Since this is what I’ve been asked most often, we’ll talk first about good books to read in the month or two you have left, and also in the first year of residency.
Right now, I would recommend getting started on a basic surgical textbook, like Schwartz, Sabiston, or Greenfield. I’ve been using Sabiston this year, and it’s ok, but I was recently pointed towards Greenfield, and I like it much better. The chapters are a more manageable size, and the writing overall is better organized and more focused on useful information. These books will give you a lot of basic science information: some anatomy, a lot of physiology and pathophysiology, and the decision-making tree, how to diagnose, how to treat, when to do surgery, when not to do surgery. This covers the information you will get pimped on as an intern. I started to say it will give you the information you need when admitting a patient for surgery; but actually it’s way more information than you need on a day-to-day basis. One of my chiefs loves to advise us to read for one hour every evening. It seems like an impossible goal, but the more you can read at least a small amount on a regular basis, rather than sporadically, the better off you will be. I realized this after the ABSITE.
These books cover things like surgical infections, critical care briefly, trauma protocols, and medical issues in surgical patients, so this is probably the best place to review basic medicine from a surgical perspective.
Regarding the ABSITE, the surgical intraining exam given in January: some programs care more about it than others, but it does seem that fellowships will look at your scores. That’s what I hear from the residents who were interviewing this year. The absolute best book, beyond regular reading, is The ABSITE Review Book. There’s a second edition out this year. You need to start reading this a few months before January – October might be good – because although it’s a thin book, it is so crammed with information that you will not be able to absorb it if you try to rush through it in the month of January.
If your program has interns in the ICU much, The ICU Book by Marino would be valuable. He has some idiosyncrasies, but he explains physiology better than any book I’ve ever read. He goes through every aspect in detail: cardiovascular, respiratory, electrolytes, infections, and gives the reasons behind (or against) common practices.
Other than that, once you get into residency, you should have a surgical atlas to refer to, at least the night before cases. Some people (better disciplined than me) read these for recreation, and as a result sound extremely intelligent on rounds. A very basic one is Zollinger’s Atlas of Surgical Operations. There are many others, in more detail. Mastery of Surgery is a two-volume book (best found in the library; not a good way for interns to spend money) which both gives extreme details on the conduct of an operation, and most of the possible variations, as well as a brief overview of the pathology and diagnosis. If you have time, this would be a good one to read before an operation. For general information, I recently became enamored of Chassin’s Operative Strategy in General Surgery. This book starts at the beginning, as in how to tie knots, why to tie knots, and so on. It tells you all kinds of secrets which people seem to assume you ought to know, but will never think to tell you, and explains how to approach a problem, as well as the specific steps of many operations. Be careful, because it covers a lot of archaic operations that it would not be a good use of time to read much about. Later, when you’re senior enough to get called for the emergency Billroth 1 or 2, you might like to read some of these chapters again.
That’s really it. Overall, I’d say you’re better served by picking a few books and trying to read all the way through, and studying specifically the areas that you currently have patients in, than by trying to read all possible books. Not that you’ll have the time or energy for that after long.
Oh, and UpToDate is wonderful, if your hospital has access. You’d be surprised how much surgical information is covered there. If you’re going to buy one or two books, I’d say Greenfield (if your program isn’t planning to give it to you – a lot of programs will provide the interns with one or two textbooks), and The ABSITE Review Book.
April 29, 2008 at 2:15 am
Thank you Alice! I am worried about examining the patients and making sure I go through all the tests necessary to come to a diagnosis. It has been more than 4 years since I have examined patients, so I am nervous about doing a good job.
I have Sabiston which my mentor gifted me, and my program provides us with Schwartz, so I might buy the Greenfield depending on how it is.
I found a website called Surgisphere. Check it out, they sell study material for the ABSITE. I thought it looked pretty useful, but I may be wrong. I have seen the ABSITE review book with a lot of residents though.
Did you take your Step 3 yet, how are you preparing for that during internship?
Thank you again, and good luck.
April 29, 2008 at 2:19 am
If you want to take a look at the Surgisphere ABSITE material they have to offer, go to:
http://www.clinicalreview.com
April 29, 2008 at 6:45 pm
hey there alice.
have u heard of this textbook called “textbook of surgery”, 3rd edition by Tjandra, etc. They are Australia surgeons and i was wondering if you had a read before.
i thought bailey and love’s short practice of surgery was the “bible” of surgery.
April 29, 2008 at 8:21 pm
Mike – Thanks for the website. The diagnostics will come back to you. Mainly, take your time with the patients and do a thorough exam; and don’t be afraid to go back in the room if you think of something you missed. You’ll find that it’s far more embarassing to have an incomplete report to give your superiors, than to walk back in to the room three times to check on things you forgot.
Step 3: take it as early as you can, because the more surgery you learn, the more medicine you forget. I love the First Aid books.
Jeffrey – I think we live in different worlds. I never heard of those books.
But medicine is practiced very differently in the US compared to places with more European/British influence. I hear in Europe they give antibiotics for appendicitis instead of doing surgery.
May 2, 2008 at 6:55 am
Yea i guess so. I’m sure you have heard of the 1st aid series. I was mightily impressed and really liked 1st Aid for USMLE Step 1, so i got the 1st aid for the Surgery Clerkship one. Its pretty succinct on the major surgical topics. I just fill up the side columns with extra details from the Tjandra surgical textbook i got.
Any handbooks you recommend? Like Mont Reid or Surgical Recall?
September 26, 2008 at 12:45 am
Hey Dr. Alice!
I have been following your blog for a long time. Thanks for keeping it updated – it has been very useful for me in the early years of my surgery residency.
I second what Mike said above. I have used http://www.ClinicalReview.com for their ABSITE review material and have done very well on my exams. Just my two cents!
Nicki
June 7, 2011 at 12:52 am
Thanks very much Dr Alice. I’m nervously awaiting the start of my intern year in Gen Surgery and this is precisely the kind of advice I have been looking for.