Wednesday, April 6, 2011

Surgery as a Med Student

Our third year surgery rotation is made out to be one of the most intimidating experiences that we will ever face in medical school. Horror stories abound about 6am rounds, standing in the operating room (OR) for hours pulling back a fat flap so the surgeon can have better access to the tissue, crabby surgery nurses that yell at you for breathing, and attendings who yell at you because you can't do anything right even when you do exactly what they tell you to do.

Needless to say, the horror stories are least mostly. Depending on which surgical subspecialty I was doing, I would have to be at the hospital some time between 6:15-7am. When I was in the operating room, sometimes I had to retract tissue, sometimes I was the first assistant helping the surgeon, sometimes I closed the surgical incision after the operation was completed, and sometimes I stood. The nurses were nice as long as you were friendly with them and showed them that you were at least competent enough to ask them questions if you had any. Experiences with attendings varied from student to student and attending to attending. No attending ever yelled at me, though, some certainly did ignore me. However, most of the attendings I worked with were actually really friendly, wanted to teach, and tried to convince me to become a surgeon.

My major frustration with my surgery rotation is that there wasn't a lot for me to do as a medical student. In some ways, that should draw a collective sigh of relief from the general public. Do you really want a medical student to be heavily involved in your surgery? However, it was frustrating for me because I had completed my internal medicine rotation and I was accustomed to managing patient care from start to finish. As a surgical med student, I was often given odd tasks here and there when the surgeons and their residents were too busy to do the task themselves. Of course, there are also a set of "med student tasks", such as closing the incision, guiding the camera in a laproscopic surgery, and checking patient labs (in order of excitement).

There is also an interesting type of unity that forms amongst the surgical residents. A surgical residency is tough...actually, brutal. They work from 6am-5pm or later for five days a week and their work is always go, go, go. They also have call 1 in 3 or 4 days, which means they are working every other weekend. They also have a huge patient load and they barely have an opportunity to familiarize themselves with the patient charts. When they get home from work, they have to find SOME time to study. And, oh yeah, they need to find some time to have a life and see their friends and families. However, they are all in the same stressful situation for five years, so there tends to be a really strong bond between them. Uniting against a common enemy, even if that enemy is a residency program, makes working with the residents a lot of fun. They were definitely the most stressed, but most entertaining group I have worked with so far.

So my thoughts on surgery as a med student:

1. Get to be in the OR (and actually do stuff).
2. Learn how to deal with acute, surgical emergencies.
3. Finally do procedures.

1. Lots of standing around feeling useless.
2. Long days.
3. Attendings and residents were often too busy to teach, even if they wanted to.
4. Residents never seemed happy...some were neutral, but most were always stressed.

Surgery was a busy rotation, but being in the OR and seeing surgeons cut people open to fix them was definitely one of the coolest experiences I have had in med school

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