The night prior to starting my surgery rotation, I couldn’t tell whether I was filled with anxiety or excitement, but either way I wasn’t getting any sleep that night. So many colleagues and faculty brought up rants and raves about the surgery rotation — 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.
How to Excel on Your Surgery Rotation:
1. Gather Your Resources in Advance
Have your rotation resources already available before your first day. The material you need to learn for the surgery shelf examination and the material that will be presented during your rotation may differ.
While certainly not a requirement, many students find it helpful to purchase a review book to ensure that they are exposed to the material that will likely be tested on the NBME surgery shelf exam and Step 2 CK.
Resource recommendations 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 before the shelf examination.
It’s also recommended to complete at least the GI and cardiovascular internal medicine questions before your surgery shelf as well, especially if you haven’t had your medicine rotation yet, as this material often shows up on the exam.
Last but not least, a copy of Surgical Recall will help you get those pimp questions in the OR correct so that you look like a superstar.
2. Be Punctual & Be Present
Never, ever, ever be late. This golden rule applies to all of your rotations, but it is especially critical in surgery. The residents and attending physicians are restrained by a rigid operating room schedule. If you are late, they will move on without you, and you will be left behind. The way to avoid being late is to arrive at the hospital early and always offer to help, making yourself an integral part of morning rounds. This will get you noticed by residents and attendings as a medical student who is willing to work hard and cares about patients.
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 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. Make use of any downtime to attend cases in the operating room and seek out opportunities to practice skills such as suturing or wound care.
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 post about getting a perfect letter of recommendation.
Lastly, be assertive in your work ethic and make sure you complete your daily readings and designated question bank. There’s no shortcut to success, and learning is a self-directed process during clinical rotations when there is no one telling you what tasks you need to get done each day. It’s up to you to plan time in your schedule for reading and completing practice questions with the goal of honoring your shelf exam.
4. Last But Not Least, Be Courteous
Never treat a colleague, resident, or patient with anything but respect. This is especially important to remember during this challenging rotation, as you will meet a variety of personalities, some of whom you may not initially get along with.
What if others are behaving badly? We have tips on how to handle unprofessionalism while on rotation.
You must remember that you are on service for only three months, but this is a career for everyone else working around you. Many of the surgical staff have countless years of experience in this setting. You have a lot to learn from everyone’s knowledge and expertise—from the neurosurgeon to the scrub tech. Never act as though you are better than anyone else in the OR and keep your medical student ego in check. Offer your help in excess to everybody—scrub nurses, patients, and all. 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.