Official Surgery Shelf Exam Discussion Thread

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MilkmanAl said:
but treat NMS as a filler sort of thing. It's a good resource, but it's not as high-yield as the other stuff.
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Definitely agree with this. People rave about this resource but there is a LOT of info in it that is superfluous for the shelf. You don't need to know about all the different operations for refractory peptic ulcer disease, for example.
 
I won't have had med before surgery and what I've gathered is to study the following with certain caveats in mind:

NMS + just skip over the super detailed stuff
USMLE World + focuses a bit too much on ortho
Pestana ++ appears to be hands down the best endorsed source
Casefiles +/- some seem to find it useful, others haven't

Is it better to do 2008-09 Kaplan Step 2 Surgery? Or is Pestana sufficient?

Also PM for Pestana video/audio info please.
 
1. I read Lawrence once and answered all of the objectives (creating a 200-page typed document). I read most of that document again a couple days before the test. I felt like Lawrence was a fantastic book, because it actually explained everything instead of just giving an outline of important facts. It also covers really important and relevant things like fluids and nutrition really well. If you don't need to get explanations behind facts and details, it may be overkill for shelf-studying, but I think it's really useful for overall medicine knowledge.

2. I read Pestana once (notes and questions). It was helpful for some of the high-yield more simple questions.

3. I read Casefiles once, which was a nice, but overly easy, review of some big topics.

4. I read Pretest once, which I liked because the questions covered some things I didn't get much of elsewhere (like oncology drugs).

5. I read NMS once all the way through and read over the key points the day of the test. Very high yield for the time and effort.

6. I did all of the UWorld Step 2 surgery questions the week of the test. Helpful, but more as practice after obtaining a basic knowledge background.

7. I went through MKSAP 4 sections again that I thought would be high-yield (GI, GU), but they seemed overly simple after taking the medicine shelf and all of the above studying.

Score came back at 90, my 2nd highest. I'm happy, considering I'm not going into surgery. Time probably could have been used more on efficient sources (like NMS), but I felt like everything I read gave me a pretty good knowledge base just in general for future use.

Good luck!
 
I would be furious if I spent that much time to get a 90 raw score on a shelf exam. Lawrence was god-awful, in my opinion. I have no clue how you paid attention to it long enough to get 200 typed pages of info out of it.
 
MilkmanAl said:
I would be furious if I spent that much time to get a 90 raw score on a shelf exam. Lawrence was god-awful, in my opinion. I have no clue how you paid attention to it long enough to get 200 typed pages of info out of it.
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👍 seriously but you can't argue with the results. If a 90 was required to get honors then more power to him. 90 on the Surgery shelf isn't exactly easy especially if OP took it early on

I thought I overdid it by reading Case Files a few times. I didn't think Lawrence was that bad but I could never sit down and just read it straight, let alone make a 200 pg guide from it. Lawrence did explain some stuff pretty well - I did the online questions and used the book for clarification in prep for our in-house exams.
 
you can't argue with the results...90 on the Surgery shelf isn't exactly easy especially if OP took it early on
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Agreed, but it isn't worth and shouldn't take anywhere near that much time to get. Even if you do want to spend more time studying for the surg shelf than Step 1, you'd be way better off just knowing a couple resources cold than sifting through all the tangential BS Lawrence tosses out and reading the less-useful review books.
 
MilkmanAl said:
Agreed, but it isn't worth and shouldn't take anywhere near that much time to get. Even if you do want to spend more time studying for the surg shelf than Step 1, you'd be way better off just knowing a couple resources cold than sifting through all the tangential BS Lawrence tosses out and reading the less-useful review books.
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Honestly, it probably wouldn't have needed to take that much reading. I loved Lawrence as a text, but more for my own learning than for shelf info. I think there was 1 question on the test I knew from that book alone.

As far as the time, I don't feel that I was particularly stressed during that rotation, and I'm glad I learned everything I did, especially since it's probably the only foundation in surgical concepts that I will ever really have for my future knowledge.

Just sharing what worked for me. To each his own, right? 🙂
 
Is the Pestana notes everyone is referring to the 70 page doc with mostly cases? Got the 18 hrs of audio... doubt I'll be able to listen to that!
 
LeLu said:
Is the Pestana notes everyone is referring to the 70 page doc with mostly cases? Got the 18 hrs of audio... doubt I'll be able to listen to that!
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Yes. It's also the same as the Kaplan notes, except the Kaplan notes have some notes at the beginning and cases at the end.
 
Sorry to beat a dead horse....but does anyone have any opinions on what practice questions are best? I was thinking of getting UWorld. If I do, what topics did everyone find the most useful? Thanks!
 
UWorld is great but not perfect. It's too heavy on ortho. You can do the medicine GI questions which are a great supplement to the surgery questions.
 
According to the general consensus on this site, I am thinking this would be a worthwhile way to prepare for the shelf:

1) NMS Casebook
2) USMLE WORLD Surgery + IM GI + IM Hepatobiliary
3) Pestana's Kaplan notes

Is this correct?
 
The Pestana audio is a great companion to the notes if you're an audio learner.
 
Took this recently, blew me away, very difficult. uworld sucked for it which is bad because it is how i have been preparing for shelfs. Don't have results yet, perhaps I didnt do as bad as I think, but it was not a pleasent experience unlike some of the other shelfs i took.
 
SGuttenberg said:
Took this recently, blew me away, very difficult. uworld sucked for it which is bad because it is how i have been preparing for shelfs. Don't have results yet, perhaps I didnt do as bad as I think, but it was not a pleasent experience unlike some of the other shelfs i took.
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I think it's just the way some of the questions are written. At times very ambiguous and you end up questioning yourself frequently. At my school everyone comes out feeling like crap after the test. I thought it kicked my ass but I ended up scoring in the 92nd percentile.
 
just took the shelf on friday. overall I had about 50 questions I knew were right, 8 i know i got wrong, 8 I was unsure about, and the rest of the 100 i forget. Topics were diverse and included GYN, ophthamology, pediatrics, infectious disease, dermatology, rheumatology, quite a bit of int. med, and last and perhaps least, surgery.

my advice: focus on non-surgical management of *potentially* surgical conditions. Potential surgical conditions could include something like glaucoma (so know everything about it! what are the canals of schlemm!?), melanoma. There was a question about a particularly difficult ethical dilemma. You should know fluid replacement regimes. Be aware of hematologic conditions that may interfere with surgical prophylaxis.

The key to doing well is to embrace the tangential nature of this exam. Suppose your post-op patient resumes antipsychotic med and develops oculogyric crisis .. yeup. Suppose you are going to start to perform a surgery and now you need to know the duration of anesthetics. Not what you talk about on your teaching rounds, but tangents like that, which barely approach the core of surgery, are all over the place.

Critical Care was an unexpectedly large portion of this exam. How does a surgeon manage her patient if she knows what the patient's glasgow coma score is? When should a surgeon tell the anesthesiologist on her team to reintubate the patient who is just coming out of his procedure in the PACU and now has respiratory distress?

Again, embrace the tangential nature of this exam, and you will do quite well. I personally found the green book (pocket medicine) to be a one-stop, very comprehensive resource. Helps with internal med shelf as well.
 
took this thing last week, just got score - 96. Here's my advice, which differs a little from the general trend of this thread.

1. I didn't really like NMS casebook. I only read like the first 50 pages and felt like it wasn't focusing on the right stuff, and felt it was a bit outdated. I would recommend giving it a shot (only because everyone else seems to swear by it) but if you are like me and don't care for it then don't feel like you are missing out if you decide not to use it.
2. I used FA for surgery as my bread and butter. I thought it provided a good overall foundation and helped me organize my studying based on organ systems and specialties. In terms of info needed for the shelf, I found it to be quite throrough as there wasn't a whole lot of info that I would come across in practice questions that wasn't in there somewhere.
3. Pestana notes are great to learn presentations of classic cases. I would not put too much stock into his management suggestions b/c some are outdated, but overall his notes are a great reference to get a feel for the more popular test subjects.
4. Questions. Uworld was ok, do all for surgery. I also did pretest and kaplan qbook. Like all pretest books, some questions were good and others were awful. If I came across a question that I knew was stupid I would just skip it. Otherwise, I felt like the majority of questions forced me to review certain topics much more closely than I would have otherwise. The kaplan qbook questions are pretty good too. There are only 100, but I used them a few days before the test just as a quick review and it was helpful.
5. In the end, this test has some random crap on it that seems like it has no business being on a surgery exam. There is not much you can do to prepare for these 5-7 questions and just have to take your best shot at em based on what you remember from other exams/step 1.

Our rotation was 8 weeks so I just did a little every week as I went along and then really stepped it up the last 2 weeks. There is a lot of stuff, but it's very doable. Overall I feel the most important thing was trying to do as many questions as possible because that is the best way to get familiar with all the different ways things can present. Hope this helps.
 
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I'm taking the surgery shelff in one week. I read a bit of Lawrence, whent through NMS casebook once, Case files once, and some questions from uworld and mksap 4.

someone mentioned that there were random questions, but is there any short paragraph questions? and will there be some easy questions in the mix with really difficult questions?
 
MedSchoolManiac said:
I'm taking the surgery shelff in one week. I read a bit of Lawrence, whent through NMS casebook once, Case files once, and some questions from uworld and mksap 4.

someone mentioned that there were random questions, but is there any short paragraph questions? and will there be some easy questions in the mix with really difficult questions?
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Yes, there are a good number of easy/straightforward questions
 
2012mdc said:
Yes, there are a good number of easy/straightforward questions
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By Straightforward/Easy, what do you mean? Couldyou give an example or two? Thank you for the information you have provided so far. It helps a bunch 🙂. im worried that all this studying wont be for anything.
 
MedSchoolManiac said:
By Straightforward/Easy, what do you mean? Couldyou give an example or two? Thank you for the information you have provided so far. It helps a bunch 🙂. im worried that all this studying wont be for anything.
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I mean questions with short stems with classic descriptions like episodic HTN, sweating, and tachy for pheo. Questions like the person is clearly dehydrated and they haven't given fluids yet. Or someone is shot and clearly hemodynamically unstable even after fluids so you take them to the OR.

I don't remember the exact percentage of easy questions but they were there. It was my 1st shelf all the way back in Sept so I'm having problems remembering more
 
I took it yesterday. My advice is to do a quick review of first aid before hand, lol. Also lots of stuff from pestana.
 
Hi everyone,

Lawrence or 1st aide? What do you think?

Also, can someone PM me Pestana Audio? 🙂
Many thanks in advance!!
 
Hi again, thank you for the advice.

Real Name: I am doing mostly questions right now. I will "skim" First Aid on Wednesday and Thursday. I am about to finish NMS the 2nd Time. So, at this point, I read First Aid at least 1x, NMS 2x, Case Files Third Edition 1x, some Lawrence (read some and referrenced some) and a bunch of USMLE Questions and USMLE Easy Questions. I also did random questions elsewhere. I have not read the Pestana notes, but should I? It is about 76 pages, correct? I believe I have it somewhere...

BTW TO ANYONE - Is taking the Surgery Shelf (like in August) better than taking the Surgery Rotation and Shelf later (as in April)? I ask this because it sounds like the exams get more difficult if you take them later.

Thank you so much to 2012mdc and Real Name for the advice. I have my exam this Friday. I hope I do well.
 
MedSchoolManiac said:
Hi again, thank you for the advice.

Real Name: I am doing mostly questions right now. I will "skim" First Aid on Wednesday and Thursday. I am about to finish NMS the 2nd Time. So, at this point, I read First Aid at least 1x, NMS 2x, Case Files Third Edition 1x, some Lawrence (read some and referrenced some) and a bunch of USMLE Questions and USMLE Easy Questions. I also did random questions elsewhere. I have not read the Pestana notes, but should I? It is about 76 pages, correct? I believe I have it somewhere...

BTW TO ANYONE - Is taking the Surgery Shelf (like in August) better than taking the Surgery Rotation and Shelf later (as in April)? I ask this because it sounds like the exams get more difficult if you take them later.

Thank you so much to 2012mdc and Real Name for the advice. I have my exam this Friday. I hope I do well.
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No problem, I found the Pestana notes pretty helpful and I went thru them a few times. Definitely recommend them
 
MedSchoolManiac said:
BTW TO ANYONE - Is taking the Surgery Shelf (like in August) better than taking the Surgery Rotation and Shelf later (as in April)? I ask this because it sounds like the exams get more difficult if you take them later.
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Yes I believe so. At least at our school, the class mean goes up, from low 70s during the 1st 2 blocks to closer to low 80s the last 2 blocks. So perhaps the exam doesn't get harder, but the students do better.
 
2012mdc - Really? Damn. I haven't gone through Pestana Notes. I tried reading through it, and it didn't feel appealing.

agrarianmonk - So the test itself probably won't get harder, but people may do better on it since it is no longer the first shelf. Since I am taking it on Friday and IF i was in your class, I would be with a group that has an average between 70-80. ANd by that, do you mean raw score or Percentile?

Oh, for First Aid - I forgot to mention - I did not read ENT, Transplantation, ORtho, or the HAnd. Will I be okay? I think I may be okay....

Thanks so much again. Any other tips for the exam will be appreciated.
 
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MedSchoolManiac said:
Oh, for First Aid - I forgot to mention - I did not read ENT, Transplantation, ORtho, or the HAnd. Will I be okay? I think I may be okay....
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I don't think any of us can say whether you will be "okay." Only you know how well you know your stuff and how well you test, in general. Can you do well WITHOUT knowing that stuff? Probably. However, I did have ENT, transplant, and several ortho questions on my test. I don't recall any hand, but there may have been (esp regarding hand function with different nerve lesions). I hope you're getting this info somewhere, if not from FA.
 
MedSchoolManiac said:
2012mdc - Really? Damn. I haven't gone through Pestana Notes. I tried reading through it, and it didn't feel appealing.

agrarianmonk - So the test itself probably won't get harder, but people may do better on it since it is no longer the first shelf. Since I am taking it on Friday and IF i was in your class, I would be with a group that has an average between 70-80. ANd by that, do you mean raw score or Percentile?

Oh, for First Aid - I forgot to mention - I did not read ENT, Transplantation, ORtho, or the HAnd. Will I be okay? I think I may be okay....

Thanks so much again. Any other tips for the exam will be appreciated.
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I don't think it's a must read and if you feel like it wasn't really helping you I wouldn't stress over it. Different people prefer different type of sources. I just liked the rapid fire nature of it with the short classical cases and quick tidbits on diagnosis and treatment.

The cases on the exam are rarely that classical but Pestana helped me organize stuff and get the easy stuff down pat
 
MedSchoolManiac said:
Oh, for First Aid - I forgot to mention - I did not read ENT, Transplantation, ORtho, or the HAnd. Will I be okay? I think I may be okay...
Click to expand...
I had one ENT question and a few ortho questions. They were classic though. I would give it a quick read. Just know a few of the classic presentations like avascular necrosis. No hand questions. You might have a different experience though.
 
MedSchoolManiac said:
agrarianmonk - So the test itself probably won't get harder, but people may do better on it since it is no longer the first shelf. Since I am taking it on Friday and IF i was in your class, I would be with a group that has an average between 70-80. ANd by that, do you mean raw score or Percentile?
Click to expand...

I think its the raw score / scaled score.
 
It's Thursday, and my exam is on Friday. Last few questions: were there ECGs to intepret? And was the exam 50% Diagnosis and 50% Management? Any last minute tips and things to do? 🙂

Thank you again for all who provided information.
 
MedSchoolManiac said:
It's Thursday, and my exam is on Friday. Last few questions: were there ECGs to intepret? And was the exam 50% Diagnosis and 50% Management? Any last minute tips and things to do? 🙂

Thank you again for all who provided information.
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I didn't have any ECGs. I'm not sure I could break it down by percentages into diagnosis and management.
 
Ok.

Oh, does this exam cover medicine topics too?

I hope things go well though. I don't want to fail this exam.
 
MedSchoolManiac said:
Ok.

Oh, does this exam cover medicine topics too?

I hope things go well though. I don't want to fail this exam.
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Plenty of medicine questions, I think where the most overlap is between surgery and medicine is with GI and endocrine (more thyroid and adrenal stuff as opposed to diabetes)

I also had a couple OB questions
 
MedSchoolManiac said:
Ok.

Oh, does this exam cover medicine topics too?

I hope things go well though. I don't want to fail this exam.
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Yeah lots of medicine. Know thyroid disease management and diagnosis, for example. Definitely will have liver disease questions, etc. I second the OB questions; I had those too. Also a few peds surgery questions. It's a wide-ranging exam.
 
The topics were somewhat random, but my raw score was the same as my Pretest/Kaplan raw score.
 
pestana notes were the pefect exploit for this test even if you know nothing about surgery as long as you have a decent grasp of medicine.

There needs to be more review resources like this where they describe the most commonly tested situations and what the exams have been asking recently. Instead of reviewing a subject as a whole just tell us the high yield presentation, buzzwords and frequently asked Q's in <100 pages.
 
SGuttenberg said:
pestana notes were the pefect exploit for this test even if you know nothing about surgery as long as you have a decent grasp of medicine.

There needs to be more review resources like this where they describe the most commonly tested situations and what the exams have been asking recently. Instead of reviewing a subject as a whole just tell us the high yield presentation, buzzwords and frequently asked Q's in <100 pages.
Click to expand...

Invent + sell it man!
 
I just took the shelf today - what a joke.

I had questions on ectopic pregnancy, ovarian torsion management, uterine cancer management + complications, etc, etc. If I didn't have ob/gyn yet I would have been screwed.
 
I took the shelf in february. It was pretty much what I had expected minus 5 questions or so that were basic science oriented and more Step 1ish. You can't study for these so don't worry about them. Otherwise nms, kaplan surgery, and uworld are all that you need.

After reading about half of nms I realized I hated the style in which it was written. I decided to make an outline of each chapter. Just 2 pages or so typed up that included the bolded comments and other things I didn't know from each chapter. From then out I studied these instead of the book, only using the book to reference pictures etc. I did uworld questions here and there when I had time, annotating uworld stuff onto my nms notes.

I didn't read kaplan surgery until the last 2 weeks of the rotation.

I opened up case files for the first time the night before the exam and read a few cases on things I didn't know anything about. I actually know I got at least 1 answer correct on the shelf because of this.

raw 98
 
raw: 89; percentile: 96th

used Pestana, NMS Surgery, NMS case book x2, UWorld (Surg + Medicine), MKSAP. to be fair, i had medicine before this.

goodluck everyone!
 
Took the exam last week... I will reiterate that medicine is the meat-and-potatoes of this exam (75%+). There was also a fair amount dealing with management of pediatric patients, which surprised me. Very little of the exam was straight surgery or anatomy.

NMS Case Files and Pestana Notes were the most helpful. UWorld surgery questions will not be helpful unless you combine them with Endocrine, Hepatobiliary, and GI IM questions.
 
I guess since people only post when they get <99.999% percentile I should post my scores to even it out. I got my score back.... 70 raw

I used NMS and read it cover to cover (ignoring obvious chapters like how to tie a knot and types of suture) and also did all of the Lange questions and read through the Pestana notes twice.

I really don't think the Pestana notes helped me out that much. You really need to know your medicine (ie the treatment of pulmonary fibrosis?) for this one, as said before. I probably wouldn't use NMS if I could again, either. It had a lot of detail and left out some really huge points (ie what is the #1 parotid tumor)
 
Hi all, I received my score back, finally. I had a raw of about 75, and the percentile was about 70. I read Case Files 1x, Most of Lawrence, NMS x2, Pestana Notes 1x, and a lot of questions. It had many questions from all topics, including OB/GYN. There was a good mix of everything. Internal, Surgery, Pediatrics, OB/GYN, Neuro, and that was about it.

i mad 3 silly mistakes, but that was it. I kept a record of about at least 57 questions correct at the end of the exam, and figured passing would be banked on the other questions (all educated guesses).
 
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