Background: Surgical education is changing, with residents having less time to learn more procedures. We aim to explore how residents prepare for the operating room and what factors impact their preparation. Methods: A qualitative study was conducted using conventional content analysis. General surgery residents at one institution were invited to participate in semi -structured interviews. Each interview was recorded, transcribed verbatim, and then inductively examined to generate themes. Results: Fourteen residents elected to participate. Six themes were identi fi ed: (1) All participants simi-larly de fi ned preparation, (2) Residents learned through trial and error and co -residents, (3) Factors impacting preparation were time, attendings, autonomy, case complexity, and dif fi culty fi nding resources, (4) Resource use varied, (5) PGY level impacted preparation and, (6) Optimal resources were high yield. Conclusion: Although surgical residents similarly de fi ned operating room preparation, they use a variety of different resources to achieve this, which is often dif fi cult and time consuming. (C) 2019 Elsevier Inc. All rights reserved.