Surgery Shelf Exam (Meaning, Benefits, Resources, Study tips, Format)7 min read

The Surgery Shelf Exam is not mandatory for every student.

Although most medical schools require an internship in surgery, the most popular way to evaluate students is by using the surgery shelf exam.

Moreover, all students must be aware that the exam can only be written at approved testing centers such as Prometric test centers or on the campus at only certain medical schools.

What is a Surgery shelf exam?

The surgery Shelf exam is a theory-based exam that evaluates students’ skills in diagnosing, managing surgical patients, and ascertaining when surgical treatment is needed.

In the third and fourth year at the College of Medicine, shelf exams are conducted by the NBME to determine students’ willingness to continue medical school.

The exams involve Psychiatry, Surgery, Pediatrics, Medicine, Neurology, and Family Medicine.

It is rated on the national average, but assessment is based on the individual’s medical school’s requirements.

However, the amount of right answers gotten in the exam puts the students on a percentile calculated over the national grades.

The exam assesses students on how they evaluate if a patient requires operation based on a diagnosis and the medical care of patients preparing for surgery.

Benefits of Surgery shelf Exam

Students thinking of residency training in a surgical field or those looking to apply for aggressive residency programs and hence wish to receive many rotations will certainly have to be successful in this exam.

What resources are best for the Surgery Shelf Exam?

Even though this is formally a surgery exam, it’s usual for students to describe it as written like Medicine Shelf. Moreover, writing the Medicine Shelf first will help, though.

Notwithstanding, new digital resources of medical ideas are now available for students to study with such as: 

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Like other Shelf Exams, UWorld is the resource to check. Students can use the Step 2 CK Qbank to search for surgery questions.

It is recommended that they make efforts to complete all of them at least once, and if possible twice, before enrolling for the Surgery Shelf exam.

Going through the world at the start of the internship will help get the students ready for surgical assessments and prepare them for their exams.

Moreover, always use UWorld as a learning tool and concentrate more on learning from every question.


This resource consists of several parts joined together like the Qbank, which has the USMLE-style questions and explanations.

Questions in AMBOSS are usually a bit more comprehensive than in UWorld. However, it is wiser to complete UWorld first to build one’s knowledge and ideas.

Afterward, move on to AMBOSS to get more comprehension to deepen one’s learning. AMBOSS provides a number of evidence-based texts on objectively pertinent topics.

This can be very helpful in learning from your patients as you rotate.

Dr. Pestana’s Surgery Notes: 

This is a great textbook on surgery. It is short and to the point but packed with important information.

It comes with a small number of practice questions compared to UWorld and AMBOS and is advisable to read this book during your rotation.

Dr. Pestana’s Surgery Notes is a little book that anyone can easily slip into their pockets to read whenever they find a little break in the wards.


OnlineMedEd has good video series that is very helpful for the surgery shelf exam. The videos on this platform present information in a comprehensive manner.

Many students who might feel tired while studying find it easier to watch videos than read a book. Moreover, what is only required is to be awake and stay focused.

Every video has notes. These notes are strong and a quick approach to review key resources before the exam.

Step Up to Medicine: 

This can be very helpful for Surgery Shelf Exam. Note that this book is very informative and, therefore, not a crammable resource.

Cramming is not advised, though, for a host of different reasons.

Step Up can be useful to any student who is a little bit lost when working with the medical side of taking care of patients prepared for surgery.

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The very useful areas are the cardiovascular and GI systems.

Method of studying for the Surgery Shelf Exam

Choosing the correct answer often comes down to selecting between two similar management options:

  • Knowledge of basic medical treatment
  • The application of pharmacological knowledge

Tips for studying for the Surgery Shelf Exam

  • Understand how to diagnose and treat serious surgical cases.
  • Do not overlook the basics and keep your ABCs in mind: airway, breathing, and circulation.
  • Go with your instincts because you would have a small amount of time for the exam; you do not want to waste any time trying to remember the details.
  • Learn while at work: Use the knowledge you have gained while in the hospital to direct your reading at home.
  • There is an obvious intersection between the Internal Medicine exam and the Surgery Shelf exam, and taking one over the other can prove useful in boosting a student’s score.
  • Concentrate on how to sharply identify when a patient requires surgery or other medical care.

Techniques used in increasing a student’s performance in the surgery shelf exam:

The following techniques are useful in increasing a student’s performance in the exam:

Choose one of the relevant resources and start reading early:

The choice of surgery textbooks is lean. The sooner a student starts building surgical foundation, the better.

The only issue associated with the exam is that just a few questions are solely related to the “surgery shelf.”

As a result, students who haven’t taken the medicine shelf exam and are studying questions on the medicine shelf will benefit greatly.

The best database to get questions from is UWorld, AMBOSS, and USMLERx.

Spend more time on rotations than in the Operating Room:

This might look unreasonable. But, be assured that everything learned on rotations is remarkably more beneficial than any skills or techniques learned in the Operating Room.

Remember that studying for the surgery shelf exam would be spent mostly away from the hospital on nights when you are tired from a long day at work.

Every day, devote at least an hour to reading and answering some questions. At the same time, always stick to this schedule strictly, even though you are tired.

Think about sitting for the medicine shelf exam first:

It is important to take the medicine shelf exam before the surgery shelf exam because it helps students do better on the surgery shelf exam.

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On the other hand, the surgery shelf exam first will enable the students to do better on their medicine shelf exam.

So, every student ought to think about which shelf is more relevant to do well on. They would have to choose either surgery or medicine and plan their shelf exams correspondingly.

What to expect in the surgery shelf exam?

The exam is in the format of an online test that comprises 110 multiple-choice questions. It lasts 165 minutes.

The Surgery Shelf exam will evaluate students on how they can discover if a patient requires operation and the medical treatment of surgical patients dependent on a diagnosis.

After spending weeks going through this routine, which is generally about 6 to 8 weeks, depending on the medical school, students will sit for the Surgery Shelf Exam.

This exam is considered to be one of the most demanding Shelf Exams. Medical schools usually use Shelf Exams to calibrate their students’ capability in clinical rounds.

Poor performance in surgical shelf exams can mean failure of the rotation for the entire clinical course. However, a good score for the surgical shelf exam is 62 or 78.


An essential aspect of answering surgery shelf exam questions is correctly determining the clinical condition.

A student who does not pass the second shelf exam will receive an F in the whole internship. They will be asked to repeat the full rotation before sitting for another surgical shelf exam.

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