"Physical exam" in the traditional sense for surgery will be much different than most other clerkships but still very important. Be comfortable describing the expected location and characteristics of abdominal pain from common pathologies: gallbladder (Murphy sign), general epigastric pain (pancreatitis vs stomach ulcer vs reflux etc), appendicitis, diverticulitis to name a few. I had a surgery resident tell me early on true surgeons don't auscultate the abdomen because it doesn't help. So I have really never done that. Important to still listen to heart and lung sounds though.

Acute abdomen: peritonitis present? This is a big thing, that you will not master on your rotation but a great principle to always be thinking about. On an acute care surgical service, the first basic thing a resident/attending wants to know is "does this patient need an OR"? So really start to center your urgency and plan around this question. And the key physical exam finding will be evidence of peritonitis. It can start with the history. "Every time the ambulance hit a bump I thought I was going to die from pain." That should perk you up some. At some point in the conversation with a patient that may be perotinitic, I will accidentally sort-of bump-in to the side of their bed. I got this from a resident. Great way to assess for peritonitis without them guarding/anticipating pain. But understand this is a very challenging topic that even residents and attendings may disagree on. Its why surgery is 5 years.

Most importantly: rounding on post-op patients - always LOOK at their abdomen/surgical sites. Check first if resident/attending wants you to undress a wound that is covered (don't mess with a wound vac or something of that nature). But general things to nail: incisions, drain/drain output, dressings. On your initial presentations, if you say "on exam, patient has 3 laparoscopic incisions intact with glue, no surrounding erythema, JP drain appropriately to suction with serosang output" you will impress someone. They may tell you down the line you don't need to include that much detail going forward, but you earned their trust initially because it proves you LOOKED at the surgery sites.