Ask a 3rd Year Medical Student Anything

[Strudel19]

#Sinombre2016

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[sinombre]

What do you think about being on the big screen?

Go on...

 

[NontradCA]

Go on...

Just have you sign this confidentiality agreement here..

 

[zhong361]

Are hemorrhoids curable? Surgery or by medicine

 

[zhong361]

Go on...

Yup ready

 

[sinombre]

Are hemorrhoids curable? Surgery or by medicine

I'm not qualified to answer this as I am no longer a 3rd year medical student.

 

[Psai]

Are hemorrhoids curable? Surgery or by medicine

I can help you. Pm me.

 

[Menander's Bust]

lol are people really suggesting that hospitals just buy Da Vinci’s for advertising or that you can do similar things without them? How do you do a Nissen or an abdominal hernia repair with mesh or a laparoscopic hysteroscopy or a sentinel LN biopsy for endometrial cancer without a robot? I promise you’re not doing any of those things with pure laparoscopy.

 

[Matthew9Thirtyfive]

I promise you’re not doing any of those things with pure laparoscopy.

I'll have to tell the surgeons I worked with that they were hallucinating then.

 

[1991Danny1991]

What is your opinion on the uphill battle (so called) that DOs have to adhere to in order to get into their specialty of choice? Is that true? And what makes that be the case, is it their curriculum, because both MDs and DOs now have the same resid. Opportunities and so DOs can just take Complex now, right? So what have you heard about that?

 

[sinombre]

lol are people really suggesting that hospitals just buy Da Vinci’s for advertising or that you can do similar things without them? How do you do a Nissen or an abdominal hernia repair with mesh or a laparoscopic hysteroscopy or a sentinel LN biopsy for endometrial cancer without a robot? I promise you’re not doing any of those things with pure laparoscopy.

Lol... I can't tell if you're being sarcastic or not. There's a lap nissen going in about 30 minutes here, I better go let the attending know what he plans on doing is impossible.

 

[sinombre]

What is your opinion on the uphill battle (so called) that DOs have to adhere to in order to get into their specialty of choice? Is that true? And what makes that be the case, is it their curriculum, because both MDs and DOs now have the same resid. Opportunities and so DOs can just take Complex now, right? So what have you heard about that?

Its true for some fields, probably most fields outside of primary care specialties. Some fields are very difficult to match as a DO, some are not. DOs historically had their own residencies that MDs couldn't apply to, but that changed/is changing with the ACGME/AOA merger. This was great for those interested in competitive fields like neurosurg/ortho because they didn't have to compete with a competitive MD cohort applying to those fields. Now that that's gone, it's unclear how things will play out. Basically now there are more residencies open to MDs but no more open to DOs (they have always been able to apply to MD residencies but not vice versa). You can still match and do well as a DO but in general it does make things harder outside of primary care specialties. My residency program doesn't interview DOs at all because of an old bias by the program director. Not saying that's right or that I agree with it, but it is what it is.

 

[1991Danny1991]

Its true for some fields, probably most fields outside of primary care specialties. Some fields are very difficult to match as a DO, some are not. DOs historically had their own residencies that MDs couldn't apply to, but that changed/is changing with the ACGME/AOA merger. This was great for those interested in competitive fields like neurosurg/ortho because they didn't have to compete with a competitive MD cohort applying to those fields. Now that that's gone, it's unclear how things will play out. Basically now there are more residencies open to MDs but no more open to DOs (they have always been able to apply to MD residencies but not vice versa). You can still match and do well as a DO but in general it does make things harder outside of primary care specialties. My residency program doesn't interview DOs at all because of an old bias by the program director. Not saying that's right or that I agree with it, but it is what it is.

Thank you.

 

[Menander's Bust]

I just watched a lap nissen on YouTube. I work at several large hospitals and I’ve never seen anyone suture inside the abdomen laparoscopically. I’ve seen colorectal surgeons suture in the rectum laparoscopically from below on a TAMIS, but nowhere in the body that a robot can be used. I guess it’s done some places but I can’t imagine why anyone would do a nissen laparoscopically rather than robotically because the robotic version looks about a thousand times easier.

My post should read laparoscopic hysterectomy as a laparoscopic hysteroscopy is not a thing. Can it be done laparoscopically? I’m sure. But why would you? Same goes for the other procedures I mentioned. No high level hospital will do these laparoscopically unless the surgeon is >80 years old and just can’t use the robot.

 

[Matthew9Thirtyfive]

I just watched a lap nissen on YouTube. I work at several large hospitals and I’ve never seen anyone suture inside the abdomen laparoscopically. I’ve seen colorectal surgeons suture in the rectum laparoscopically from below on a TAMIS, but nowhere in the body that a robot can be used. I guess it’s done some places but I can’t imagine why anyone would do a nissen laparoscopically rather than robotically because the robotic version looks about a thousand times easier.

My post should read laparoscopic hysterectomy as a laparoscopic hysteroscopy is not a thing. Can it be done laparoscopically? I’m sure. But why would you? Same goes for the other procedures I mentioned. No high level hospital will do these laparoscopically unless the surgeon is >80 years old and just can’t use the robot.

Not sure what kind of clinical experience you have, but LAVH and lap nissens are done without a robot all the time.

 

[sinombre]

I just watched a lap nissen on YouTube. I work at several large hospitals and I’ve never seen anyone suture inside the abdomen laparoscopically. I’ve seen colorectal surgeons suture in the rectum laparoscopically from below on a TAMIS, but nowhere in the body that a robot can be used. I guess it’s done some places but I can’t imagine why anyone would do a nissen laparoscopically rather than robotically because the robotic version looks about a thousand times easier.

My post should read laparoscopic hysterectomy as a laparoscopic hysteroscopy is not a thing. Can it be done laparoscopically? I’m sure. But why would you? Same goes for the other procedures I mentioned. No high level hospital will do these laparoscopically unless the surgeon is >80 years old and just can’t use the robot.

Because the majority of surgeons in practice have more experience operating laparoscopically than robotically. The robot is to laparoscopy what laparoscopy used to be to open--it will probably change over time, but most surgeons are more comfortable with laparoscopic surgery because that's what they've done more of.

Suturing inside the abdomen (laparoscopically) is called intracorporeal suturing. Alternatively you can suture laparoscopically by suturing extracorporeally. There are plenty of youtube tutorials. It's something every surgery resident has to know how to do and be proficient at.

You've probably just spent a lot of time at a place that does a lot of robotic cases. My main teaching hospital is like that as well (the satellite hospitals we rotate at basically don't use robots at all). But that's not how things are done at most hospitals across the country at this point. Laparoscopic surgery is still dominant.