Surgery shelf?

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Chanakya

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To all MSIII, MS IVs,

Can anyone give their experience on surgery shelf exam?
I know there are different versions of the exams...
I am looking for some advise on where to focus?
any formulas to memorize?
what type of Q books you have used?
Is it possible to ace this without doing medicine? etc...

Thank you
Chanakya
😉
 
It is statistically shown that students who take the surgery shelf before completing medicine do less well than students who have taken medicine. This is b/c a LOT of the test is based on management, which, at least at my school, 3rd years dont do much of - we stand in the OR holding retractors for 12 hours a day instead.

DOnt bother with subspecialties like urology or otolarngology - there are a couple of questions, but your time will be better spend with the general stuff and CV, etc.

good luck!
Star
 
Of course you will do better if you've already had medicine, but you can do quite well by thoroughly preparing, even if you haven't had medicine. remember that about 90% of the questions are on management, so think along those lines when you study.

Pretest and A&L books are good, there are of course other review books so check them out too.

You will need to know "formulas" related to fluids/electrolytes, etc. (maintenance fluids, the Parkland formula, etc.) also know things like Ranson criteria, etc., etc.

I would disagree with Starflyr in that the subspecialties ARE important. At least on my version of the shelf, close to 40% of the exam was ENT/GU/NS/ortho.

good luck!
 
Thank you both starflyr and doc 05.
I really appreciate your input.
I have no choice but to ace (minimum H) this shelf exam b/c I am seriously considering a surgical subspecialty. I am doing pretest and A&L questions and trying to do BRS and NMS Qs. I agree with star that it is difficult to ace this without medicine, but then again like doc05 said it can be done (staying + here). Also, it is graded according to your peers who take that exam with you. they are also in the same boat as I am. Anyway,
my exam is on tuesday so I have 3 full days to get to my goal.
I will keep checking this site to look for more insights.
thanks again,
Chanakya 😉
 
I took the shelf yesterday. It thoroughly kicked my ass. I thought I knew the stuff pretty well, too. It's too bad there was very little SURGERY on the thing!!!

Sorry, just had to vent. 😡 +pissed+
 
Originally posted by doc05
Of course you will do better if you've already had medicine, but you can do quite well by thoroughly preparing, even if you haven't had medicine. remember that about 90% of the questions are on management, so think along those lines when you study.

good luck!

Well, I am influenced by a few things...

1) I dont want to go into surgery
2) Surgery was my first rotation ever (didnt do electives between 1st and 2nd year, eg)
3) If you're standing in the OR 12 hours a day plus have rounds, etc, plus have call plus have a family, plus have a commute b/c of said family learning all the stuff you're supposed to learn in Medicine in addition to all the surgery stuff is a pretty impossible load.

At this point, I dont care, I passed, and that's all that matters....

Maybe th OP shouldnt listen to me, since Im not a surgery gunner type person 🙂.

Star
 
Originally posted by Starflyr
Well, I am influenced by a few things...

1) I dont want to go into surgery
2) Surgery was my first rotation ever (didnt do electives between 1st and 2nd year, eg)
3) If you're standing in the OR 12 hours a day plus have rounds, etc, plus have call plus have a family, plus have a commute b/c of said family learning all the stuff you're supposed to learn in Medicine in addition to all the surgery stuff is a pretty impossible load.

At this point, I dont care, I passed, and that's all that matters....

Maybe th OP shouldnt listen to me, since Im not a surgery gunner type person 🙂.

Star

actually, if you don't plan on doing surgery, it is even more important to learn surgical management now. the rotation may be the only time you get to learn things from the surgeon's viewpoint.

there's no reason to spend 12 hours in the OR every day. I typically scrubbed in 2-4 cases per day on most days, but was rarely there more than 8 or 9 hours per day. since all you are doing is retracting, as opposed to learning surgical technique, you should have lectures (even informal ones with the seniors and chiefs, but I guess this depends on your school and your clerkship site), and most importantly time to read.

rounds aren't really that important, except for the seniors and chiefs who are calling the shots, and the interns, who are doing the work. so most of the time you can stand in the back and read through a pocket-book. following 1 or 2 patients at a time won't require much pre-rounding, so try to read in the am before rounds or before/between cases.

another thing: make sure that your interns aren't scutting you. you are there to learn, not to pick up the slack for the interns. after your first few blood draws, iv's, and foley's, there's little or no educational value in doing these things, and you'll have plenty of opportunity for this sort of work during your own internship. so if you don't go to the OR (no cases, or just don't want to), hide in the library.

good luck.
 
I suppose. I do still have one month of Sr. surgery left - the way it works here is that 3rd years are sent to the OR constantly, while the 4th years stay on the floor with the interns. I was also on 2 Pedi surg rotations- one at Shriners Burns and one in regular general Pedi. We had 2 maybe 3 students on the team, with 10-15 patients, so we couldnt spread it around like the General teams that had 7-8 students and the same number of patients. And as for rounds....we had to cover all patients on the service - with 2-3 students, that leaves just enough time to shuffle papers, take notes on your current patient, and remember who the next one is before moving on to another one of your patients. Plus, in Shriners, there was a dearth of residents, so it was our responsibility to oversee our patient's management = get all the tests oredered and done, write orders, follow up on them, admit & discharge paperwork, etc... plus we also were supposed to spend time with the nurses doing central lines, IVs, adjusting respirators, etc...but burns management is also way different that say, managing an appendectomy...so... Being pure Pedi also screwed me on the exam, since management is different for kids than it is for adults, especially since kids dont usually have all those co-morbid conditions like CHF and diabetes etc.

LOL Im really not bitter, though I just read through this and i realize I sound bitter. Im just glad its over and next year I DONT have to go to the OR. (We did learn techniques, and especially in Shriners were often responsible for parts of the surgery - kind of an "everyone take a limb" thing. In other surgeries, we would bovie, suture, all that fun stuff. I even got to do one hernia repair just me and the resident once.)

Star
 
you should complain about the amount of work given to you as a student. unless you are doing a sub-I, you shouldn't be given the responsibility of managing the patients on the floor. that is the residents' (mainly the intern's) job.
 
two books did it for me--

A&L-->most closely reflects the questions on the test

Lawrence-->read the little blurb in the very beginning of surg recall "surgeyr rotation lasts 49 days, 10 pages a day gets you through lawrence by the end." its not too hard to do, but then again, it sure was!

My exam didn't have any subspecialty stuff. Just medicine, fluid and electrolytes, and trauma. I used surg recall for the pimp sessions. Another good book to look into, but of course not buy, is Zollinger's atlas of surgical procedures. A quick browse through this gem before a case will give you indications for the procedure, releveant anatomy, nuances of the procedure, and postop care. It'll make you look like a f%&#ing superstar in the OR and on the wards!
 
imho, this shelf is the hardest. i read lawrence and A&L. biggest prob for me was the ammt of sub spec questions and ID that i didn't prepare for. in general, do the last 20 questions first to maximize your odds.
 
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