Books- you'll see quite a few Surgery Recall books floating around in pockets. This is great for pimping, a must-read prior to scrubbing for your procedure, but really won't help much on the board. I didn't like FA, thought Case Files was so-so, but really wish I had used the NMS Surgery Casebook looking back. You'll find that the shelf exam is about management, what diagnostic test to order next, which diagnostic test is best, etc.
List- you will likely be responsible for updating the list in the morning prior to rounds. Things you must include- POD# (post-op day), fluids in/out, drains, NG output, their diet regimen, flatus/BM, electrolytes, what their wound looked like, presence of bowel sounds, pain control. Have it done before they expect it. Try and work on as much of it as possible before you leave for the day- you won't be as precise at 4:30 a.m. These residents hate floor work, basically want to get through it to charge their way into the OR, so don't be late, 'cause they'll start without you.
Attitude- Lose it. Unless you have just **the nicest** group of surgery residents to walk the earth, suppress your personality, too. If you like to joke, they'll think you don't take anything seriously. Exception is in the OR (again, their favorite place), where a few properly told jokes/anecdotes/observations can lighten the burden of that 4 hour lap appy. Basically, you are a drone to them, sent to update the list, see patients, remove sutures/staples, drain pus, write notes, etc. They usually don't care what you did over the weekend, and certainly will ridicule your chosen specialty unless it involves a general surgery stint. No stupid questions, either. Search back a few days on this forum to the poor guy who has to speak to the Chief of Surgery for mistaking which procedure he was scrubbing in for. As a matter of fact, unless you want to actually be a GS resident at the hospital you are working, I would steer clear of asking any questions, unless you already know the answer. Let the upper levels focus on pimping the intern, not you! Find the nice surgeon, work with him/her if you need an LOR.
Rounds- Keep your presentation brief, like 60 sec. "Mr. X is POD#? s/p Lap whatever for obstruction. Overnight vitals were stable, afebrile, pain 2/10, was +1000 fluids, good UOP, tolerated clear liquids, will start regular diet today. Wound looks good, no drainage, no erythema. Good bowel sounds, passed flatus and had first BM last night. NG drainage clear, less than 200 overnight." Maybe they'll ask for your plan, maybe they'll just tell the intern what to do. This is nothing like IM, where the team can spend 20 minutes outside each room, with each team member contributing their thoughts. You will round on 10 patients in 20 minutes, and you should really have nothing to say if it is not your patient. Certainly there will be time to ask questions, but morning rounds is not it.
Committment- Basically, the interns have committed their life to the dream you dare consider. Early mornings, late nights. Get there before they do, leave only after they've told you to. Don't ever complain about the hours, the work, or anything other than the hospital food. Their life is harder than yours (or they think it is). Put on a smile, act like you love every minute, and volunteer to do anything. But don't be too aggressive, either. By week two you should have learned to anticipate what they will want, so try to be ahead of them. Know the history of the patient heading for the emergent appy so you can tell them about it.
