Having just taken this stupid exam, I can reply in the affirmative...yes, it is a LOT of medicine. I'm trying to think of what, if anything, I could have read or done to prepare for this exam, other than having my surgery rotation last instead of first.
This exam is very tough if it is your first one. I read through NMS, ditched First Aid because I thought it was useless, read Recall to survive the rotation itself, read quite a bit of Current Surgical Diagnosis and a little bit of Lawrence. I did as many practice questions as I possibly could.
Its hard, but try to focus a bit on perioperative care, especially cardio-pulmonary symptoms. Just knowing that the patient can get a pulmonary embolism is not enough. Know why it can occur, how it occurs, how the patient will present, what their blood gases will look like, associated electrolytes and enzymes, what tests you'd order (if any) and management. In fact, if you could know all that for everything you study, you'd do quite well. Perioperative care is not the entire test, but a sizeable enough chunk if you haven't reviewed it at all. (It always seems like it takes up "HALF THE TEST" when you don't know, right? heh)
I also got a couple "what cardiac test would you suggest for preoperative workup" type questions (w/ extensive history of patient included for your confusing convenience). Don't just know, "echo" or "EKG"...because so rarely are the answers that simple. The answers are more like "24h ambulatory EKG" "dobutamine stress echo" "resting echo". Superficial knowledge (like you would get in First Aid) is not enough for this exam. And I think that's exactly why people get into trouble...they approach it like an exam from first or second year.
Personally, I think the best possible thing to do is ask "why?" a lot during your rotation. The hard part is 1. having the luxury and 2. knowing when to ask why (sometimes its hard when you don't even know the question to ask, right?) And just read, read, read and do practice questions.
All in all, I feel really bad about this exam, but I did study for it. (I mean, what business does multiple myeloma have on a surgery exam?) If I'm not too ashamed, I'll let you know how I did on the exam three weeks from now. Maybe I could give better advice in retrospect.