GENERAL SURGERY
06/24/2020
6 weeks
SCHEDULE: Monday through Friday, 24 hour at-home call every Thursday + weekend call once a month (I had this twice)
6:15 am: change into surgical scrubs, look at patient list for the day. Round on patients in the hospital
7:00am - update attending on patients. scrub into surgeries.
12:30 - 1:00pm - get lunch
1:15pm - 5:00pm - clinic
- twice a week we had scheduled surgeries all day, no clinic
- Friday's (after call on Thursday) my attending had scheduled surgeries in the morning then NO clinic.
5:00pm - 5:30pm - round on post-op patients, get updates on other patients
SETTING: hospital + attached clinic
Even though I had an assigned attending, I scrubbed into surgeries with 3 of the other general surgeons on service. The majority of my days were spent in the operating room (and some clinic in the afternoon), because of there being so many providers to go between.
Call was "at home", so my attending would text me if I needed to come in. I was called in 50% of the time, my most memorable one being a 2am call on New Year for an emergency ex-lap.
- Make the surgeon's number in your phone an "emergency bypass number" and create a very long ringtone as your text tone for this person. That way, you will never miss a text at 3am. From the moment I received the text to me walking into surgeries was less than 30 minutes (I lived 20 min away).
MOST COMMONG ILLNESSES & SURGERIES:
- GALLBLADDER REMOVAL - cholecystectomy
- APPENDICITIS REMOVAL - appendectomy
- DIVERTICULITIS - sigmoidectomy
- HERNIAS - mostly laparoscopic - I got to witness the DaVinci robot in action one time
- NISSAN FUNDOPLICATION
- BOWEL PERFORATIONS & BLOCKAGES NEEDING REQUIRING REMOVAL - due to infection and/or necrosis
OVERALL IMPRESSION: My biggest take away from this rotation is to 𝘳𝘦𝘮𝘢𝘪𝘯 𝘤𝘰𝘯𝘧𝘪𝘥𝘦𝘯𝘵 - in my skills, mistakes, questions, presentations, and personality. I consciously tried to bring a fun, fresh attitude to the OR every day (even when I didn't feel like it), and I honestly feel it made all the difference. Some people go their whole life never being able to witness the incredible things I did over those 6 weeks. Always remember how cool and unique it is to be able to see someone on the inside.
- Learn basic suturing skills - practice holding the instruments in your hands, opening & closing, practice on kits/bananas. Amazon suturing kit linked here
- At least know how to 2-hand tie or close up basic laparoscopic incisions
- Watch videos of surgeries online beforehand
- Pre-round on all the patients you saw or are going to see (look up overnight events, labs, pain status, meds, diet, and plan from the day before). Have an idea of how you want to present them
- Know your abdominal anatomy
- Ask to participate in everything (removing staples, closing up cases, help move a patient, grab gloves/gowns, etc)
- Ask if you're confused - especially with sterile techniques - if you're not sure, ask before you touch! ProTip: if it's blue or plastic, DONT TOUCH! Keep a notepad in your pocket for notes/questions/criteria if the time isn't right and you have to ask later
- Bring lots of snacks and a giant water bottle - eat, drink, pee - even if you don't feel like it.
- Ask your surgeon if they want you to pre-scrub and towel off for later or go in fresh & wet to each case.
- Thank the person who explains/shows you something .. every time
- Be nice to nurses and techs. Always.
- Show up to the hospital at least 1 hour before your first surgery
- Believe in your ability - students make mistakes. It happens. Learn from it & own it.
- NEVER LIE OR SAY THAT YOU DID SOMETHING IF YOU DIDN'T.