I just finished my first day of gen surg as a gen surg resident. What a fabulous day! I started at 6, and just got home now at 8:30pm. I spent the morning covering the ward, but then at 2 I was paged to the OR. 3 lap choles - i even got to clip the artery and the cystic duct. I was promised by my staffman that by the end of the week i'll be doing most of it by myself. THen there was a messy total cholectomy that I did with my senior resident. I got lots of practice suture ligating the mesentaries (actually my fingers are still aching). The last case was a ventral hernia repair, which i did all by myself (with close supervision of coarse). What a great day! I just had to share!
first day of gen sx
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Tussy!
Wow! What a busy day for you! In general surgery rotation, do you do repairs for children or just adults? What I'm getting at is... is there a different rotation for pediatric surgery? Just curious about what rotations you have. Any information is appreciated.
Sincerely,
Christy
Wow! What a busy day for you! In general surgery rotation, do you do repairs for children or just adults? What I'm getting at is... is there a different rotation for pediatric surgery? Just curious about what rotations you have. Any information is appreciated.
Sincerely,
Christy
Well Christy, the city i'm in has a children's hospital where all peds cases are done, so no, i don't get to do any peds on this rotation. I do get to rotate thru the children's hospital next year where i'll get to see lots of kiddies! This year, in adission to 5 months of gen surg, I do plastics, vascular, neurosurg, cardiac surg, as well as some internal med and ER.
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Just for a different point of view:
during my first year of Gen Surg I do Peds (which I'm just finishing up this week), SICU, CT, Vascular, Colorectal, Surg Onc, Breast/Endocrine, and the VA.
On Peds I have done *very* little - I've scrubbed in 4 times over 4 weeks, have done no more than suture some lap ports closed and hold retractors. However, I've been told that more is done by the PGY1s on other rotations and I knew that most of the first year here was floor work. Still it gets hard to maintain enthusiam - I do get to remove lines (woo hoo) but that's about it. Mostly hernias, Nissens, Mediport insertion, bowel obstructions and then because we're a quartenary center stuff like gastrochisis, omphalocoeles, etc.
We generally start at 5 am (depending on how long the list is) and finish around 7:30 pm, occ. earlier, occ. later. Call is usually q3 but with 2 blocks of q2 on which sleep can vary from 5 hours I got 1 night to none at all. You do not go home early post call so are generally here up to 38-40 hours straight, sometimes without any sleep. CT is supposed to be worse - you basically start rounding at 1-2 am so you can be ready for rounds with the chief in the morning.
My fellow interns and I have thought about quitting about q 15 minutes!
during my first year of Gen Surg I do Peds (which I'm just finishing up this week), SICU, CT, Vascular, Colorectal, Surg Onc, Breast/Endocrine, and the VA.
On Peds I have done *very* little - I've scrubbed in 4 times over 4 weeks, have done no more than suture some lap ports closed and hold retractors. However, I've been told that more is done by the PGY1s on other rotations and I knew that most of the first year here was floor work. Still it gets hard to maintain enthusiam - I do get to remove lines (woo hoo) but that's about it. Mostly hernias, Nissens, Mediport insertion, bowel obstructions and then because we're a quartenary center stuff like gastrochisis, omphalocoeles, etc.
We generally start at 5 am (depending on how long the list is) and finish around 7:30 pm, occ. earlier, occ. later. Call is usually q3 but with 2 blocks of q2 on which sleep can vary from 5 hours I got 1 night to none at all. You do not go home early post call so are generally here up to 38-40 hours straight, sometimes without any sleep. CT is supposed to be worse - you basically start rounding at 1-2 am so you can be ready for rounds with the chief in the morning.
My fellow interns and I have thought about quitting about q 15 minutes!
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BTW, congrats tussy on surviving the first day!
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My roommate is a general surgery intern -- her rotations this year include Peds surgery, CT, Thoracic, Neurosurg, Vascular, and Trauma. She also does a bunch of general surgery at the university hospital as well as the VA and the county hospital this year. (the general surgery services here combine colorectal, breast, and onc, so they're spread out among all the services.)
She got to start out with a month of general and *loved* it. What she got to do varied each day -- some days it was all floor work and other days she was in the OR the entire time. She also got to do a colectomy at one point, and her residents still won't let her forget it! Interns don't usually do the larger cases -- here they are typically given the hernias, appys, breast cases, some lap choles, and line placements. Now she's recently started neurosurgery earlier this week, and I haven't seen her since she started!
My roommate is planning on going into Peds Surgery, so she requested to do her peds rotation last, which is what she got. She also knows all the ped surgery attendings really well, so she's hoping that by knowing them, and by doing the rotation when she's the most experienced, she'll be able to put in a lot more quality OR time during the rotation.
Her schedule sounds a lot like yours, Kimberli, except her program decided that all the interns that are on general surgery months will only have q5 call! In return, they have to do a *lot* more cross-cover, so it makes their call nights absolutely crazy. She has also slept in the hospital during non-call nights about once a week so far because sometimes she gets out so late that she's too tired to drive home! (One time she did that post-call -- we got a little worried about her then!)
She got to start out with a month of general and *loved* it. What she got to do varied each day -- some days it was all floor work and other days she was in the OR the entire time. She also got to do a colectomy at one point, and her residents still won't let her forget it! Interns don't usually do the larger cases -- here they are typically given the hernias, appys, breast cases, some lap choles, and line placements. Now she's recently started neurosurgery earlier this week, and I haven't seen her since she started!
My roommate is planning on going into Peds Surgery, so she requested to do her peds rotation last, which is what she got. She also knows all the ped surgery attendings really well, so she's hoping that by knowing them, and by doing the rotation when she's the most experienced, she'll be able to put in a lot more quality OR time during the rotation.
Her schedule sounds a lot like yours, Kimberli, except her program decided that all the interns that are on general surgery months will only have q5 call! In return, they have to do a *lot* more cross-cover, so it makes their call nights absolutely crazy. She has also slept in the hospital during non-call nights about once a week so far because sometimes she gets out so late that she's too tired to drive home! (One time she did that post-call -- we got a little worried about her then!)
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We do the same when we are on some of the General Surgery rotations. Call is only q5 but since you cross cover its painful because you have heaps of patients you know nothing about.
I start SICU tomorrow and my schedule looks pretty cushy. I'm definitely looking forward to it!
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Originally posted by whynotme?:
•Hey Kimberli,
I am just interested to hear what a "cushie" schedule is like....I bet it would make mere mortals groan.
Looks like this...
Rounds start at 7:30-8 am so I don't have to come in and pre-round until around 6:00-7:00 (depending on patient load of course). I'm currently coming in at 4:30 or so.
Call appears to be q5. You leave early post-call, as soon as the work is done, so that might be around 2-3 pm (instead of the full 38-40 hours I was working on Peds Surg). again depending on patient load. Of course some days I still have conferences at 5 pm I'll have to go to...groan.
I get 1 day off a week instead of the 2 days off the entire month on Peds. We may get a fellow who might want to pre-round before the attendings so it is possible I can be asked to come in early but perhaps not.
I'm gonna enjoy this month!
Wow Kimberli, not a bad schedule!
I did my very first lab chole today - entirely by myself. My staffman walked me thru it. It was tedious (took me nearly 2 hours), but he let me do it all! I know i'll have done hundreds of them before i'm done, but it sure feels nice to have the first one under my belt!
I did my very first lab chole today - entirely by myself. My staffman walked me thru it. It was tedious (took me nearly 2 hours), but he let me do it all! I know i'll have done hundreds of them before i'm done, but it sure feels nice to have the first one under my belt!
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Wow...I'm TOTALLY jealous. I have yet to do anything remotely approaching doing an operation myself (although I did a couple during medical school). However, I'm told Peds Surgery is a special breed and didn't expect much. Apparently at the VA I get to do heaps.
Enjoy yourself!
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Really?!? I'd be so nauseated. I mean, I guess I've pulled some all-nighters before, thus ending up staying up about 34 hours. But this is crazy!
I hope this doesn't trigger any headaches for you, Kimberli.
--kris
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Tussy- congrats on your first laparoscopic cholecystectomy. I still remember mine some 2+ years ago. An absolute horrible case! (chronic diseases, retained CBD stone, very FAT patient). You will be surprised at how comfortable you feel with it after 40-50, but every now & then some variant anatomy will really scare you & remind you just how easy it is to mess someone up for life with a very common/routine case. Injuring the CBD or someone's ureters are two of the worst things you can do, potentially creating a lifetime of probs. due to multiple operations to fix them & strictures from the scarring. BTW: my personal record is now 13 minutes for a gall bladder- from port placement to having it out :} If you don't mind me asking, where are you training?
Kimberly-
it's nice to hear things are going somewhat ok I guess with your internship (I hope you were joking about considering quiting Q15 minutes on some other thread!). I too do not enjoy pediatric surgery- very often you must struggle with the pediatricians & pediatric nurses to take care of the surgical or trauma patient in the appropraite way. You will appreciate this as you go along. Q5 call for the ICU is a little strange to me as is having an intern manage an ICU (I'm not sure that is the best model), but I wish you luck.
Kimberly-
it's nice to hear things are going somewhat ok I guess with your internship (I hope you were joking about considering quiting Q15 minutes on some other thread!). I too do not enjoy pediatric surgery- very often you must struggle with the pediatricians & pediatric nurses to take care of the surgical or trauma patient in the appropraite way. You will appreciate this as you go along. Q5 call for the ICU is a little strange to me as is having an intern manage an ICU (I'm not sure that is the best model), but I wish you luck.
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Really. So far I've been lucky and haven't had any serious migraines but did suffer through a pretty bad tension headache my second day.
I find that as long as I'm busy the hours aren't bad - they go by fast. Its not usually until the drive home or some late afternoon conferences that I start drifting off into la la land.
I'm told it will be worse in that respect on SICU because rounds are more mediciny - hence they can take hours. Hours of basically standing, which makes me really tired!
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I was joking about the frequency but to be honest quitting had crossed my mind after getting yelled at for something I COULD NOT have known I was supposed to do (and didn't). Dealing with the parents on Paeds Surgery also makes things more tricky and often it was they who let things stew all day, saying everything was ok and then ask the nurse to page me at 2 am.
I am also a bit overwhelmed at the idea that the intern is the one who is first call in the SICU. I had assumed, wrongly I am told, that there would be someone more senior there with me all night. I'm hoping the nurses will be willing to assist me because its a pretty darn scary thought to think about me being first call in some emergency. The call is q5 because we have 1 other surgical intern, a anesth resident and a couple of ER residents who rotate through as well. So we simply divide it up amongst ourselves. At least I'm not on until Thursday so it gives me a chance to get to know the patients first - and we only see some patients, ie, CT and Transplant patients are seen by those teams and those interns are called first, not me.
Here's wishing me luck!
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