First rotation advice; cardiothoracic surgery

[mellow yellow]

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I am a fresh 3rd year med student and just started my first rotation last week which is cardiothoracic surgery 😱 and will be continuing on this service for a couple more weeks and wanted your advice on my situation. I wanted your advice on how to get more involved in patient care and shine... I spoke w/ the chief regarding what his expectations were of me and his reply was "absolutely nothing." He said our role is going to be entirely "observatory" and we were not going to be pre-rounding. He said when they round in the morning to "stay out of the way" because they have alot of patients to see prior to heading into the OR and not to ask questions. He said that we will not be writing SOAP notes while they are in the CT-ICU and will basically have no role while the patients are in the ICU. He said that we can write very brief notes when they move to another unit but that we're basically here to just observe. THere is no call for this service according to the chief. We do get to scrub in on the surgeries (which are pretty much all CABGs) which is cool but I'm not sure how I can learn or even shine on this rotation when we have no role other than to observe and stay out of the way of everyone else... At this point, I don't even know how I could possibly learn much or attain an evaluation of anything other than "average." My day so far usually consists of the following: tag along w/ the fellows/residents during morning rounds, head to the OR and scrub in, head back to the CT-ICU and follow the residents/fellows around. I continually ask them for things to do but they insist that there is nothing for me to do... I'm the type of person who is comfortable taking charge and taking matters into my own hands but right now I almost feel like there isn't much I can do... I feel a bit lost, overwhelmed, and not really learning much at the moment. Any advice would be greatly appreciated.

 

[b&ierstiefel]

My last set of rotations during M3 year was in General Surgery. The evaluation process in surgery is kinda hokey. Surgery is almost all observation. Usually there is no prerounding. Your job is mainly to write notes and/or perform dressing changes and/or perform scut.

Senior residents generally evaluate based on how smoothly the month goes. They probably won't even remember your name, sadly. However, they will remember the month during which you rotated. If it was a bad month, your evaluations may suffer. If it was a good month, you'll probably get good evals which won't really have to do with how stellar you are. Remember, the seniors want to get the work done efficiently and go home. If you help out in that process, you'll already look like an important member of the team. If you get in their way by being too assertive or doing things without permission, this will provoke furious anger from your seniors.

The OR is another great opportunity to shine. Know your patients. Know why they are there. Know the indications for the surgery they are having. And most importantly, read Surgical Recall prior to the surgery. The surgeons WILL pimp you. However, many surgeons are not too creative and most of their pimp questions you will find in recall.

I know it's frustrating for you to just have an observer role. That's understandable. I hope that at your school you'll get to do more on other rotations. Personally, I hated all of third year because med students have mainly an observer role and are in essence, nonessential workers. The work CAN get done in the absence of medical students. Very humbling indeed.

 

[b&ierstiefel]

BTW, if there's nothing going on, it IS ok to go home 🙂