My surgery rotation was at a busy hospital in Philadelphia. I chose to do a more general surgery rotation to get a wider scope of what happens in the OR. This included general surgery, colorectal, breast, and ortho. My favorite was colorectal…not. I never knew how they had to position a patient for rectal surgery, and let me tell you, it ain’t pretty. Backside up, retractor in. If you have never had a surgical experience, be prepared for the brutality of it. The patient is anesthetized, the music blasts, and there is no finesse necessary for getting the job done. Mostly as a student you will be holding instruments. You will be retracting. You will be on your feet for 10 hours a day. I was lucky enough to work under the chief resident who happened to look like Meg Ryan from City of Angels and she actually was pretty decent. Here are some heads up about what to expect.
1) Surgical residents get treated like pond scum….so thats the only way they know how to treat you.
2) There is a TON of pimping going on. The attendings pimp the resident and the residents pimp you. You should learn this phrase “I’m not sure but I will look it up and give you the answer later today.”
3) It would be helpful to get a pocket guide for the most common surgical procedures and their indications. You will be asked about epidemiology, pathophysiology, anatomy, treatment, etc.
4) Surgery Departments are typically boys’ clubs. Unless things have drastically changed since I graduated, expect that it will be more difficult to be successful during this rotation if you are a woman. There is a lot of male camaraderie and strutting going on. “Oh hello, did you know I’m a surgeon? Just wanted to remind the whole hospital how awesome I am” Just ignore it. Show them your book smarts and be prepared.
5) Go over sterile procedure. You will scrub in so know how to it before you get there. Know about the sterile field. If you break the field you will be the most hated person in the OR for your entire rotation.
6) The surgical techs are gods in the OR. They know every instrument, how to handle them and how to maintain the sterile field. They may help you get your gown and gloves on.
7) Expect to stay late. Everyday. There will always be a late, add-on, once-in-a-lifetime case that you would be a complete idiot to miss.
8) Continuing off of #7, sometimes you can’t stay late. Its okay to say no if you have something REALLY important happening. An example would be that you are in labor and your water breaking would contaminate the field. If you truly have to leave on time, just be prepared to get some seriously disappointed looks. If you can handle it, walk out the door with your head up.
9) Bring protein bars…at least 3 or 4. Lunch break is rare. Breakfast and dinner breaks are even rarer. Pretty soon, that mass you just helped remove will start to look delicious. Gross.
10) This may be the specialty for you if you find out that you like instant gratification. Someone’s gall bladder turns black, you take it out. BOOM! The End. There is less direct patient contact, but you are in close contact with your supervising MD everyday. In all seriousness, surgeons typically come from the top of their class. There are many kind hearted and gifted surgeons that you can learn a great deal from. So be prepared to work long, hard hours this rotation. Suddenly the textbooks will be replaced by real people and so many pieces of the puzzle will fall into place for you. I promise, retracting is not nearly as bad as it sounds 🙂