January 2, 2015
Article by Global Pre-Meds
Hospital doctor shadowing & global health experience programs.
Medical school rotations are a great opportunity to learn what you have been taught in the classroom. Rotations bring anticipation and excitement for some medical students and maybe a little fear. Medical school curriculums may be bit different, and rotations may vary among schools. But most medical schools include surgery as one of the required rotations. The length of your surgical rotation will vary by school, but many rotations are about eight weeks long.
During your surgery rotation, you may have the opportunity to observe such varied procedures as a kidney transplant, biopsy and cardiac and trauma surgery. It can be a great chance to learn about different types of surgery and determine if surgery may be something you are interested in specializing. Even if you do not plan on becoming a surgeon, you can still gain a lot from the rotation. Your surgery rotation consists of different things, such as patient’s rounds, working in the operating room and being on call.
Patient Rounds: Surgeons round on their patient’s first thing in the morning before they perform scheduled surgeries. They may also round again at the end of the day to follow-up on patients who had surgery performed. The number of patients a particular surgeon will round on varies.
As a medical student, you may be assigned to one surgical resident or work with several. Your supervising resident will likely assign you a few patients to follow. Following a few patients means you are expected to know as much as possible about them, such as medical history, allergies, current problems and where they are in their treatment.
In many cases, you will be expected to see your patients before rounds start. During pre-rounds, you should assess the patient and check lab values and any test results. You will present this information during rounds, so you need to have the information ahead of time.
During rounds pay attention to your colleagues even if you are not involved in the case. You are expected to know at least the basics about each patient on the surgical services, even if they are not the ones you are assigned to follow.
Many residents cannot wait to get into the operating room, especially if they are considering becoming a surgeon. The tasks you are given during surgery may vary depending on the procedure and individual surgeons you are observing. Some surgeons may enjoy teaching and let you get involved by holding a retractor or cutting sutures.
One thing you can do to get the most from the experience is prepare for each procedure you will be watching. Make sure you know the anatomy related to the surgery being performed. Read up on the procedure and be prepared to answer questions.
Although it may sound harsh, you are better off not talking during surgery unless you are spoken to first. Surgery can be intense and take a great deal of concentration. Surgeons vary greatly on how much conversation they like during a procedure. Err on the side of caution, and keep it quiet until you find out otherwise.
Keep in mind, before surgery starts may also be a great time to perform some procedures. For example, you may get the opportunity to prep the patient, insert a catheter or start an intravenous line.
Being on Call
Surgical residents are on-call a certain number of hours each month. Although it may vary by program, some medical students will also be expected to be on-call similar to their supervising resident. Being on-call is an opportunity to see urgent cases firsthand.
Because you never know how busy you will be when you are on-call, it can be helpful to take study material with you to use in your downtime. At the start of your rotation determine where medical students are allowed to hang out during their on-call time. Med students may be given a designated on-call room separate from the residents.
Be on time or early for rounds. Scheduled surgery starts early, and rounds start before surgery. Rounds are done as a team with residents, nurses and attending physicians. If you are late, it will be very noticeable. Bing early for rounds is even better. Med students need to be early to prepare and get ready for the day.
Know your patients. It is important to know as much as you can about the patients you are assigned to follow. Many hospitals have electric medical record systems in place. This means you can access different patient’s records from the same computer.
Ask what you can do. If you want to learn as much as possible, you need to take charge of the experience. Don’t expect the residents to always persuade you to do certain procedures. There may also be first-year residents, physician and physician assistant students who need to practice procedures. Step up and ask if you can do something.
Remember you are a reflection of your teaching resident. It is your resident’s job to teach you. If you look bad, so does your resident. If an attending asks you a question and you don’t know the answer, your resident is not going to be too happy.
Ask your resident for feedback. Some residents may be better than others about giving you feedback on how you are doing. If you do not receive feedback, consider asking what you can do to improve. Determining where you need work may help you for future rotations.
Respect all staff. The doctors are not the only ones you need to respect. Other staff, such as nurses, technicians and social workers can also be valuable resources for learning.
Don’t take things personally. Of course, everyone is different, and you can’t always stenotype the type of person who goes into a specialty. But surgeons are not known for being warm and fuzzy. There may be instances where you are snapped at. Learning to brush it off and not let it upset you will help make your surgical rotation a bit easier.