery texts and studied medicine instead, then that obviously worked for you.

Let's see if we can't reach a common ground here.

There is a lot of medicine on the surgery shelf. However, it could best be described as....... "The Medical Management of Surgical Patients."

You will have ZERO anatomy questions (which is why some people angrily declare, there is no surgery on this exam!!!).

Prepare for questions involving preoperative care, trauma, postoperative care, and the diagnosis of surgical conditions (which is where most people see "medicine").

And good luck.

Originally Posted by bigfrank

Let's see if we can't reach a common ground here.

There is a lot of medicine on the surgery shelf. However, it could best be described as....... "The Medical Management of Surgical Patients."

You will have ZERO anatomy questions (which is why some people angrily declare, there is no surgery on this exam!!!).

Prepare for questions involving preoperative care, trauma, postoperative care, and the diagnosis of surgical conditions (which is where most people see "medicine").

And good luck.

Hey Frank, how about some sample Q's off the top of your head?

like bigfrank says, the medical management of surgical patients is a big part of surgery. when people say the surgery shelf is all medicine, it's because they don't understand what surgery is. being a surgeon isn't just about cutting and suturing. it's being a physician that cares for patients before, during, and after surgeries. for a lot of people, the first year of surgical internship is spent nowhere near the operating room. there's a reason for that.

surgery looks at things differently than medicine, the focus is different. yes you need to understand the disease, but you also have to know possible differential diagnoses, which are surgical, which are not. then you need to know how to narrow the differential with studies. then know when to operate, what post-op care is needed, what complications might arise...

there's a reason why surgeons go to medical school and mechanics don't. it's not just about anatomy or fascial layers or the names of primitive metal tools. seems obvious but i keep reading about "it's all medicine" and to me that's just stupid. just b/c the material doesn't strictly concern what's in the OR, it doesn't mean it's not surgery related. i mean, if surgery was simply medicine + OR time, you would have students on the medicine service popping their head into the OR from time to time. but you don't, because it's different.

Originally Posted by bigfrank

Let's see if we can't reach a common ground here.

There is a lot of medicine on the surgery shelf. However, it could best be described as....... "The Medical Management of Surgical Patients."

You will have ZERO anatomy questions (which is why some people angrily declare, there is no surgery on this exam!!!).

Prepare for questions involving preoperative care, trauma, postoperative care, and the diagnosis of surgical conditions (which is where most people see "medicine").

And good luck.

Frank, surgery does not equal anatomy, one way or another. I don't know anyone who subscribes to this notion. When a surgeon pimped you on what antibiotic to give perioperatively, did you say "Uh, recurrent laryngeal nerve"?

Originally Posted by 12R34Y

Lots of fluids, electrolytes, nutrition, mostly diagnosing common medical problems like choleycystitis, appendicitis, cardiac tamponade all things covered in medicine. Gi bleeding (again medicine) etc....

hardly any surgery.

Crack open any of the major surgery texts and look at the first 12 or so chapters...nutrition, electrolytes, response to injury, trauma, etc......all part of SURGERY.

Of course there is going to be overlap between surgery and medicine, but the questions on the surgery shelf are distinctly different from the medicine shelf.

Surgery doesnt begin and end in the OR, think about how much time a surgery intern spends in the OR, at my institution it's about 2-3 hours a week, the rest is spent managing surgical patients on the floor....that's the type of info you need for the shelf exam.

My study plan for the surgery shelf:
Pestana Review (almost 10 questions verbatim) + pre-test (decent) + A&L question book (good) + First Aid (meh) = 95 raw score

Put your self in the test maker's shoes, when designing a test for ALL medical students concerning surgery, what should ALL medical students know, if you think about it, its stuff like what type of patient needs to see a surgeon (appendicits, cholecystitis, tamponade, etc. . .), also, how do I keep my patient who just had surgery from crumping, ie post surgical management, and of course there is trauma and fluids and electrolytes, stuff all of us should know no matter what basic rotation we are on. Focus on a good surgery book, I liked Lawrence, if you havent had medicine yet, really pay attention to the first several chapters that deal with more "Medicine" like issues. This debate will never end, but maybe some peeps will benefit from the discussion.

Anyone who tells a medical student to study medicine for the Surgery Shelf exam is both lying and doing them a major disservice. Study pre-op/post-op care and medical issues in surgical patients (the first three chapters in any surgery text). Medicine aren't the only ones who can read ABGs. I've also said before, don't neglect the thyroid or the breast.

Pre-op care: i.e. know what to do if you patient has an abnormal EKG when you are doing a pre-op eval. What antibiotic prophylaxis should a 50 year old patient with a prosthetic valve get if he is undergoing cystoscopy?

Post-op care: i.e. know how to read ABGs (are you looking at a PE?), DVT prophylaxis, etc.

Medical issues in surgical patients: what type of insulin do you give a diabetic in surgery, if at all? Do you continue their anti-hypertensives?

And regular surgical questions: Ellie Mae comes in with diverticulitis. How do you study her? Barium enema? Colo?
Farmer Bob comes in with a nodule in his neck that turns out to be follicular cell thyroid cancer. Do you do a thyroid lobectomy? Take the whole thing out?
Sally Sue has a lump in her breast that is mobile and tender, what is the next best step?

Yes, these are variations of questions I had my my surgery shelf. Trust me, the medicine shelf is way different.

One of the best things you can do for this exam (and all other shelf exams) is do as many questions as possible. A step II question book is a good way to go, because the questions are similar. I didn't really like PreTest or FirstAid for Surgery, but that's just my opinion. (I did think PreTest was golden for Peds, though).

Originally Posted by Pox in a box

Hey Frank, how about some sample Q's off the top of your head?

Nope.

Originally Posted by Pox in a box

Frank, surgery does not equal anatomy, one way or another. I don't know anyone who subscribes to this notion. When a surgeon pimped you on what antibiotic to give perioperatively, did you say "Uh, recurrent laryngeal nerve"?

This statement makes absolutely no sense. Usually, your posts are littered with jealous comments, vague idiocy, or something that is remotely tangible. This post, however, is a bad one (even for you).

Point out the 1) jealous comment, 2) vague idiocy, and 3) remotely tangible ideas. You have a hard time admitting when you are wrong sometimes. It's not your fault. You were raised this way. Your post was indicating that everyone thought the surgery shelf was pure anatomy. I totally agreed with what you were saying. You didn't understand the sarcasm.

"You will have ZERO anatomy questions (which is why some people angrily declare, there is no surgery on this exam!!!)."

Only someone that equates surgery with anatomy would say that the exam was either all or none anatomy.

Please see my above post and paste it (again) here.

Originally Posted by bigfrank

Please see my above post and paste it (again) here.

The war was over last week. You're shooting blanks.

Originally Posted by Pox in a box

Only someone that equates surgery with anatomy would say that the exam was either all or none anatomy.

Pox, I think you are taking Bigfrank's comment too literally. There are "zero anatomy questions" on the exam. In other words, you won't find questions on the exam that ask you "what is this structure?" or "where is the lesion?" At least I didn't have any on my exam.

Now, they may ask you whether you should perform an Appendectomy or not. To answer this question, you will need to know where the appendix is located and the clinical presentation but it is not a straight anatomy question.

Originally Posted by TruTrooper

Pox, I think you are taking Bigfrank's comment too literally. There are "zero anatomy questions" on the exam. In other words, you won't find questions on the exam that ask you "what is this structure?" or "where is the lesion?" At least I didn't have any on my exam.

Now, they may ask you whether you should perform an Appendectomy or not. To answer this question, you will need to know where the appendix is located and the clinical presentation but it is not a straight anatomy question.

Yeah, I was trying to be funny while at the same time pointing out that nobody actually believes the saying, "The exam was pure medicine" or "there was no anatomy", etc. I see the point. Having already taken the shelf in surgery, I can admit that most of it seemed to be ER or trauma medicine and a rotation on the actual surgery service did not seem to be too relevant at all. I believe a rotation on the ER would definitely help prepare you for the exam. Fluids and electrolytes, what would you do next (H&P, labs, imaging, etc.), and a couple of gimmee pathophysiology Step 1-type questions were on the exam. In terms of books, Surgical Recall was probably the best. Blueprints was trash and I didn't like A&L either. Pretest was a decent representation but still not as good as I would have liked. All in all, memorizing Surgical Recall (perhaps 2-3 straight reads...the subspecialty things were very minor since I can only recall one ENT question and no others). I would have read it more but I simply did not have time. My surgery service was very intense and I contstantly had to review the anatomy that would appear in the middle of the operations. My school's attendings tended to pimp on anatomy instead of surgical management.

Originally Posted by Pox in a box

Yeah, I was trying to be funny while at the same time...

Keep trying.

But, seriously, when you haven't even taken the Shelf exam, it makes you come across very foolishly when you're lecturing ME regarding what's on the exam or how the exam is structured. And I don't need to remind YOU how I did on this particular Shelf -- I'm sure you've got my results saved on your computer somewhere.

Originally Posted by bigfrank

Keep trying.

But, seriously, when you haven't even taken the Shelf exam, it makes you come across very foolishly when you're lecturing ME regarding what's on the exam or how the exam is structured. And I don't need to remind YOU how I did on this particular Shelf -- I'm sure you've got my results saved on your computer somewhere.

Bigfrank,
Would you mind posting which books you found helpful?
Thanks.

Originally Posted by bigfrank

Keep trying.

But, seriously, when you haven't even taken the Shelf exam, it makes you come across very foolishly when you're lecturing ME regarding what's on the exam or how the exam is structured. And I don't need to remind YOU how I did on this particular Shelf -- I'm sure you've got my results saved on your computer somewhere.

Hey, do you read posts? I took the shelf exam. What's with your ego?

Originally Posted by bigfrank

Keep trying.

But, seriously, when you haven't even taken the Shelf exam, it makes you come across very foolishly when you're lecturing ME regarding what's on the exam or how the exam is structured. And I don't need to remind YOU how I did on this particular Shelf -- I'm sure you've got my results saved on your computer somewhere.

It's not like there's anyone on SDN who DOESN'T know your shelf scores, since you seem to remind everyone of them at every available opportunity. Not that I don't find this little soap opera entertaining, but maybe you guys should just bury the hatchet or at least take this to PMs?

Originally Posted by Pox in a box

Hey, do you read posts?

I try to avoid yours. Don't be so obtuse.

Movie reference, anyone?

Originally Posted by Pox in a box

Frank, surgery does not equal anatomy, one way or another. I don't know anyone who subscribes to this notion. When a surgeon pimped you on what antibiotic to give perioperatively, did you say "Uh, recurrent laryngeal nerve"?

This was your idiotic post on 8/11 to which I've been referring. You clearly hadn't taken the Shelf yet and were lecturing me on what's on it.

P.S. In your defense, Pox, this is one of your [many] nasty posts that you haven't edited or deleted altogether. You might wanna get on that.

Originally Posted by bigfrank

I try to avoid yours. Don't be so obtuse.

Movie reference, anyone?

shawshank redemption...which, by the way contains many great metaphors for the surgery rotation.

Originally Posted by bigfrank

This was your idiotic post on 8/11 to which I've been referring. You clearly hadn't taken the Shelf yet and were lecturing me on what's on it.

P.S. In your defense, Pox, this is one of your [many] nasty posts that you haven't edited or deleted altogether. You might wanna get on that.

You have a major problem with criticism daddy-o. First off, that post is not even critical of you. By calling that a lecture you're obviously not akin to the classroom. By the way, my comments still hold true. You're one person. I've talked to dozens of people before and after I took the shelf exam in surgery. They all agreed with me. How about you get off my back for posting or not posting things that are inconsequential to the world. This all started because I have not told what I got on Step 1 to you (who cares besides me and the PDs I apply to anyway?). You act like I'm an alien monster if I don't tell this silly three-digit number to you and the world. If you weren't so arrogant I wouldn't have said anything about you broadcasting your ego to the world every time you take an exam. I'm glad you have enjoyed these so-called posts that have been edited or deleted. Everyone would like to see them alongside your Step 1 score in full color. Here's an idea, get over it and move on. I've already tried to bury the hatchet once with you and obviously you have to have the last word by trolling behind me in any post I make. So, after you reply to this, you win. Checkmate, you have taken the queen. Only the king remains! The bigfrank is secure on the throne!

YOU WIN FRANK. The trophy is yours!!! Congratulations! We knew you could do it.

Back to the surgery thread...for everyone else, I apologize for everytime I post something lately it seems to have controversy behind it. Some people just can't accept what they can't have. I have praised bigfrank many times about his successes and knowledge but I'll give up now. I'm sick of it.

Hey all.
I used:

1. BRS Surgery - good rundown of basics, and a quick read
2. First Aid for Surgery Clerkship - also a solid source of high yield info
3. Appleton and Lange Questions - damn good

IMHO, know these three really well, and try to learn about the management of surgical patients while on your clerkship (as opposed to being a scut monkey) and you will do fine.

Jayman

Originally Posted by CallawayDoc

shawshank redemption...which, by the way contains many great metaphors for the surgery rotation.

Very nice!

Originally Posted by Pox in a box

You have a major problem with criticism daddy-o. First off, that post is not even critical of you. By calling that a lecture you're obviously not akin to the classroom. By the way, my comments still hold true. You're one person. I've talked to dozens of people before and after I took the shelf exam in surgery. They all agreed with me. How about you get off my back for posting or not posting things that are inconsequential to the world. This all started because I have not told what I got on Step 1 to you (who cares besides me and the PDs I apply to anyway?). You act like I'm an alien monster if I don't tell this silly three-digit number to you and the world. If you weren't so arrogant I wouldn't have said anything about you broadcasting your ego to the world every time you take an exam. I'm glad you have enjoyed these so-called posts that have been edited or deleted. Everyone would like to see them alongside your Step 1 score in full color. Here's an idea, get over it and move on. I've already tried to bury the hatchet once with you and obviously you have to have the last word by trolling behind me in any post I make. So, after you reply to this, you win. Checkmate, you have taken the queen. Only the king remains! The bigfrank is secure on the throne!

YOU WIN FRANK. The trophy is yours!!! Congratulations! We knew you could do it.

Back to the surgery thread...for everyone else, I apologize for everytime I post something lately it seems to have controversy behind it. Some people just can't accept what they can't have. I have praised bigfrank many times about his successes and knowledge but I'll give up now. I'm sick of it.

Nice long post!!!

Is transplant covered on the surgery shelf exam?

Originally Posted by cremasteric

Is transplant covered on the surgery shelf exam?

I can't imagine how it would be asked. It may ask the mgmt of one, but the only difference would likely be the immunosuppression factors/approach?

Originally Posted by cremasteric

Is transplant covered on the surgery shelf exam?

There weren't any questions on mine (which was a few weeks ago)...but as BF said it would probably just be about immunosuppression.

How much of this test is devoted to the surgical subspecialties... I havent rotated through any of them yet and am not sure how much time to devote to them study-wise... probably won't be much since my time is running out pretty quickly .

Thanks for any replies.


Oh yeah, and any consensus on which of the subs might be higher yield... anesthesia, uro, etc.???

Originally Posted by JMD

How much of this test is devoted to the surgical subspecialties... I havent rotated through any of them yet and am not sure how much time to devote to them study-wise... probably won't be much since my time is running out pretty quickly .

Thanks for any replies.


Oh yeah, and any consensus on which of the subs might be higher yield... anesthesia, uro, etc.???

I didn't see anything but a transplant question on immunosuppression (basic Step 1 type of question).

Thanks bigfrank, opus03, and pox!

Originally Posted by Pox in a box

I didn't see anything but a transplant question on immunosuppression (basic Step 1 type of question).

Anyone have any idea of the number of questions correct & how they correlate with various percentiles? 10th percentile is pass, 80th percentile is honors at my school.

Holy $&!# that test sucked! I just finished it about 1/2 an hour ago. Thought I learned at least a little bit over the last three months in surgery, but it sure didnt feel like it while i was taking the exam. In fact, I think learning from attendings, etc. in real-life probably makes you do worse on the exam... haven't seen anyone who actually practices all of those protocols in such detail. At least where I have been, it's just CT, CT, CT... Oh well, its over for now. Beer-time.

Originally Posted by JMD

In fact, I think learning from attendings, etc. in real-life probably makes you do worse on the exam... haven't seen anyone who actually practices all of those protocols in such detail.

I agree. The chief residents would probably outscore the attendings on the exam, just because they are subjected to that type of questioning for so many years in a row starting in second year of med school.

Took it earlier in the day as well. Thanks to the advice on this forum, I wasn't expecting it to be classic surgery but more medical/surgical decision making. A lot of trauma/critical care, a heavy dose of GI, some urology, and about 1-2 questions selected from other specialities (5 from vascular that I had trouble with- and I just spent 3 weeks doing it!). To call this a medicine exam isn't fair, but I would advise knowing stuff like electrolytes, shock, renal failure, erectile dysfuncion (which isn't a surgical disease but something a urologist would have to deal with), etc.

Our school sells this packet written by a Dr. Pestana (an old hand from the Mayo Clinic) that helped with some of the trickier scenarios (like slipped femoral head capitis or whatever it is); I'm willing to post/mail a word document that is similar to the thing and was given to me for free. Really, about the only source consistently solid thing for this exam was The Absite Review by Fiser; wish I had been reading it earlier. Seems geeky to read, but it really cuts the crap (about 200 pg and pocketable) and gives you straight forward answers, which is where Lawrence and NMS to me are weak. Wasn't too impressed by A&L or Pretest question books. A lot of texts seem to be conflicting or wishy-washy (i.e. say that 3 different diagnostic tests are acceptable for a disease); Absite Review and Surg Recall just give it to you. Recall is just too scatter shot at times for me, and it's pretty thick now to boot. So, in short Absite Review and Pestana (sort of like Goljan). Well, I hope so at least; I could have blown the thing and render my advice as useless.

Thanks and God bless y'all, I'm goin' to Austin.

Hi,

Took it last Friday, man it owned me. I thought I prepared well for the test by reading the Recall a couple of times, but wow there were definitely a couple of things that were a little too esoteric on that exam. I honestly was not ready for so many "what would you do next?" questions, but in all, there was a lot of EM (40%) on my exam, breast care, endocrine, and a couple of easy anatomy questions. I tried to do the NMS, but it was too long a read and I was getting way behind on my reading midway through the rotation. I still think that the Recall is the best bet and some vignette-style questions to prepare (UCV's). Good luck on the exam.

I also took the exam last Friday. Like some before me, the exam owned me. I wish I had some baseline in Medicine to answer some of the questions. I read NMS Surgery and did the Pre Test questions for Surgery. I thought they were fairly decent. Sabitson's Pocket Companion (shorter version of the primary textbook we are required to read) was useless as was Appleton and Lange. I just hope I passed the exam