Books and other learning resources for MS/DNB General Surgery residency

SURGERY RESIDENCY-MADE EASY

In this post, we tried to address some of the issues related to the resources that should be used during post graduation/residency in General Surgery.

Before going further, there are some key considerations:

• Most of these recommendations are from my personal experience, if you think there is a better way of doing things, please do as such.
• I am not promoting any of the products given below. I personally used them and felt they are rather under-utilised.
• Many of the resources have leanings on MRCS exam preparation, and which I think is a standard way of testing surgical residents in their initial years.
• Most of these may not be used by your faculty or seniors, so I suggest go through them personally, read some more reviews, google everything, then form an opinion before proceeding further.

SURGICAL ANATOMY

Quite an under-rated subject all through residency. But I must say ANATOMY IS EVERYTHING. Whether it is clinical examination of a patient in clinic, assisting a surgery in operating theatre, caring for the patient in critical care unit, you just can’t do anything without sound understanding of anatomy, most importantly surgical/applied anatomy.

1. Professor Harold Ellis lectures on Surgical Anatomy. It is a part of package for MRCS course material from Pastest. The lectures are very good and are based totally on clinical application.
2. Clinical Anatomy: Applied Anatomy for Students and Junior Doctors by Harold Ellis, This book works as a companion to the above lecture series.
3. Atlas of human anatomy by Thieme publishers anatomy atlas. This is the only book I came across till now where the images of Atlas are SURGICALLY ACCURATE.
4. Mrcs Part B Osce : Anatomy by Lynch. Good book to revise all the key points. Again, very good emphasis on real life application.

Anatomy is an ocean, be careful in choosing what you read and remember. You may not need to remember all of it.

Revision is always the key. Try applying whatever you learn in your clinical practice and teach your juniors whenever you could either in ward rounds or in the operating room. It only adds to your knowledge.

CRITICAL CARE

1. The ICU book by Paul Marino. Very under-rated book, clears most concepts about critical care quite decently. Can be of much help in resuscitation of surgical emergencies and care of critically ill postoperative surgical patients.
2. CRISP Manual by RCSEng. Official manual of the Royal college of surgeons, England, quite useful if you could attend their course.

OPERATIVE SURGERY

Most residents are under the wrong impression that operative surgery is everything. In fact it is quite over-rated. I don’t deny its importance, but other aspects of surgery should not be neglected at its cost.

The era of using books to learn surgical procedures is over and it makes sense to use video lectures to learn in a better way!!

1. Clinical Procedures book set by Matt Stephenson. An excellent book and video lecture CDs on basic procedures that are needed by any young surgeon during his internship and residency.
2. Operative procedures by Matt Stephenson. Another resource from the same author as above that covers basic surgical procedures and a good introduction to advanced procedures. It also covers the aspects of knot tying, instrument handling etc, which need to be learnt in a standard way at the very beginning of surgical training.
3. Youtube, Cheap and quite useful. Punch in the procedure name in search box and get access to hundreds of free videos.

CLINICAL SURGERY

Das manual for clinical surgery is outdated and irrelevant. Other than for passing MS/DNB exams, its practicality is highly debatable. IMHO

1. Dr Exam books for MRCS part B, Includes a DVD that clearly explains all aspects of case taking and clinical examination.
2. Geeky Medics, A YouTube channel with all the required clinical examinations conducted in a OSCE pattern. Simple and precise. Absolutely free!!!

SURGICAL SPECIALITIES

While undergoing rotations in speciality postings, it is of great help to pick a few books which make sense of what is going on in the OR and OPD. This is a great chance to know your interests and planning future in surgical sub groups.

I found this area of training akin to rapid dating, at the end of all the rotations, you can pick the one you like and stick with it. Sounds fun!

1. Urology/Genito urinary surgery: Oxford American Handbook
2. Plastic / Reconstructive surgery: McGregor Plastic Surgery
3. Neuro-surgery: Geraint Fuller’s Neurology and Neurosurgery illustrated
4. Surgical Radiology: William Herring’s learning radiology.
5. Cardiothoracic / Vascular surgery, Oxford handbook to CT surgery
6. Pediatric Surgery Al Salem’s illustrated guide to pediatric surgery.
7. Emergency surgery: Bailey’s surgical emergencies
8. Trauma: ATLS handbook
9. Vascular Surgery: Vascular Surgery at a Glance
10. GI surgery: Fisher (very selectively)

Bailey is a good basic textbook to start on any topic, you can use this as a baseline to annotate and add in anything else you come across elsewhere.

I chose not to include Sabiston, Schwartz, Maingot, Fisher and other heavy textbooks, as I felt they can be quite misleading in early days of training. These books what I feel make more sense at least after 2-3 years of surgical training. So my suggestion is use the above resources in early days and then shift to the standard books once you are comfortable with routine cases.

Sabiston made sense only at the end of MS training days so if you are in the face of final MS exams or NEET SS, you can consider avoiding it till then.

Unorthodox is the new norm. My personal inspiration being Field Marshal Erwin Rommel, whose thought processes were out of the box compared to his contemporaries.

So, don’t be afraid to do things differently.