Book excerpt: There are over 250 surgical residencies in the United States. Most residents experience some degree of shock once they start on the very first day, and the demands of residency are high. The current overall dropout rate is 16%, and there is evidence for higher burnout rates, suicide rates, addiction rates and divorce rates among all surgeons compared to other careers. There is therefore a critical need for the education of resiliency during surgical residency and guidance on surviving this challenging portion of their career. Unfortunately, the experiences of trial and error are the basis for survival, and resiliency training is often overlooked as part of the traditional surgical training. This practical guide is founded on many conversations with struggling general surgery residents and will have wide appeal, utilizing these experiences via interviews with current residents at different residency programs and covering an even wider variety of topics, with variable experiences based on differing ages, races, sexes, and marital statuses. Each chapter begins with a topic and a brief introduction, expansion on the topic based on their unique experiences, and then a concluding list of pearls to remember and use in daily residency. The topics are broken down thematically into five main sections, covering the breadth of residency experience and work/life balance: academics, clinical duties, life outside of work, leadership and ethics, and basic survival skills and self-care. Written by current residents for current residents, General Surgery Residency Survival Guide will be a valuable resource for everyone navigating this challenging portion of their medical career.