Prereading before gensurg intern year

[globalsurgeon]

I'm a nontrad med student (MS4) who just applied into General Surgery. I have a few months off between my graduation and July 1 and really need some advice on what resources I should use to keep my medical knowledge current before starting internship. A lot of residents say things along the lines of "don't worry, just enjoy the time off / you will re-learn everything" but having taken a couple years off during medical school for personal reasons, I know how hard it is to get back into the swing of things and really want to do whatever I can to prepare. Don't get me wrong, I plan to enjoy this vacation time, but I would like to spend a few hrs per day studying and working so my brain doesn't turn to mush.

I'd appreciate your help trying to come up with a sample "curriculum" of things I can do. Here are some options I'm considering. Please help me prioritize or suggest other resources that might be better suited to this goal. Also I'd appreciate strategies on how to make learning more "active". I like q-banks bc they help me stay focused, but I also like the structure that comes from reading textbooks.

- Reread DeVirgilio
- Go through AMBOSS questions for Step 2 again (just the surgery questions) - as my subscription won't expire for a few months more
- Start reading one of the gen surg textbooks (I've read a bit of Sabiston and really like it. However, I'm a slow reader and it's a thick textbook. Based on my current rate, I don't think I can get through more than half of it before intern year.
- Read Marino's ICU book
- Do additional surgery qbank questions - not sure which is a good qbank - maybe find a way to access score/truelearn questions (please advise if this makes sense)
- Onlinemeded CaseX - interactive clinical case scenarios
- study the Fisher red "Absite book" - make an anki deck and go through these "facts"

Thank you so so much. This has really been stressing me out. Very grateful for your advice.

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[WinslowPringle]

Don’t go overboard with it but sure those are some things you can read if you want. Doing all of what you mentioned sounds like a lot and I’d get burned out personally and would pick one thing and move on to more if I finished it.

I’d recommend Fiser - there’s a version with a question bank as well. Going through and making an Anki deck would be helpful especially if you are familiar with Anki and will use it. Also agree that the ICU book is helpful.

After you match, contact your program and ask about their reading/study plans. Some places do a specific textbook or program a year and some purchase it for you or have library access or an educational fund.

There is a SESAP which is a question and detailed answer bank. Expensive but good. I saved this for dedicated ABSITE study and went through it in detailed review the two months prior.

 

[Dr.LeoSpaceman]

My advice: Take a break.

Do something easy like read through Fiser. Covering some of the basics in the ICU book isn't a bad idea either. Focus on diagnostic workup and management of common surgical issues and post-op issues/complications.

But honestly, the best thing you can do is take this opportunity to rest and recharge. Residency is a slog, and going in "fresh" is likely more valuable than having spent 6 weeks cramming in knowledge.

 

[mikeGR]

Another idea would be to study something that you will never get formal training on but you will be doing for the rest of your life.

If you insist on something relevant to surgery, you can consider studying the fundamentals of radiology (basic interpretation principles, different contrast agents, phases, protocols, etc). That will give you a huge edge over your peers in residency and it will be really useful in the middle of the night.

Not directly related to surgery, but on a similar note - you can learn the basics of leadership and/or management. As a surgical trainee and later a surgeon, communication, negotiation, and conflict resolution skills will be very important for both your career and your life.

If you learn the basics in any of the above fields, you will get the opportunity to develop these skills quite a bit during residency.

 

[AnatomyGrey12]

Another idea would be to study something that you will never get formal training on but you will be doing for the rest of your life.

If you insist on something relevant to surgery, you can consider studying the fundamentals of radiology (basic interpretation principles, different contrast agents, phases, protocols, etc). That will give you a huge edge over your peers in residency and it will be really useful in the middle of the night.

Not directly related to surgery, but on a similar note - you can learn the basics of leadership and/or management. As a surgical trainee and later a surgeon, communication, negotiation, and conflict resolution skills will be very important for both your career and your life.

If you learn the basics in any of the above fields, you will get the opportunity to develop these skills quite a bit during residency.

Are there any particular resources you would recommend for the radiology basics?

 

[Banco]

I would honestly just do a few amboss/uworld questions a day and call it. Everything else seems overboard.

 

[Feelgood MD]

What is the typical timeline at this point for someone at the end of 4th year about to start surgery? How many weeks of "time off" is usual? Don't mean to hijack but was curious and figured it would make sense to clarify if there are many resources that could be used.

 

[balaguru]

I started reading Schwartz cover to cover before intern year. Don't remember how far I got before residency but I eventually finished it and I continued to read and re-read it during 1st and 2nd year. Our conferences were pimp sessions meant to prepare residents for oral boards and it helped me make a good impression during those and also helped me score high on the ABSITE without studying specifically for it.

 

[Lem0nz]

I would take the time off and not study, at all, until residency starts. What we don't do a good job communicating to medical students and incoming interns is that your first three to six months are not really learning surgery, they're learning how to be a resident, learning the culture of the institution, and learning how to get things done. Being "the intern" that knows all the things doesn't give you a leg up on that at all. Being the intern who's always available, always offers to help, and is excited and wears a smile (even if you're dead inside) is worth way more in those first six months, for better or worse, than raw medical knowledge or surgical knowledge. Many *many* interns are judged on their ability to be an intern for the first 6-9 months and attendings don't start really invest in teaching you surgery until like, Jan-Feb in a lot of places when you've shown that you have what it takes, you're sticking around, and you can be taught and follow instructions well. It doesn't mean they don't care or won't teach you anything - just means that you need a foundation first and in a lot of places that foundation actually comes from PGY2-5 residents rather than the attendings for this first piece. That's normal.

Time off and enjoying your life will give you that energy you need to be the star intern who has no trouble coming in at 5am and leaving at 7pm because you want to help and get it right. Reading... won't help you with that.

You will of course need to start studying at some point. I recommend, if I'm being honest, around September. Gives you two months to focus on doing a good job learning how to be a resident and then you can change gears towards your first ABSITE.

Hope that helps. This is just my experience. Others have studied into the ground and absolutely crushed it and are fountains of youth. Others don't study at all, are lazy, and fail miserably. I can't tell you who you are. My experience is what I would say is the average experience for 80% of residents. Maybe others feel differently and if so I would take their opinions to heart as well.

 

[TraumaLlamaMD]

My assumption is my new interns haven’t been on a surgery rotation since their Sub-I, and can’t tell a hernia from a hemorrhoid. It’s the enthusiastic, indefatigable ones who learn quickly that make the best impression Day 1.