SURGERY 101
A straightforward roadmap to doing well on surgery — covering pre-rounding, OR basics, feedback, and shelf strategy. Clear, practical, and built for real clinical days.
Surgery can feel intimidating for a lot of reasons: early mornings, strong personalities, high expectations, and the quiet fear that you’ll somehow scrub in wrong and be remembered forever. Doing well on surgery is far more predictable than it seems. You don’t need to be brilliant—you need to be prepared, reliable, and coachable. As a medical student who finished up my surgery rotation, here are my top tips to doing well and staying alive.
1. Efficient and accurate pre-rounding.
Pre-rounding is where surgery evaluations are quietly made. Before rounds, you should know:
POD #.
Procedure.
Overnight events.
Vitals trends (tachycardia matters).
I/Os (especially drains).
Pain control.
Diet status.
Labs (Hgb, WBC, Cr).
Red flags (fever, tachycardia, worsening pain).
You don’t need a long speech. You need a clean, confident 30–60 second summary. If you sound organised, people assume you are organised.
2. Learn the operation before you see it.
The night before, read up on:
Why the patient needs surgery.
Key steps.
1–2 complications.
Anatomy.
3.In the OR, be helpful, not in the way.
Introduce yourself.
Ask where to stand.
Stay engaged even if you’re not scrubbed in.
Do not:
Touch anything without asking.
Lean on sterile fields.
Talk just to talk.
Check out mentally.
4.Answer pimp questions without panicking.
You will be pimped. That’s normal. The goal is not to be perfect. The goal is to be thoughtful. If you don’t know the answer, say what you do know and try to reason out loud. A good response would be “I’m not sure, but based on the anatomy/pathophysiology, I’d think…”
5.Work ethic is visible on surgery:
Attending’s and residents notice the small things like helping move patients, grabbing supplies, setting up and cleaning the OR. You don’t need to do everything. Just don’t do nothing.
6.Ask for feedback.
Mid-rotation feedback can change everything. Ask your attending if there is anything you can do better and how you can improve. It shows maturity, self-awareness, and motivation—and gives you a chance to fix things before evaluations are written.
7.Don’t act like a surgeon.
You need to act like a good teammate. If people trust you, they teach you more, let you do more and write better evaluations. Most students who “do well” on surgery aren’t louder, smarter, or more aggressive. They’re prepared, reliable, curious, and coachable.
8. Learn the basics.
Before or during your first week, spend time on: One/two handed knot tying, instrument ties, simple interrupted sutures, running sutures and how to load a needle driver.
9.Shelf exam: be strategic.
Surgery shelves test patterns, not obscure facts. Focus on high yield topics like post op complications, acute abdomen, trauma algorithms, biliary disease, hernias, vascular basics and surgical oncology. Studying a little every day beats cramming at the end.