4th YR Surgery Audition Rotation

[bengeminy]

Hey all,
So I am currently on my 4th year surgery audition rotation and I feel like things have been mixed. First off, I have been away from the hospital for 6 months (won't go into details why). So I'm rusty and third year rotations, I mostly was either writing progress notes and following residents around. I did well third year for surgery but on an audition I feel I need to behave more like an intern. Some residents like me and see that I'm trying hard. But I think most of the residents see me as a useless student and only give me 2 patients to see and then stick me in the OR because I am of no help to them on the floor. I really really want to be helpful and also to learn, but I guess since I'm rusty and my experience as a 3rd year has been less involved I don't know how to progress. And I'm depressed because I feel like as a fourth year I should know how to do a lot of things and shouldn't ask for help so I'm afraid to. If any one has advice on how they excelled in their 4th year rotation, what they did to be helpful and stand out during their surgery audition, I would really appreciate it.

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[operaman]

Get there before everyone else.
See all the patients on your service, or as many as you can.
Make sure everything needed for rounds is preset in each room by the bedside.
Write your own notes for everyone.
If your team uses a printed rounding list and puts vitals/labs/etc on it, prep it before the intern gets there so they don't have to.
On rounds, make sure you stay in the circle and not to the side.
Glove/gown and be ready to help in every room.
Anticipate needs of the team. Have a light out and turned on before asked. Have plenty of supplies on hand. Have gloves handy for others. This sort of QUIET anticipation is a great way to show interest and work ethic without any risk of being annoying.
Offer to call consults and then do it well.
Do any scut work you know needs doing and then ask what else needs doing.
Read like a fiend for the OR.
Don't be annoying.

I'm sure others will have ideas too. I've found that the more initiative I take, the more people above me respond and allow me to do more. Often they don't know what any given student is capable of, so show them. Don't forget that on surgery the OR is a huge part of things and the residents may actually be trying to help you by giving you more time operating. If you do the above for awhile and get nowhere, sit down with your chief and talk about it.

 

[SouthernSurgeon]

Read @neutropeniaboy 's stickied post in the ENT sub-forum.

Do all the things he recommends doing for clerkships/away rotations.

Don't do any of the things he says not to do.

 

[gators21]

Get there before everyone else.
See all the patients on your service, or as many as you can.
Make sure everything needed for rounds is preset in each room by the bedside.
Write your own notes for everyone.
If your team uses a printed rounding list and puts vitals/labs/etc on it, prep it before the intern gets there so they don't have to.
On rounds, make sure you stay in the circle and not to the side.
Glove/gown and be ready to help in every room.
Anticipate needs of the team. Have a light out and turned on before asked. Have plenty of supplies on hand. Have gloves handy for others. This sort of QUIET anticipation is a great way to show interest and work ethic without any risk of being annoying.
Offer to call consults and then do it well.
Do any scut work you know needs doing and then ask what else needs doing.
Read like a fiend for the OR.
Don't be annoying.

I'm sure others will have ideas too. I've found that the more initiative I take, the more people above me respond and allow me to do more. Often they don't know what any given student is capable of, so show them. Don't forget that on surgery the OR is a huge part of things and the residents may actually be trying to help you by giving you more time operating. If you do the above for awhile and get nowhere, sit down with your chief and talk about it.

While most of this is excellent advice, some of it is impractical. You can't have all supplies ready for every patient unless you carry a supply closet on you. However know where the supply closet is, so you can get things quickly.
Also don't round on every patient, it makes you look like a j@ck@ss and trying too hard (however the vitals of all your patients is spot on) . Nobody cares that you saw 25 patients by 5 am, but cant remember a thing about them. Instead, find out what patients are assigned to you and know everything about those patient. If they had a scan know the result, every lab result you ordered, have print outs of the susceptibilities of your cultures, ect. Don't rely on writing it down or looking it up when asked. Know numbers and know the progressions, not just the current set. Also if you have another medical student on service, don't see their patients too...big no no
I agree with anticipation and initiative, however the most important thing is to know your place and to understand the dynamics of your team. If your rotating in July your job is to help out the struggling new intern in any way possible. If that means you get no OR time, then whatever as long as you are helping. Their concern is that intern in the program, not some temporary med student. The truth of the matter is you are not going to impress your attending. They see too many students, are too busy, and frankly care too less. However, that intern you helped on his 4th admission will remember you and most likely will help you get that residency.

 

[VisionaryTics]

However, that intern you helped on his 4th admission will remember you and most likely will help you get that residency.

As a July intern, do I really wield such power?

The answer is no.

 

[SouthernSurgeon]

While most of this is excellent advice, some of it is impractical. You can't have all supplies ready for every patient unless you carry a supply closet on you. However know where the supply closet is, so you can get things quickly.

It's called a wound bucket.

Also don't round on every patient, it makes you look like a j@ck@ss and trying too hard (however the vitals of all your patients is spot on) . Nobody cares that you saw 25 patients by 5 am, but cant remember a thing about them. Instead, find out what patients are assigned to you and know everything about those patient. If they had a scan know the result, every lab result you ordered, have print outs of the susceptibilities of your cultures, ect. Don't rely on writing it down or looking it up when asked. Know numbers and know the progressions, not just the current set.

My chiefs expected me to round on 1/3 the service (two interns and me, no M3s - so it was an even split). But I also pre-rounded and chart biopsied every patient and knew their results as well.

A lot of it is about knowing exactly what the expectations are.

The truth of the matter is you are not going to impress your attending. They see too many students, are too busy, and frankly care too less.

Disagree. You impress your chief - he tells your attending. Thus attending is impressed. Then you confirm that impression by being spot on with the clinical knowledge, pimp question answers, etc. in the OR and clinic. But having the attending primed to like you by the team is key.

However, that intern you helped on his 4th admission will remember you and most likely will help you get that residency.

LOL.

 

[gators21]

It's called a wound bucket.



My chiefs expected me to round on 1/3 the service (two interns and me, no M3s - so it was an even split). But I also pre-rounded and chart biopsied every patient and knew their results as well.

A lot of it is about knowing exactly what the expectations are.




Disagree. You impress your chief - he tells your attending. Thus attending is impressed. Then you confirm that impression by being spot on with the clinical knowledge, pimp question answers, etc. in the OR and clinic. But having the attending primed to like you by the team is key.



LOL.

So you're telling me you think the responsibility of a med student is to carry a wound bucket around 24/7? That's what impresses you?


And please don't throw out lame straw man statistics. You can say you saw 1/3 of you patient list, but if that list is only 10 patients then big freakin deal. However if you had a 30 patient list with 2 attendings, then I'm calling BS you chart checked, saw your 10 patients, did notes, and had time to operate with your attendings before they rounded.

You can argue that to impress your chief, you impress your intern, who tells your chief how helpful you are, who tells your attending. The point is that your best bet to impress people is not by following your attending, but your residents.

 

[gators21]

As a July intern, do I really wield such power?

The answer is no.

Actually you do. These are people you have to spend the next 4 years with. Say someone on your rotation is a complete wierdo, ahole, lazy, ect. Whenever it comes interview time, and you see them you absolutely can "remind" your attending about that person. On the other hand if that person is someone you enjoyed on your service, then speak up. I'm not saying that an intern has the ultimate power, but it surely helps.

 

[SouthernSurgeon]

So you're telling me you think the responsibility of a med student is to carry a wound bucket around 24/7? That's what impresses you?

It doesn't impress me. It's a bare minimum necessity. On services with a lot of wounds, rounds will never get done if med students are constantly running to the closet. Someone will be carrying a wound bucket. If there are M3s they will do it, if not M4s, if not...intern.

I don't really care whether you believe me about how many patients I saw. I was a sub-I on a busy vascular service and I was asked to work hard, so I did. It was also about six years ago now, and I've worked much harder in the interim as a resident so I have little need or reason to brag. I have worked with dozens of sub-Is going into surgery, so I have a pretty good sense of the work ethic that separates the excellent ones from the middling ones.

Your advice is extremely limited from the perspective of a medical student, and you called the advice of someone with a much more seasoned perspective "unrealistic". I sought to give a counterpoint to that. Operaman's advice was how exactly what I'd tell a student looking to excel.

 

[gators21]

It doesn't impress me. It's a bare minimum necessity. On services with a lot of wounds, rounds will never get done if med students are constantly running to the closet. Someone will be carrying a wound bucket. If there are M3s they will do it, if not M4s, if not...intern.

I don't really care whether you believe me about how many patients I saw. I was a sub-I on a busy vascular service and I was asked to work hard, so I did. It was also about six years ago now, and I've worked much harder in the interim as a resident so I have little need or reason to brag. I have worked with dozens of sub-Is going into surgery, so I have a pretty good sense of the work ethic that separates the excellent ones from the middling ones.

Your advice is extremely limited from the perspective of a medical student, and you called the advice of someone with a much more seasoned perspective "unrealistic". I sought to give a counterpoint to that. Operaman's advice was how exactly what I'd tell a student looking to excel.

Just so that I get this straight and not trying to be argumentative, but you are gonna say yea or nay on a potential future resident on whether or not they always had some tape and gauze on them? It just seems so useless when trying to decide a potential colleague.
I feel like we are disagreeing on something that means absolutely nothing. (In my defense I did say his advice was excellent, but disagreed with 2 points)

I will say to anyone that reads this, absolutely listen to the residents advice before me as I don't have as much experience as them. I have gotten As in 4 surgery rotations and still talk to residents from them, but they have actual residency experiences.

 

[SouthernSurgeon]

Just so that I get this straight and not trying to be argumentative, but you are gonna say yea or nay on a potential future resident on whether or not they always had some tape and gauze on them? It just seems so useless when trying to decide a potential colleague.

You will be evaluated on how helpful you are on rounds. You will be evaluated on how much initiative you take, and how well you anticipate the needs of the team. In other words, you will be evaluated by how much you help the team run smoothly.

If we don't have the supplies we need one time? No big deal, who cares.

If rounds are consistently being held up looking for supplies, and we are wasting time on every wound, every day, then that is a problem. An unacceptable one - unless you'd prefer me to start rounds 30 minutes earlier every day to allow for such inefficiency. If it is a consistent issue, I will correct it with someone. If you as a sub-I are unwilling or unable to carry out the needed tasks, I'll delegate it to someone else. But that will reflect poorly on you in your evaluations.

Further, if there is any sniff that you have an attitude that some task (like carrying a wound bucket or bag) is "beneath" you as a sub-I, then that is a problem.

 

[Wordead]

Just so that I get this straight and not trying to be argumentative, but you are gonna say yea or nay on a potential future resident on whether or not they always had some tape and gauze on them? It just seems so useless when trying to decide a potential colleague.
I feel like we are disagreeing on something that means absolutely nothing. (In my defense I did say his advice was excellent, but disagreed with 2 points)

I will say to anyone that reads this, absolutely listen to the residents advice before me as I don't have as much experience as them. I have gotten As in 4 surgery rotations and still talk to residents from them, but they have actual residency experiences.

On one of my sub-Is I saw about 10 patients and wrote notes on them before rounding with attendings, so southernIM's experience is not unique.

And yeah, you should have some goddamn gauze, tape and scissors on you if you're doing a surgery sub-I and you are on rounds. That was expected of us as M3s, come on.

 

[gators21]

You will be evaluated on how helpful you are on rounds. You will be evaluated on how much initiative you take, and how well you anticipate the needs of the team. In other words, you will be evaluated by how much you help the team run smoothly.

If we don't have the supplies we need one time? No big deal, who cares.

If rounds are consistently being held up looking for supplies, and we are wasting time on every wound, every day, then that is a problem. An unacceptable one - unless you'd prefer me to start rounds 30 minutes earlier every day to allow for such inefficiency. If it is a consistent issue, I will correct it with someone. If you as a sub-I are unwilling or unable to carry out the needed tasks, I'll delegate it to someone else. But that will reflect poorly on you in your evaluations.

Further, if there is any sniff that you have an attitude that some task (like carrying a wound bucket or bag) is "beneath" you as a sub-I, then that is a problem.

We completely agree, all of which is what I said earlier. To excel you have to anticipate and be useful. If something is holding up rounds, then do something to help it. But I'm not wearing a freakin fanny pack (when you said vascular a wound bag made a lot more sense)

On one of my sub-Is I saw about 10 patients and wrote notes on them before rounding with attendings, so southernIM's experience is not unique.

And yeah, you should have some goddamn gauze, tape and scissors on you if you're doing a surgery sub-I and you are on rounds. That was expected of us as M3s, come on.

Again, saying this means absolutely nothing without context. If your only job is 10 patients and your attending doesn't round until the afternoon, then big deal. My attendings rounds at 5 am and the other at 730. The rest of the time were either in clinic or the OR. You gonna say I'm a slacker when I'm at the hospital at 330 am every day? Putting in 100+ hour weeks. (yes there are med student caps but they are not enforced)

 

[Armadillos]

yikes, you surgeons really sound like fun people waving your epeens around about who can get there earliest so they can carry around the most gauze and compete to see who can slap "NAD RRR NTND BS+ c/d/i, advance diet" on the most charts before 6am hits.

 

[evilbooyaa]

yikes, you surgeons really sound like fun people waving your epeens around about who can get there earliest so they can carry around the most gauze and compete to see who can slap "NAD RRR NTND BS+ c/d/i, advance diet" on the most charts before 6am hits.

I know this is slightly tongue-in-cheek, but I literally laughed out loud at the bolded.

Although I would add - 'No flatus/BM'.

 

[pocket-medicine]

It's called a wound bucket.

May I ask what consists of a wound bucket, beside gauze?

 

[SouthernSurgeon]

May I ask what consists of a wound bucket, beside gauze?

All kinds of stuff.

A generic wound bucket would include:
ABDs
4x4s
2x2s
Kerlix
Drain sponges
Tape (medipore, paper, etc)
Vaseline gauze
Xeroform gauze
Staple remover
Cotton tip applicators (qtips)
Scissors
Scalpel
Steri-strips
Adhesive remover
Packing strips (nu-gauz)
Saline
Triple antibiotic ointment
Lube

That's just off the top of my head. I'm sure there is more I'd think of with more time

An "advanced" bucket would include precisely the needed supplies for the existing wounds on the service, plus some generic supplies.

 

[Wordead]

We completely agree, all of which is what I said earlier. To excel you have to anticipate and be useful. If something is holding up rounds, then do something to help it. But I'm not wearing a freakin fanny pack (when you said vascular a wound bag made a lot more sense)

Again, saying this means absolutely nothing without context. If your only job is 10 patients and your attending doesn't round until the afternoon, then big deal. My attendings rounds at 5 am and the other at 730. The rest of the time were either in clinic or the OR. You gonna say I'm a slacker when I'm at the hospital at 330 am every day? Putting in 100+ hour weeks. (yes there are med student caps but they are not enforced)

I didn't even know afternoon rounds was a thing. How would you arrange everyones schedules to match up perfectly? 5 am rounds, preround at 4 am. And who was calling you a slacker? It sounds like your expectations and mine are the same.

 

[SouthernSurgeon]

I didn't even know afternoon rounds was a thing. How would you arrange everyones schedules to match up perfectly? 5 am rounds, preround at 4 am. And who was calling you a slacker? It sounds like your expectations and mine are the same.

Goes to show how different institutions can be. I thought PM rounds were universal.

Logistically the way PM rounds work (at our hospital) is that they happen whenever the chief gets done for the day (OR or clinic). The intern on call (or the night float intern if it is late) and whoever else is still around rounds with the chief. Afternoon rounds are actually nice because it's a little slower pace than the morning so there is more teaching, time to talk with the patients and families, etc.

Our attendings usually see their patients independently at some point during the day between cases or meetings or whatever. Many of them will grab the intern on call when they get to the floor and take them with them but that's not universal. Some of them will round with the chief if, say, they are operating together and they go between cases.

For a student, especially a sub-I, afternoon rounds can be painful since you are often sitting and waiting for the chief to be done. I will usually send our students (esp M3s) home if it looks like it will be awhile. The outside rotating Sub-I is in a tougher spot since they are usually trying to gun pretty hard.

 

[Winged Scapula]

Goes to show how different institutions can be. I thought PM rounds were universal.

Me too.

They were beneficial for us because we found that most consultants don't finish their rounds until mid to late afternoon, so we would than have a chance to read their recommendations and implement them.

Now in PP I don't round twice a day but I do a "chart check" in the PM because when I round in the am or between cases the vast majority of time the other consultants have not dropped notes yet.

Logistically the way PM rounds work (at our hospital) is that they happen whenever the chief gets done for the day (OR or clinic). The intern on call (or the night float intern if it is late) and whoever else is still around rounds with the chief. Afternoon rounds are actually nice because it's a little slower pace than the morning so there is more teaching, time to talk with the patients and families, etc.

Our attendings usually see their patients independently at some point during the day between cases or meetings or whatever. Many of them will grab the intern on call when they get to the floor and take them with them but that's not universal. Some of them will round with the chief if, say, they are operating together and they go between cases.

For a student, especially a sub-I, afternoon rounds can be painful since you are often sitting and waiting for the chief to be done. I will usually send our students (esp M3s) home if it looks like it will be awhile. The outside rotating Sub-I is in a tougher spot since they are usually trying to gun pretty hard.

The above was my experience in residency and fellowship as well.

 

[Wordead]

Goes to show how different institutions can be. I thought PM rounds were universal.

Logistically the way PM rounds work (at our hospital) is that they happen whenever the chief gets done for the day (OR or clinic). The intern on call (or the night float intern if it is late) and whoever else is still around rounds with the chief. Afternoon rounds are actually nice because it's a little slower pace than the morning so there is more teaching, time to talk with the patients and families, etc.

Our attendings usually see their patients independently at some point during the day between cases or meetings or whatever. Many of them will grab the intern on call when they get to the floor and take them with them but that's not universal. Some of them will round with the chief if, say, they are operating together and they go between cases.

For a student, especially a sub-I, afternoon rounds can be painful since you are often sitting and waiting for the chief to be done. I will usually send our students (esp M3s) home if it looks like it will be awhile. The outside rotating Sub-I is in a tougher spot since they are usually trying to gun pretty hard.

I think PM rounds sound a lot more logical, since half the labs in the morning aren't even back yet, but it sounds worse for med students if they are scrubbed in on cases (which is usually the case in the afternoon). They either miss a case or miss rounds then.

 

[Winged Scapula]

I think PM rounds sound a lot more logical, since half the labs in the morning aren't even back yet, but it sounds worse for med students if they are scrubbed in on cases (which is usually the case in the afternoon). They either miss a case or miss rounds then.

PM rounds make sense but what cases are going on that late in the day? Sure they may be some but IMHO most scheduled cases were usually done by PM round time (eg, 5 pm or so).

 

[Wordead]

PM rounds make sense but what cases are going on that late in the day? Sure they may be some but IMHO most scheduled cases were usually done by PM round time (eg, 5 pm or so).

Maybe your institutions have had good support staff, but my experience on home and sub-I rotations were that scheduled cases never started when they should, except the very first case of the day (and even then, there were delays). Whether the case had complications or room turnover just took forever, or anesthesia was dragging their feet bringing the patient in, there was always a delay. And as a sub-I I don't think I ever got out of cases before 5...

 

[SouthernSurgeon]

PM rounds make sense but what cases are going on that late in the day? Sure they may be some but IMHO most scheduled cases were usually done by PM round time (eg, 5 pm or so).

It's pretty variable for us.

OR utilization at our hospital is jam-packed; we are running at like 120% of the intended capacity. So there is a lot of pressure for our attendings to schedule more cases in their block time than they probably should. Then when you add the usual MAFAT and the slow OR turnover time it means cases spill over past five pretty regularly. Even our breast surgeons get nailed by it sometimes...my PGY3 year we had a day where we were starting a double mastectomy at 7pm (*most of the time the breast and melanoma surgeons operate at an ASC so they don't have this problem, but occasionally they get a higher risk patient that the anesthesiologists insist be done at the big house. Or they have a day where they are running joint cases with plastics)

But most of our chiefs are pretty reasonable - they will either delegate rounds to the mid-level resident if they are going to be super late, or they will tell everyone else to go home and just round with the night float. Sometimes I will just PM round alone which I actually really like because I can spend a lot more time with the patients that way...and despite what I tell the interns I do actually remember how to enter orders myself so I can just take care of whatever needs to get done and then let the intern know what changes I made.

Long story short - it usually works out that someone will PM round at 5-6 ish. But sometimes it is more like 6-8.

No one cares if the students are in a case and aren't there. OR obviously takes priority.

 

[Winged Scapula]

Gotcha. It may have been that way in residency as well for me but I don't recall it being routine except on some services.

Even I am occasionally operating after 7 pm; the cancer cases have to get done and the mastectomies are done in the main OR rather than an ASC and sigh...they are just as slow as any academic center. I shudder when cases are booked after 3 because the work ethic and speed of staff on the night shift sucks (it's not so great during the day either).

 

[Winged Scapula]

Maybe your institutions have had good support staff, but my experience on home and sub-I rotations were that scheduled cases never started when they should, except the very first case of the day (and even then, there were delays). Whether the case had complications or room turnover just took forever, or anesthesia was dragging their feet bringing the patient in, there was always a delay. And as a sub-I I don't think I ever got out of cases before 5...

Most likely I've just forgotten what it was like for the students on their GS rotation (rather than having good support staff)...LOL.

 

[SouthernSurgeon]

Gotcha. It may have been that way in residency as well for me but I don't recall it being routine except on some services.

Even I am occasionally operating after 7 pm; the cancer cases have to get done and the mastectomies are done in the main OR rather than an ASC and sigh...they are just as slow as any academic center. I shudder when cases are booked after 3 because the work ethic and speed of staff on the night shift sucks (it's not so great during the day either).

Guess it depends on what you call "routine"

It's certainly not happening in every OR, every day. Our services would grind to a halt if that were the case.

But on a busy service with 5+ attendings, it's not uncommon for one room to run late at least once a week.

As to the bolded...the worst is when you can sense that a case is going to end right around 2:30-3. Because then you know the day team will dawdle around between cases, and then the after hours crew will take their sweet time getting started. So you can pretty much count on double the normal turnover time (which is already painfully slow).

 

[alpinism]

Funny story... Our current chief resident detests wound buckets as she believes they spread infections and "anything you need you can easily get in the pt's room or with a quick trip to the supplies closet down the hall."

Sometimes you just can't win.

 

[alpinism]

We completely agree, all of which is what I said earlier. To excel you have to anticipate and be useful. If something is holding up rounds, then do something to help it. But I'm not wearing a freakin fanny pack (when you said vascular a wound bag made a lot more sense)

Again, saying this means absolutely nothing without context. If your only job is 10 patients and your attending doesn't round until the afternoon, then big deal. My attendings rounds at 5 am and the other at 730. The rest of the time were either in clinic or the OR. You gonna say I'm a slacker when I'm at the hospital at 330 am every day? Putting in 100+ hour weeks. (yes there are med student caps but they are not enforced)

Hey at least you're not on transplant. Our SPK went till 4am last night.

 

[SouthernSurgeon]

Funny story... Our current chief resident detests wound buckets as she believes they spread infections and "anything you need you can easily get in the pt's room or with a quick trip to the supplies closet down the hall."

Sometimes you just can't win.

You shouldn't take it in the room...

But yeah you are right. Sometimes you can't win. Which is why it's so important to find out the expectations of YOUR team

 

[Smurfette]

In residency, one of our vascular attendings bought a wheeled bag for us to use as a "wound bucket" for rounds. That worked wonders (as an added bonus, the Doppler was not "left behind" in a random location nearly as often).

 

[SouthernSurgeon]

In residency, one of our vascular attendings bought a wheeled bag for us to use as a "wound bucket" for rounds. That worked wonders (as an added bonus, the Doppler was not "left behind" in a random location nearly as often).

Our plastic surgeons have that. Ophtho carries a ridiculously large backpack with all their gear that looks like it would cause a lot of back strain

 

[Winged Scapula]

Guess it depends on what you call "routine"

It's certainly not happening in every OR, every day. Our services would grind to a halt if that were the case.

But on a busy service with 5+ attendings, it's not uncommon for one room to run late at least once a week.

I'd define routine as several times a week or even daily, not once a week, which is to be expected any place.

As to the bolded...the worst is when you can sense that a case is going to end right around 2:30-3. Because then you know the day team will dawdle around between cases, and then the after hours crew will take their sweet time getting started. So you can pretty much count on double the normal turnover time (which is already painfully slow).

Definitely. It also happens when they don't like the surgeon following you or the case scheduled; they'll dawdle, trying to keep me in the room to avoid doing the next case any sooner than possible and it's magnified when it's close to end of shift.

 

[Kaustikos]

All kinds of stuff.

A generic wound bucket would include:
ABDs
4x4s
2x2s
Kerlix
Drain sponges
Tape (medipore, paper, etc)
Vaseline gauze
Xeroform gauze
Staple remover
Cotton tip applicators (qtips)
Scissors
Scalpel
Steri-strips
Adhesive remover
Packing strips (nu-gauz)
Saline
Triple antibiotic ointment
Lube

That's just off the top of my head. I'm sure there is more I'd think of with more time

An "advanced" bucket would include precisely the needed supplies for the existing wounds on the service, plus some generic supplies.

I have those minus the saline (duh) in my condo. Why? I don't know... my white coat became my wound bucket and by the time my rotations finished I had them in my coat at my condo. So...I just have them there. But honestly - I almost always check to see if I have access/can get to a supply closet at every hospital and if I can, then I don't carry that around. The only time was during my Anesthesia sub wherein they told me to "Get a **** ton of IV **** and just set up IV's! Do IV's!"

Me too.

They were beneficial for us because we found that most consultants don't finish their rounds until mid to late afternoon, so we would than have a chance to read their recommendations and implement them.

Now in PP I don't round twice a day but I do a "chart check" in the PM because when I round in the am or between cases the vast majority of time the other consultants have not dropped notes yet.



The above was my experience in residency and fellowship as well.

Afternoon rounds is actually one of the major reasons that sold me on Surgery. Most of the afternoon rounds were positive experiences... I'm not saying everyone was happy to be there, but they did do their job as they should. If someone was in a case, the team just started without them and they caught up.

And Neurosurgery was the only time I can think of where cases rarely ended before 5pm. If there were cases after 1pm, then you were prolly there till 8-9pm. I didn't mind because that rotation month was the most interesting/fun month ever. It sucked leaving at 8pm sometimes, but whatever, it was a worthwhile experience.

 

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http://forums.studentdoctor.net/thr...etent-fool-on-rotations.988111/#post-13752337