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The night prior to starting my surgery rotation I remember laying in bed entertaining a fleet of thoughts. I couldn’t tell whether I was filled with anxiety or excitement, but either way I wasn’t getting any sleep that night. Rants and raves about the rotation were brought up by so many colleagues and faculty — always with mixed reviews — and that resulted in even more confusion. I didn’t know what to think, how to approach the rotation, or how to succeed.

Two years after completing my surgery clerkship and becoming a resident, I recall the factors that led to my success during the rotation along with some lifelong lessons I learned during those three months:

1. Be Prepared

Have your resources for the rotation already available prior to starting. The material you need to learn for the shelf examination and the material that will be presented during your rotation may differ. It is of utmost importance that you budget for a book reflecting the content of the Shelf Examination and USMLE Step 2CK.

Recommendations from my previous students include Blueprints, Case Files, and Pestana’s Notes. Make sure you have access to a question bank — if possible, UWorld — as you will need to complete all of the medicine and surgery questions prior to the shelf examination. Last but not least, a copy of Surgical Recall will help you get those pimp questions in the OR correct so you look like a superstar.

2. Be Punctual & Be Present

Never, ever, ever be late. The residents and attending physicians are restrained by a rigid operating room schedule; don’t get in their way. The way to avoid being late is to be present extra early and always offer to help. You should get in to the hospital early and make yourself an integral part of morning rounds.

You should know your patients well (i.e., more than what’s expected of a resident, who often have more patients and less time). After rounds, pick up cases where you have the best chance of getting hands on training. These cases are usually with the more senior and chief residents. This is your best chance to be rewarded for your hard work during morning rounds.

Sign up for as many cases as you can and be present. If you do not have a case, inform the residents that you have some free time and would love to help with their clinical duties. In short, go to cases in the operating room or be around the residents. 

3. Be Assertive

Always ask to see more, do more, and be more involved in patient management. Offer your patients exceptional care. This will not only delight your patients, but it will be recognized by the residents and staff.

In addition to patient management, be assertive in your approach to preparing for the match by asking for a letter of recommendation from a senior faculty member or program director. Make professional connections early on and maintain them by assisting in cases with faculty that you revere. For more about LORs see my other post about getting a perfect letter of recommendation.

Lastly be assertive in your work ethic and make sure you complete your daily readings and your designated question bank. There’s no shortcut to success. 

4. Last But Not Least… Be Courteous

Never treat a colleague, resident, or patient with anything but a smile. This is especially important to remember during this challenging rotation, as you will meet a variety of personalities. You must remember you are on service for only three months, while this has been and will be the staff’s career. Offer your help in excess to everybody — from the scrub nurses to the patients. This will not be overlooked by the staff and you will be rewarded for your enthusiasm and utility.


By being prepared, punctual and present, assertive, and courteous, you will be on your way to honoring your surgery clerkship and shelf examination.

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Samuel Azeze, MD

Samuel Azeze, MD

Samuel Azeze MD, MPH is a graduate of St. George’s University School of Medicine in Grenada. He is currently a resident in Diagnostic Radiology at University Hospitals Cleveland Medical Center. Prior to that he completed a one year internship in Internal Medicine at Staten Island University Hospital where he had the opportunity to work one on one with medical students who have a variety of learning styles. Sam has a firm knowledge of the medical basic sciences that has been tried and tested through his clinical experience. He has impressive USMLE scores that gave him a competitive edge while applying for residency. Sam plans to stay in the academic arena as a physician and has a soft spot for teaching and mentoring.
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