At this time of year, we see a variety of changes on surgical services in our academic medical center. We see graduating residents and new attendings, but the most exciting dynamic is when new third year medical students arrive ready to cut their teeth on some good clinical experiences. Over the years I have seen several students succeed and fail on surgical rotations. With that in mind, I have the following ten tips of advice for anyone getting ready to start a surgical clerkship rotation:
1. Come early and leave late
Surgery is a game of capturing the moment. Most operating rooms start their first cases at 730 to 800 AM. This means most resident teams are rounding at 600 AM. I would allow an additional thirty minutes of pre-rounding to gather overnight information and to examine your patients. There are several reasons for this. One it will be helpful to your team if you have done some of the leg work of getting the story about the clinical progress of your patients before the team actually rounds on all the patients. Also when you examine your patients each morning there might be things that you pick up that others might have missed. Additionally, it also builds clinical rapport.
2. Get involved
No matter in the operating room or on the wards, get your hands into the game. You might need to get permission to place for example a foley in the operating, regardless, the more you do - the more you see and the more you see - the more you grow as a doctor.
3. Talk to everyone
Either on rounds or in the operating room, make conversation with all the members of the health care team. You might or not might know it but you are picking up subtle information about your patients and their disease states. But more importantly, you are learning how to talk with people at all levels in the hospital as a medical professional.
4. Know a little bit about every patient
As a student you will be most likely assigned a set of patients to follow while admitted. I would keep an ear open to all the patients especially on rounds. You will become essential and lots of people (residents, attendings, nurses, etc.) will start asking you what is going on with so and so. Being in the know means you are in the know.
5. Wound care
An essential part of any rotation is the wound care you render to patients. Get to know what the dressings are and more importantly why you are using them. Regardless of if you become a surgeon or not, you will most likely remember your wound care training as a medical student.
6. Dress the part
Try to dress professionally especially on clinic days. It is easy to fall into “scrub causal” but dressing you nice will distinguish you from your classmates and patients like that you are dressed up to see them.
7. Help in the operating room
Most of the time as the student you are at the end of the bed and sometimes you don't see too much. Take time to look at the instruments – it is an easy way to learn the names as instruments are called for during an operation and what is handed up to the surgical field.
8. Have fun
Most students will not end up choosing surgery as a career, that said this is the only time in your life when you get to see how surgeons act and take care of patients. Most people don't this close of an picture of surgery and you should take advantage. Listen to what helps and hurts surgical care especially what people are asking for or not asking for in consults. It will help you especially if you are not a surgeon in the future because you will be interfacing with surgeons most of your professional life in some fashion.
9. Hang out in the operating room
The operating room is a busy place and by simply hanging around you will get exposed to more surgical education than you can imagine. Try to get to know the nurses in the operating room, they will help you. Most of the time they start with a healthy criticism of all students, from their point of view, they are just trying to keep the patient safe. Once you have their trust they will go out of their way to help you.
10. Talk to your residents
Talking to your team constantly, let alone your fellow medical students, is essential to your rotation. Talking to residents to find out how you can help and what's going on as well as relaying information about the service will go a long way. Residents play an important part in your education and they often help you especially in tailoring your studying for the shelf exam. By speaking with residents, you get a sense of what their lifestyle is like and if you think you could do surgery as a career.
So there you have it, some quick tips for your rotation. Any feedback you have please forward on to me here at the website.
Hang in there and good luck.
Michael Amendola