Official Surgery Shelf Exam Discussion Thread

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Day man said:
Sorry for all these questions...as far as everyday pimping questions, what is recommended? Does NMS cases cover that? FA? Or is NMS surgery/surgery recall/surgical attending rounds/uptodate needed? Thanks!
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Surgical recall is money for pimp questions.
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I'm having trouble finding the Pestana audio files... Could someone PM me about this?
Thanks!
 
Does anyone know how I can get ahold of the ~200pg Pestana? I'm having a little trouble... Thanks!
 
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Is the casebook everyone using the 2002 version? That seems old, but I can't seem to find a newer version.

How useful is NMS surgery text (not the casebook)?
thanks
 
Totem said:
Is the casebook everyone using the 2002 version? That seems old, but I can't seem to find a newer version.

How useful is NMS surgery text (not the casebook)?
thanks
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read both the NMS casebook and text. NMS casebook has the potential to be helpful for the oral exam. NMS text goes above and beyond for the shelf but good for general knowledge. ended with an 89 raw, 96th percentile, I'm thinking they change the questions everytime and so the bell curve probably changes for each exam.
 
Was just reading thru past posts and was a bit confused....

What is a better use of time, read the 250pg kaplan surgery book or would the 79 pg pestana review suffice?

Also, is the kaplan qbook just a general book for questions and you pull the surgery questions? How many questions is this book?

Thank you in advice.
 
I was wondering which UW IM subsets should I do for surgery? I was thinking lytes, cardio,GIT,hep,ENT,ophtho... any others? thanks!
 
DRads1 said:
Was just reading thru past posts and was a bit confused....

What is a better use of time, read the 250pg kaplan surgery book or would the 79 pg pestana review suffice?

Also, is the kaplan qbook just a general book for questions and you pull the surgery questions? How many questions is this book?

Thank you in advice.
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I don't know about a 250 page Kaplan book. The Pestana file is very good. It's very similar to the Kaplan notes. Yes, the Kaplan QBook is a question book and you just do the surgery ones if you'd like.


sincity college said:
I was wondering which UW IM subsets should I do for surgery? I was thinking lytes, cardio,GIT,hep,ENT,ophtho... any others? thanks!
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Those are really good. You can probably drop cardio. I would also do endocrine, specifically thyroid parathyroid questions.
 
Just as a note, I thought that Pestana notes were useless. I enjoyed reading it, but it wasn't helpful for my NBME at all.

I'd read a question and think I knew the answer based on Pestana, then the answer choices would be completely different. Just a heads up!
 
Sheldor said:
Just as a note, I thought that Pestana notes were useless. I enjoyed reading it, but it wasn't helpful for my NBME at all.

I'd read a question and think I knew the answer based on Pestana, then the answer choices would be completely different. Just a heads up!
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i can see how the notes alone can be useless and difficult to follow but if you combine them with the video/audio of the lectures and then follow that up with the 200 kaplan questions in the kaplan qbook then you'll get something out of it.
 
Got surgery coming up

Pestana
NMS Casebook
Kaplan surgery
Uworld
Kaplan Qbank

Am I missing anything? I'm gonna hold off on Pretest and Lange unless someone can sway me
 
SlickNickMD said:
Got surgery coming up

Pestana
NMS Casebook
Kaplan surgery
Uworld
Kaplan Qbank

Am I missing anything? I'm gonna hold off on Pretest and Lange unless someone can sway me
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Given that Kaplan surgery is itself written by Pestana, isn't using both sort of redundant?

(And I'm asking this just because I'm trying to figure out if there's any meaningful difference between the two.)
 
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has anyone used the surg questions from usmleasy? wondering if it's a waste of time, gratsi.
 
i used usmleasy. the questions can be very nit-picky, and one or two of their explanations explain how the "correct" answer choice just flat-out incorrect.that said, these are some of the minor annoyances and overall it does have some 500-odd questions that will bring up and discuss concepts you should know.

you just have to use it with the knowledge that your percentages will be lower than you're going to be comfortable with if you're used to UWorld, but that's at least partly due to the way some of the questions are poorly written/scored.

for example, i got roughly 70-80% correct on average in uWorld's surgery Q's and was around 60-65% for usmleasy. that's just the way it goes.

i scored 85 (91%ile nat'l avg) on the shelf
 
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dozitgetchahi said:
Given that Kaplan surgery is itself written by Pestana, isn't using both sort of redundant?

(And I'm asking this just because I'm trying to figure out if there's any meaningful difference between the two.)
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I guess, maybe I should just read the 200+ page pestana file---anyone know where I can get that? A link or information on how to get it is appreciated
 
So I have the following at my disposal:

Kaplan Surgery 'Pestana notes' (240pages)
Kaplan Step 2 QBook
NMS Case Files (2003)
usmle world Step 2

I have already had my IM shelf and am awaiting the score from that. My exam is in 4 weeks. I was planning on using Pestana as my basis and then doing NMS along with that.

Can you guys tell me if my time is better off spent going through pestana (multiple passes) and doing questions (kaplan and/or uworld) or should i really try and get through the NMS casebook as well?
 
I just got my shelf score back - 94 raw, 98%

I had to cram in the last 2 weeks but this is what I used:

Pestana notes x1
NMS case book x1.5
UWorld x2
Pretest x1
Appleton and Lange ~40% completion

I dont think I could point to a single source (other then UWorld emulating the format of exam the best) but the key is repetition of the basic presentations of things; in the sense of if you get asked enough in practice questions about cardiogenic shock vs septic vs hypovolemic, the answer will pop out at you on the test.
 
This goes out to all the reasonable people out there:

It is not necessary to read all these books and do 10 million questions to do well on this shelf exam. Know the pestana notes cold. If you are unsure about anything from those notes, read up on it somewhere. Also, try to learn something while on wards or in OR.

That's it. If you did OK on Step 1, you already know enough about medicine to fill in most of the blanks.

These exams are more about thinking through the problems than memorizing stuff.

(Pestana Notes --> 98)
 
mushok103 said:
This goes out to all the reasonable people out there:

It is not necessary to read all these books and do 10 million questions to do well on this shelf exam. Know the pestana notes cold. If you are unsure about anything from those notes, read up on it somewhere. Also, try to learn something while on wards or in OR.

That's it. If you did OK on Step 1, you already know enough about medicine to fill in most of the blanks.

These exams are more about thinking through the problems than memorizing stuff.

(Pestana Notes --> 98)
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This would not have worked on my version of the shelf. Remember that there are 4 versions of this test so take all advice with a grain of salt!
 
Hey all,
I'm new here. I have three weeks left before my surgery shelf- so far I've done the pestana review and half of pretest. In that amount of time what do you suggest would be the best resources to use? I started case files- thoughts?

Has anyone done the practice questions on the AccessSurgery website? thoughts on that?

Thanks!
:)
 
mushok103 said:
This goes out to all the reasonable people out there:

It is not necessary to read all these books and do 10 million questions to do well on this shelf exam. Know the pestana notes cold. If you are unsure about anything from those notes, read up on it somewhere. Also, try to learn something while on wards or in OR.

That's it. If you did OK on Step 1, you already know enough about medicine to fill in most of the blanks.

These exams are more about thinking through the problems than memorizing stuff.

(Pestana Notes --> 98)
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hmm... for me, memorizing only the pestana notes --> 65, and I scored in the 250's on step I. The assertion that these tests are primarily about "thinking" is wrong. These tests are about memorizing guidelines, algorithms, epidemiology, and outcomes. Once I realized that, I did much better on the medicine and psych shelves.

Sheldor said:
This would not have worked on my version of the shelf. Remember that there are 4 versions of this test so take all advice with a grain of salt!
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:thumbup:
 
WashMe said:
hmm... for me, memorizing only the pestana notes --> 65, and I scored in the 250's on step I. The assertion that these tests are primarily about "thinking" is wrong. These tests are about memorizing guidelines, algorithms, epidemiology, and outcomes. Once I realized that, I did much better on the medicine and psych shelves.



:thumbup:
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I almost never memorize stuff...mostly because I'm awful at it and panic when I forget under stress.

How useful a resource is is directly related to the type of learning/studying you've become accustomed to over the past few years. Some people are much more intuitive and prefer big picture reminders and reverse engineering questions, while others prefer hammering in the details until there is a flow chart in their head. Neither way is wrong and they both have their advantages.
 
MossPoh said:
I almost never memorize stuff...mostly because I'm awful at it and panic when I forget under stress.

How useful a resource is is directly related to the type of learning/studying you've become accustomed to over the past few years. Some people are much more intuitive and prefer big picture reminders and reverse engineering questions, while others prefer hammering in the details until there is a flow chart in their head. Neither way is wrong and they both have their advantages.
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sounds reasonable
 
Am I the only one who found the pestana notes underwhelming, I read it in 2 days and it gave me the impression that there is much more to this exam than what was covered in it
 
I've heard that if you know the pestana notes cold its a good foundation for the exam but of course you want to supplement with other things like questions for minor details
 
After looking at the nbme subject breakdown for the shelf, I'm considering doing the cards and Pulm sections in UW (breakdown says its 20-25%). Is this a good idea? Or is time better spent going over marked questions. I haven't done medicine yet if that affects anything. Thanks!
 
Hello fellow SDNers,

I was hoping to get some advice about a good overall surgical text to use. I looked at my friend's NMS surgery book (not the casebook but the actual text) and it was quite daunting to say the least. What text did you guys use as an overall review? Pestana, NMS casebook, casefiles, etc. are all great but I would like a "go-to" book to look up things. Step up to medicine was fantastic for medicine. Is there a "step up to medicine" equivalent book for surgery that you could recommend?

Thanks!
 
Shelf grade - 93 raw. Studied from Kaplan notes and relied a lot on my medicine knowledge. Also found Step Up to be a pretty useful aid as a good chunk of the exam was straight up medicine. Most of the purely surgical questions had to do with ortho or trauma problems.
 
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Just took the test yesterday. Lots of trauma and lots of 'emergent' surgical decision making with medicine questions mixed in. I used Pestana pdf x3, NMS casebook x1, pretest (90%), and MKSAP (i was also studying for medicine). Pestana is awesome for all the trauma and surgical decision making (particularly after you've studied everything, it helps put it all together). NMS casebook is outdated but is a quick read with good princples of how to approach things--i recommend it. Pre test was good I thought, I ended up just looking up each answer without reading the options because many of the questions are structured so you have to pick the correct sentence and i'm paranoid about reading/remembering the 3 incorrect options. This approach made it possible to get through the questions quickly. I also re-read pestana the night before. MKSAP was more useful for the medicine questions on the surgical shelf than the medicine shelf I thought. Overall, I felt like I knew what each question was getting at and had a solid reason for every answer. I felt more prepared for this exam than any other shelf, but we'll see what the score shows.
 
took the surgery shelf a few days ago

I was told that not yet having done internal medicine would hurt me on the exam but I found this not to be the case. The material covered on my exam could be found in any surgery review source. I used the Pestana notes and they were so money.

My exam was really heavy on urology but otherwise reflected the breakdown described on the NBME site. There were however, a few questions that seamed better fit for the ob/gyn shelf and I don't know how anyone would have known these without already having done that rotation.

I didn't realize that the "matching set" was a format still used on subject exams but there were four such items on my exam (two lists of diagnoses with two question stems for each). These were really straightforward.
 
Okay, so I gained a lot of info for my study approach for this shelf from this thread so I thought I would give my thoughts.

I got my score back yesterday and found out I got a 90. The resources I used were:
NMS casebook x2
Kaplan CK surgery notes (200pgs) x2
Kaplan Qbook tests x2
Uworld Surgery Questions x2 GI, Endo, Hepto, Fluids/Electrolyte Qs x1 (quickly reviewed about a week before the test)

I scanned casefiles one day and wasnt that impressed. If you are using NMS casebook then you wont gain anything from casefiles. My roomate owned pretest so I took a look at that and pretty much agree with the sentiment that it really wont be that much benefit to use.

The test will definitely have some random questions on it, but if you know that ahead of time going in it isnt that bad. I had internal first which I agree def helps things. If you havent had internal or feel weak on the above internal subjects I listed, I would recommned some review on them (step up to med or otherwise) or at least doing the Uworld Questions.

As far as the multitude of people asking for the Kaplan surgery notes...literally it took me 30 seconds to find them via google. Go to google, type in "Kaplan Surgery CK notes download" should be much quicker than posting on this thread hoping someone sends them to you.
 
What did you think about NMS Casebook's information, is a lot of the information outdated now or only less than ten percent outdated. I am feeling uneasy reading it, I feel like some of the information just doesn't sound right and might be outdated? I already did Pestana and plan to do UW the week before the exam (which is in two weeks from now)? Any suggestions greatly appreciated :)
 
boostta said:
What did you think about NMS Casebook's information, is a lot of the information outdated now or only less than ten percent outdated. I am feeling uneasy reading it, I feel like some of the information just doesn't sound right and might be outdated? I already did Pestana and plan to do UW the week before the exam (which is in two weeks from now)? Any suggestions greatly appreciated :)
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There are def some parts that are probably outdated at this point but as a whole I thought it is still a surprisingly good source if you like the format. My approach to reading the casebook was to skim over the parts where specific surgical procedures were described as you wont be asked about them on the shelf, and anytime they mentioned any drugs I would generally skim over it or double check it elsewhere. Other than that I felt it still had a lot to offer being as condensed as it was.
 
I took it last Friday and boy was it a BEAST. I did FA x1.5, pestana x1, uworld surgery x1.5, nms casefiles x1. I haven't done imed but i felt nothing prepared me well for this shelf. It was just the most random set of questions. I've kind of blocked that shelf out of my head

Anyone know how long the results come back?
 
I abused this thread quite a bit, will chime in.

My score was an 88. I took this exam seriously because I heard it sucked, I want to do surg, and i hadn't had IM yet.

Started by reading first 300 pgs of FA and listening to pestana audio on drive to house of god. Good foundation, but very dense/time consuming (took about 2 weeks).
Read Pestana notes after, kinda annotated in explanation from UW and FA that were glanced over in the notes.
Did UW questions for surg, GI, lytes, Hepato, Ophtho, ENT.
Did Kaplan tests, these explanations were EXCELLENT, I highly recommend them.

Read back over pestana and did my marked ? in UW at the end. I looked at NMS and I think if you really read pestana just about everything is repeated...I also was running out've time at the end.

Overall the test was what I expected from these shelf exams: a mix of classic presentations, some harder management questions, questions from other disciplines, then a few random questions you get very angry they put on the test (ethics? really NBME?)

This exam is doable. I haven't been a superstar on shelves (avg around a 84-85), but I was happy enough with this. Start early. Any questions, PM me.
 
Got my results last week. 85. Used NMS Casebook, Lange qbook & Pestana review notes (short version). Like other shelves questions are key. I thought the Pestana review was money to read the day before the shelf.

I'm not sure what percentage an 85 is. I think in previous months it was like a 91% so probably for this month it'd be high 80th percentile or something.

I thought the medicine stuff on the shelf was pretty basic compared to the IM shelf. A lot of 1st step management questions (for which pestana is great for). Some basic diagnosis stuff. Some basic OB-GYN. All in all I didn't think it was that bad, but that's probably because it was my 4th shelf and I had already had IM.
 
Should I bother with that lange book, everytime I talk myself into doing it I get turned off when I look at the questions:( They look a little low yield, I may be wrong tho?

I need some structure, I've read Casefiles, NMS and the Kaplan book

Just doing medicine uworld qs that I missed or marked from medicine :/
 
This is the approach I took to the surgery shelf (ended with raw 96 and 98th percentile)

NMS Surgery Book (the big one)
NMS Casebook
Kaplan Surgery notes (the vignettes)
UWorld Surgery
Pretest Surgery

The NMS Surgery Book would have been more useful had I just not had medicine. Easily 80% of the book aside from the first 4 chapters is basically a medicine review with an addition regarding surgical indications for each medical condition. I do not feel it is a necessary book but it definitely was a nice review.

NMS Casebook is extremely good but you need to know what to skip (easily 30% of more of the book) where it describes procedures in detail or facts involving calculations.

Kaplan surgery is excellent and is probably the quickest and best surgical management review for the time.

Pretest surgery also involves selectively ignoring the questions that nitpick about specific procedures.

UWorld surgery is on the money, but more so for Step 2 than the shelf (still the best question source for the shelf)

My impression of the shelf:

I honestly feel I got by on my knowledge of Medicine and Step 1 material. I felt that I had less questions than I would expect about actual surgical management or diagnosing surgical conditions, the ones that I did have essentially came from the Kaplan notes, and to a much lesser extent from NMS casebook. Mainly my surgery questions were general and vascular surgery with a smattering of complications and probably 5 or 6 peds surgery questions (Slipped Cap, Legge-Calve-Perthe thing, intussusception, etc.), nothing congenital.

The "Step 1" questions I refer to were a fair amount (let's say 10 or so) that revolved around either pharmacologic mechanisms or pathophysiology mechanisms (like how something can cause a pneumonia, how renal failure can occur, how a drugs mechanism can cause a complication).
 
SlickNickMD said:
Should I bother with that lange book, everytime I talk myself into doing it I get turned off when I look at the questions:( They look a little low yield, I may be wrong tho?

I need some structure, I've read Casefiles, NMS and the Kaplan book

Just doing medicine uworld qs that I missed or marked from medicine :/
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I'll admit that the lange qbooks generally have poorly written questions but I tend to like using them because they have the most questions and span the most topics so it forces me to look up or review the most stuff. I think Pestana hits the most high yield surgical stuff. Can't help you with IM stuff because I had medicine right before and relied mostly on prior knowledge.
 
NTF said:
I'll admit that the lange qbooks generally have poorly written questions but I tend to like using them because they have the most questions and span the most topics so it forces me to look up or review the most stuff. I think Pestana hits the most high yield surgical stuff. Can't help you with IM stuff because I had medicine right before and relied mostly on prior knowledge.
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Yea I've taken medicine already as well, hopefully that helps. I heard this exam is just a random set of qs, hopefully I get the right mix of questions in topics that I'm strong in.
 
How significant is Ortho on the exam % wise. What about electrolytes? I have few days and they're my weakness, would rather review what I studied than try to get these two in. What do you think?
 
Every exam is a little different. If they are your weaknesses, I'd spend a couple hours on them. The ortho questions are usually pretty easy if you reviewed.
 
boostta said:
How significant is Ortho on the exam % wise. What about electrolytes? I have few days and they're my weakness, would rather review what I studied than try to get these two in. What do you think?
Click to expand...

I had a few
Medial meniscus
SCFE
Dislocations



Pretty straight foward presentations
 
.Your Raw Score = 86.

.Your National % Rank = 90.


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closeenough.png
.
.
.
.
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.Did casefiles x1, NMS x1, kaplan surgery notes x 1, short pestana notes x 2

For questions I did uworld surgery + random medicine blocks in uworld, kaplan qbook and qbank, a few sections in lange
.
 
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Sorry to be redundant, but for those who prepared for the medicine portion, what source did you find most helpful? Ive heard step 1 first aid, uworld step 2 medicine Qs or step up to medicine but wanted to get other opinions. Also, what is the consensus on surgical attending rounds? Thanks.
 
I've been reading the thread and am freaking out. I have roughly three weeks until my shelf.

I've been using FA, Pestana, and a smattering of Pretest.

For all those who have used FA, what're your thoughts? Which sections are high yield and which are low yield? FA seems to be good on GI organs but I got lost with neurosurgery, vascular, and even peds-- just too much useless junk about epidemiology, how to do the surgeries, and anatomy but skimpy on management. Use it for selective reading?

I like Pestana both the 70pg and 200pg so those have been my go to sources of late, but wondering if I need to continue with FA. Any thoughts?
 
So I have two weeks before the test and am in panic mode. Due to bunch of outside factors (overzealous PI, family matters, health reasons), I've only gotten through about the first quarter of NMS Casebook. I've done IM shelf a few months ago, and did okay. What are your suggestions for somehow breaking 80 raw?

Thanks in advance for all your help, guys :(
 
I am planning on using:

1. Pestana 79 page document
2. Pestana audio files (Is this the same as the video others have mentioned?)
3. Kaplan Step 2 CK Notes
4. UWorld

Prefer to keep the resources to a minimum!
 
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