One of the most surreal feelings: you are in the OR, scrubbed in and present in the sterile field. All of the lights go off aside from the laparoscopic camera monitors and the focus is entirely on what is going on inside the patient at that moment. Everything else in life is put on pause and your brain is hyper-focused on only the patient. It is like you stepped out of the world and you get to use a combination of your brain and hands to make someone better. I love it.
The Role of Surgery in Patient Care
I went from Family Medicine to Surgery, and I have to say… I love them both. They are definitely two totally different rotations and play completely separate roles in a patient’s care. But it was so cool first working along side hospitalists (my family medicine had two weeks of in-patient) and consulting surgery. Then I had surgery and would go to the consults that the hospitalists requested! One thing I know for sure is that I love being in the hospital and working with different specialties of medicine. The internists/family docs work with the surgeons, nephrologists, cardiologists, etc. to come up with the best treatment plan for the patient. It is so awesome to experience this type of team environment. But now let’s talk about surgery, specifically!
Surgery is awesome. SO awesome. It is a totally different world and requires a whole new mindset. Learning sterile field and how to constantly maintain it doesn’t always come naturally. Your default is to not move, which can throw a lot of people off. You also have to get used to standing for long periods of time. Once you get used to that aspect, you can really enjoy it (or at least I did!).
A Day in the Life of a Surgeon
Every surgery practice is going to be different, but I really loved the way that my rotation was set up. I worked with a practice of 4 surgeons and 2 PAs. We worked Monday-Friday and the surgeons which switch off being on call every 4 weekends.
I got there at 6am to round on patients. Surgeries start at 7am and go to around noon. Sometimes we would have more surgeries, sometimes less. Clinic runs from 1pm-5pm. In clinic you will see post-op patients and patients that potentially need surgery. Throughout that 6am-5pm day, we might get anywhere from 0-10 consults. I loved the variety and constantly being on your feet.
Surviving the Surgery Rotation
The best thing you can do (just like in all rotations) is to be proactive. Scrub in on as many surgeries as you can, ask questions, read up on common surgeries at night, go to all the consults that you can. Surgeons work hard. They are only going to be impressed by medical students that are also willing to work hard. Be respectful and professional, but show up early and do all that you can to learn! If you can, practice suturing ahead of time. I use the Sim Vivo Suture Kit.
Also, learn how to gown and glove yourself. Be nice to the scrub nurses and scrub techs because they can really help you out. Only touch things when asked to and try to stay out of people’s way as much as you can. And of course, the rules of surgery: Don’t stand when you can sit. Don’t sit when you can sleep. Eat when you can. And don’t f*** with the pancreas.
The Surgery Shelf Exam
Most of the shelf exam consists of GI; expectantly so because most general surgery deals with the GI tract. You will also get questions on breast cancer and thyroid diseases because general surgeons treat these as well. What I didn’t expect was so many anesthesiology questions! There were a ton! It was definitely my lowest section because I didn’t study any anesthesiology, so read up on that before you take the exam. You will also get a lot of burn questions and post-op fever questions.
I used UptoDate, COMBANK, and Online MedEd to study. I felt well prepared except for the anesthesiology questions. COMBANK and Online MedEd doesn’t really cover a lot of anesthesiology, so look elsewhere for that.
So far, I LOVE surgery and I LOVE inpatient family medicine (read about it here!)… and they are completely different. You’re supposed to get clarity once you start rotations, and I feel like I am discovering so many new things that I love instead of narrowing it down more. One thing that I do know is that I prefer being in a hospital over being in an out-patient clinic.