Hours in the OR

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bowlofmushypeas

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For surgery, my site is pretty flexible In that I can choose how many surgeries to go to during the day. I'm trying to figure out a good balance now between time spent in the OR vs studying at the hospital so I'm wondering how many hours or number of surgeries do you participate in daily without coming across like a slacker but still having sufficient time to study?
 
No, but Id still like to leave a good impression while maximizing learning
 
For surgery, my site is pretty flexible In that I can choose how many surgeries to go to during the day. I'm trying to figure out a good balance now between time spent in the OR vs studying at the hospital so I'm wondering how many hours or number of surgeries do you participate in daily without coming across like a slacker but still having sufficient time to study?

It depends on a lot of variables.

1. What counts more? At my school, your grade was determined by your shelf. Yeah, there were evaluations from attendings, but it didn't matter what they said. Anybody with > 80 on the shelf got honors. Period. So, in that case, if I could CHOOSE not to be in the OR? I just wouldn't go.

2. How many students are with you? If there are students who want to go into surgery, then you can easily give up your surgery spot to them. Make it known you're doing it because you know they want to go into surgery and they really want the experience. You want it to, so you'll go to a few, but you are willing to sacrifice such an awesome experience for someone else who wants it more than you. This makes you look like the good guy, even though you are thankful you are in the library rather than sweating it out standing in one spot for 8 hours during a Whipple.

Likewise, if there are multiple students, then there should always be a student in an OR. That's sort of expected. But if there's one OR and 5 of you, its easy to blend out.

3. Learning. Personally, I didn't learn anything IN surgery, except maybe what a Pringle Maneuver is (once you pop, you cant stop). I did once save a woman's recurrent laryngeal nerve by asking "is the neural stimulator plugged in?" (neural stimulator is the thing the surgeon uses to test if that white thing is a nerve or not). It was not plugged in and they were just going to cut it. But as far as learning? None. Zippo. It was cool, sometimes, painfully boring at most. If you are interested in learning and not actually cutting, its best to spend most of your time out of the OR.

Now, before people unleash on me. By "learning" i mean medicine, not what's teh difference between a Kelly and a Fischer, nor the difference between a continuous or simple interrupted suture, nor the difference between 4.0 Vicryl and 3.0 Nylon. Those things are super surgery specific, and, since bowlofpeas isnt going into surgery, consitutes as "inane factoids"
 
I completely agree with the above poster. Your grade is what matters above all else. If Shelf counts little, then go to the surgeries and try to stay awake. If shelf counts for a lot, then skip the surgeries and study. In my experience, surgeons and residents dislike clinic. If you volunteer for clinic, more props to you. AND you learn more in clinic than the surgeries. The management you learn in clinic is what will help you on the shelf exam.

What worked well for us was that we split into two teams of students with one team taking surgeries MWF and the other TTh and switching the subsequent week. This way, we all roughly get the same number of days in the OR. The other students would then either go to clinic/man the floors. You can always volunteer your spot away to the surgery-gunner in the group. It's a win-win. 👍
 
Thanks for the responses, I'm not sure how often my docs do clinic but I'll definitely ask about that. For my situation then, how many or hours or surgeries do ppl typically shoot for each day?
 
I try to go for as few as possible. If there is a AAA repair vs. a lap chole, I go for the lap chole just because it takes much less time. Look for the short surgeries.
 
I try to go for as few as possible. If there is a AAA repair vs. a lap chole, I go for the lap chole just because it takes much less time. Look for the short surgeries.

If it's an open AAA repair you can't miss out. That surgery is sweet..

If you do go into cases and are looking to maximize your learning, you're always welcome to ask the attending to discuss xyz disease with you. Granted, they will then turn around you and ask you to explain it... but if you know the basics they'll appreciate the enthusiasm and help you through any sticking points in management.

Hope it all works out for you!
 
As few as possible would be my answer. I was the only student on some of my rotations and had to scrub for every surgery. One day that meant five back to back lap choles. I think I still have PTSD from that day.
 
It depends on how you learn and how you feel about the rotation. Personally, I learned better by seeing so I tried to scrub as much as possible. It made studying for the shelf really hard but not impossible. That's also why in surgery, it is recommended you carry a lot of reading material with you so you can study with all the downtime that you'll have. Of course, I almost went into surgery so I guess my take on it is a little different. Unless you know for sure that you are going to a strictly non-procedural specialty I think it's a good idea to have an understanding how certain surgeries go. Even if you go into primary care, I'm sure you'll get questions from your patients when they get referred for surgery and having actually seen a case may best equip you to answer said questions. Practicing sterile technique is never a bad thing. Learning to anticipate in the OR is a skill that will carry out of the OR. Pre and post op care is something great to pick up. My point really is that you may never need to know the difference between a Balfour and a Deaver ever again but there are still concepts in a surgical rotation that can help you in other rotations.

Also for selecting shorter cases, there are only so many appies, choles and breasties you can observe before you want to shoot yourself in the foot.
 
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