How to Honor in Your Surgery Clerkship

Introduction

Whether you currently rotate in your surgery rotation, about to start it, or are just a first-year student, you will find value in this blog. The important aspects I wish to convey is the value of performing at a high level and learning as much as you can, even if you committed to apply to another specialty. Surgery is arguably the toughest 3^rd year rotation. However, two of your goals should be to excel and enjoy it, in fact honor in it, despite your interest being perhaps in primary care. Why just survive surgery, when you can thrive. In this blog, you learn how to excel and get the most out of your surgery rotation, whether you are an aspiring surgeon or already decided to pursue pediatrics, psychiatry, medicine or OB.

Outline

• Social Intelligence
• Be Prepared
• Learn from Your Mistakes
• Read (Study) Everyday
• Do’s & Don’ts
• Be Confident, not arrogant: Be enthusiastic, yet Humble

 

• Social Intelligence
  • Humans are social creatures by nature. In my opinion, while introverts can succeed in life, extroverts tend to engage others positively more often and stand to be more successful. Introduce yourself to everyone in the OR, whether it be the anesthesiologist, the nurse or the OR tech. Students with interpersonal skills, I suspect, learn more, enjoy more and get better evaluations. Show integrity, respect & enthusiasm. Establish your reputation early and help the team in any way that you can; ask relevant and timely questions. But, develop a sense of when to be quiet, such as during a difficult case.

 

• Make your Residents Look Good
  • Never outshine or embarrass your resident in front of the attending, nurses or patient. Your residents are under tremendous pressure. Do not add to their burden.

 

• Be Prepared
  • Arrive Early! Perhaps, even be the first to show up!
  • Know your patient well, read about the next day’s surgery the night before and know your anatomy, the indications and potential complications of the case. This will serve you well.
  • Practice Your Presentations. This is within your control. It is your choice whether to look professional, or as an amateur.
  • Know about Your Attendings! Perhaps you went to the same college or were raised in the same town. Showing that you cared to research him or her shows a seriousness in your character and in the rotation.
  • If you plan to be a surgeon, try to schedule Medicine, then OB before Surgery. This should help prepare you optimally.

 

• Learn from Your Mistakes
  • Don’t make the same mistake twice. Make mental and take written notes throughout the day. You will not remember everything you were told throughout the day. So write it down at your first opportunity. Or perhaps record notes on your phone. 
    • Get early Feedback
      • You don’t want to wait until midway through the rotation, or worse – at the end, to receive constructive feedback.
    • Read (Study) Everyday
      • Surgery is long and exhausting. Waiting until after your dinner to first begin studying is a strategy fraught with failure. Study when you are freshest, early in the day when the opportunity presents. Being Busy is no excuse not to read. When you have five to ten minutes throughout the day, take advantage of it. Time is your most precious, non-renewable resource. Don’t waste it.
      • Also take regular timed practice exams, and under test-taking conditions. The Shelf exam and your Step exams are exercises in stamina and endurance. Take them seriously & study consistently throughout the clerkship.

 

• Must have resources for Surgery:
  • UWorld The Surgery Shelf is “medicine heavy.” So study the UWorld sections on GI, Pulmonary, and Cardiology as well.
  • Devirgilio – Surgery Case-Based Clinical Review – 700 pages – comprehensive – great illustrations, Q&A format – good for trauma if your rotation doesn’t have any.
  • Pestana Surgery Notes – succinct, high yield material & fits in your coat pocket, only 140 pages. – Since it’s a book, this is a better “aesthetic” look than studying than from your phone, which can look as though you are on social media.
  • Online MedEd – A killer resource for its note’s outline, great case scenarios, uses a decision-tree format, just like the shelf.
  • Surgical Recall – Not a book to study for the shelf; great for getting pimped in the OR, such as indications and complications.
  • NMS Surgery Casebook – This is like a workbook, interactive, and shorter than Devirgilio
  • Artaga Med’s Suture Practice Kit: a must have
• Do:
  • Learn to Scrub, Gown & Glove, Stay Sterile & Suture, including hand tying; right-handed and left-handed
  • Stuff your pockets with tape, 4×4’s, scissors
  • Reflect on experiences and how to be more efficient
  • Ask relevant & timely Questions
  • Do as you are told! Don’t improvise
  • Go Slow & smooth during surgery
  • Know how to answer the resident’s phone when it goes off during the case
  • Ask what is expected and how to excel on Day
  • Know the AAMC Core Competencies
  • Be Confident, not arrogant; Be enthusiastic, yet Humble
  • Ask if you can put the Foley catheter in
  • Ask to suture! Show initiative!
• Don’t:
  • Take Criticism too Seriously
  • Touch the Mayo Stand or back into a sterile table
  • Make Jerky movements
  • Stand too far away from the action; you are part the team, not an observer
  • Be Afraid to “Get Your Hands Dirty.” You are there to learn.

 

Follow these rules and you’ll not only survive, but thrive on your surgery rotation. Strive and prepare to score well on your Shelf and your evaluations. Wishful thinking alone will not get this done. You must be prepared. You must have a plan. And you must execute. You don’t need to be perfect. You just need to impress and keep making progress.

 

If you need assistance, contact Dr. Richardson at mrichardson@physicianbound.comor text to 609.608.6258.