High Yield Topics
The single highest yield topic for the surgery shelf is easily GI; it comprises anywhere from 25 to 30% of the exam. Pulmonary and cardiology topics are the next highest yield topics. The lowest yield topics are immunology, dermatology, and obstetrics. Roughly half of the exam is diagnosis; almost one-third is management, and mechanism/pathophysiology questions comprise about one-quarter of the exam.
High Yield Resources
In general, the surgery shelf exam is an extension of the medicine shelf exam. It is not about surgical technique or procedures, it is ostensibly concerned with the medical management of surgical patients. That said, I took my surgery shelf before my medicine shelf and was frustrated by the number of medicine questions that were completely unrelated to surgery. If you are taking your surgery shelf after your medicine shelf, you will likely do well, as the preparation is fairly similar. While I would recommend doing more than the 130 or so surgery questions in UWorld, I exclusively did the surgery questions in UWorld and read through Pestana’s twice, and managed to slide by with one point above the class average on my shelf. In other words, it was my worst shelf, and in retrospect, I would have at least reviewed GI, pulmonary, and cardiology UWorld questions insofar as the were the highest yield topics on the exam.
Almost every sentence in this little book it is literally gold; it’s a very succinct book that does an excellent job of covering the most high yield material for the surgery part of the surgery shelf. Some people recommended NMS Surgery Casebook, but I personally found it too long, and cumbersome to use, particularly during the surgery rotation when hours are long and motivation to study at the end of the day is very low. Pestana’s was convenient enough to read in between cases. I read through Pestana’s twice and went through the questions twice as well.
I won’t reiterate the importance of NBME shelf exams, except to say that I took one for my surgery shelf which overestimated my score. Typically, the NBME shelf exams underestimated my score, such that I scored between 5 and 10 points higher on the actual shelves than I did on the practice NBMEs. Nevertheless, NBME shelf exams are an important resource for seeing questions written by the test-writers themselves.