Help with surgery rotation

Docgeorge

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    I am very interested in surgery and at my school I have two options for for doing my surgery rotation. I would really appriciate any imput you guys might have.

    Option 1: Do 1 month in the preceptor style where it would for the most part be me and the surgeon. On the plus side I would get 1 on 1 interaction and get to be 1st assist on most of the cases. Then do 1 month on the G-surg service at the hospital whose surgery residency I'm interested in. I've been told that if I do it this way I'll be able to keep to a minimun the stupid mistakes I might otherwise make.

    Option 2: Do both months at the Hospital G-surg service.

    FYI:

    At my school we have a Class taught by the Surg Dept that teaches us how to scrub, gown and glove and OR etiquite. We also learn common surgical intraments and how to receive and pass them as well as how to suture and how to do one and two handed ties and cautery. We learn how to transfer our patient form the OR table to the gurney for transport and the indications and contra indications and how to place: Chest Tubes, Foley, NG tubes, IV and Central Lines and venus cut downs and how to drive a scope. In additon we learn how to do Pre and Post op notes and progress notes.

    I have been a TA in this calss since the middle of my 1st year.

    Thank You in advace for your advice.
     

    surggal

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      Would your preceptor be someone who is academic/well-known? Is it at the same hospital or at least at a teaching hospital?

      My advice would be:

      1) Consult current 4th year students to ask their advice. You may also try to reach recent grads who went into surgery. They would probably be better suited to advise you on this.

      2) If you are looking for a LOR from the preceptor, you may want to consider doing the preceptorship second.

      3) If not, I would probably advise you to do the traditional hospital-based clerkship. You should learn how to manage patients on the wards and work with the team. You will also want letters from the hospital faculty who can comment not only on you OR etiquette, but also on your interaction with faculty, residents, and patients. Perhaps you could do the preceptorship later as an elective if you want more OR experience.
       

      teamdick

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        i think that the one month with a preceptor may be very helpful. personalized attention, more opportunities and likely will prep you for the 2nd month. this way you can stand out a little bit more when on the hospital service. another plus: if you do well in your preceptor month, that is a potential letter of recommendation. if you really would like to do residency at this hopsital, you should return for a 4th year elective. Right now you would just be one of scores of 3rd years who rotate through, the majority of whom probably would not end up in surgery.
         
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        SocialistMD

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          Docgeorge said:
          Option 1: Do 1 month in the preceptor style where it would for the most part be me and the surgeon. On the plus side I would get 1 on 1 interaction and get to be 1st assist on most of the cases. Then do 1 month on the G-surg service at the hospital whose surgery residency I'm interested in. I've been told that if I do it this way I'll be able to keep to a minimun the stupid mistakes I might otherwise make.

          surggal brings up some good points. Here are a couple of other things on which to think...

          Pros of option 1:
          A. 1 on one exposure to the faculty. If you want a letter of rec, the better the attending knows you, the better the letter can be.
          B. I imagine it is an easier service as far as time requirements. This can manifest itself in a huge way if you have to take the shelf exam at the end of the rotation, as it is not an easy exam and any extra time to study would be beneficial.

          Cons of option 1:
          A. 1 on one exposure to the faculty. It is much easier to make a stupid mistake when you are known well than if you are a face in the masses.
          B. It might be a private rotation with a private surgeon. This can be hit or miss in terms of the letter you receive (who knows your letter writer is a huge deal, and academic surgeons tend to have their names more known)

          In the end, I think it is going to have to come down to which option would make you comfortable. You know the situation better than I, so you would be better able to evaluate which pros and cons weigh heavier. Regardless of which road you take, I'm sure you will be able to get into a surgical residency if it is what you want to do.
           

          Docgeorge

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            Evals I've seen from other people that have done is that it (preceptor)was usually a really good experience. The preceptors for the most part are private and not really acedemically oriented so I would guess that they are probally not well known. The flip side is that these priviates practice with inthe same hospital system as the place that I'm interested in and might be know to the PD.
             

            doc05

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              I'd go with option 1. if you want to be a surgeon, it's very important to see what it's like for a private-practice attending -- it can be considerably different from a month on the g-surg service, depending on the practice setup.

              a LOR is a second consideration, but probably less important, since you'll have 1-3 months of surgery sub-i's as an ms4.
               

              LovelyRita

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                teamdick said:
                i think that the one month with a preceptor may be very helpful. personalized attention, more opportunities and likely will prep you for the 2nd month. this way you can stand out a little bit more when on the hospital service. another plus: if you do well in your preceptor month, that is a potential letter of recommendation.

                I did this :thumbup:

                The doc I worked with was patient with me and literally showed me the ropes. I do my regular GS rotation in a couple months. I'm glad because I have less anxiety now about stepping foot in the OR...at least it won't be the first time, and I feel proud that thus far I've been trained by an attending.
                 

                SteadyEddy

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                  Docgeorge said:
                  We also learn common surgical intraments and how to receive and pass them as well as how to suture and how to do one and two handed ties and cautery. .

                  Thank You in advace for your advice.

                  My advice is to NEVER do a one handed tie until you are a senior resident. I did one and nearly got my head ripped to shreds!!!
                   

                  surggal

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                    SteadyEddy said:
                    My advice is to NEVER do a one handed tie until you are a senior resident. I did one and nearly got my head ripped to shreds!!!

                    SteadyEddy brings up a good point. A one-on-one preceptor, particularly if a private attending, may very well let you do much more than you would during the standard hospital clerkship. The "one-handed knot" is a good example (don't do one in the OR unless specifically told to by an attending). The point here is to remember NOT TO EXPECT to do anything in the OR on a service rotation. Just be glad and thankful to be offered opportunities to participate in the OR when they arise.

                    I don't think you could go wrong with whichever option you choose asl long as your compatible with the preceptor.
                     
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