Trevor Wolterink, MD
May 15, 2026
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Transitioning into the second year of residency marks a pivotal shift in a surgeon’s career. It is the year where you move from the role of a passive observer to that of an active learner and vital assistant in the operating room. To help navigate this transition, here are the ten essential surgical skills every second-year resident should aim to master.
1. Operating Room Etiquette
Mastering the OR begins with arriving early to introduce yourself and gather your own gown and gloves. Taking the initiative to assist with room set-up and patient positioning sets a professional, collaborative tone for the entire case.
2. Collaborative Communication
Effective surgery relies on clear, synchronized communication. You should be prepared to share your observations or opinions, as different perspectives are vital for maintaining safety and optimizing the OR.
3. Anatomy and Surgical Approaches
A deep, practical understanding of surgical approaches and tissue planes is the foundation for successful surgery. Focus on visualizing the structures beneath the surface and mastering alternative routes.
4. Orthopaedic Surgery Principles
Solidify your grasp of orthopaedic principles, such as the difference between primary and secondary bone healing. Thinking through your surgical goals allows you to select the correct instrumentation and apply it in the desired manner.
5. Sterile Technique
Maintaining a sterile field through disciplined scrubbing, prepping, and draping is your most fundamental duty for ensuring patient safety. You must remain hyper-aware of your movements and have the professional courage to address any breaks in sterility.
6. Active Assistance
Great assistants anticipate the lead surgeon’s next move, proactively retracting tissue or requesting the next tool before being asked. Staying mentally “two steps ahead” of the current action accelerates your learning and keeps the case moving smoothly.
7. Basic Surgical Skills
Mastering the basic handling of the knife, the bovie, and simple reduction instruments allows you to operate with precision. Gaining comfort with power tools and implants ensures you are ready to execute the plan when the surgeon hands you the lead.
8. Closure
Proficiency in “closing in layers” and mastering various suturing techniques, such as the figure-of-eight or subcutaneous stitch, is essential for wound healing. You should be comfortable selecting the appropriate dressings to finish closing the wound.
9. Fluoroscopy
Developing an eye for high-quality intraoperative imaging is paramount for successful open reductions and minimally invasive procedures. Knowing how to correctly position both the patient and the C-arm allows you to navigate anatomy with precision and confidence.
10. Postoperative Management
Surgical care extends well into recovery, requiring a thorough knowledge of weight-bearing protocols and immobilization requirements. Being prepared to guide patients through their postoperative milestones and expectations helps ensure the long-term success of the intervention.
DISCLOSURES: Dr. Wolterink This individual reported nothing to disclose.
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