How to honor in surgery

[anicha06]

Besides doing well on the shelf (at our school you must honor the shelf if you want to be in the running for honoring the rotation), are there any other specific recommendations?

We also have different sites for the same rotation. There's a team of 6 at some places and a team of 2 at others. Does anyone have any ideas as to how a clerkship director gives honors fairly? (For instance, are students evaluated compared to their teammates?)

Thanks for your input.

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[Hurricane]

General rule for doing well in most clinical rotations: be early and be perky. 🙂

For surgery specifically, get Surgical Recall. Read up on your cases the night before using that and whatever textbook/review book you have, so that you can answer pimp questions and ask intelligent questions in the OR. Be interested in whatever is going on, even if it's the zillionth lap chole you've seen. Offer to do dressing changes, suture removal, type stuff on the floor. Be nice and helpful without being an annoying overbearing gunner.

Be friendly and courteous with the OR staff. Offer to help them transfer the patient, place the foley, etc. Always tell the scrub nurse you're scrubbing in and then ask if he/she needs you to open a gown and gloves for you. (I'm not sure if this specifically will help your grade, but it will make your life much more pleasant to be on good terms with the staff.)

 

[ljl1982]

Agree with above post regarding working hard and being courteous, and with reading Surgical Recall (the regular one, not the Advanced version, is fine for students).
Also, I thought the first ten or so chapters of the Lawrence Essentials of Surgery book were helpful (my surgery clerkship director commented that I had the best knowledge base among my group of students 🙂.

If your med school requires the NBME "shelf" exam for surgery, please refer to the numerous threads about preparation for that exam. I used Pre-test and NMS Casebook Surgery, and got an outstanding in the rotation.

General rule for doing well in most clinical rotations: be early and be perky. 🙂

For surgery specifically, get Surgical Recall. Read up on your cases the night before using that and whatever textbook/review book you have, so that you can answer pimp questions and ask intelligent questions in the OR. Be interested in whatever is going on, even if it's the zillionth lap chole you've seen. Offer to do dressing changes, suture removal, type stuff on the floor. Be nice and helpful without being an annoying overbearing gunner.

Be friendly and courteous with the OR staff. Offer to help them transfer the patient, place the foley, etc. Always tell the scrub nurse you're scrubbing in and then ask if he/she needs you to open a gown and gloves for you. (I'm not sure if this specifically will help your grade, but it will make your life much more pleasant to be on good terms with the staff.)

 

[Hurricane]

Also, I thought the first ten or so chapters of the Lawrence Essentials of Surgery book were helpful (my surgery clerkship director commented that I had the best knowledge base among my group of students 🙂.

Yeah, Lawrence. That was the required textbook for our rotation, but I couldn't remember the name of it. I thought it was very good, and very readable.

 

[azzarah]

You know the common sense stuff...work & study your a$$ off and be pleasant to work with in order to do well. However, it's not always that easy. You need to ask other students at your school which services grade easy & then beg the course director for that service. I got stuck with this particular service where almost everyone on the basic clerkship gets a pass. It was fun, I worked really really hard, the evaluator wrote in the comments that I was an amazing student blah blah blah, but guess what, he still gave me a pass. I had friends on other services who easily got honors AND had more time to study for the shelf.

 

[TaiShan]

It totally depends on what you want from the rotation. It looks like your goal is to get a "H". I would recommend:

1) Common senses: be early, look interested, etc etc

2) Pick a smaller site so that you can work with attendings a little bit more directly. The surgeon I worked only gets one student every period and he pretty gives "H" or "HP"to every student. Big sites are more fun but you have to compete with the other students and most of time you are evaluated by angry and crappy surgery residents.

3) Study for the shelf. That is another benefit of smaller sites because you have tons of down time. I have classmates doing surg at inner-city trauma center and they were overworked and never able to do any reading. Doing well on the shelf is all about reading.


Of course, if you want to be a surg, it is a different story..

 

[Buckeye(OH)]

Can you follow up by what you mean by that last sentence?

 

[Anka]

Tai Shen might answer for himself, but I interpreted it to mean (and it's true), that if you want to be a surgeon, you're going to spend a lot of time in the OR. It has an irresistable draw to those so afflicted. For anyone else, it's just time wasted standing there, holding a retractor, staring at the clock, waiting for intermitable miinutes to pass. If you find yourself in the latter group, you should probably avoid the OR in favor of spending more time with your textbook -- i.e., choose a slower site with a lot of downtime. The same goes for floor work -- if you want to be a surgeon, you need to get comfortable with JPs, chest tubes, lines, removing staples, etc. If not, you can probably choose a site where the NPs or PAs do that sort of thing, and have more time to study.

 

[TheCat]

Can you follow up by what you mean by that last sentence?

THe last sentence means-if you want to be a surgeon then you probably want to be busy and want to be in a busier bigger service v. a smaller service with less time in the OR cause obviosuly if you are into surgery than youll likely want to be in the OR the max time.

As far as honoring-let me tell you its all LUCK in who you get as a service-There were five med students while i did surgery, each on a different team. Out of all of them, I was the only one who had ****TY residents the whole month who were just plane mean and had a reputation of failing some students over the past. Basically I had Butt ugly females who were just angry with life and even angrier when a good looking guy like me was around-so no matter what i did, half way through the rotation i realized their was no shot at honors but i still "did the right stuff" everyone talks about-and sure enough I got all minimal passes from those residents-although some attendings were great and gave me honors-the 2 residents evals were enough to give me straight passes. Honestly you can do everything you want but it comes down to what team you get. HOnestly the otehr teams werent even required to take call-had weekends off. Me-no days off and Q 3 call-seriusly some residents are just bitter. but good luck and hope for the best.
As far as the shelf i thought lawrence was crap-First 10 chapters was ok-but I i dont thin trauma is well enough covered for how important it is on the shelf so this is what i recomened
1. Trauma-pick a surgery text-sabiston etc. and read the 1-2 chapters on trauma/critical care-it will serve you well and doesnt take that long
2. fluids/electrolytes/acid/base-read your favorite medicine text/source-i found medicine coveres these issues better than lawrence-I liked harrisons/Step up Medicine for this
3. Surgery shelf is alllll about MEDICALmanagmanet of surgical things-its alll about GI diseases and Endocrine problems- My advice-lawrence sucks at coverage on these most important thinsg. Read a medicine source you like that covers Gi diseases and endocrine diseases well and make sure you read the diagnosis, workup and various treatment options including surgical and non surgical-but you dont have to know what each surgical procedure entails, just know when surgery is indicated.

For the other toipcs, like vascular surg, tranplant , urology, optho, etc is very low yield and i think there were maybe 10/100 on those topics. very low yeild.
good luck

 

[omarsaleh66]

In surgery it helps to know:

1)
What cases are going on during the day, some attendings didnt just pimp me on the surgery or procedure, but actually wanted details about the patient and why he was getting the surgery. It seems common sense but alot of times u dont know what u are scrubbing in on so its good idea to plan early and know what procedure u are doing, and why the patient is getting it.

2) In surgery, I was pimped heavily on the pathology reports and radiology studies, attendings dont just expect u to look at the reports but some wanted u to actually look up the CT or MRI or whatever, I was even asked about some of the margins and what centimeters the polyps were on some of the pathology reports.

3) U gotta know alot of details that arent that important on other services such as fluids (is it Ringers lactate or Normal Saline? what is the composition of these fluids?) how much are they getting? what was the estimated blood loss during the surgery? How much fluid did they get? U will get pimped on this stuff especially if u have some wierd lab like a low hematocrit. U as the student might be asked "is it due to some comlication of the surgery or is it secondary to fluids?"

4) Most important of all. Did the patient have a bowel movement post-op? or did he pass gas? if he did, then he can go home. It doesnt matter if he has elevated ST waves on his ekg, as long as he can pass gas, the patient can go home.


U gotta know alot of wierd details for surgery. Just try to know your patient as best as u can, u might even get pimped on random stuff so its good to cover everything.

 

[Ypo.]

Basically I had Butt ugly females who were just angry with life and even angrier when a good looking guy like me was around-

I would think they would be happy to have a good looking guy around.

Seriously, of course this is subjective, but its not all luck. Like you said, by working hard and trying to keep on people's good side, you were able to get a pass from a tough situation. Sometimes we just don't click with people.

 

[Ypo.]

I have classmates doing surg at inner-city trauma center and they were overworked and never able to do any reading.

Do people often get to study while on their surgery rotation?

 

[p53]

Best Correlation for Surgery Grade = Surgery Shelf Exam Grade
Best Correlation for NBME Surgery Shelf Exam = USMLE Step 1 Score.

Nuff said.

 

[HamOnWholeWheat]

Best Correlation for Surgery Grade = Surgery Shelf Exam Grade
Best Correlation for NBME Surgery Shelf Exam = USMLE Step 1 Score.

Nuff said.

So to honor your surgery rotation you should re-take Step I. 👍

 

[Ypo.]

So to honor your surgery rotation you should re-take Step I. 👍

What is wrong with your cat?

 

[autoimmunity]

What is wrong with your cat?

I was just thinking the same thing!

 

[HamOnWholeWheat]

What is wrong with your cat?

You're just jealous. You wish your cat was as awesome as mine. 😍

 

[fun8stuff]

I would think they would be happy to have a good looking guy around.

Seriously, of course this is subjective, but its not all luck. Like you said, by working hard and trying to keep on people's good side, you were able to get a pass from a tough situation. Sometimes we just don't click with people.

I've been in situations (i.e. volunteering) with not-so-pretty/overweight woman and it seemed they treated the guys great... but were pretty mean to the good looking woman. A lot of bashing behind their back (i.e. she's a dirty tramp)... giving them crap jobs.... ignoring them... etc

 

[autoimmunity]

You're just jealous. You wish your cat was as awesome as mine. 😍

No seriously, what's wrong with your cat? He/she looks jaundice and has some funny looking hair. Furthermore, is your cat's mouth open or closed in the pic? I'm just curious so that I know if I need to take my cat to the vet in case she starts looking like that. 😉

 

[Ypo.]

I've been in situations (i.e. volunteering) with not-so-pretty/overweight woman and it seemed they treated the guys great... but were pretty mean to the good looking woman. A lot of bashing behind their back (i.e. she's a dirty tramp)... giving them crap jobs.... ignoring them... etc

That does sound very cruel and unprofessional.
Sigh...welcome to the world of passive feminine aggression. Would you prefer we duked each other out? Society frowns on women being directly aggressive towards each other, so we have evolved other ways. I prefer being direct, but thats not 'feminine'. Its not just aggression, even just talking out our differences is a hard thing for us to do. I think women prefer to avoid being direct, so when a conflict arises, we take out our frustration in other ways, some of them very pyschologically cruel. We need to start practice being more direct and airing out our differences and then moving on, rather than doing this kind of passive aggressive BS.

 

[Ypo.]

You're just jealous. You wish your cat was as awesome as mine. 😍

I don't have a cat, but I was wondering what happened to yours.

 

[fun8stuff]

I don't have a cat, but I was wondering what happened to yours.

i'm not a vet, but my guess would be Feline Herpes Virus (FHV).

http://www.veterinarypartner.com/Content.plx?P=A&A=1327&S=1&SourceID=42
(this link contains some graphic pics of FHV)

 

[HamOnWholeWheat]

i'm not a vet, but my guess would be Feline Herpes Virus (FHV).

http://www.veterinarypartner.com/Content.plx?P=A&A=1327&S=1&SourceID=42
(this link contains some graphic pics of FHV)

Look guys, the cat just got done eating and is yawning. Admit your jealousy and be done with it.

 

[Koko]

i'm not a vet, but my guess would be Feline Herpes Virus (FHV).

http://www.veterinarypartner.com/Content.plx?P=A&A=1327&S=1&SourceID=42
(this link contains some graphic pics of FHV)

Entirely unnecessary

HOWW, your kitty scares me.

 

[pharmer]

Look guys, the cat just got done eating and is yawning. Admit your jealousy and be done with it.

I just got done eating and then saw your cat ....I must go re-eat dammit

PS> does your cat have wool and possibly go baaaah?

 

[Ypo.]

I just got done eating and then saw your cat ....I must go re-eat dammit

PS> does your cat have wool and possibly go baaaah?

It's fur looks like a toy poodle's.

 

[Zoom-Zoom]

there really is something wrong with that cat. sad..