Any Advice?

[Sweet Tea]

I tried and failed for a spot in an EM program this year and scrambled into a sugery prelim at my home program. And it's, well, weird. While I loved my M3 sugery rotation and even did an extra trauma surgery AI my M4 year, I always planned on going straight into EM and so all my resources are EM-based, not surgery. There's a slight chance that I'll want to stay in sugery, but I'll most likely re-try for an EM spot next year. That being said, I want to make the most of my year in surgery and any tips would be greatly appreciated. I don't even know what books I should buy at this point. And when do folks in prelim spots take Step 3?

As you can see, I'm a n00b. Any tips or advice would be greatly appreciated.

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[blackdiamond]

It all depends if you are planning a career in surgery or in EM if you are going to invest in major textbooks. Since it seems like you've had some good experience already in surgery while in med school, you might already have the necessary books. As a surgical intern, if you already have surgical recall, surgical secrets, or Lawrence's, you're pretty much set since they have most of the necessary info to be a competent intern. Just make sure you know it cold. I am planning a career in surgery and I plan to use Sabiston's (lots of pretty pictures) as my textbook. Other choices are Greenfield's, ACS, Schwart's, Cameron's if you want to shell out $150+. Personally, I suggest Tools of the Trade Rules of the Road by Deitch. Best $40 I ever spent.

 

[Sweet Tea]

It all depends if you are planning a career in surgery or in EM if you are going to invest in major textbooks. Since it seems like you've had some good experience already in surgery while in med school, you might already have the necessary books. As a surgical intern, if you already have surgical recall, surgical secrets, or Lawrence's, you're pretty much set since they have most of the necessary info to be a competent intern. Just make sure you know it cold. I am planning a career in surgery and I plan to use Sabiston's (lots of pretty pictures) as my textbook. Other choices are Greenfield's, ACS, Schwart's, Cameron's if you want to shell out $150+. Personally, I suggest Tools of the Trade Rules of the Road by Deitch. Best $40 I ever spent.

Thanks! I still have my M3 text books and surgical recall, so that's good. I'm more than willing to shell out $40 on a book I'll use for one year if it'll help me tell my ass from my elbow. Thanks!

 

[Winged Scapula]

I wouldn't spend money on books if you aren't sure you'll stay in the field. Most residency programs have book funds, so even if you were to purchase books, wait until residency starts and take advantage of the fund (no matter how ridiculously thin it might be).

Besides, most hospitals have a medical library or resource center where you can go and read while in house and can check stuff out to use at home. Your senior residents may also have books they can lend you. The big surgical texts are $150+ which would be a waste if you end up going into EM.

Taking Step 3 depends on your program; most require it before going onto 3rd year, so check with them as to what they require. You'll obviously need it before getting an unrestricted license (if you are allowed to moonlight, you'll want it asap) and a DEA #.

Also keep in mind that you will have to take the ABSITE as well; so you might want to invest money in a book for that - the ABSITE Review by Fiser is pretty good.

 

[njbmd]

I tried and failed for a spot in an EM program this year and scrambled into a sugery prelim at my home program. And it's, well, weird. While I loved my M3 sugery rotation and even did an extra trauma surgery AI my M4 year, I always planned on going straight into EM and so all my resources are EM-based, not surgery. There's a slight chance that I'll want to stay in sugery, but I'll most likely re-try for an EM spot next year. That being said, I want to make the most of my year in surgery and any tips would be greatly appreciated. I don't even know what books I should buy at this point. And when do folks in prelim spots take Step 3?

As you can see, I'm a n00b. Any tips or advice would be greatly appreciated.

Hi Sweet Tea,

I am so sorry to hear that you didn't match in EM because I know for sure that you are a class person and would be a great EM physician. Now, for getting the best out of your surgery slot: First, if you still have Lawrence and Surgical Recall, you have some pretty good resources for the day-to-day care of your patients as a PGY-1. Unless you fall in love with surgery and want to finish the residency, don't invest in one of the big surgical texts.

You want to be an excellent intern and thus I recomment Chamberlain's "Surgical Intern Survival Guide" to keep in your pocket. This little book will give you guidelines for things like admissions, pre-op stuff, post-op etc. It's a very cheap book (less than $10). Another good resource along this line is the "Washington Manual Internship Survival Guide". Both of these will get you going and keep you going.

Things that you want to master from your Surgical year: placement of central lines, placement of chest tubes, surgical closures of wounds (especially knowing when to call the plastic surgeon) and any intensive care skills/advanced life support/advanced trauma life support. You want to be an excellent PGY-1 and you want to get good LORs and evaluations so that you can go back into the match next year and head into EM strong.

If you wind up loving surgery (What's not to love?), then you may want to pick up an ABSITE review book like Fiser's so that you can do well on your ABSITE (American Board of Surgery In-Training Exam). This exam is given the last Saturday in January so start reading early (Lawrence is an excellent start and Fiser's book will finish the process.

Master every surgical skill that you can (will serve you well in EM) and enjoy the year. It will fly by quite quickly. If you decide to go back into the match, be sure to let your PD know fairly quickly so that they can evaluate you and get your letters done in a timely manner. Also, if you change your mind and love surgery, let your PD know that too.

Schedule Step 3 after ABSITE if you are staying in Surgery. If you are going into EM, take this exam as soon as you are eligible and prepared. You want to take this exam when you have thoroughly prepared for it using Step 3 resources. (I took my Step 3 the first week in Feb in my PGY-1 year.). You want to have enough patient care under your belt and you want to have some time to prepare for this exam but you don't want to wait too late. My Step 3 prep materials were Crush USMLE Step 3 and Kaplan's Q-Bank (one month) along with totally knowing how to use the software for the Clinical Cases. I have seen USMLEWorld for Step 3 and I can totally recommend that resource over Kaplan especially the Clinical Cases. This test isn't as difficult as the other two steps but you need to have a few weeks of solid prep and you don't want to wait too far away from medical school.

Good luck and be strong and totally rock this year and go back into the Match strong because you are a great candidate.

 

[Winged Scapula]

Yeah! You're back...I was getting lonely here! <sniff, sniff>

 

[Sweet Tea]

Thanks for the advice, KC and njbmd. I really appreciate it! And thanks for the compliments, njbmd. It's not been a pleasant week but I've had some amazing support.

I loved my M3 surgical rotations and my M4 trauma AI, but I've always been so sold on EM that I never really gave surgery serious thought as an actual career. So I'm just going to see where this year takes me; I think that the first few months are going to tell me a lot. I'm very lucky to be at my home program b/c the PD here is really going out of his way to help me and all the residents and attendings I've run into have been so supportive. They know I wanted to do EM and they're willing to help me try to do EM. I'm fine with delaying EM for a year, what I'm most upset about now is being away from my fiance for another year. But he'll finish his residency the same time I finish my prelim, so at least we'll both be able to move.

The ABSITE doesn't sound like a lot of fun. Thanks for the heads up!

 

[deleted109597]

Of note, my prelim year does not require the ABSITE. You may want to ask your program if they require it as well.

 

[ispic]

Hi,

Another of the EM hopefuls turned Surgery prelims here...
I am stil packin' around my NMS Surgery from third year, it helped out quite a bit, however, would the Lawrence provide a little better prep in case that I have to take the ABSITE at Hershey. Thanks in advance