Do medical students perform surgeries or participate in surgery during medical school?

[unfulfilled_beauty]

Just to be clear I am not asking about resident students. I'm asking about students in MS 1-4. During your surgery rotation/clerkship do you perform or assist in performing different surgery? If so, how much will you actually be doing? What will be expected of you?

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[md-2020]

This should be in the allo subforum.


Why are you wondering about this so far in advance?


Imagine the lawsuits if med students were assisting on cases....

 

[gyngyn]

Medical students do assist in surgery.

 

[md-2020]

Medical students do assist in surgery.

Really? Wow.


My state school doesn't even let Gen Surg interns scrub into cases so that's very surprising!

 

[Cyberdyne 101]

Medical students do assist in surgery.

I hear they let them clip aneurysms at the California schools!

Really? Wow.


My state school doesn't even let Gen Surg interns scrub into cases so that's very surprising!

That doesn't sound right...

 

[gyngyn]

My state school doesn't even let Gen Surg interns scrub into cases so that's very surprising!

This is disturbing.

 

[Meeehai]

Imagine the lawsuits if med students were assisting on cases....

 

[genericpremedstudent]

Really? Wow.


My state school doesn't even let Gen Surg interns scrub into cases so that's very surprising!

you might want to double check that lol

 

[md-2020]

I hear they let them clip aneurysms at the California schools!

That doesn't sound right...

No joke. The interns handle all the scutwork, and almost never get to assist on a case. I have 2 friends just starting PGY2, did like 1 case total their first year. There too many residents (50++), not enough cases/attendings.

This is disturbing.

 

[gyngyn]

Imagine the lawsuits if med students were assisting on cases....

They scrub on cases all the time!

 

[md-2020]

They scrub on cases all the time!

I know they scrub, but are they generally allowed to participate in the actual procedure?

 

[Cotterpin]

Really? Wow.


My state school doesn't even let Gen Surg interns scrub into cases so that's very surprising!

No joke. The interns handle all the scutwork, and almost never get to assist on a case. I have 2 friends just starting PGY2, did like 1 case total their first year. There too many residents, not enough cases/attendings.

This sounds like season 1 of Grey's Anatomy.

 

[Cyberdyne 101]

Lol, I've scrubbed in on cases!!!

 

[gyngyn]

I know they scrub, but are they generally allowed to participate in the actual procedure?

Of course, with supervision.
They help position, prep, drive the laparoscope, retract, suction, irrigate, elevate the uterus, place the foley, hold the transducer, close...

 

[md-2020]

This sounds like season 1 of Grey's Anatomy.

?

I seem to remember one of the main characters doing an appendectomy by himself Day 1.

Of course, with supervision.
They can drive the laparoscope, retract, suction, close...

There were a couple times during my ortho shadowing where MS4's were also present and they only got to watch, hence my surprise. In addition to the aforementioned lack of hands-on experience that GS interns have told me about.


Glad I'll be able to do stuff during rotations though!

 

[Cotterpin]

?

I seem to remember one of the main characters doing an appendectomy by himself Day 1.

You remember that but you don't remember how it was a major plot point for the whole season that people were always desperate to be allowed to scrub in and made a huge deal out of it every time? The whole point of letting the intern do an appendectomy (scrub in, not do it on his own) on his first day was that he was being hazed.

 

[md-2020]

You remember that but you don't remember how it was a major plot point for the whole season that people were always desperate to be allowed to scrub in and made a huge deal out of it every time? The whole point of letting the intern do an appendectomy (scrub in, not do it on his own) on his first day was that he was being hazed.

I watched 2 episodes and quit so I wouldn't know how the series turns out

 

[joker2400]

This should be in the allo subforum.


Why are you wondering about this so far in advance?


Imagine the lawsuits if med students were assisting on cases....

This is exactly where this should be. Allo is for discussing things that pertain to med students in med school.

Also yes med students scrub, assist, and sometimes amputate some legs. Everything depends on the level of comfort the surgeon has

 

[Cotterpin]

I watched 2 episodes and quit so I wouldn't know how the series turns out

That all happened in the first episode. Anyway, real life isn't like tv shows.

 

[Cyberdyne 101]

This is exactly where this should be. Allo is for discussing things that pertain to med students in med school.

Also yes med students scrub, assist, and sometimes amputate some legs. Everything depends on the level of comfort the surgeon has

If this thread were posted in allo by a pre-med, it'd get moved to pre-allo by a mod. There are plenty of med students and doctors who answer these types of questions in pre-allo. Notice that gyngyn, who's a surgeon, was the second person to respond to the OP.

 

[joker2400]

If this thread were posted in allo by a pre-med, it'd get moved to pre-allo by a mod. There are plenty of med students and doctors who answer these types of questions in pre-allo. Notice that gyngyn, who's a surgeon, was the second person to respond to the OP.

Isn't that what I said?

 

[Cyberdyne 101]

Isn't that what I said?

You know, I could easily say that I meant to quote md-2020, but then I'd be lying.

 

[Mr.Zero]

At the end of MS1, my school has us do a three week rural family med or surgery block. I did family med, but I still got to scrub in with the surgeons to run the laparoscope and close for a cholecystectomy. Some of my friends who took the surgery block where scrubbing in everyday and helping with all the tasks that gyngyn mentioned

 

[ciestar]

I watched 2 episodes and quit so I wouldn't know how the series turns out

Terribly

 

[22031 Alum]

0.00% chance

The national means for general surgery interns is about 100 major cases (major cases are those that have been defined as falling into a set of categories needed for graduation), plus a bunch of minor cases that don't count for graduation like central lines, chest tubes, lipoma excisions.

There is even a requirement that you have at least 250 by the end of PGY2 or else you can't move on to PGY3.

If a program had interns doing one case the whole year, they'd literally get shut down by the ACGME.

General surgery intern year certainly involves more hands on patient care (and scut) than it does operating, but you definitely operate.

The lesson here is, even when you "know a guy," you aren't always getting the full story.

At lower-volume programs students are less likely to do a lot because the residents need the numbers/practice. Interns definitely operate.

 

[Law2Doc]

Participate - yes. Perform - no.
Med students during surgical rotations will scrub in and assist. That experience frequently involves holding a retractor, a limb, a pannus, maybe cutting the excess off sutures, often suctioning. If the attending is generous he may let you make an incision or throw a stitch or two. I know of no US allo programs where med students don't get to at least retract and suction.

At big academic programs where interns are stuck working the floor, that tends to be an exaggeration. They do get into cases, but those opportunities can be more limited than at leaner programs.

 

[Psai]

Ive done a little bovieing and cutting. Sutured. Held cameras and retracted for hours in terribly awkward positions after which my legs were shaking and i could barely stand up

 

[hoihaie]

my PI said in his 4th year surgical sub, he was removing the veins for grafts under supervision of the attending. this was in 70s tho, so probably won't be possible now

 

[Psai]

my PI said in his 4th year surgical sub, he was removing the veins for grafts under supervision of the attending. this was in 70s tho, so probably won't be possible now

If pas can do it why not medical students

 

[hoihaie]

.

 

[Strudel19]

I came across this video at one point somehow or another. He talks about his experience during his MS-3 surgery rotation.

 

[unfulfilled_beauty]

I came across this video at one point somehow or another. He talks about his experience during his MS-3 surgery rotation.

Participate - yes. Perform - no.
Med students during surgical rotations will scrub in and assist. That experience frequently involves holding a retractor, a limb, a pannus, maybe cutting the excess off sutures, often suctioning. If the attending is generous he may let you make an incision or throw a stitch or two. I know of no US allo programs where med students don't get to at least retract and suction.

At big academic programs where interns are stuck working the floor, that tends to be an exaggeration. They do get into cases, but those opportunities can be more limited than at leaner programs.

Medical students do assist in surgery.

Thanks for everyone's input! I am inquiring about the what the surgery rotation entails for students early because of a physical limitation that I have. I may not be able to perform certain tasks assigned by the surgeon during the surgical rotation. I may be able to hold and guide the laparoscope or the retractor or suction, but I may not be able to suture an incision or a wound. My next question is can you ask the attending to round and observe only? Or is that inappropriate? Do schools offer accommodations for such students?

I apologize for posting this in the wrong thread I am new to student doctor network forums. This made the most sense to me.

 

[gyngyn]

Thanks for everyone's input! I am inquiring about the what the surgery rotation entails for students early because of a physical limitation that I have. I may not be able to perform certain tasks assigned by the surgeon during the surgical rotation. I may be able to hold and guide the laparoscope or the retractor or suction, but I may not be able to suture an incision or a wound. My next question is can you ask the attending to round and observe only? Or is that inappropriate? Do schools offer accommodations for such students?

I apologize for posting this in the wrong thread I am new to student doctor network forums. This made the most sense to me.

Each school will post (and require you to attest to) technical standards. These standards will vary but often include the ability to efficiently perform resuscitation, deliver a baby, assist at surgery, see, hear, perform and interpret the physical exam and various tests...
Reasonable accommodation is still required but, like pilots, some physical, psychological and social disabilities cannot be accommodated.

 

[Psai]

Thanks for everyone's input! I am inquiring about the what the surgery rotation entails for students early because of a physical limitation that I have. I may not be able to perform certain tasks assigned by the surgeon during the surgical rotation. I may be able to hold and guide the laparoscope or the retractor or suction, but I may not be able to suture an incision or a wound. My next question is can you ask the attending to round and observe only? Or is that inappropriate? Do schools offer accommodations for such students?

I apologize for posting this in the wrong thread I am new to student doctor network forums. This made the most sense to me.

Do you have hands?

 

[moisne]

In my MS1 - I did retractor work and they allowed me to screw in a few plates in neurosurgery (once the surgeon already stablized the plate with 1-2 screws).

 

[Winged Scapula]

No joke. The interns handle all the scutwork, and almost never get to assist on a case. I have 2 friends just starting PGY2, did like 1 case total their first year. There too many residents (50++), not enough cases/attendings.

As noted above, the chance that your friends are significantly exaggerating is close to 100%.

Presuming your "state school" is "University of <insert state from which you are posting from>" this is a large academic program with 6 categorical GS residents per year and large contingent of non-designated prelims, designated prelims and fellows. The medical center, which I am very familiar with, is very busy with lots of cases, lots of trauma; residents also rotate at local community and VA facilities.

It is certainly possible that interns don't operate as much there as they would other programs or that your friends are prelims so the focus is on the categoricals but as @SouthernSurgeon notes, doing "1 case" their intern year is a gross exaggeration.

As for medical students watching cases, there may be reason why you and others have seen that: no room for them at the table, litiginous patient (so want med students name out of the chart), Hep C+ patient, annoying student or attending who isn't invested in teaching.

 

[Señor S]

You'll probably get to retract, suction and cut sutures; you may get to Bovie, suture, staple, drive the camera, tie knots and make the incisions in an I and D. Sometimes an attending will let you pull the chest tube through or make the cut for an amputation. I'm sure there are individual attendings who will let a med student do more, but there are also a few who don't even want you scrubbed in, much less assisting. There's also a pecking order, with the attending(s) at the top, then the residents in order of seniority, then you. You may end up watching a PGY-2 resident cutting sutures and suctioning, which I found kind of comforting in a way. It's fun to do stuff, and also a bit demoralizing when you watch some snot-nosed 25 y/o PA closing after harvesting a vein and thinking that that's something that you could be doing, but I wouldn't get too worked up about it either way: the purpose of a surgery rotation is not for you to learn how to operate.

 

[Chir0nex]

You will spend most of your surgery clerkship scrubbed in and assisting. As has been said, you should expect to be suturing, restracting, handling camera etc... Beyond that it really depends on the program. For example, one attending let me sew part of a Carotid artery graft (perhaps the single coolest thing I got to do all year). Another let me due the majority of a hernia repair (under very close supervision on a very simple procedure).

If you want to do more in the OR the key is to really master the basics. Show that you can suture well, that you can follow directions (e.g hold retraction as reuested) and pay attention in to the procedure to see how the operation is progressing. There is a a large luck component as well, and getting a chill senior resident who will speak up for you to the attending can go a long way to letting you do more hands on work.

 

[maxwell_edison]

Depends. I observed an donor organ recovery operation. Surgical team was 1x tx surgeon, 1x resident, 1x med student, plus scrub nurses, perfusionists, etc. The med student was scrubbed in, and actually got to do some work, incision, assistance with dissection, holding, etc. Though in this situation, it is more permissive, as the patient is a cadaver with a beating heart who chose (or their family chose) to donate their organs to others, and in the process also helped educate a physician. At the time of actual cross-clamp however, the student was mostly just holding things, as this is a very time critical procedure.

 

[Spector1]

Isn't that the whole point of clerkships?

 

[VictorAlpha]

it really depends on the clerkship and the attending. On OB/GYN, I scrubbed in frequently; others i just watched; you may close fascia or skin; you may do more depending on your competence and how much you have worked with that attending or resident. You always will start with simple things like moving the patient, holding traction, cutting sutures...etc. But if the attending and or residents are comfortable then you can do more. I was on L&D when the residents when on a retreat and got to do more stuff because they weren't around. My friend was on surgery week when the retreat happened so he was participating in laparoscopic procedures (working the atraumatic graspers etc...).