Pal Surgery — free surgical guides for medical students

Choose a topic

Every guide, every case to clerk and every calculator on the site sits under one of these. Open a topic and you get all of it in one place.

Jaundice & liver testsWhy a patient turns yellow, how to tell the three types apart at the bedside, and how to read the liver function tests that follow.7 guides · 1 calculator · 2 cases Bile & the gallbladderThe enterohepatic circulation in ten steps, what bile actually does to a fat meal, and what happens when the circuit is broken.3 guides · 1 case · book Part 1 The acute abdomenThe commonest reason a student is sent to clerk a patient. Where the pain started, where it went, and what that movement tells you.3 cases to clerk Gastrointestinal bleedingBlood from the top and blood from the bottom: what to ask, which drug history matters, and what must not be called haemorrhoids.2 cases to clerk Hernia & the groinA lump in the groin, and the three questions that decide whether it can wait until the morning or needs a surgeon tonight.1 case to clerk Calcium & the parathyroidFour glands defending one number, the hypercalcaemic patient, the parathyroid operation, and the tingling fingers the morning after a thyroidectomy.5 guides · 1 calculator · book Endocrine & bariatric surgeryThe thyroid, the parathyroids and the metabolic patient — the operations this unit does most, and the histories behind them.1 case · 1 peer-reviewed chapter Wounds & the lower limbVenous, arterial or neuropathic. Three ulcers that look similar on a ward round and are told apart almost entirely by the history.1 case to clerk

Interactive · 9 cases Clerk a real surgical patient Choose your own questions, hear what the patient actually says, commit to a diagnosis — then see a scored debrief against a model clerking. New · 12 model clerkings Learn history writing Twelve complete histories and examinations as they should read on the ward, with a key box beside every part explaining why it is written that way. New · 27 OSCE stations Dry stations: imaging, results, charts, equipment and prescribing Real X-rays and scans from Radiopaedia, laboratory reports, scores, ward charts, surgical equipment and prescribing, with the examiner’s questions and model answers. Free calculators Corrected calcium & the R-factor Two numbers in, the answer out. Is this calcium really low, or is it the albumin? Is this liver injury hepatocellular or cholestatic?

The current guide

Bile and Jaundice

A Visual Guide for Medical Students · 31 pages

Why is the urine dark but the stool pale? Why does the INR rise in obstruction, and correct with vitamin K? Part 1 follows bile acids around the enterohepatic circulation in ten illustrated steps. Part 2 applies that circuit to the patient with jaundice: history, examination and laboratory interpretation.

Download the free PDF What's inside

Answers to the questions students actually ask

Each page below answers one question properly, with a diagram, the bedside relevance and a surgical pearl. Nothing is behind a sign-up.

Classic question Why are the stools pale and the urine dark? The most-asked question about jaundice, answered from the pathway up. Interpretation Reading liver function tests Three patterns, one table, and the three questions to ask of every set of results. Physiology meets ward Why the INR rises in obstructive jaundice Vitamin K needs micelles. No bile in the gut, no absorption, higher INR — and why it corrects. Examination Courvoisier's law, explained properly What it actually says, why it works, and the two exceptions examiners like. OSCE Taking a jaundice history Six questions, the exact words to say, and a model summary for the examiner. Research AI in bariatric surgery A peer-reviewed chapter reviewing 300 studies on machine learning in metabolic surgery. Commonly confused Emulsification is not micelle formation 1 µm versus 5 nm. Two stages, two jobs — and the mistake examiners notice.

Who writes this

Dr. Mohammed Maree is a consultant general, laparoscopic, bariatric and endocrine surgeon at Al-Makassed Hospital in Jerusalem, and teaches undergraduate surgery at Al-Quds University Faculty of Medicine. Everything here grew out of bedside teaching for fourth-year students on their surgical rotation.

He also publishes peer-reviewed work: a 2026 IntechOpen chapter on artificial intelligence in bariatric and endobariatric surgery reviews some 300 studies on where these models help and where they still fall short.

The guides are deposited with a DOI and licensed CC BY-NC 4.0, so any medical school may print and teach from them, with attribution. More about Pal Surgery.

Coming next

Acid–Base Balance — the next guide in the series
An MCQ bank for surgical finals and the OSCE
More case trainers — trauma, breast, and the acute abdomen in depth

Everything will stay free.