How to prep for 1st surgery rotation?

[SurgDoc95]

Starting my first rotation two weeks from today and that just happens to be surg. I’d like to be able to contribute as much as I can so was wondering how best to prep in the days before starting? I’ve got a suture kit and plan to practice sutures next week and thought about perusing through surgical recall. Any suggestions would be appreciated!

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[ciestar]

You could watch some OME.
Nobody is going to expect you to be able to suture. Tying knots you could practice though

 

[Lebowski9]

Hi.

Most surgeons you’ll work with won’t expect you to be an expert in suturing. My best advice would be to look up your surgeries the day before and familiarize yourself (if you have access to the surgery schedule). I personally liked reading the UpToDate articles on surgeries but OME/YouTube works as well.

Another piece of advice, and I may say this is the most important, is befriend everyone in the OR (techs, nurses, CRNA,etc) because if those people like you life is going to be so much more enjoyable. Help them set up the room, get your gloves out (without contaminating), help them transfer the pt after surgery is over, etc.

Comfortable shoes. Compression stockings help a lot.


I really enjoyed my surgery rotations even though I don’t intend on pursuing that. It’s fun.

 

[sunshinefl]

I’m on my last couple days of surgery... it’s probably rotation dependent but I absolutely am expected to suture at closing as well as knot tying. In addition to learning that, learn surgical instruments by appearance/name/use, types of sutures by name/use/material, read about the basic procedure, particularly the anatomy.

 

[ciestar]

I’m on my last couple days of surgery... it’s probably rotation dependent but I absolutely am expected to suture at closing as well as knot tying. In addition to learning that, learn surgical instruments by appearance/name/use, types of sutures by name/use/material, read about the basic procedure, particularly the anatomy.

Sheesh my school never went that far in depth. No resident had the patient to teach you to close. I learned to tie knots on youtube. Suture types? No. Equipment? No.

Anatomy: YESSSSS.
Was never expected to know the knitty gritty on a procedure, but i best knew what structures we were looking that

 

[Synchronous]

My advice for Surgery rotation: Show up on time, Be where you are supposed to be, If given a task then complete the task, Read about the case the night before (if not that then night after), Know your patient, Be interested ( we know most people aren’t going to go into surgery, but it doesn’t matter which speciality you go into you’re still going to end up talking to surgeons about things you’d like for your patients. So it still worthwhile paying attention to). Also Anatomy, Anatomy, Anatomy.

I don’t expect a student to be able to close, but I’d like them to know how to tie at least one type of knot so when you close the 5mm port I don’t have to redo it. We teach the other stuff.

 

[sunshinefl]

My advice for Surgery rotation: Show up on time, Be where you are supposed to be, If given a task then complete the task, Read about the case the night before (if not that then night after), Know your patient, Be interested ( we know most people aren’t going to go into surgery, but it doesn’t matter which speciality you go into you’re still going to end up talking to surgeons about things you’d like for your patients. So it still worthwhile paying attention to). Also Anatomy, Anatomy, Anatomy.

I don’t expect a student to be able to close, but I’d like them to know how to tie at least one type of knot so when you close the 5mm port I don’t have to redo it. We teach the other stuff.

I don’t suture the fascia. I just suture the dermal closure. Not just ports, but also open incisions.

 

[IntheClouds4ever]

Know how to do a sub-cuticular stitch Incase they want you to close up laparoscopic ports.. some do and some don’t. You’re not going to be helpful in any way. You will always be in the way and causing cases to take longer than usual. Your goal is to minimize the that extra time you consume with your presence by knowing what’s going on in the case, not contaminate anything, know when to ask questions, and when to get out of the wya if something goes awry. Also, get to the OR before the techs set everything up and make sure they are aware that you’ll be in the case and offer to get your necessary PPE. Be cool with the circulators and techs, they will have more practical knowledge than you and will likely take more time before, during, and after cases to explain simple things that we haven’t seen, yet, but should be aware of. Had one first assist rn/tech offer to teach me the surgeons different preferred closing sutures for different cases. During that time she also gave tips on his idiosyncrasies and how to basically stay on his good side without kissing ass all day.

 

[WedgeDawg]

Here's how to be a strong 3rd year on any surgical service:

1. Have a good attitude. Be engaged, receptive to feedback, a team player, attentive, and willing to learn. This is the most important.
2. Communicate with your resident about expectations early so you know what they are and how to meet or exceed them.
3. Know the case you're going to the next day. Read the H&P, look at the imaging, and spend maybe 10-15 minutes reading about the anatomy and pathology that you'll encounter
4. Know the patients on your list. You don't have to know them as in depth as your residents, but be familiar with their surgery, what it was for, and the overall plan
5. Figure out what small tasks need to be done for patients in the mornings and volunteer to help do them. These include staple and suture removal, drain pulls, dressing changes, collecting I/O values, etc
6. Arrive early. Ask your resident when to arrive and beat that time by 5-10 mins.
7. Be a team player. Volunteer to do things even if they aren't educational, like fetching x rays or transporting patients. Yes it's scut, and yes, that responsibility shouldn't fall to you, but things need to get done, and you're part of the team. The more you act like you're part of the team, the more you'll be treated as such and the better your experience will be
8. Skills like suturing, tying, etc can be learned. This shouldn't be your primary focus. They're good to learn, but they're not the most important thing as a 3rd year.
9. When you're told to go home, go home. Seriously.
10. Don't be a dick

That's it.

 

[cryhavoc]

Be nice to everyone.

Always remember to wear your glasses, head cover, and mouth cover and make sure they are all on and the scrubs they give you. You will be tired and don’t want to forget.

Know the anatomy of the abdominal wall stone cold. If you have five minutes of free time or more before a surgery, frantically look up the anatomy on your cellphone in the bathroom stall and pray the surgeon is kind.

Accept that the scrub nurses will all have different procedures for gowning and gloving and you will learn through painful trial and error. And they will dramatically indicate your very existence is a huge inconvenience to them.

If you have a rotation where you must be there for 12+ hours a day, bring study materials for in-between surgeries. Set two alarms. Go to bed early.

Know at least the basics of stitching someone up.

Get ready to hold a retractor all day.

Get ready for your back and feet and butt and legs to hurt. A lot. Especially the first week.

Asking questions is okay BUT don’t distract the surgeon. Good luck balancing that.

Watch out for you. Don’t let some surgeon stitch an inch from your hand, ask for retractor.You don’t need a stick. Some surgeons are not looking out for you. You watch out for you.

You have less priority than a resident or an older student observing. Accept that. Being tall helps.

Good luck. All first hand experience I learned the hard way.

Nobody learns anything from watching their hundredth gallbladder be removed. If told you can go home, please please please run for your life and get out of there.

 

[holdthemayo]

Watch out for you. Don’t let some surgeon stitch an inch from your hand, ask for retractor.You don’t need a stick. Some surgeons are not looking out for you. You watch out for you.

This whole post is golden, but I want to second this. Watch your fingers, your surgeon might not. A needlestick is not a fun way to start a rotation. Trust me on that.

 

[sunshinefl]

Be nice to everyone.

Always remember to wear your glasses, head cover, and mouth cover and make sure they are all on and the scrubs they give you. You will be tired and don’t want to forget.

Know the anatomy of the abdominal wall stone cold. If you have five minutes of free time or more before a surgery, frantically look up the anatomy on your cellphone in the bathroom stall and pray the surgeon is kind.

Accept that the scrub nurses will all have different procedures for gowning and gloving and you will learn through painful trial and error. And they will dramatically indicate your very existence is a huge inconvenience to them. (AND DRAMATICALLY INDICATE THAT BECAUSE YOU WERE COMPLIANT WITH THE OTHERS’ STYLE AND PROCEDURES, NOT THEIRS, THAT YOU DIDN’T MYSTICALLY PREDICT, YOU ARE PAINFULLY IGNORANT AND WORTHLESS).

If you have a rotation where you must be there for 12+ hours a day, bring study materials for in-between surgeries. Set two alarms. Go to bed early.

Know at least the basics of stitching someone up.

Get ready to hold a retractor all day.

Get ready for your back and feet and butt and legs to hurt. A lot. Especially the first week.

Asking questions is okay BUT don’t distract the surgeon. Good luck balancing that.

Watch out for you. Don’t let some surgeon stitch an inch from your hand, ask for retractor.You don’t need a stick. Some surgeons are not looking out for you. You watch out for you.

You have less priority than a resident or an older student observing. Accept that. Being tall helps.

Good luck. All first hand experience I learned the hard way.

Nobody learns anything from watching their hundredth gallbladder be removed. If told you can go home, please please please run for your life and get out of there.

Agree with all of this, especially the bolded. The capital letter words in parentheses are my addition. 2. More. Days.

 

[ciestar]

Agree with all of this, especially the bolded. The capital letter words in parentheses are my addition. 2. More. Days.

Longest 10 weeks of my life.
Thankfully i was on an easy service the last two weeks... so id hide in the locker room or call room. Id call or text my resident every few hours if i hadnt heard from them.

Clerkship director wanted us to observe/scrub other cases if we didnt have any. I did everyhing not to. The one time i was pulled off a case to first assist an ENT doc.. case lasted 8 hours.




I honored this rotation

 

[Matthew9Thirtyfive]

Agree with all of this, especially the bolded. The capital letter words in parentheses are my addition. 2. More. Days.

I’m starting med school and was hoping the fact that I was a scrub nurse for like 8 years might help me on my surgery rotation, but I’m guessing it won’t. I was always really nice to all the med students and residents, seems like I might have been the only one lol.

 

[WedgeDawg]

I’m starting med school and was hoping the fact that I was a scrub nurse for like 8 years might help me on my surgery rotation, but I’m guessing it won’t. I was always really nice to all the med students and residents, seems like I might have been the only one lol.

I worked with some quality scrub nurses and techs as a med student who definitely looked out for me. They’re a tough bunch and for good reason but if you’re there to do your best they’ll have your back.

 

[WedgeDawg]

I’m starting med school and was hoping the fact that I was a scrub nurse for like 8 years might help me on my surgery rotation, but I’m guessing it won’t. I was always really nice to all the med students and residents, seems like I might have been the only one lol.

Also you’ll know how to glove and gown, how to maintain sterility, how to drape, what the names of the instruments are, how to conduct yourself in the OR, how to help turn and position, how to anticipate the needs of the surgeon, and how to keep yourself, others, and the patients safe. I would say you are going to be very well prepared from that standpoint.

 

[Matthew9Thirtyfive]

Also you’ll know how to glove and gown, how to maintain sterility, how to drape, what the names of the instruments are, how to conduct yourself in the OR, how to help turn and position, how to anticipate the needs of the surgeon, and how to keep yourself, others, and the patients safe. I would say you are going to be very well prepared from that standpoint.

Oh yeah I know. I meant help me in the sense that the scrubs and circulators won’t give me **** lol.

 

[jurassicpark]

Sleep well the night before, because you will get little of it afterwards

 

[SurgDoc95]

Sleep well the night before, because you will get little of it afterwards

2 surgery rotations then 2 IM rotations to start the year. I’m never going to sleep

 

[Neopolymath]

Oh yeah I know. I meant help me in the sense that the scrubs and circulators won’t give me **** lol.

You know how it goes. It's just that ant hill or bee hive mentality. New person = idiot intruder until a week goes by and then you could drop your gown on the floor and no one would notice. Experienced this in every OR even with traveling staff. Just ignore it and smile.

 

[sunshinefl]

You know how it goes. It's just that ant hill or bee hive mentality. New person = idiot intruder until a week goes by and then you could drop your gown on the floor and no one would notice. Experienced this in every OR even with traveling staff. Just ignore it and smile.

Lol when I was telling the surgical staff on Friday it was our last day on service... I was like now before you get excited cause I know you’re thinking medical students are stupid and in the way, you’re just going to get new students. At least we’re groomed. And they were like “omg you’re right, we’d rather just keep you guys.” Lol

 

[jurassicpark]

2 surgery rotations then 2 IM rotations to start the year. I’m never going to sleep

Wasn't that bad. I think during my trauma rotation if I wasn't overnight call I would be in the hospital no later than 4-5am depending on census, pre-round before all the trauma-activations started rolling in, get home by 7-8pm.

 

[AsianPersuasion]

I know I'm only an intern, but for the love of God, do not argue with me when I tell you to do something!

I don't know what it is with the surgical fanatic these days but damn, you guys love to complain and argue.

I know some of you know a lot and that's great, but please, don't flex over the other interns or resident if the question weren't directed towards you. We're all here to learn.

And last I check, the PD ask for our comments regarding your performance...so please, don't be a tw8t.