Canadian Association of General Surgeons

Residents Committee

Residency Survival Guide

2010 Edition



Authors:

Allison Maciver, Alison Archibald, Gavin Beck,
Ali Cadili, Vanessa Cranford, Erin Cordeiro, Luc
Dubois, Suleena Duhaime, Janet Edwards,
Andrea Faryniuk, milie Joos, Cailan
MacPherson, Chloe McAlister, Joey McDonald,
Alisha Mills, Jonathan Spicer, Julie Ann Van
Koughnett




1. CACS and Lhe 8esldenLs CommlLLee
2. Maklng ?our Llfe (and Learnlng) Lasler
3. nuLs and 8olLs of Lvery new 8oLaLlon
4. Cn Call
3. Cn Lhe Wards
6. 1eachlng as a 8esldenL
7. Well-8elng
8. 1exLbooks We Llke
9. WebslLes and Apps We Llke
10. Clvlng 8ounds
11. naLlonal Lxams
12. A noLe on Loupes
13. 8esearch
14. MenLors and rofesslonal uevelopmenL
13. MllesLones ln Ceneral Surgery 8esldency
16. lnLernaLlonal Surgery
17. rofesslonal 8esources and 8esldenL AssoclaLlons
Table of Contents

We|come to Genera| Surgery!

1hls handbook was developed for you, a Ceneral Surgery resldenL, by Lhe Canadlan AssoclaLlon
of Ceneral Surgeons 8esldenLs CommlLLee. We are comprlsed of sevenLeen resldenLs
represenLlng nearly all of Lhe Ceneral Surgery programs across Lhe counLry.

And, we|come to CAGS!

?ou are now a member of a dynamlc organlzaLlon LhaL represenLs Lhe volce of Ceneral
Surgeons ln Canada. CACS promoLes Lhe Lralnlng, educaLlon, professlonal developmenL,
LhoughLful pracLlce, and research essenLlal Lo Lhe provlslon of exemplary surglcal care
Canadlans expecL and deserve.

1he CACS 8esldenLs CommlLLee ls comprlsed of represenLaLlon from all programs across Lhe
counLry and Lhe Chalr ls a member of Lhe CACS 8oard. Cur mlsslon ls Lwofold: Lo unlfy and
represenL Lhe lnLeresLs of all Ceneral Surgery resldenLs across Canada, and Lo fosLer an
awareness of CACS and lLs acLlvlLles Lo all Ceneral Surgery resldenLs.

Lach year, CACS hosLs Lhe Canadlan Surgery lorum ln SepLember, ln a ma[or Canadlan clLy. As
parL of Lhls naLlonal meeLlng, Lhe 8esldenLs CommlLLee hosLs a symposlum on a currenL Loplc of
lnLeresL Lo Canadlan Ceneral Surgery resldenLs. CLher evenLs lnclude a CACS 8esldenL's ulnner
durlng Lhe lorum.

1he 8esldenLs CommlLLee meeLs once or Lwlce a year, and also communlcaLes vla emall, web
lnLerface and Leleconference as ofLen as necessary.

8esldenLs CommlLLee Members:
Chalr: Alllson Maclver, unlverslLy of AlberLa
vlce Chalr: Allson Archlbald, Cueen's unlverslLy
asL Chalr: Luc uubols, unlverslLy of WesLern CnLarlo


CAGS
rogram 8epresenLaLlves:
vanessa Cranford, Memorlal unlverslLy
Lrln Cordelro, ualhousle unlverslLy
Lmllle !oos, Laval unlverslLy
!onaLhan Splcer, McClll unlverslLy
Suleena uuhalme, unlverslLy of CLLawa
Allson Archlbald, Cueen's unlverslLy
Chloe McAllsLer, unlverslLy of 1oronLo
Allsha Mllls, norLhern CnLarlo School of Medlclne
!oey Mcuonald, McMasLer unlverslLy
!ulle Ann van koughneLL, unlverslLy of WesLern CnLarlo
Andrea larynluk, unlverslLy of ManlLoba
Cavln 8eck, unlverslLy of SaskaLchewan
All Cadlll, unlverslLy of AlberLa
!aneL Ldwards, unlverslLy of Calgary
Callan Macherson, unlverslLy of 8rlLlsh Columbla

!"#$%& (&() (** (+,-.-%/ ,0)%/1 .#(. %2 1%-/3 .#0 1()45 &%$6 &0**7 "#0 .$(80*0$5 %/ .#0 $%(1
.% 59::055 *-80 -/ .#0 ;$050/.< #001*055 %2 .(6-/3 .#%93#. 2%$ .#0 +%$$%&7 =-80 /0-.#0$ -/ .#0
;(5. /%$ -/ .#0 29.9$0< ,9. *0. 0(:# 1()45 &%$6 (,5%$, )%9$ 0/.-$0 0/0$3-05< (/1 5(.-52) )%9$
&-*105. (+,-.-%/7! > ?-$ @-**-(+ A5*0$
Genera| 1|ps:
Learn Lhe preferences of each aLLendlng surgeon for operaLlve work and ward
managemenL. keep noLes on each aLLendlng ln a noLebook/blackberry Lo access Lhem
easlly aL a laLer daLe.
8uy a blank drawlng book Lo skeLch ouL Lhe sLeps of an operaLlon soon afLer you see or
do a case, and keep Lhls book ln your locker Lo revlew qulckly Lhe nexL Llme you happen
Lo scrub ln on, say, a rlghL hemlcolecLomy wlLh ur. x. AL Lhe end of flve years, you wlll
flnd you have noLes wrlLLen on many dlfferenL surgeon's preference Lo perform Lhe
same operaLlon, whlch you may wanL Lo refer Lo when you're sLarLlng ouL ln pracLlce
and developlng your own Lechnlques.
Copy and save an operaLlve noLe LhaL Lhe sLaff has dlcLaLed, and save lL as a LemplaLe for
fuLure dlcLaLlons.
undersLand why you are dolng a Lask on Lhe ward or a surglcal procedure. uon'L [usL do
Lhe Lask because you are asslgned Lo lL. Learn by asklng quesLlons.
knowledge can be galned dally from experlence, however, you wlll noL geL Lhe blg
plcLure wlLhouL readlng.
8emember, even lf you are noL Lhe prlmary surgeon, Lhere ls always educaLlonal value
ln Lhe operaLlng room.

Gett|ng your work done:
uo noL procrasLlnaLe, especlally wlLh C8 reporLs and dlscharge summarles, unless you
are prepared Lo spend some lonely nlghLs sweaLlng lL ouL ln a cublcle ln PealLh 8ecords
Lrylng Lo remember deLalls. We have all been Lhere, and lL's unnecessary.
Check up on Lhlngs ln a Llmely fashlon so LhaL you can plck up earller ln Lhe day lf Lasks
were forgoLLen, cancelled or mlssed.
uo Lhlngs LhaL depend on oLhers flrsL, le. calllng for consulLs or schedullng xrays or oLher
LesLs.
llll ouL paperwork and scrlpLs Lhe day before for a paLlenL ls planned Lo go home Lo save
Llme ln Lhe mornlng.
MAKING YOUR LIFE (AND LEARNING) EASIER
uelegaLe buL do noL forgeL Lo follow-up on your asslsLanLs (oLher resldenLs and medlcal
sLudenLs). Cne useful Lechnlque ls Lo requesL LhaL each asslsLanL reporL back Lo you on
Lhelr progress (closlng Lhe loop").
8e seen. ?our sLaff wlll noL know you are worklng hard lf Lhey do noL see you. 1ry Lo
maxlmlze face Lo face Llme durlng each roLaLlon. lf you musL spend Lhe day on Lhe ward
lnsLead of Lhe cllnlc or C8, leL aLLendlngs or Lhe chlef resldenL know why and make sure
you lnform Lhem of lmporLanL updaLes.
8emember, your flrsL prlorlLy ls Lo learn Lo be a surgeon. 1here wlll always be scuL
work" Lo do, buL make Lhe C8 a prlorlLy and Lry Lo use Llme ln beLween cases for scuL"
as much as you can.
SLarL a consulL even lf you don'L Lhlnk you have Llme Lo flnlsh. aLlenLs don'L mlnd
havlng Lhelr exam lnLerrupLed, lL ls beLLer Lhan noL havlng seen Lhe docLor aL all.

keep|ng up w|th read|ng
8ead around cases on Lhe ward and ln cllnlc. ?ou wlll remember more lnformaLlon lf lL
ls assoclaLed wlLh a paLlenL experlence and real conLexL.
urchase a sLandard surglcal LexL and a good aLlas (refer Lo Lhe recommendaLlons laLer
ln Lhls handbook.)
Conslder purchaslng or subscrlblng Lo onllne coples of LexLbooks Lo revlew lf your book
ls noL avallable ln Lhe hosplLal.
CMA! and oLher [ournals arrlve ln our mallboxes buL rarely geL read - lf Lhere ls an
arLlcle LhaL sounds llke lL's worLh readlng, Lear lL ouL and puL ln your scrubs pockeL aL
Lhe beglnnlng of your day. ?ou wlll flnd some down-Llme somewhere durlng Lhe day Lo
read lL (walLlng for your nexL case, over lunch, eLc.)
ln a slmllar veln, carry coples of papers you've been meanlng Lo read (eg. [ournal club,
prep for Lhe nexL Leachlng sesslon or rounds, eLc.)
LlsLen Lo medlcal podcasLs whlle commuLlng or worklng ouL.
keep a copy of a LexLbook ln your car for Lhe unexpecLed Llmes you flnd exLra Llme Lo do
a llLLle readlng. ?ou wlll be surprlsed by how many Llmes you pull lL ouL lf you have lL
wlLh you.
8uy a flllng cablneL and sLay organlzed. Conslder keeplng [ournal arLlcles organlzed by
Loplc. lL's [usL as easy Lo Lhrow a paper ln Lhe drawer under Crohn's apers" Lhan on
your floor (or ln Lhe Lrash). 1hls provldes maLerlal ready Lo grab when you flnd ouL
you're dolng rounds on a speclflc Loplc or need Lo prep for academlc half-day.

repar|ng for the Ck
know whaL's golng Lo happen beforehand, you can usually geL Lhe C8 llsL ahead of Llme
from Lhe C8 desk or from your sLaff's secreLary.
lL goes wlLhouL saylng - whenever posslble meeL Lhe paLlenL before Lhe procedure!
Make Llme Lo lnLroduce yourself, and glve yourself Lhe opporLunlLy Lo maLch a paLlenL's
presenLaLlon wlLh Lhelr paLhology.
ay aLLenLlon Lo noL only Lhe operaLlve procedure, buL also paLlenL poslLlonlng, safeLy
checkllsLs, Lrocar poslLlonlng eLc.
Arrlve ln Lhe C8 early Lo prepare Lhe paLlenL. Lnsure Lhe llghLs are ln Lhe approprlaLe
poslLlon Lo sLarL (and able Lo move easlly), lnserL Lhe foley caLheLer (lf needed), poslLlon
Lhe paLlenL, shave lf necessary (lf your sLaff or senlor ls shavlng, you can geL Lhe Lape
ready Lo plck up Lhe halr), eLc.
know Lhe relevanL anaLomy, lncludlng ln[urles Lo avold.
ulscuss Lhe case wlLh Lhe aLLendlng aL Lhe scrub slnk or posL-operaLlvely.
MosL of us feel lL ls accepLable Lo ask Lo do someLhlng ln Lhe C8 such as openlng or
performlng Lhe lnlLlal lnclslon.

1h|ngs to do before you start a new rotat|on
CeL orlenLed Lo your hosplLal slLes, know how long lL Lakes you Lo geL from one place Lo
anoLher.
MeeL your rogram ulrecLor and rogram AdmlnlsLraLor.
CeL your pager and know where Lo geL baLLerles.
Crganlze your CMA lnsurance.
know where your call room ls.
know where Lo secure valuables ln Lhe hosplLal / lockers.
know Lhe scrubs dlspenslng sysLem ln your hosplLal.
llnd ouL where cafeLerla and cafes are... and whaL Llme Lhey close!
llnd ouL where 8adlology ls, and where Lhe radlologlsLs hang ouL.
llnd ouL where Lmergency ls, and where Lhe paLlenL charLs are kepL.
llnd ouL where aLhology ls, and where Lo drop off speclmens you wanL rushed.
CeL your parklng pass.
CeL your nameLag.
ConLacL your flrsL senlor/Chlef resldenL Lo geL any addlLlonal orlenLlng Llps for a
parLlcular roLaLlon abouL a week 8LlC8L you sLarL.
NUTS AND BOLTS OF ANY NEW ROTATION

LeL's face lL, durlng resldency you are a real resldenL" of Lhe hosplLal for some porLlon of your
Llme. ?ou probably sleep ln a call room x of your nlghLs, mosL of your meal Llmes wlll happen
ln Lhe hosplLal cafeLerla, and much of your soclal neLwork wlll lnclude oLher housesLaff by
necesslLy. lL ls lmporLanL Lo make Lhls Llme noL [usL Lolerable, buL as poslLlve as you can. 1here
are many slmple Lhlngs LhaL oLher resldenLs have found LhaL make Lhe whole experlence more
comforLable.
1here ls some lnformaLlon LhaL you can only geL by Lalklng Lo oLher resldenLs. CeL Lhe scoop on
hosplLal secreLs such as: Where ls Lhe besL place Lo have a shower? Where can you flnd
someLhlng Lo eaL laLe aL nlghL? Where do you flnd exLra llnens/Lowels/warmed blankeLs?

L|st of Cn-Ca|| N|cet|es

Lock for your locker
Small snacks. SuggesLlons: fllllng Lhlngs" wlLh proLeln such as cheese, almonds, box
of granola bars/power bars, lnsLanL oaLmeal or noodles, Luna, frulL cups, chocolaLe
mllk, and any oLher snacks LhaL you en[oy. Do not underest|mate the power of a
snack.
lresh palr of socks and underwear. Many resldenLs clalm [usL changlng Lhese Lhlngs
can make a blg dlfference ln how Lhey feel.
Spare L-shlrL. lf you don'L geL a chance Lo change your greens, aL leasL you can have
a new shlrL on underneaLh your old ones.
1olleLrles - anLlpersplranL, LooLhbrush and LooLhpasLe, shampoo, condlLloner, brush,
shower gel/soap, face wash, and skln care producLs. keep your favourlLe klnd, noL
[usL Lhe Lravel slze-bln speclal!
Palr elasLlcs or cllps
8ody loLlon/hand loLlon
?our favourlLe prep book or cllnlcal handbook
Cdour eaLers/fooL spray for any shoes LhaL sLay ln your locker
SweaLer/sweaLshlrL
Change of cloLhes for cllnlc or afLer-work ouLlng
ON CALL
nandover
A proper and conclse handover ls cruclal for opLlmal paLlenL care. Pandover ls Lhe Lerm LhaL ls
used Lo descrlbe Lhe communlcaLlon LhaL occurs beLween resldenLs when paLlenL care
responslblllLles are belng Lransferred. As every program wlll have sllghLly dlfferenL meLhods of
dolng handover our dlscusslon wlll lnclude general prlnclples only. Call responslblllLles vary
sllghLly from program-Lo-program so clarlfy your duLles before you sLarL.
1he followlng are some general prlnclples LhaL apply Lo glvlng a proper handover. llrsL and
foremosL - be conclse! We are all very busy people and handover lLself should aL Lhe most Lake
30 mlnuLes. Second, Lhe lnformaLlon LhaL you glve musL be accuraLe, so know your paLlenLs.
SomeLlmes Lhere ls no Llme Lo furLher read over a paLlenL's charL.
1here are Lwo maln Lypes of handover for resldenLs - Lhe handover glven Lo Lhe on-call person
from Lhe day sLaff and Lhe one glven by Lhe on-call person Lo Lhe day sLaff Lhe nexL mornlng.
1he expecLaLlons of each vary.
When handlng over Lo Lhe on-call resldenL before leavlng for Lhe day, Lhere are a few key
aspecLs Lo cover (some of Lhese may or may noL apply dependlng on your on-call
responslblllLles). WlLh regard Lo floor paLlenLs Lhe on-call resldenL does noL generally need a
comprehenslve dlscusslon of every paLlenL. 8aLher, glve a brlef descrlpLlon of a parLlcular
paLlenL whlch you feel may be a concern durlng Lhe nlghL hours. Slnce you, as Lhe day sLaff,
know Lhe paLlenLs qulLe well, glvlng Lhe on-call resldenL a suggesLlon for overnlghL
managemenL ls noL unwelcome. lf Lhe on-call resldenL wlll also be handllng consulLs Lhan a
brlef menLlon of any ouLsLandlng consulLs LhaL Lhe day Leam has noL yeL compleLed musL be
menLloned. Also, lf you know of any ouLsLandlng paLlenL Lransfers from oLher healLh care
cenLres Lhe on-call person should be made aware of Lhese so LhaL Lhey are noL surprlsed when
Lhey arrlve. llnally, any operaLlons LhaL are scheduled Lo occur afLer hours should be dlscussed.
1hls would lnclude Lhe paLlenL's name, whaL surgery ls planed, a 88lLl presenLlng hlsLory on
Lhe paLlenL and any dlagnosLlc work-up LhaL has been performed. 1hls should merely be a
[umplng polnL for Lhe on-call resldenL as lL ls Lhelr responslblllLy Lo Lhen meeL and examlne Lhe
paLlenL prlor Lo Lhe operaLlon. 1he oLher key plece of lnformaLlon ls wheLher a consenL form
has been slgned or noL, however, agaln lL ls Lhe on-call resldenL's responslblllLy Lo ensure Lhls ls
compleLed prlor Lo Lhe procedure.
llnally, when Lhe call shlfL ls compleLed and Lhe on-call resldenL ls handlng over Lo Lhe day Leam
Lhere are a few oLher lssues Lo keep ln mlnd. llrsLly, any new admlsslons overnlghL should be
dlscussed. Cenerally, Lhe paLlenL's name, age, brlef hlsLory of presenLlng lllness, pasL medlcal
and surglcal hlsLory and any dlagnosLlc LesLs LhaL were performed should be sLaLed. Agaln,
should be brlef as Lhere may be many paLlenLs Lo dlscuss. Any surgerles LhaL were performed
afLer hours should brlefly be dlscussed lncludlng Lhe procedure performed, any perLlnenL lnLra-
operaLlve flndlngs and speclflc posL-operaLlve lnsLrucLlons. llnally, wlLh regard Lo floor paLlenLs
only ma[or lssues should be broughL up, such as any LesLs or consulLs LhaL need Lo be
compleLed durlng Lhe day.
SomeLlmes resldenLs wlsh Lo hurry a proper handover as lL can be a Llme consumlng process
buL Lhls does noL need Lo be Lhe case! Many medlcal errors are commlLLed when Lransferrlng
paLlenL care and Lhese can be avolded lf proper lnformaLlon ls glven. A proper handover should
sLrlke Lhe balance beLween belng Lhorough and conclse.



now to be Lff|c|ent on Ward kounds
ually expecLaLlons of every Leam member musL be esLabllshed clearly, and early.
lormally orlenL any new resldenLs or medlcal sLudenLs Lo Lhe ward and Lo whaL happens
durlng ward rounds. Ask for Lhls lnformaLlon lf you are Lhe new resldenL ln quesLlon.
LsLabllsh a rouLlne. Lvery mornlng should be slmllar so LhaL Lhlngs go smooLhly and
efflclenLly, and Lhere ls no uncerLalnLy abouL flnlshlng on Llme.
lf you wanL Lo be on Llme, you have goL Lo be early.
lan ahead and sLarL rounds aL an approprlaLe Llme based on Lhe Leam's schedule LhaL
day.
Medlcal sLudenLs (and [unlors) should be encouraged Lo Lake an acLlve role ln geLLlng
Lhe Leam organlzed Lo sLarL rounds. Lvery member of Lhe Leam should be provlded wlLh
a paLlenL llsL, bloodwork musL be revlewed, and lssues from Lhe nurses' problem board
and lasL nlghL's on-call resldenL should be noLed before sLarLlng.
Cnce you have rounded, meeL as a Leam Lo run Lhe paLlenL llsL and dlscuss Lhe plan for
Lhe day for every paLlenL. 1hls ls essenLlal Lo avold errors, unnecessary dupllcaLlon of
work, and laLe or mlssed Lasks.
reserve a small amounL of Llme for coffee and Leachlng every mornlng before dlvldlng
up Lhe day's work and dlsperslng. Many of us feel Lhls goes a long way Lo keep up Leam
morale.
ON THE WARDS
Cha|k-ta|k]Coffee-ta|ks
1eachlng ls one of your roles as a resldenL. ?ou are parLly responslble for educaLlng medlcal
sLudenLs who roLaLe Lhrough Lhe servlce you happen Lo be on, and you have a loL of
valuable experlence and knowledge Lo draw from and share - even Lhough as Lralnees, we
sLlll have a loL Lo learn.

Many of Lhe mosL valuable learnlng opporLunlLles are lnformal and brlef. 1hey requlre llLLle
preparaLlon buL can have a lasLlng lmpresslon on sLudenLs. A few Llps:

8rlng a prop. 1hls can be anyLhlng: a phoLo, suLures, a chesL Lube, a phoLocopy of a
LexLbook flgure wlLhouL labels on lL, eLc. use your lmaglnaLlon. 1he prop can keep
people lnLeresLed and caLers Lo dlfferenL learnlng sLyles.
Ask sLudenLs whaL Lhey wanL Lo Lalk abouL. lor example, ls Lhere a recenL paLlenL,
dlagnosLlc LesL, CSCL sLaLlon eLc. Lhey wanL Lo know more abouL?
keep Lhe scope deflned: Lry Lo sLay on a Loplc and keep lL aL Lhelr knowledge level. lf
Lhlngs sLarL geLLlng ouL of hand, deslgnaLe anoLher Llme and place for addlLlonal
Leachlng.
lf Lhere are quesLlons you do noL know Lhe answer Lo, look lL up LogeLher.
lck a comforLable envlronmenL LhaL ls noL lnLlmldaLlng. 1hls may mean flndlng a
quleL room or cafeLerla corner, raLher Lhan ln Lhe C8 lounge ln fronL of sLaff
members.
Make a noLe of Leachable Loplcs as Lhey arlse Lo be reLurned Lo laLer ln Lhe day when
Lhere ls Llme.

Pere ls a llsL of good Loplcs Lo geL you sLarLed wlLh your sLudenLs:
llulds and elecLrolyLes SuLurlng
C8 eLlqueLLe/scrubblng Admlsslon orders
osLoperaLlve orders osL op fever
lnLerpreLlng A8Cs lnLerpreLlng x-8ays
rlmary survey of Lrauma paLlenL AppendlclLls
Abdomlnal paln 8lllary collc and
TEACHING AS A RESIDENT
cholecysLlLls
8reasL exam ulglLal recLal exam
8owel obsLrucLlon AcuLe abdomen
ulverLlcullLls ancreaLlLls
Cl bleedlng erlanal dlsease
AnLlbloLlc prophylaxls osL op SC8
osL op chesL paln Pernlas
Advanced procedures such as
chesL Lubes, cenLral llnes
Pow Lo dlcLaLe



now to keep your p|pes t|ght
hyslcal flLness lmproves concenLraLlon as well as ablllLy Lo survlve call.
llnd a gym CLCSL Lo your worklng place or Lo your home. CLherwlse you wlll noL go.
urop-ln classes: reglsLer for regular aeroblc, marLlal arLs, dance or any oLher Lype of
class and force yourself Lo go aL leasL once a week.
Conslder buylng an aeroblc exerclse machlne (can be more cosL-effecLlve Lhan Lhe gym).
AL work, Lake Lhe sLalrs!

now to keep that pretty face
8elng awake for more Lhan 24 hours lncreases prevenLable medlcal errors by seven fold, resulLs
ln a 60 lncrease ln accldenLal percuLaneous ln[urles, decreases vlgllance, and doubles Lhe rlsk
of moLor vehlcle colllslons. 1he performance lmpalrmenL of faLlgue ls slmllar Lo a blood alcohol
level of 0.03. 1herefore, proper sleep hyglene ls essenLlal. We are all adulL learners,
however, conslder whaL may be aL sLake lf you sLay posL-call because lf l leave, lL looks bad."

1|ps for good s|eep hyg|ene
8emember, your bed ls for sleep and sex only! uo noL brlng medlcal books Lo bed. ?ou
need a worry-free sleep.
keep your bedroom LemperaLure comforLable- noL Loo cold or hoL (cooler room ls
beLLer Lhan a warm one)
1ry Lo have a regular posL-call paLLern: glve yourself aL leasL 4 hours of awake Llme
before you go back Lo bed.
erform a 20-mlnuLe 'wlnd-down' before golng Lo bed (baLh, 1v show, eLc.).
uon'L sLress ouL over noL geLLlng enough sleep, lL wlll only make maLLers worse.
Avold looklng aL Lhe clock ln Lhe mlddle of Lhe nlghL - lL only creaLes anxleLy. 1urn Lhe
clock away from you so you have Lo reach ouL Lo see lL durlng Lhe nlghL. Chances are
you won'L and wlll [usL fall back asleep.
lf you cannoL fall asleep wlLhln 30 mlnuLes, geL up and do someLhlng llghL unLll you
become sleepy agaln.
Wear ear plugs, Lurn off pager/cell phone aL home, shuL off all llghLs, and close
wlndows.
WELL-BEING
Some resldenLs geL heavy drapes or bllnds Lo have a nlghL Llme" room anyLlme.
1ry Lo avold alcohol, nlcoLlne and caffelne before bedLlme. Caffelne however has llLLle
effecL on subsequenL sleep ln normal sub[ecLs lf glven durlng Lhe day, avold lL aL nlghL lf
posslble.
1ry Lo avold exerclse for aL leasL 2 hours before bedLlme. Lxerclse ln Lhe laLe afLernoon or early
evenlng buL noL close Lo bedLlme. 8egular exerclse helps regulaLe sleep paLLerns.
1ry Lo malnLaln regular sleep-wake Llmes lf you can, even on weekends
lf you musL eaL before sleep, eaL llghLly. uo noL go Lo bed hungry.
Cn-call naps as shorL as 10 mlnuLes can help wlLh menLal alerLness, especlally when
good sleep ls unobLalnable. 1ry Lo avold naps beLween 1-2 hours ln lengLh.

8eferences:
SLepanskl L!, WyaLL !k, use of sleep hyglene ln Lhe LreaLmenL of lnsomnla, Sleep Medlclne
8evlews (2003), vol 7, no 3 pp213-223.
llcca eL al., naps, cognlLlon and performance. Sleep Medlclne 8evlews (2009),
dol:10.1013/[.smrv.2009.09.003
8radley, WC: neurology ln Cllnlcal racLlce, 3Lh ed. (2008) 8uLLerworLh-Pelnemann.

Stay|ng sane
8esldenLs are vlLal Lo Lhe healLh care sysLems we work ln, and we play many roles wlLhln lL -
lncludlng professlonal, learner, Leacher, and menLor. We have conLacL wlLh many dlfferenL
people, wlLh many dlfferenL personallLles and vlews Lowards resldenLs. We are exposed Lo
numerous evenLs LhaL can be boLh Lroubllng and dlfflculL. We work ln a fleld ln whlch mosL
people cannoL and wlll noL ever fully undersLand. We have Lo make llfe and deaLh declslons
(someLlmes very qulckly). We work long hours, and yeL have Lo flnd Llme Lo sLudy. 1aklng ln all
of Lhls, sLaylng sane can someLlmes seem hard. AL some polnL ln resldency we all have a
momenL and Lhlnk Lo ourselves Why am l dolng Lhls?" SLaylng sane and keeplng well balanced
ls dlfflculL and can be one of Lhe mosL challenglng aspecLs of resldency. 1here ls help ouL Lhere
when needed. 8emember, we have Lo Lake care of ourselves ll8S1 before we can Lake good
care of our paLlenLs.

Pere are a few Llps Lo keeplng good menLal healLh:
8ead non-medlcal books - you wlll burnouL preLLy qulck lf all you read for flve years
ls surglcal LexLbooks. 1ry Lo make a rouLlne for non-medlcal readlng Llme", no
maLLer how long LhaL Llme ls or whaL lL ls you choose Lo read.
keep up your non-medlcal lnLeresLs - Lhey may have Lo be placed on Lhe back-
burner aL Llmes, buL do noL drop Lhe Lhlngs LhaL lnLeresL you mosL. 1hey are
lmporLanL ouLleLs.
8elaxaLlon exerclses can help make Lhe body more relaxed (whlch ln Lurn wlll relax
Lhe mlnd):
- abdomlnal breaLhlng
- shoulder shrugs (lnhale whlle pulllng your shoulders up Lowards your head
roLaLe your shoulders and exhale whlle leLLlng your shoulders fall back down)
- head rolls (exhale whlle leLLlng your chln fall lnhale whlle roLaLlng your head)
- progresslve muscle relaxaLlon (alLernaLlng Lenslon and relaxaLlon of each
muscle group)
uC nC1 underesLlmaLe Lhe prevalence of menLal healLh lssues and subsLance
abuse ln resldency. Ask for help! 1here are many places Lo go. 8ecognlze when
you need help and seek lL ouL before lL ls Loo laLe.
1he provlnclal psychologlsLs dlrecLory ls easy Lo use. lnsurance coverage ls up Lo
80.
We all should be able Lo work ln a harassmenL free workplace. Lvery school has a
pollcy ln place Lo deal wlLh lnLlmldaLlon and harassmenL. 8eporL an lncldenL lf you
feel uncomforLable.

WebslLes
bttp.//www.cpo.oo.co
bttp.//www.otJtepsy.pc.co/eo/loJex.btml
bttp.//www.psycboloqlstsossoclotloo.ob.co/
bttp.//www.cpmb.co/
bttp.//www.skcp.co/
bttp.//www.psycboloqlsts.bc.co/
bttp.//www.opos.co/
bttp.//www.ofpsycb.com/


now to keep your honey
lnform your parLner of work hours and responslblllLles prlor Lo sLarLlng resldency or
roLaLlons (and keep Lhem up Lo daLe of any changes). 8emember, Lhey are golng
Lhrough resldency wlLh you (and are maklng a loL of sacrlflces as well - do nC1 Lake
Lhem for granLed)!
ALLempL an 'offlclal' daLe once every Lwo weeks (plan ln advance).
Make offlclal calendar wlLh calls, classes eLc. (lnclude parLner's schedule).
1ry Lo call home once a shlfL, even lf lL's [usL Lo say Pl/Mlss you/Love you.
Acknowledge when you had a bad day and share feellngs buL do noL Lransfer work
sLress onLo parLner.
Pave unofflclal daLes ln hosplLal - brlng or order dlnner ln.
CulLlvaLe relaLlonshlps wlLh non-medlcal frlends Lo avold medlcal Lalk and do non-
medlcal acLlvlLles (you would be amazed by how good lL feels Lo geL away and
reallze Lhere are more Lhlngs Lo llfe Lhan Lhe hosplLal).
MAkL yourself go ouL LvLn lf youare Llred, now and Lhen - you won'L regreL lL.
ALLend resldenLs' soclal evenLs and parLner's work evenLs.
8ond wlLh oLher surglcal resldenLs so you have oLher ouLleLs for shop Lalk."

regnancy - 'cuz on|y Cbs]Gyne res|dents shou|d de||ver on ca||
1lmlng: 1here never seems Lo be a besL Llme," of course. Conslder LhaL your
workload wlll be dlfferenL and llkely more flexlble durlng a research year(s). 1alk Lo
your rogram ulrecLor and oLher resldenLs who have been pregnanL durlng Lhelr
resldency.
MaLernlLy leave: 8efer Lo your provlnce's resldenLs assoclaLlon conLracL and your
programs' pollcles. 1he mlnlmum ls 3 monLhs.
aLernlLy leave: As above.
Work resLrlcLlons: ?ou wlll need Lo consulL wlLh your rogram ulrecLor. llnd ouL
hours resLrlcLlons from your provlnclal resldenLs assoclaLlon and seL a clear daLe for
when you are Lo sLop Laklng call.
Chlldcare: lnform yourself of ln-hosplLal daycare.
8reasLfeedlng: Conslder buylng a breasL pump for Lhe hosplLal.
Survey-based research suggesLs LhaL occupaLlonal characLerlsLlcs (worklng >80
hrs/week or >40 hrs/week ln Lhe operaLlng room, and preblrLh/posLblrLh leave <2
weeks) are noL correlaLed wlLh pregnancy compllcaLlons. Powever, gullLy feellngs
abouL havlng a demandlng career slgnlflcanLly correlaLe wlLh neonaLal compllcaLlons
and resldenLs were found Lo have slgnlflcanLly more gullL Lhan fellows and
aLLendlngs. Surgeons have slgnlflcanLly hlgher raLes of preLerm dellvery,
preeclampsla and abrupLlon Lhan Lhe general populaLlon. Surgeons also have hlgher
raLes of preLerm dellvery and preeclampsla compared Lo oLher women of hlgh
socloeconomlc sLaLus, however, ouLcomes were no dlfferenL (8eference: ?ao C.A. eL
al, 2009 !ACS 209, 3S 113-116).
lor a revlew of Lhe llLeraLure, see: llnch, S.!. regnancy durlng resldency: A
llLeraLure revlew. Acad Med. 2003 Apr,78(4):418-28.
A sLudy of women urologlsLs found LhaL Lhey have chlldren laLer ln llfe, have fewer
chlldren, have a hlgher lnducLlon raLe, and have a hlgher lncldence of pregnancy
compllcaLlons. AuLhors concluded LhaL Lo avold compllcaLlons, chlldbearlng should
noL be delayed and resldency programs wlll need Lo develop programs Lo supporL
Lhe growlng number of women urologlsLs." 8eference: Lerner eL al., 2009 !ACS
208(2), 293-297.



now to keep money |n your wa||et
Avold Lhe LempLaLlon of a posL call shopplng spree
llnd an accounLanL LA8L? and make a budgeL. 1alk Lo upper year resldenLs and
fellows who may be able Lo suggesL someone. Mu ManagemenL also offers free
accounLanL servlce as parL of your CMA membershlp,
bttp.//www.cmo.co/loJex.cfm/cl_lJ/51787/lo_lJ/1.btm
8udgeL for exam cosLs:
- LMCC arL 2: $1830 (laLe $2773)
- CS: $640 + pre-reglsLraLlon $330
- 8oyal College Lxam: $3400
llnu Cu1 ALlCA1lCn uLAuLlnLS and make sure you apply on Llme.* LaLe fees
are subsLanLlal.
CLher dues:
- CMA
- ulsablllLy lnsurance
- CMA and provlnclal assoclaLlons
- Amerlcan College of surgeons (ACS)
- PealLh plan and uenLal plan (lncluded ln some programs)
- 1ulLlon fees
CLher cosLs Lo facLor ln:
- 1exLbooks (flnd ouL lf your program wlll provlde any before buylng)
- Conferences (flnd ouL whaL your program wlll cover)
- 1ravel home and holldays
- Loan consolldaLlon
- 88S (8LL8)
Save all your recelpLs for Lax Llme. Make a folder Lo puL Lhese ln over Lhe course of
Lhe year so LhaL you aren'L scrambllng ln Lhe sprlng. 1alk Lo your accounLanL abouL
whlch Lhlngs mlghL be deducLlble. 1hese may lnclude movlng expenses, books, loupes,
cell phones, bllls, uA's, compuLer equlpmenL, offlce furnlLure, gas recelpLs and car
expenses. ?ou may also be able Lo clalm once you sLarL a pracLlce, so keep Lhem
organlzed.

1|me savers

Conslder a cleanlng servlce lf you can budgeL for lL. ?our Llme ls preclous and you
may wanL Lo avold spendlng your free Llme dolng chores and Lasks you do noL en[oy.
Lven once-monLhly servlces may make a dlfference for you.
lood: buy bulk granola bars, nuLs eLc. (non-perlshable goods) so you wlll noL have Lo go Lo
Lhe grocery sLore every week. Many of us love our CosLco membershlps.
Laundry drop-off on Lhe way Lo work
Cook ln baLches, freeze lefL-overs for lunches and when you are Loo Llred Lo cook.

Safety recaut|ons
keep your lmmunlzaLlons up Lo daLe
uouble glove (Lhere ls good evldence abouL Lhls)
8LC81 ?Cu8 nLLuLL S1lCk ln!u8lLS
Always wear glasses, or buy lnexpenslve shlelds (MLC sells Lhem for less Lhan $20),
or use whaL Lhe C8 provldes.
Compresslon sLocklngs: sLudles show LhaL even low levels of compresslon reduce
Lhe feellng of leg faLlgue caused by dependenL leg edema. MosL programs cover Lhe
cosLs of several palrs. 1hey are worLh Lhe lnvesLmenL.
8uy good shoes. Many comforLable" C8 shoes (eg. crocs) are noL acLually good for
your feeL. Conslder maklng an appolnLmenL aL a shoe place Lo geL a proper flL and
orLhoLlcs.
lf you're slck, Lake Lhe day off maklng sure you conLacL your supervlsor and Leam
and arrange for anoLher resldenL Lo cover for you.
Wash hands regularly (Alcohol gels do nC1 klll C.dlfflclle).
Call Lhe CMA/ACM or your provlnclal resldenL assoclaLlon for advlce on An? legal
lssue: bttp.//www.cmpo-ocpm.co/cmpopJ04/loJex.cfm, feeJbockcmpo.otq, 1 800
267-6322

Cther usefu| webs|tes:
bttp.//www.epbyslcloobeoltb.com
bttp.//www.ewotkploce.com
bttp.//www.cmo.co

1here ls a dlzzylng number of LexLbooks avallable. 1he Lrlck ls plcklng Lhe rlghL one or Lwo
for you from each caLegory."

8efore we beg|n the deta||s, our genera| consensus on textbooks:
MUS1 nAVL CNL CI
Schwartz
Sab|ston
Greenf|e|d's
Amer|can Co||ege of Surgeons
CNL SUkGICAL A1LAS
CAMLkCN (cons|der after r|nc|p|es of Surgery)
Sen|or |eve|: access to "Surg|ca| C||n|cs of North Amer|ca" through CMA webs|te


1. Standard surg|ca| textbooks: 1he Legends
All avallable onllne for free, aL hLLp://www.cma.ca. 1hese books are generally equlvalenL, so
plck one Lo sLarL your advenLure ln Ceneral Surgery 8eadlng. We suggesL you borrow Lhem
from Lhe llbrary or peruse onllne before you buy.

r|nc|p|es of Surgery: Schwartz
AdvanLages: Ceneral gulde on all general surglcal lssues. AnaLomy, embryology,
paLhophyslology.
ulsadvanLages: noL an aLlas or surglcal Lechnlque book. 1oo deLalled aL Llmes, dlfflculL
Lo recall all maLerlal read ln one slLLlng.
use for: CuLllnlng presenLaLlons, CS, a sLarLlng polnL for [unlor resldenLs, general
overvlew of all Loplcs.

Sab|stons
TEXTBOOKS WE LIKE
AdvanLages: Ceneral gulde on all general surglcal lssues. lncludes anaLomy, embryology,
paLhophyslology. Some of us Lhlnk lL ls Lhe mosL useful of Lhe Lhree ln preparlng for oral
exams and aLLendlngs' qulzzes as opposed Lo Creenfleld's belng beLLer for preparlng for
wrlLLen exams.
ulsadvanLages: noL an aLlas or surglcal Lechnlque book. 1oo deLalled aL Llmes, dlfflculL
Lo recall all maLerlal read ln one slLLlng.
use for: CuLllnlng presenLaLlons, CS, acLs as sLarLlng polnL for [unlor resldenLs, general
overvlew of all Loplcs.

Greenf|e|d
AdvanLages: Some flnd lL easler Lo read and remember chapLer deLalls.
ulsadvanLages: Agaln, no speclflc operaLlve deLalls.
use for: Cvervlew for [unlor and senlor resldenLs, good revlew book.

ACS Surgery. (Amer|can Co||ege of Surgeons)
AdvanLages: Avallable onllne, updaLed yearly, free wlLh your ACS or CMA membershlp,
revlew quesLlons and end of every chapLer.

Cameron: Current Surg|ca| 1herapy
AdvanLages: Cllnlcally relevanL, conLalns algorlLhms, good preparaLlon for senlor years
posL CS. rovldes a very focused and manageable overvlew of speclflc subLoplcs.
ulsadvanLages: Mlnlmal anaLomlcal lnformaLlon, mlnlmal paLhophyslology, dlfflculL for
[unlor resldenLs due Lo lack of background knowledge. ulfferenL auLhors for each
edlLlon Lherefore llLLle conLlnulLy beLween edlLlons.

2. Cther he|pfu| genera| references

Lange: Current D|agnos|s and 1reatment - Surgery
AdvanLages: 8rlef, conclse, porLable, lnLroducLlon Lo a Loplc, lnformaLlon on oLher
surglcal speclalLles.
ulsadvanLages: noL enough deLall. noL approprlaLe for advanced levels.
use for: !unlor resldenLs, medlcal sLudenLs, on call lssues.

kush kev|ew of Surgery
AdvanLages: ure quesLlon and answer formaL. MosLly only useful for self-assessmenL
as Lhere ls only brlef explanaLlon of answers. very helpful Lo check knowledge of
concepLs, ldenLlfy weak areas.

A8SI1L kev|ew
AdvanLages: Cood reference for CS, porLable, easy Lo read, addlLlonal subspeclalLy
lnformaLlon.
ulsadvanLages: 1oo general for senlor years, no surglcal Lechnlques.

Cperat|ve D|ctat|ons |n Genera| and Vascu|ar surgery
AdvanLages: Pelpful for learnlng Lo dlcLaLe. CreaL scrlpL/sLarLlng polnL.

1op kn|fe
Well-loved book on emergency general surgery. Lasy Lo read sLyle, fun for all ages. CreaL Llps
for surgeons lnLeresLed ln Lrauma.

Cope's Lar|y D|agnos|s of the Acute Abdomen
AdvanLages: reasoned approach Lo physlcal exam. A classlc. LaLesL edlLlon ls 2010.
ulsadvanLages: noL a good qulck reference, Lhls ls more a cover-Lo-cover read.

Chass|n's Cperat|ve Strategy |n Genera| Surgery: An expos|t|ve at|as
AdvanLages: LxcellenL approach Lo mosL general surglcal operaLlons ln a conclse and
pracLlcal formaL. nlce flgures and well wrlLLen. Cood descrlpLlon of Lhe sLeps of an
operaLlon, useful for preparlng for oral exams.
ulsadvanLages: May noL be Lhe mosL up Lo daLe LexLbook regardlng surglcal declslon
maklng.

Shacke|ford, Surgery of the A||mentary 1ract
AdvanLages: CompleLe revlew of paLhologles of Lhe Cl LracL. used by some programs as
1PL revlew book for C?-3. Lspeclally good for pancreaLlcoblllary LracL. CuLsLandlng
flgures.
ulsadvanLages: uoes noL cover non-Cl general surgery.

Acute Care Surgery: r|nc|p|es and ract|ces
AdvanLages: Cood for resldenLs lnLeresLed ln acuLe care surgery/Lrauma/lCu. Pead-Lo-
Loe approach Lo surglcal emergencles.
ulsadvanLages: nC1 a revlew book.


3. At|ases, 8ooks on Surg|ca| 1echn|que

Skanda|ak|s: Surg|ca| Anatomy and 1echn|que: A pocket manua|
AdvanLages: Culck reference for surglcal anaLomy and Lechnlque lf you have noL
revlewed Lhe operaLlon beforehand. Cood Lo keep ln locker.
ulsadvanLages: noL very deLalled, no Lhorough anaLomy, all plcLures ln black and whlLe.
use for: 8evlewlng operaLlon and Lechnlques pre-op.

2o|||nger: At|as of surg|ca| operat|ons
AdvanLages: LoLs of plcLures, Lhe classlc aLlas.
ulsadvanLages: Mlnlmal wrlLLen deLall, cumbersome and noL porLable.

Mastery of surgery
AdvanLages: Covers a loL of laparoscoplc and open surgery, lnformaLlon on pre-
operaLlve and posL-operaLlve care, Lhorough revlew of anaLomy, excellenL colour
plcLures. Avallable onllne.
ulsadvanLages: noL a qulck reference, noL always up Lo daLe.
use for: Learnlng operaLlons.

Cperat|ve anatomy: Scott-Connor, Dawson
AdvanLages: locuses ln on lmporLanL anaLomy for surglcal procedure, good wrlLLen
deLalls on how Lo perform operaLlon.
ulsadvanLages: Could use more plcLures, noL a loL of lnformaLlon on pre and posL-
operaLlve managemenL and compllcaLlons.
use for: Learnlng operaLlons

Ma|ngot's Abdom|na| operat|ons, Vo|ume I and II
AdvanLages: Cood mlx of LexL and aLlas. CreaL Lechnlcal deLalls. Clear lllusLraLlons and
good llLeraLure revlew. 8eneflLs boLh senlor resldenL and general surgeon.
ulsadvanLages: noL porLable (excepL newesL edlLlon)

At|as of Laparoscop|c Surgery
AdvanLages: ALlas of laparoscoplc procedures, boLh baslc and advanced. lncludes
commenLarles and lllusLraLlons.

4. ocket references
1he Mont ke|d Surg|ca| nandbook
Cood for 81 and preparlng rlghL before a case or consulL, polnL form and brlef.

Cn Ca||: r|nc|p|es and rotoco|s, and Cn Ca||: Surgery
LxcellenL reference for ward managemenL, [unlor resldenL level.
MD Anderson
Conclse revlew on all cancers, lncludlng epldemlology, dlagnosLlc LesLs and LreaLmenL
algorlLhms. Cood references. Cnly draw-back: very speclflc Lo Mu Anderson proLocols.

naLlonal Culdellne Clearlnghouse
hLLp://www.guldellne.gov/browse/guldellne_lndex.aspx
Cllnlcal guldellnes from worldwlde webslLes.

new Lngland !ournal of Medlclne Cllnlcal vldeos
hLLp://conLenL.ne[m.org/mlsc/vldeos.dLl
CreaL resource for day-Lo-day procedures on Lhe ward.

Websurg
hLLp://www.websurg.com/lndex.php
Laparoscoplc Surgery webslLe. ConLalns over 1000 lnsLrucLlonal vldeos on procedures,
operaLlve Lechnlcques, and lecLures. lree reglsLraLlon.

Access Surgery
hLLps://www.accesssurgery.com
LxcellenL collecLlon of a dlverse seL of surglcal resources. lncludes reference, aLlas, operaLlve,
and subspeclallLy LexLbooks, [ournal access, procedural vldeos, [ournal revlews, and board
revlew quesLlons. 8equlres subscrlpLlon, provlded by some programs.

LAS1 1rauma Culdellnes
hLLp://www.easL.org/Lpg.asp
Lvldence-based guldellnes for Lrauma.

1he Cochrane CollaboraLlon, Cochrane 8evlews
hLLp://www2.cochrane.org/revlews/
lree Cochrane 8evlews absLracLs, an agreemenL for conLlnuaLlon of free full access Lo Lhe
Cochrane Llbrary ls ln dlscusslon. lor now, en[oy Lhe free access lf logglng ln from a Canadlan l
address.

Wheeless' 1exLbook of CrLhopaedlcs
hLLp://www.wheelessonllne.com/
WEBSITES AND APPS WE LIKE
Cnllne lnLeracLlve orLhopaedlc aLlas and LexLbook. LxcellenL for Lrauma and general use.

SLanford collecLlon of key surglcal publlcaLlons
hLLp://scalpel.sLanford.edu/arLlcles.hLml
lree access Lo a selecLlon of key arLlcles, organlzed by sysLem.

up1ouaLe
www.upLodaLe.com

Canadlan Medlcal AssoclaLlon cllnlcal resources
www.cma.ca
lree access Lo surglcal LexLbooks and [ournals for all resldenLs and medlcal sLudenLs.

WebMu
hLLp://www.webmd.com
Can have currenL general surgery arLlcles e-malled Lo you.

CACS WlklSurgery
hLLp://www.cags-accg.ca/
Modlflable Canadlan LexLbook of surgery, consLanLly ln evoluLlon. Avallable for anyone Lo posL surglcal
lnformaLlon or sLudy noLes.

CACS WebslLe for [ournals
hLLp://www.cags-accg.ca/lndex.php?page=128

Amerlcan College of Surgeons
hLLp://www.facs.org/

Lvldence-8ased Medlclne LducaLlon
hLLp://www.cebm.neL/

vancouver CoasLal PealLh 1herapeuLlc 1oolseL
hLLp://www.vhpharmscl.com/vPlormulary/1ools/1ools-lndex.hLm
CollecLlon of LherapeuLlc Lools, (eg. Lqulanalgeslc dose converLers, anLlblograms, elecLrolyLe
replacemenL cards, eLc.). very useful.

!eff Cuy lCu podcasLs, noLes, lecLures
hLLp://www.lcurounds.com/
hLLp://www.burndoc.neL/
hLLp://lLunes.apple.com/us/podcasL/lcu-rounds/ld234707344
CrlLlcal care noLes, audlo lecLures and free odcasLs on a wlde varleLy of surglcal crlLlcal care
Loplcs. odcasLs are beLween 20-30 mlnuLes, greaL for commuLes.

lhone Apps
Medlcal Calc
MedlquaLlons
MedlMaLh
LCC Culde
Lponyms
eocraLes
!effCuy lCu rounds podcasLs
resentat|ons

WheLher you llke lL or noL, you are golng Lo spend regular amounLs of Llme speaklng on a
Ceneral Surgery Loplc ln fronL of colleagues and sLaff, for years Lo come. 1he only way Lhls
geLs easler ls by dolng lL. Lmbrace lL, lL ls one of Lhe mosL valuable parLs of your learnlng.
resenLlng rounds can allow you Lo develop as a person and a Leacher, and glves you a
deeper undersLandlng of a parLlcular area ln surgery. 1he Loplcs you presenL wlll become
deeply enLrenched ln your memory. As wlLh everyLhlng else, Lhe more energy you puL lnLo
lL, Lhe more you'll geL ouL of lL, so prepare as Lhoroughly as you can.
Do not underest|mate the opportun|ty th|s represents to show your co||eagues and
teachers what a va|uab|e member of the team you are. Maklng a good lmpresslon early on
wlll make people look forward Lo hearlng you presenL. 1ake Lhe exLra Llme Lo go Lhrough
Lhe followlng sLeps as you prepare your nexL presenLaLlon. lL wlll pay off ln how prepared
you are (or [usL seem!)
Check||st:
8LICkL 1nL DA.
know what |s expected of you. WhaL ls Lhe formaL: Pow long does Lhe presenLer
usually Lalk for? ls lL case or evldence based? Who leads dlscusslon? uo expecLaLlons
vary by presenLer's Lralnlng level?
know your room. Wlll Lhe door be unlocked when you arrlve? Wlll Lhere be a
compuLer and pro[ecLor Lhere or do you have Lo be Lhe gopher (and be responslble for
reLurnlng Lhem)? ls lL C or Mac and do you have Lhe necessary connecLlons? uo you
need an lnLerneL connecLlon? uo you know how Lo connecL Lo your elecLronlc paLlenL
records sysLem on Lhe fly lf needed durlng Lhe Lalk?
know your aud|ence. ls lL mosLly people aL your Lralnlng level? Are Lhere golng Lo be
experLs ln Lhe fleld presenL? Are Lhere golng Lo be oLher dlsclpllnes presenL (paLhology,
radlology, Cl, oncology, palllaLlve eLc. as well as oLher allled healLh Leam members such
as nurses and LheraplsLs)?
Ior case presentat|ons, rev|ew the deta||s thorough|y. Who (sLaff and resldenLs)
parLlclpaLed ln Lhe care of Lhls paLlenL? Are Lhey golng Lo be ln aLLendance? lf so, you
GIVING ROUNDS
may be able Lo ask for Lhelr lnpuL before and durlng your presenLaLlon. 1ake Lhe Llme Lo
reLrleve paLlenL flles and revlew all of Lhem (lncludlng nurses noLes, ward noLes,
operaLlve reporLs, and paLhology reporLs). ?ou should know more Lhan anyone else ln
Lhe room abouL Lhls case.
Do not b|te off more than you can chew. lL may be beLLer Lo answer a focused quesLlon
raLher Lhan Lrylng Lo compleLely revlew or summarlze a large Loplc. lL may also be
preferable Lo focus on a new or emerglng Loplc, and be able Lo cover mosL of Lhe
llLeraLure on lL by vlrLue of lL belng small. Check wlLh more senlor resldenLs or sLaff Lo
flnd ouL lf you are on Lhe rlghL Lrack, or lf your scope should be narrowed.
1h|nk of what quest|ons m|ght be asked of you beforehand. repare an answer for Lhe
llkely quesLlons, and know lf you wlll have backup ln Lhe audlence.
ract|ce what you are go|ng to say, out |oud, as many t|mes as poss|b|e unt|| you fee|
conf|dent. As you pracLlce, you should noL flnd yourself apologlzlng for someLhlng. Lg.
Sorry Lhe plcLure ls blurry, sorry Lhe fonL ls Loo small, sorry Lhls sllde ls a llLLle busy..."
8y pracLlclng beforehand, you can flx Lhose foreseeable problems.


NU1S AND 8CL1S CI SLIDL-MAkING:

S||des shou|d be v|sua| a|ds, not a scr|pt. eople read fasLer Lhan you can speak,
and lf people are readlng, Lhey are noL golng Lo be llsLenlng Lo you. keep Lhe LexL on
slldes Lo a mlnlmum (eg. suggesLed rule of max 7 words per llne, max 7 llnes per
sllde").
1ry to ||m|t to 3 to 4 po|nts per s||de. 1ry Lo reveal Lhe lnformaLlon Lo your audlence
ln sLepwlse fashlon - bulld some suspense.
1he format shou|d not be a d|stract|on |n |tse|f. 1emplaLes, whlle aLLracLlve, requlre
more processlng before Lhe message ls undersLood. Avold uslng any background aL
all. use Lhe same fonL LhroughouL.
kesearch on the top|c suggests keep|ng s||de font to no sma||er than 24 po|nt.
Spe|| check a|| s||des. Lven one spelllng mlsLake ls dlsLracLlng and can send Lhe
message you are careless, wheLher LhaL ls falr or noL. CeL a frlend Lo proofread your
slldes as well as uslng Lhe spell check sofLware.
Avo|d abbrev|at|ons. Agaln, Lhere may be audlence members who aren'L famlllar
wlLh Lhe abbrevlaLlons, don'L allenaLe Lhem.
A p|cture speaks a thousand words. uon'L underesLlmaLe Lhe vlsual lnLeresL LhaL
lnLraoperaLlve phoLos, or phoLos of Lhe paLlenL happy ln follow-up, can add. Always
obLaln Lhe besL quallLy radlology lmages you can, and Lake Lhe Llme Lo revlew Lhem
wlLh Lhe 8adlology sLaff before you are asked Lo explaln, Where ls LhaL lymph node
exacLly?" lmage slldes should sLand alone, and Lhe lmage should be as large as
posslble, occupylng Lhe whole screen wlLh only Lhe mlnlmum of labels. 8emove any
ldenLlfylng paLlenL lnformaLlon beforehand.
Incorporate v|deos |f poss|b|e. llnd procedures onllne or record your own!
Ant|c|pate quest|ons on a premade s||de. Pave a sllde ready Lo presenL when you
answer a parLlcular quesLlon Lo show you were prepared Lo dlscuss cerLaln polnLs
furLher.

CN 1nL DA:
kem|nd your staff and sen|or res|dents you are present|ng today. 8emember lL's
always easler Lo scrub ln Lhan scrub ouL of a case! Pelp your Leam manage Lhe day's
work by dlvldlng up responslblllLles keeplng your presenLaLlon ln mlnd.
Make sure you are on t|me. lan Lo arrlve aL leasL 10 mlnuLes before you are
scheduled Lo sLarL Lo seL up A/v, grab a cup of coffee or waLer, and seLLle your
nerves.
8r|ng mu|t|p|e backups of your ta|k. Lmall a copy of lL Lo yourself, sLore a copy on
an onllne sLorage webslLe, brlng a key, brlng your lapLop.
Speak c|ear|y, conc|se|y, and |oud|y enough to be heard by everyone. uon'L geL
flusLered lf you're lnLerrupLed.
If you stumb|e, pause to co||ect your thoughts, and cont|nue. 8epeaLed apologles
only brlng aLLenLlon Lo Lhe error.
Adm|t |f you don't know. uo noL make up an answer Lo a quesLlon or make an
excuse why you cannoL answer. Cffer Lo flnd an answer lf LhaL appears Lo be
requlred.
Use humour w|th caut|on. lL may be Loo rlsky dependlng on Lhe clrcumsLances and
noL worLh loslng face. lf you're noL sure, bounce lL off a senlor resldenL or sLaff
beforehand.
If you open an |ssue, c|ose |t. lor example, lf you say, 1he paLlenL had a
lumpecLomy for uClS 10 years ago," your nexL senLence should be, and she has had
no sympLoms of breasL dlsease slnce LhaL Llme." uo noL leave your llsLeners
wonderlng abouL Lhe breasL cancer when you move onLo Lhe nexL Loplc.
Laboratory va|ues shou|d be d|sm|ssed as norma| whenever poss|b|e. uon'L wasLe
everyone's Llme spelllng ouL all Lhe lrrelevanL elecLrolyLes.
Use a po|nter. 1hls can be as slmple as uslng Lhe mouse on Lhe compuLer. lf you
prefer a laser polnLer, use lL sparlngly, and resL your arm on Lhe podlum Lo avold
annoylng [lggllng.
AI1Lk 1nL DA:
Ask for feedback. Learn as much as you can for nexL Llme. ulsLrlbuLe any papers or
answer any quesLlons LhaL you may have promlsed Lo flnd Lhe answer Lo.
LMCC ll: 1he cllnlcal verslon of Lhe LMCC l. MandaLory for all Canadlan resldenLs. rlce:
$1830 (lf on Llme). ueadllnes: !anuary 31

for Lhe Sprlng exam, !une 30 for Lhe lall exam.
www.mcc.ca reparaLlon suggesLlons: old case scenarlos and 1oronLo noLes. 1here seems
Lo be a loL of repeLlLlon from old exams.

rlnclples of Surgery (CS): All surglcal resldenLs (excepL for Cbs/gyne) musL compleLe.
usually lL's done ln second year, buL can be delayed lf necessary. ?early slLLlng ln Aprll. ?ou
musL apply for assessmenL of Lralnlng (ueadllne: Aprll 30 for Lhe followlng Sprlng exam,
rlce: $323 (lf on Llme). 1hey Lhen emall you Lhe followlng november wlLh anoLher
reglsLraLlon form and ask for fees for Lhe exam (ueadllne: lebruary 1 for upcomlng Aprll
exam, rlce: $640). www.rcpsc.medlcal.org reparaLlon suggesLlons: form a group and
pracLlce LogeLher. racLlce CuesLlons are very useful, and wldely avallable from upper year
resldenLs, read around Lhem Lo flnd Lhe answers. See LexLbook secLlon for suggesLed
readlng. 1here ls ofLen repeLlLlon noLed from prevlous exams.

8oyal College Lxam: WrlLLen early May ln varlous cenLres, oral componenL mld-!une ln
CLLawa. ueadllnes: Apply for assessmenL of Lralnlng Lhe year before (deadllne end of Aprll
for Lhe nexL year's exams, rlce: $323) Anu 1PLn 8eglsLraLlon lorm (deadllne: leb 1 of year
of exam, rlce: $3400) www.rcpsc.medlcal.org reparaLlon: form a sLudy group and meeL
regularly. ulvlde up maLerlal lnLo sub[ecLs and plck approprlaLe readlngs. Co Lhrough
sub[ecLs one aL a Llme (eg: llver, breasL, colorecLal, eLc.). nC C8AM S1uu?lnC! arLlclpaLe
ln mock orals and sLarL as early as second year.

CACS Lxam: 1hls ls a naLlonal exam Laken by all resldenLs ln Ceneral Surgery, ln every year
of resldency Lralnlng, usually someLlme ln lebruary. lL ls a mulLlple cholce exam. urposes
lnclude preparaLlon for Lhe flnal 8oyal College exam and measurlng progress ln Lralnlng -
marks may be compared across your own years, and wlLhln your year's cohorL.




NATIONAL EXAMS

Why buy surg|ca| |oupes?

1here's a reason why Lhe experlenced surgeon operaLlng across from you ls wearlng
unfashlonable, 8uddy Polly"-sLyle glasses. lf she has Lo wear loupes Lo perform Lhls operaLlon,
why shouldn'L you Loo?
1he maln advanLage of surglcal loupes, ln addlLlon Lo enabllng more parLlclpaLlon ln an exclLlng
surgery, ls Lhe allevlaLlon of eye sLraln by enlarglng Lhe lmage. 1he expecLaLlon Lo buy loupes
varles by program. Check wlLh oLher resldenLs Lo see lf you are encouraged Lo have loupes as a
Lralnee.
now does one choose surg|ca| |oupes?
1he mosL lmporLanL aspecL ln chooslng surglcal loupes ls Lhe magn|f|cat|on. 1he amounL of
magnlflcaLlon deLermlnes Lhe slze of Lhe lmage vlewed Lhrough Lhe loupe. lor mosL slmple
surglcal procedures, and for mosL beglnner Lralnees, loupes wlLh a magnlflcaLlon of 2.3x or 3.0x
ls sufflclenL. More dellcaLe and compllcaLed surgerles requlre a magnlflcaLlon of 3.3x-4.3x.
Mlcrosurgery usually demands magnlflcaLlon of 3.0x-6.0x.
ln chooslng Lhe magnlflcaLlon of your surglcal loupes, remember LhaL boLh depth of f|e|d (Lhe
amounL of depLh LhaL ls ln focus when vlewlng Lhe ob[ecL Lhrough Lhe loupe), and Lhe f|e|d of
v|ew (Lhe area LhaL ls ln focus when vlewed Lhrough Lhe loupe), are boLh compromlsed wlLh
hlgher magnlflcaLlons. ln addlLlon, loupes are heavler wlLh hlgher magnlflcaLlons. 1he welghL
of loupes can cause a hosL of annoyances lncludlng posL-aurlcular paln, sllppage of Lhe loupes
down Lhe nasal brldge, and dlscomforL on Lhe nasal brldge.
CLher facLors Lo conslder lnclude fllp-up versus a flxed lens sysLem, headband versus glasses,
prescrlpLlon lenses, and, mosL lmporLanLly, frame deslgn! 1here ls no rlghL or wrong cholce
amongsL Lhese opLlons, lL all depends on personal preferences. Cne Lhlng Lo remember,
however, ls LhaL Lhe headband surglcal loupes prohlblL wearlng a surglcal head lamp. When
chooslng your surglcal loupes, balance your currenL Lralnee needs wlLh your poLenLlal fuLure
career needs.

A NOTE ON LOUPES
What are some common prob|ems w|th surg|ca| |oupes?
1he loupes consLanLly sllp down Lhe nose. MosL surglcal loupes come wlLh an earplece Lo
LlghLen behlnd Lhe head. AnoLher opLlon ls Lo Lape Lhe browbar of Lhe glass frame Lo your
forehead.
1he loupes are fogglng. 8reaLhlng lnLo Lhe mask can ofLen fog loupes or masks. Cne effecLlve
sLraLegy ls Lo Lhe Lape Lhe Lop parL of Lhe mask Lo Lhe skln Lo creaLe a barrler.
1he loupes cause posL-aurlcular paln. 1he hlgher Lhe magnlflcaLlon, Lhe heavler Lhe loupes.
Conslder purchaslng sofL paddlng for Lhe ear pleces.
1he loupes are noL approprlaLe Lo your worklng dlsLance or cause neck and back sLraln. Lnsure
LhaL Lhe company from whlch you purchase your surglcal loupes meeLs wlLh you and measures
Lhe loupes Lo flL your face and your needs.
1o faclllLaLe an lnformed declslon, we suggesL peruslng Lhe followlng arLlcle:
8aker, !., Meals, 8. (1996). A racLlcal Culde Lo Surglcal Loupes. I nooJ 5otq (Am), 22 (6): 967-
74.

Why do research?

ersonal en[oymenL and curloslLy are Lhe drlvlng forces for mosL researchers, buL Lhere
are also a number of frlnge beneflLs:

8esearch offers a unlque learnlng opporLunlLy. ln dally cllnlcal pracLlce, problems abouL
how Lo offer Lhe besL LreaLmenL Lo our paLlenLs are mosL ofLen found ln LexLbooks or Lhe
publlshed llLeraLure. 8esearch ls abouL delvlng lnLo Lhe unknown. 1he mlndseL ls
compleLely dlfferenL, Lhough we are unlquely equlpped as cllnlclans Lo ask Lhe lmporLanL
quesLlons.

8esearch ls abouL learnlng how Lo answer quesLlons LhaL have yeL Lo be answered. 1hls
lnvolves creaLlve Lhlnklng and applylng new ldeas.

?ou wlll learn how Lo exchange ldeas, formulaLe a sclenLlflc quesLlon and presenL daLa.
1here ls no beLLer way Lo undersLand Lhe llLeraLure LhaL guldes Lhe fuLure of medlclne and
currenL paLlenL care Lhan Lo parLlclpaLe ln produclng LhaL very llLeraLure.

lL ls an opporLunlLy Lo explore academlc medlclne and wlll help you make declslons abouL
whaL Lype of career you would llke Lo pursue. lL ls an excepLlonal chance Lo have dedlcaLed
Llme Lowards bulldlng your academlc caplLal LhaL wlll serve you for Lhe remalnder of your
career.

lL ls a Llme when your pager wlll noL be rlnglng qulLe as ofLen as usual!

ln Lhe end, Lhe ulLlmaLe goal ls Lo generaLe new medlcal knowledge and lmprove paLlenL
care.

kesearch branches
- 8aslc sclence
RESEARCH
- 1ranslaLlonal
- Cllnlcal
- ubllc healLh
- LducaLlon
- AdmlnlsLraLlon
- Law/LLhlcs
- Lpldemlology


Choos|ng your superv|sor

1hls ls one of Lhe mosL lmporLanL declslons you wlll have Lo make wlLh regards Lo
research. lL ls worLh your Llme Lo meeL wlLh as many poLenLlal supervlsors as you can so LhaL
you can make an educaLed declslon. ?our relaLlonshlp wlLh your supervlsor wlll mosL llkely
dlcLaLe Lhe quallLy of your research experlence.

lL ls lmporLanL for you Lo feel lnsplred by Lhe pro[ecL and for Lhe pro[ecL Lo be relevanL Lo
your career goals. Powever, one musL undersLand LhaL Lhe Loplc of your research pro[ecL ofLen
does noL mesh exacLly wlLh whaL your ulLlmaLe speclalLy or research lnLeresL wlll become. lor
example, a research pro[ecL ln LransplanL lmmunology could be useful Lo a fuLure career ln
cancer research or crlLlcal care ln addlLlon Lo Lhe obvlous fleld of LransplanL surgery. arL of
whaL one learns from dolng research ls how Lo LranslaLe knowledge from one fleld Lo anoLher.
1he greaLesL dlscoverles come from brlnglng new ldeas from prevlously unrelaLed flelds Lo
produce a new paradlgm.

?ou should be sure LhaL your supervlsor has adequaLe funds and experLlse Lo lead you
Lhrough Lhe proposed pro[ecL. ?ou can flgure Lhls ouL by slmply asklng abouL Lhe fundlng
slLuaLlon. LxperLlse can be deLermlned by prevlous publlcaLlons and Lhe lnvolvemenL of
collaboraLors. lL ls a good ldea Lo make sure LhaL Lhe research Leam you choose Lo [oln has
regular meeLlngs where progress ls Lracked and feedback ls offered. lf posslble, we hlghly
recommend LhaL you aLLend a few 'lab meeLlngs' prlor Lo chooslng your supervlsor.

I|nd|ng funds to pay for |unch (sa|ary awards)

1o obLaln dedlcaLed research Llme lL ls lmporLanL Lo flgure ouL who wlll pay your salary.
As soon, as you leave your regular resldency for more Lhan 6 monLhs mosL provlnces wlll
conslder LhaL you are no longer provldlng a servlce LhaL ls worLh belng remuneraLed.

Many programs ln Canada have lnLernal funds Lo allow resldenLs Lo pursue dedlcaLed
research. Powever, Lhese funds can be llmlLed. lL ls Lherefore lmporLanL Lo apply for exLernal
fundlng. lf you manage Lo geL exLernal funds, you wlll noL only be able Lo pay for lunch, buL you
wlll also beneflL from Lhe presLlge of peer-revlewed fundlng. lL ls a greaL way Lo valldaLe Lhe
lmporLance of your pro[ecL and begln bulldlng your academlc caplLal.

lL wlll be worLhwhlle Lo dlscuss research wlLh a research chalr ln your program. Some
programs have a Surgeon SclenLlsL rogram, whlch may fund you as a resldenL Lo compleLe a
M.Sc. or h.u. 1hls ls Lled ln wlLh Lhe accredlLed 8oyal College of hyslclans and Surgeons
Cllnlclan lnvesLlgaLor rogram aL some schools. llnd ouL lf Lhls program exlsLs where you are.
See hLLp://rcpsc.medlcal.org/resldency/accredlLaLlon/arps/cllnlclan_e.php.

8elow are a few key sources of exLernal fundlng. keep ln mlnd LhaL Lhere may be oLher
speclalLy speclflc fundlng agencles noL llsLed. Make sure Lo ask your supervlsor abouL all
posslble fundlng opporLunlLles and apply Lo as many as you can. 1he process of applylng for
Lhese Lypes of granLs wlll help you undersLand your pro[ecL beLLer and wlll help you perfecL
your wrlLlng skllls.

Nat|ona| and |nternat|ona| fund|ng sources:

Canadlan lnsLlLuLe of PealLh 8esearch (ClP8)
- MasLers and docLoral awards. AppllcaLlon deadllne: lebruary 1, 2010
- lellowshlp award. AppllcaLlon deadllne: lebruary 1, 2010
CandldaLes musL choose one or Lhe oLher. 1hose wlLh a sLrong research background
and/or prevlous graduaLe work may be compeLlLlve for Lhe lellowshlp award. 1hose
wlLh llLLle or no research experlence are probably besL sulLed Lo Lhe MasLer's award.

Surg|ca| soc|ety sources:

Amerlcan College of Surgeons
- 8esldenL 8esearch Scholarshlps. AppllcaLlon deadllne: SepLember, 2010.

AssoclaLlon of Academlc Surgeons
- 8esearch lellowshlp Award. AppllcaLlon deadllne: uecember, 2010

SocleLy of unlverslLy Surgeons
- LLhlcon-SuS Surglcal 8esearch lellowshlp Award. AppllcaLlon deadllne: !une 2010

rov|nc|a| grant|ng sources:
1here are many provlnclal granLs avallable, however for Lhe mosL accuraLe and Llmely
lnformaLlon you may wlsh Lo seek ouL your 8esearch/rogram ulrecLor.

Gett|ng your own operat|ng grants
8egardless of Lhe Lype of research you plan on dolng, havlng some money Lo pay for lL ls
essenLlal. WheLher you wlll be conducLlng a naLlon-wlde survey or managlng a mouse colony,
research ls far from belng a cheap endeavour. lL ls prlmarlly your supervlsor's [ob Lo secure
funds for Lhe work, buL some granLlng agencles allow you Lo apply as a resldenL wlLh your
supervlsor as a co-lnvesLlgaLor. WrlLlng Lhls Lype of granL ls a challenglng experlence LhaL wlll
LesL wheLher you really undersLand your Loplc. lL ls a fun exerclse Lo flgure ouL how Lo deslgn
sLrong experlmenLs LhaL wlll besL answer your quesLlon. 8eyond addlng Lo your academlc
caplLal, obLalnlng one of Lhese granLs lends credence Lo Lhe valldlLy of your research. Lven
when Lhe odds seem sllm, any chance ls beLLer Lhan none, and no one llkes Lo see mlce sLarve.
Pere ls a non-exhausLlve llsL of poLenLlal granL compeLlLlons (please consulL Lhe relevanL
webslLe for up Lo daLe lnformaLlon):
Surg|ca| soc|ety grants:
- Canadlan Surglcal 8esearch lund (hLLp://www.cags-
accg.ca/cagsaccg.php?page=113)
o value = $10,000 x 1 year
o AppllcaLlon deadllne: !uly 1, 2010
- SACLS 8esearch CranL
(hLLp://www.sages.org/leadershlp/commlLLees/research/granLs.php)
o value = up Lo $30,000 x 1 year
o AppllcaLlon deadllne november, 2010
- Canadlan SocleLy of Colon and 8ecLal Surgeons CperaLlng CranL
(hLLp://www.cscrs.ca/2010_Call_for_roposals.pdf)
o value = $10,000 x 1 year
o AppllcaLlon deadllne: !une 1, 2010

koya| Co||ege grants:
- Medlcal LducaLlon 8esearch CranL (hLLp://www.rcpsc.edu/awards/ML8C_e.php)
o value = $30,000 over a maxlmum of 3 years, maxlmum of $23,000/year
o up Lo $10,000 ln salary supporL
o AppllcaLlon deadllne: March, 2011


Cn||ne kesources for Grants and roposa| Wr|t|ng:

ClP8 lC: Culdebook for new rlnclpal lnvesLlgaLors:
hLLp://www.clhr-lrsc.gc.ca/e/27261.hLml

nlP CranL WrlLlng 1lp SheeLs
hLLp://granLs.nlh.gov/granLs/granL_Llps.hLm

Pow Lo WrlLe a Cood roposal
hLLp://www.mcmasLer.ca/ors/gulde/gulde_proposal.hLm

CranL WrlLlng 8esources
hLLp://www.schullch.uwo.ca/research/lndex.php?page=CranLWrlLlng


Cn||ne Iund|ng kesources

8oyal College of hyslclans and Surgeons of Canada Awards and CranLs
hLLp://rcpsc.medlcal.org/awards/

CommunlLy of Sclence
hLLp://www.cos.com/

hyslclans' Servlces lnc loundaLlon, 8esldenL 8esearch rogram
hLLp://pslfoundaLlon.org/

Canadlan Surglcal 8esearch lund
hLLp://www.cags-accg.ca/lndex.php?page=112

Canadlan SocleLy for Cllnlcal lnvesLlgaLlon
hLLp://www.cscl-scrc.org/

Amerlcan SocleLy of Colon and 8ecLal Surgeons
hLLp://www.fascrs.org/physlclans/research_foundaLlon/granLs/

Amerlcan College of Surgeons 8esldenL 8esearch Scholarshlps
hLLp://www.facs.org/memberservlces/acsresldenL.hLml

nSL8C
hLLp://www.nserc-crsng.gc.ca/Medla-Medla/lndex_eng.asp

Usefu| sk|||s for research

1. Wr|t|ng an Abstract for a Conference
AbsLracL wrlLlng ls a cruclal sklll. noL only ls lL expecLed for all manuscrlpLs and publlcaLlons ln
sclenLlflc [ournals, lL geLs you Lo conferences and meeLlngs.

1he followlng are general Llps for preparlng an absLracL:
8ead Lhe lnsLrucLlons. Slmple, yeL cruclal! Conferences and meeLlngs usually have a
very speclflc formaL requlred. 1hls may lnclude Lhlngs as speclflc as bo|d|ng, ltollclzloq,
and CAS fonL.
o WhaL Lo look for ln Lhe lnsLrucLlons:
! WhaL ls Lhe word lengLh?
! WhaL formaL ls accepLed (Word, elecLronlc, paper)?
! Can l lnclude references?
! Can l lnclude flgures?
! Should Lhere be headlngs (8ackground, MeLhods, 8esulLs, Concluslon) or
should Lhe absLracL be one paragraph?
! Should l lnclude auLhor LlLles and/or afflllaLlons?
! WhaL ls Lhe deadllne?
! Can l submlL more Lhan one absLracL?
! Can l submlL an absLracL LhaL has been prevlously presenLed?
8e falr Lo Lhe organlzaLlon. uo noL submlL an absLracL lf you wlll noL be able Lo aLLend
Lhe meeLlng.
8ead absLracLs from Lhe conference from prevlous years. 1hese are ofLen publlshed on
Lhe organlzaLlon's webslLe or ln Lhelr afflllaLed [ournal. use Lhese as your gulde.
keep wlLhln Lhe speclfled word lengLh. lf noL speclfled, 200 Lo 330 words ls a general
suggesLlon.
use Lhe same language and Lechnlcal Lerms as lf you were wrlLlng a sclenLlflc paper.
AbsLracLs are noL lay summarles.
1he LlLle should be descrlpLlve, buL shorL and conclse. lL should glve Lhe reader a
general knowledge of Lhe populaLlon and purpose of Lhe sLudy.
uo noL guess resulLs. ln oLher words, do noL submlL an absLracL for a pro[ecL you have
noL compleLed.
Make Lhe absLracL lnformaLlve and lnLeresLlng, yeL conclse. SLay wlLhln Lhe formaL of:
o 8ackground
o Cb[ecLlve
o MeLhods
o 8esulLs
o Concluslon
lf space ls aL a premlum, cuL Lhe background secLlon ouL or Lo a mlnlmum.
Pave your supervlsor revlew your absLracL for quallLy and valldlLy.
repare well ln advance of Lhe deadllne Lo glve yourself plenLy Llme for edlLlng afLer
recelvlng feedback.


2. oster preparat|on
Ceneral Llps:
skeLch Lhe posLer deslgn ln advance
arrange ln columns, Lhls allows for easy readlng by Lhose walklng by
common dlmenslons for posLers are: 42 x 42 lnches, 42 x 48 lnches,
or 42 x 32 lnches
alm for: 20-23 LexL, 40-43 graphlcs, 30-40 empLy space
use bulleL polnLs and shorL, abbrevlaLed senLences Lo hlghllghL
dlscreLe ldeas
LlLle all graphlcs and label daLa llnes
double-space all LexL
make sure LexL ls readable from 1 Lo 2 meLers away
A noLe abouL fonLs: for LlLle, use Lhe largesL fonL LhaL Lhe lengLh of your LlLle wlll
allow, secLlon headlngs 36-42 pL, supporLlng LexL 24-28 pL. Always use slmple
fonLs - sans serlf fonLs are generally beLLer.
A noLe abouL colours: use sofL, neuLrals for Lhe background, as brlghL colours can
be overly harsh and Llresome afLer a day readlng posLers
lf you're uslng dark phoLos, use a llghL background colour, use darker
backgrounds for llghL phoLos
Lnsure conLrasL wlLh LexL and graphlcs and Lry Lo use a colour scheme Lo Lle Lhe
posLer LogeLher
lf space permlLs, use Lhe auLhor's flrsL names. 1hls wlll faclllLaLe lnLeracLlons
beLween you and your audlence. Leave ouL mlddle lnlLlals

ANA1CM CI A CS1Lk
Introduct|on: keep lL brlef - a few senLences on whaL you've Lrled Lo do and why lL ls
lmporLanL.
Abstract: Check Lhe conference/symposlum guldellnes Lo see wheLher an absLracL ls
requlred. lf lL's noL requlred and lf you've managed space on Lhe posLer well, an
absLracL ls llkely unnecessary.
Conc|us|ons]D|scuss|on: 1hls wlll appear on Lhe boLLom-lefL, noLe only Lhe mosL
lmporLanL flndlngs, recommendaLlons, and/or suggesLlons for fuLure sLudy.
Methods and kesu|ts: lnclude research deslgn, seLLlng, number of paLlenLs enrolled,
selecLlon crlLerla. May also lnclude a descrlpLlon of Lhe lnLervenLlon, how ouLcomes are
measured, and Lhe meLhod of sLaLlsLlcal analysls. 1ry Lo use flgures, slmple Lables, and
plcLures Lo package and hlghllghL key polnLs.
Graph|cs: Should domlnaLe Lhe posLer. use brlghL colours, lnclude only Lhe mosL
lmporLanL lnformaLlon.

?our audlence should be able Lo grasp your pro[ecL wlLh a qulck scan. lf Lhey have
quesLlons, you'll be Lhere Lo flll ln any deLalls.

Cn||ne resources:
hLLp://www.acponllne.org/resldenLs_fellows/compeLlLlons/absLracL/prepare/pos_pres.hLm
hLLp://gradschool.unc.edu/sLudenL/posLerLlps.hLml


1hey ||ke me, they rea||y ||ke me! Cr not. Dea||ng w|th kev|ewers Comments
1he mosL lmporLanL Lhlng when deallng wlLh revlewers commenLs ls Lo address each commenL
speclflcally and do noL lgnore any commenLs no maLLer how absurd Lhey seem Lo you. CfLen
revlewers may make commenLs LhaL seem ouL of place or superfluous buL addresslng Lhem ln
an lLemlzed fashlon ls Lhe easlesL and mosL efflclenL way Lo proceed. CfLen Lhe revlewer wlll
glve you a paragraph of commenLs and lL can be dlfflculL Lo dlscern whaL Lhey are looklng for
buL lf you break lL down lnLo speclflc polnLs Lhen lL ls easler Lo deal wlLh each commenL ln Lurn.
lL ls always easler Lo make Lhe changes suggesLed by Lhe revlewers unless Lhey have
mlslnLerpreLed Lhe lLems Lhey wlsh Lo change. lL ls noL worLh flghLlng wlLh Lhe revlewers unless
you feel Lhey have made an error ln lnLerpreLlng your work. CfLen revlewers read manuscrlpLs
qulckly and lL ls posslble LhaL Lhey have made an error. lf Lhls ls Lhe case, polnL lL ouL ln a pollLe
and dlplomaLlc way and suggesL Lhe proper lnLerpreLaLlon.
8evlewers may suggesL a change LhaL ls already presenL ln Lhe manuscrlpL. 1hls can be
frusLraLlng, lndlcaLlng LhaL Lhey dld noL read Lhe work carefully. lf Lhls ls Lhe case, don'L polnL
ouL Lhere negllgence, lnsLead slmply sLaLe LhaL Lhe paper already emphaslzes" Lhe change Lhey
wanLed you Lo make.
Always keep a flaLLerlng and pollLe Lone wlLh Lhe revlewers when respondlng Lo Lhelr
commenLs. lf a revlewer has made an lnslghLful and asLuLe commenL, Lhen leL Lhem know.
Always end by Lhanklng Lhe revlewer for Lhelr Llme and for maklng Lhe manuscrlpL beLLer.
Seelng a paper Lhrough Lhe submlsslon process can be a long and frusLraLlng experlence buL, ln
general, revlewers' commenLs can ofLen sLrengLhen your paper so always remaln courLeous
and keep an open mlnd when respondlng.
Mentorsh|p

lL helps Lo flnd and Lalk Lo an aLLendlng LhaL you geL along wlLh and flnd approachable abouL
any problems or lssues LhaL you may encounLer durlng resldency. 1he mere acL of sharlng your
concerns and geLLlng a dlfferenL perspecLlve can go a long way ln helplng you deal wlLh Lhem.
8emember you are noL Lhe flrsL resldenL Lo go Lhrough a surglcal resldency. lf Lhere are lssues
Lroubllng you, chances are LhaL someone more senlor Lo you has seen or dealL wlLh Lhem
before. ApprenLlceshlp has long been Lhe cornersLone of surglcal Lralnlng, and menLorshlp
relaLlonshlps ofLen evolve beLween surgeon and resldenL ln a formal or lnformal seLLlng.

SLudles conslsLenLly show LhaL role models and menLors are among Lhe cruclal Lop facLors
lnfluenclng a career cholce ln surgery. 1hls ls Lrue of medlcal sLudenLs and resldenLs maklng
Lhelr flnal speclalLy declslons. MenLors may play Lwo broad roles ln your resldency. 1he flrsL ls
Lhe career developmenL role Lhrough sponsorshlp, coachlng, challenglng knowledge, and
provldlng exposure Lo lmporLanL career neLworks. 1he second ls Lhe more soclal or personal
role of role modellng, counselllng, llfesLyle advlce, and frlendshlp.

When you are new Lo a program, lL may be dlfflculL Lo know who's who" ln Lhe deparLmenL
and who Lo Lurn Lo for guldance. Some menLorshlps develop naLurally Lhrough sLrlklng up a
conversaLlon wlLh a surgeon wlLh a career you asplre Lo or wlLh common lnLeresLs. uon'L be
afrald Lo approach and ask quesLlons of a surgeon you flnd lnLeresLlng. lf you would llke
someone Lo Lalk Lo buL aren'L sure where Lo Lurn your rogram ulrecLor ls a greaL sLarL Lo llnk
you wlLh someone who shares your lnLeresLs or personal slLuaLlon. Also ask lf Lhere ls a formal
menLorshlp program or maLchlng process aL your lnsLlLuLlon.

LasLly, remember Lo pay lL forward. Medlcal sLudenLs are quleLly waLchlng us LhroughouL Lhelr
surglcal roLaLlon. 1ake some Llme Lo dlscuss career goals and Lhe llfe of a surgeon wlLh all your
medlcal sLudenLs. Lven as a [unlor resldenL, medlcal sLudenLs look Lo you as a surglcal role
model and poLenLlal menLor. uLlllze one-on-one Llme as menLorlng opporLunlLles for keen
medlcal sLudenLs. lL may have a greaL lmpacL on Lhelr career cholce!

MENTORS AND PROFESSIONAL DEVELOPMENT MENTORS AND PROFESSIONAL DEVELOPMENT


Ie||owsh|ps after Genera| Surgery

MosL of us have been Lold LhaL you should probably have an ldea of wheLher or noL you mlghL
wanL Lo pursue a fellowshlp by Lhe beglnnlng of your fourLh year. 1hls ls a llsL of currenL
fellowshlp programs ln Canada, however, Lhere are many more cropplng up all Lhe Llme and
more ln Lhe uS and abroad lf you are lnLeresLed. 1here ls more deLalled lnformaLlon for
resldenLs abouL surglcal fellowshlps ln Canada on Lhe 8esldenLs porLlon of Lhe CACS webslLe.

AcuLe Care Lmergency Surgery
8arlaLrlc Surgery
8reasL Surgery
ColorecLal Surgery
Pead and neck Surglcal Cncology
PepaLopancreaLlcoblllary
1ransplanL
Mlnlmally lnvaslve Surgery
edlaLrlc Surgery
Surglcal Cncology
1horaclc Surgery
1rauma Surgery
vascular Surgery

AnoLher common non-surglcal cholce ls lnLenslve/CrlLlcal Care.


Cn all roLaLlons and ln every medlcal career lL ls lmporLanL Lo base your pracLlce on Lhe
CanMLuS CompeLencles, llsLed below. 1hls ls whaL all of our evaluaLlons are based on, and
really lL comes ln handy ln dlfflculL slLuaLlons.
Medlcal LxperL-read, read, read! CeL Lo Lhe C8 and cllnlc as much as posslble!
CommunlcaLor-Lhls lncludes verbal/wrlLLen communlcaLlon beLween yourself and peers,
[unlors, sLaff and paLlenLs. *1be oombet ooe toot coose of o meJlcol low solt-poot
commoolcotloo, os pet tbe cMlA*
Manager-make sure you are organlzed before sLarLlng a roLaLlon, arrlve on Llme, and learn Lo
mulLlLask.
rofesslonal-Lhls applles Lo how you presenL yourself: dress, language and behavlour.
Scholar-Leach Lhose who are [unlor Lo you and sLay up Lo daLe on llLeraLure.
CollaboraLor-use Lhe resources of Lhe mulLldlsclpllnary Leam Lo your advanLage and make
everyone's llfe easler!
PealLh AdvocaLe-remember why we are all ln Lhls professlon. Speak up lf you have a concern
regardlng paLlenL's besL lnLeresLs. uo so dlplomaLlcally however!



MILESTONES IN GENERAL SURGERY RESIDENCY
8eference:
8oyal College of hyslclans and Surgeons of Canada
hLLp://rcpsc.medlcal.org/canmeds/lndex.php

Cur f|ex|b|e gu|de||ne of LkLC1A1ICNS for res|dents throughout the years:
CLkA1ICN G 1-2 G 3-4 CLkA1ICN G 1-2 G 3-4
LxploraLory
LaparoLomy
AsslsL/
Surgeon
Surgeon Axlllary Ln
dlssecLlon
AsslsL/
Surgeon
Surgeon
LxploraLory
Laparoscopy
AsslsL/
Surgeon
Surgeon 1horacoLomy Surgeon Surgeon
Laparoscoplc
AppendecLomy
Surgeon Surgeon Lung resecLlon AsslsL/
Surgeon
AsslsL/
Surgeon
Cpen
AppendecLomy
AsslsL/
Surgeon
Surgeon vascular
reconsLrucLlon
AsslsL AsslsL/
Surgeon
Laparoscoplc
CholecysLecLomy
Surgeon Surgeon elvlc exenLeraLlon AsslsL AsslsL/
Surgeon
Cpen
CholecysLecLomy
AsslsL/
Surgeon
Surgeon Low AnLerlor
8esecLlon
AsslsL/
Surgeon
Surgeon
umblllcal Pernla
8epalr
Surgeon Surgeon Abdomlnoperlneal
resecLlon
AsslsL/
Surgeon
AsslsL/
Surgeon
Laparoscoplc
lngulnal hernla
repalr
AsslsL/
Surgeon
Surgeon Llver resecLlon AsslsL/
Surgeon
AsslsL/
Surgeon
Cpen lngulnal
hernla repalr
Surgeon Surgeon Whlpple rocedure AsslsL/
Surgeon
AsslsL/
Surgeon
Lysls of Adheslons Surgeon Surgeon Common 8lle uucL
LxploraLlon
AsslsL AsslsL/
Surgeon
Small bowel
resecLlon/
reanasLamosls
AsslsL/
Surgeon
Surgeon 1hyroldecLomy AsslsL/
Surgeon
Surgeon
ColecLomy
(heml/S1C)
AsslsL/
Surgeon
Surgeon araLhyroldecLomy AsslsL AsslsL/
Surgeon
8reasL Surgeon Surgeon aroLldecLomy AsslsL AsslsL/
LumpecLomy Surgeon
MasLecLomy AsslsL/
Surgeon
Surgeon 1ransplanL AsslsL AsslsL/
Surgeon

1he llsL goes on.
Cbvlously mosL surgerles have a role for everybody (e.g. Lhe [unlor opens and sLarLs Lhe case
unLll lL becomes Loo complex for Lhelr level, Lhen Lhe senlor Lakes over). lf Lhe case becomes
Loo dlfflculL for LhaL resldenL Lo conLlnue or Lhere are Leachlng polnLs Lo share, Lhen Lhe fellow
or sLaff may declde Lo Lake over.
Lvery case ls a learnlng opporLunlLy, even lf lL [usL serves Lo famlllarlze you wlLh Lhe name of Lhe
procedure for LhaL speclflc dlsease enLlLy. 1here ls always someLhlng worLh paylng aLLenLlon
Lo, lf you are aLLenLlve Lo flnd lL: Pow ls Lhe more experlenced operaLor belng a good asslsLanL?
WhaL ls Lhe proper way Lo hold LhaL lnsLrumenL? Why has LhaL parLlcular suLure and suLure
placemenL been chosen? 1ry paylng expllclL aLLenLlon Lo cerLaln mundane" aspecLs of a case:
Llssue handllng, lnsLrumenL cholce, poslLlonlng, exposure, eLc. ?ou wlll be surprlsed aL whaL can
be galned.
*lease noLe Lhe level of responslblllLy for each operaLlon ls exLremely
hosplLal/roLaLlon/unlverslLy-dependenL. 8y your C? 3 year, you should be Lhe maln surgeon
(wlLh sLaff asslsLance as needed) ln mosL cases, assumlng Lhey are noL fellow-level/subspeclalLy
cases. AL Lhe end of 3 years, we all come ouL [usL abouL Lhe same.

keen Lo parLlclpaLe ln an lnLernaLlonal Surgery elecLlve? Many resldenLs hope Lo lncorporaLe
an lnLernaLlonal experlence lnLo Lhelr resldency Lralnlng. 8elow are several greaL onllne
resources avallable Lo help make Lhls happen. 1hls llsL ls noL exhausLlve. ConLrlbuLe your
experlences Lo Lhe CACS Wlkl Surgery slLe. Some schools also have deparLmenLs seL up
speclflcally Lo faclllLaLe Lhese experlences - ask your rogram ulrecLor for dlrecLlon.

Resource Suggestions
key S|tes
coooJloo Assoclotloo of Ceoetol 5otqety (cAC5) lotetootloool 5otqety commlttee
hLLp://www.cags-accg.ca
laclllLaLes CACS members lnLeresLed ln Lhe developlng world
rovldes names of CACS members lnLeresLed ln lnLernaLlonal Surgery.
ueLalls lnformaLlon on CACS lnLernaLlonal collaboraLlve surglcal pro[ecLs and several
lnLernaLlonal lnlLlaLlves of CACS members.

Ametlcoo colleqe of 5otqeoos (Ac5) - Opetotloo Clvloq 8ock
hLLp://www.operaLlonglvlngback.facs.org
rovldes lnformaLlon Lo help surgeons and surglcal resldenLs flnd and organlze
volunLeer opporLunlLles aboard.

Academ|c Cff|ces of Internat|ona| Surgery
1oronLo
hLLp://www.uLoronLo.ca/ols

vancouver - 8ranch for lnLernaLlonal Surgery
INTERNATIONAL SURGERY
hLLp://www.lnLernaLlonalsurgery.ubc.ca


Internat|ona| Surgery In|t|at|ves
coooJloo Netwotk fot lotetootloool 5otqety (cNl5)
hLLp://www.cnls.ca
1he world's largesL organlzaLlon of lnLernaLlonal Surgery.
8uns programs ln seven Afrlcan counLrles LhaL focus on surglcal skllls Leachlng, ln[ury
prevenLlon, and safeLy promoLlon.

hLLp://www.operaLlonglvlngback.facs.org/conLenL2271.hLml

wotlJ neoltb Offlce (wnO)
hLLp://www.who.lnL/surgery/publlcaLlons/lmeesc/en/lndex.hLml
WPC recommendaLlons for mlnlmum sLandards ln surglcal care

Llnks Lo resldenL assoclaLlons

newfoundland/Labrador: Al8n: www.palrn.nl.ca
nova ScoLla/new 8runswlck/Ll: A8l-M: www.parlmp.ca
Cuebec: lM8C: www.fmrq.qc.ca
CnLarlo: Al8C: www.palro.org
ManlLoba: A8lM: www.parlm.org
SaskaLchewan: Al8S: www.usask.ca/palrs
AlberLa: A8A: www.para-ab.ca
8rlLlsh Columbla: A8-8C: www.par-bc.ca


rofesslonal assoclaLlons
Canadlan Medlcal AssoclaLlon: hLLp://www.cma.ca
8rlLlsh Columbla Surglcal SocleLy: hLLp://www.bcss.ca/
AlberLa Medlcal AssoclaLlon: hLLp://www.alberLadocLors.org/
SaskaLchewan Medlcal AssoclaLlon: hLLp://www.sma.sk.ca/
uocLors ManlLoba: hLLp://www.docsmb.org/
CnLarlo Medlcal AssoclaLlon: www.oma.org
CnLarlo AssoclaLlon of Ceneral Surgeons: hLLp://www.oags.org/
College des Medeclns du Cuebec: hLLp://www.cmq.org/
new 8runswlck Medlcal SocleLy: hLLp://www.nbms.nb.ca/
uocLors nova ScoLla: hLLp://www.docLorsns.com/
Medlcal SocleLy of rlnce Ldward lsland: hLLp://www.mspel.org/
newfoundland and Labrador Medlcal AssoclaLlon: hLLp://www.nlma.nf.ca

PROFESSIONAL RESOURCES and RESIDENT
ASSOCIATIONS