How to succeed clinically on surgery?

[JP2740]

Have it coming up, any advice appreciated

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[gators21]

Don't bring up stupid topics that can be answered with 2 seconds of effort on your part

 

[Kahreek]

we are not brainstorming, here. You have to be more specific

 

[JulyMorning]

When operating, 'fess up if you're about to vasovagal. When assisting, don't cut the surgeon's knots.
Seriously, come prepared: read up on cases, know the region anatomy, know case-relevant clinical stuff (ie, know the parkland formula for resusc if you're in on a burn case).

 

[HelpPleaseMD]

cutting the surgeon's knot lol. definitely know the right cutting technique and read up on the relevant anatomy 5 mins before the case.

 

[alpinism]

You didn't read surgical recall bro?

HAMMERHEAD

"The perfect surgery student is one who is never hungry, thirsty or tired, never whines or complains, always enthusiastic, loves scut work and can never get enough, and never wants to leave the hospital. ”

 

[hurdlepup]

1. Eat when you can

2. Poop when you can

3. Sleep when you can

4. Don't **** with the pancreas

 

[startswithb]

You didn't read surgical recall bro?

HAMMERHEAD

"The perfect surgery student is one who is never hungry, thirsty or tired, never whines or complains, always enthusiastic, loves scut work and can never get enough, and never wants to leave the hospital. ”

It's kinda true. There will be students like this on your rotation. We are not gunners, we just really freaking love surgery.

Gunners exist and they are truly the weak students who tell your resident "I got here first today!!!!!" and as someone else mentioned, monopolize the resident's time by asking extremely broad questions that show how little they know.

 

[Anastomoses]

1. Eat when you can

2. Poop when you can

3. Sleep when you can

4. Don't **** with the pancreas

Why is the pancreas so special?

 

[VisionaryTics]

Why is the pancreas so special?

Because when the pancreas gets angry, everyone is going to have a bad day.

To answer OPs question: git gud/be a low drag, high speed HAMMERHEAD.

 

[J ROD]

Why is the pancreas so special?

Think about your anatomy and where it is and all what it does. And you cant give a lobe away like the liver. Love thy pancreas! lol

 

[evilbooyaa]

Don't complain about your hours.
Don't be overtly perky if your residents aren't.
Look up the next day's cases and read up on anatomy/surgical technique/attending surgeon's music preference the previous night.
Try to limit the amount of times you contaminate yourself. It'll most likely happen at least once.
Become friends with the scrub techs. They will make you look most intelligent.

DON'T TOUCH THE MAYO UNLESS THE SCRUB TECH SAYS ITS OK, EVEN IN AN EMERGENCY.

 

[Kahreek]

Why is the pancreas so special?

because post op acute pancreatitis can be a train wreck. Read on severe acute pancreatitis and how it can be caused by simple manipulation of pancreas.

 

[KinasePro]

Just relax. There's so much melodrama in these threads about surgery. Sheesh.

I'd say the same advice applies to surgery as does all other rotations: try to learn how to do the intern's job. Also, don't be a annoying and do try to be a team player (you'll learn what this means by watching the intern). Follow these guidelines and you'll generally net 4s/5s, regardless of personal ability.

Also, caffeine pills >> coffee.

 

[Winged Scapula]

We hate it when:

- you're late

- we can't find you (unless you're unlike able then we don't care)

- you don't have a sense of (black) humor

- don't try to enjoy or learn something ( we get that most students have no intention of going into surgery but it's really annoying to be lectured about how the field sucks, the hours sucks or anything else involving whining)

- you whine or complain; trust me, we've had it worse

- you shaft your fellow medical students

- you're rude to staff

- you lie about needing to leave early for lecture/family problem etc. At least keep your stories straight.

See - it's no different than any other rotation. Show up, don't complain, be nice and personable, do your work and try to see the positive in everything you do.

 

[throw away]

The truth is that on surgery, nothing you do or don't do will make a difference. Either they will love you or hate you based on things you can't control (your personality, their personal issues, your appearance, their personal issues, your gender, their personal issues, etc.).

On surgery, I answered almost every pimp question correctly, showed up early to every surgery, pre-wrote everyone's notes, and was super polite. I worked as a scrub tech before medical school so I knew way more than my peers. NO evaluations that I got commented on my knowledge or competence. They all commented on things that I could have never seen coming (e.g. "Was too enthusiastic," "Not enthusiastic enough," "The scrub nurse did not like her" [news to me], "Was too aggressive to scrub in on surgeries," "Showed up the residents.") One resident got angry with me because he asked if I needed help tying knots and I honestly said, "No, that's okay, I've got it." I've tied many, many knots before (this was before he'd seen me tie any). An attending got mad at me--seriously angry--because she said a famous movie quote and I responded, "Oh, I love X movie." She said, "That's not from a movie! You are wrong! That's from a baseball game. Jesus." Then she grabbed the suction away from me as punishment. Another attending pimped me on a looong line of questions that I got all right, then yelled at me when I didn't know which person in Greek mythology a particular lymph node was named after.

Try your hardest. But know that you will still be cussed out. You will still have stuff thrown at you including sharp objects. You will still have to stand when you use the computers because the nurses won't let you use the chairs (sometimes you will be tired and squat on the floor). You will not be allowed to eat because the break room is only for the residents, attendings, and nurses--no med students allowed and no eating outside the break room. You will be expected to show up at 3:45 am and work until 8 or 9:00 pm every day (longer than the residents, and with no food). Not exaggerating on that schedule That's surgery. Just keep smiling.

If I sound bitter, that's because I am. I went to med school to be a surgeon. Any interest in surgery was beaten out of me. I am saying all this because during those three months, I felt sooooo alone. If this happens to you, I want you to know that you are not alone!

I should add that after all that, I ended up with a HP. So even if they seem to hate you, you can still do well enough.

 

[VisionaryTics]

The truth is that on surgery, nothing you do or don't do will make a difference. Either they will love you or hate you based on things you can't control (your personality, their personal issues, your appearance, their personal issues, your gender, their personal issues, etc.).

That may have been your experience, but is certainly not the experience of 95% of medical students.

On surgery, I answered almost every pimp question correctly, showed up early to every surgery, pre-wrote everyone's notes, and was super polite. I worked as a scrub tech before medical school so I knew way more than my peers.

Maybe that attitude contributed to your interpersonal difficulties.

NO evaluations that I got commented on my knowledge or competence. They all commented on things that I could have never seen coming (e.g. "Was too enthusiastic," "Not enthusiastic enough," "The scrub nurse did not like her" [news to me], "Was too aggressive to scrub in on surgeries," "Showed up the residents.")

Those are all ridiculous comments which I could never imagine a resident or attending writing (aside from maybe "not enthusiastic enough".)

One resident got angry with me because he asked if I needed help tying knots and I honestly said, "No, that's okay, I've got it." I've tied many, many knots before (this was before he'd seen me tie any). An attending got mad at me--seriously angry--because she said a famous movie quote and I responded, "Oh, I love X movie." She said, "That's not from a movie! You are wrong! That's from a baseball game. Jesus." Then she grabbed the suction away from me as punishment.

Oh wow that seems brutal.

Another attending pimped me on a looong line of questions that I got all right, then yelled at me when I didn't know which person in Greek mythology a particular lymph node was named after. Try your hardest. But know that you will still be cussed out. You will still have stuff thrown at you including sharp objects.

This never, ever happens any more. Surgeons who do that crap get fired.

You will still have to stand when you use the computers because the nurses won't let you use the chairs (sometimes you will be tired and squat on the floor). You will not be allowed to eat because the break room is only for the residents, attendings, and nurses--no med students allowed and no eating outside the break room. You will be expected to show up at 3:45 am and work until 8 or 9:00 pm every day (longer than the residents, and with no food). Not exaggerating on that schedule That's surgery. Just keep smiling.

If I sound bitter, that's because I am. I went to med school to be a surgeon. Any interest in surgery was beaten out of me. I am saying all this because during those three months, I felt sooooo alone. If this happens to you, I want you to know that you are not alone!

I should add that after all that, I ended up with a HP. So even if they seem to hate you, you can still do well enough.

If true, sounds like you had a uniquely miserable experience. Other students interested in surgery should be aware that your rotation is in the remote minority.

As above.

 

[throw away]

Re-reading that post makes me regret posting it. I was very miserable and that tarnished my overall view. There were good times too: surgeons who taught well, many fascinating cases, cool robotic surgeries, grateful patients, and I got much closer to my classmates. Also not all of my classmates had bad experiences on surgery like I did. Some really enjoyed many aspects of it.

My school is known to have a malignant surgery program. I didn't realize how uniquely malignant my school is until I went on the interview trail and spoke to students from across the country. I'm guessing that the majority--or even vast majority--of programs are not like that. But if yours is, then you are not the only one. And you are always free to vent back to me on sdn.

 

[startswithb]

Re-reading that post makes me regret posting it. I was very miserable and that tarnished my overall view. There were good times too: surgeons who taught well, many fascinating cases, cool robotic surgeries, grateful patients, and I got much closer to my classmates. Also not all of my classmates had bad experiences on surgery like I did. Some really enjoyed many aspects of it.

My school is known to have a malignant surgery program. I didn't realize how uniquely malignant my school is until I went on the interview trail and spoke to students from across the country. I'm guessing that the majority--or even vast majority--of programs are not like that. But if yours is, then you are not the only one. And you are always free to vent back to me on sdn.

Maybe do an away rotation at another school. Also, NEVER,EVER reject a learning opportunity from a superior. Ever. Don't ever think you don't have something to learn from someone else. That is when you stop learning. Be humble. I can see why you would get poor evaluations based on your behavior in the situations you described.

 

[Kaustikos]

- you don't have a sense of (black) humor

- don't try to enjoy or learn something ( we get that most students have no intention of going into surgery but it's really annoying to be lectured about how the field sucks, the hours sucks or anything else involving whining)

- you whine or complain; trust me, we've had it worse

First part - why I ****ing love you guys. You can pimp me/bitch slap me/insult me/make me do scut work all you want if I like you. And surgeons have the personality/sense of humor I just love. I almost broke sterile field multiple times laughing at the jokes during procedures.... jk.

Whiners - no one likes em. I cringe every time a med student complains in front of residents.

 

[Winged Scapula]

Unfortunately, one's thoughts about certain specialties can be skewed by unfortunate experiences such as yours. Its good that you were able to recognize that your experience may simply be a function of *your* experience, at that time, in that programs. If you honestly had objects, especially sharp objects, thrown at you, then that physician needs to be reported. Such behavior is no longer tolerated anywhere.

On surgery, I answered almost every pimp question correctly, showed up early to every surgery, pre-wrote everyone's notes, and was super polite. I worked as a scrub tech before medical school so I knew way more than my peers. NO evaluations that I got commented on my knowledge or competence. They all commented on things that I could have never seen coming (e.g. "Was too enthusiastic," "Not enthusiastic enough," "The scrub nurse did not like her" [news to me], "Was too aggressive to scrub in on surgeries," "Showed up the residents.") One resident got angry with me because he asked if I needed help tying knots and I honestly said, "No, that's okay, I've got it." I've tied many, many knots before (this was before he'd seen me tie any). An attending got mad at me--seriously angry--because she said a famous movie quote and I responded, "Oh, I love X movie." She said, "That's not from a movie! You are wrong! That's from a baseball game. Jesus." Then she grabbed the suction away from me as punishment. Another attending pimped me on a looong line of questions that I got all right, then yelled at me when I didn't know which person in Greek mythology a particular lymph node was named after.

I highlighted the above because it may well hint at a common issue with students who have been allied health care providers prior to attending medical school. Students who have been nurses, scrub techs, pharmacists, etc. in previous lives (and residents who have been attendings in other specialties or countries) sometimes come across as arrogant or assume they have little to learn. One of the most annoying students I had was a former nurse who stated that she didn't want to go to the OR that day because "I've seen hernias before" and would lecture her fellow 3rd year students about peri-operative care (some of which she was wrong about). Sometimes you just gotta hold your tongue, suck it up and know your place.

 

[Lavan]

Throw Away does make some points that relevant. Evaluations are often based on interpersonal dynamics, gender, and a variety of awkward subjective things. Medical students are sometimes treated like a group instead of individuals. I know a lot of very pleasant women to get poor evaluations (not just in surgery) for "lack of confidence" and other BS-y type comments, particularly from older male physicians.

That said, a clerkship is a clerkship. Everyone wants you to respect what they do and be pleasant to be around.

 

[Kaustikos]

I had a hilarious moment during my anesthesia Sub. I was looking at the procedure (colectomy) because I just like this **** for some reason. The attending/resident are in there working on the proximal left colon and the med student is kinda in la-la land because, I think, she's just not really into the procedure. The attending is periodically looking at me and I'm hoping it's not annoying that I'm peering over the curtain to watch. He then looks at the other student and asks "Do you even know what we're doing?" Deer in headlights and she mutters something and he looks at her for a bit and then says "They call it a colectomy... This guy over here even knows"
I kinda feel bad so I just say "Oh, I thought we were doing a pulmonary lobectomy"
And he adds insult to injury - "At least you're watching"

Ugh...I felt bad for her but all I can say is - try to look interested/watch. Some procedures have you doing nothing but at least try to see where they are/what they're doing. Or end up like her.

 

[npappasan]

I did my surgery rotation with Richard Karl as my attending at Moffitt Cancer Center. First day in the OR, he asks me "What is Whipple's Triad?" and "What is Courvoisier's Sign?". I answered both in detail. He replies back "You're cool" and never asked me another question for 2 months. Frankly, I think there were just too many residents and fellows to contend with to bother worrying about me but I think that he got the notion I came prepared and respected that. With that being said, I always had my rounds and notes done. My memory was much sharper when I was younger so I could always memorize details about a chart and could present it rote during rounds. He actually wrote one of my LOR's for residency. One of my group members was kind of a hipster. Smart, but goofy. One time in rounds he asked him how a patient was doing. He replied "He's 5 by 5". Karl was like WTF does that mean??? He replied "You know, he's jiggy". The collective imaginary group facepalm was palpable. He did go on to do a general and plastic surgery residency at that university program so it obviously didn't affect him too badly!

 

[npappasan]

I had a hilarious moment during my anesthesia Sub. I was looking at the procedure (colectomy) because I just like this **** for some reason. The attending/resident are in there working on the proximal left colon and the med student is kinda in la-la land because, I think, she's just not really into the procedure. The attending is periodically looking at me and I'm hoping it's not annoying that I'm peering over the curtain to watch. He then looks at the other student and asks "Do you even know what we're doing?" Deer in headlights and she mutters something and he looks at her for a bit and then says "They call it a colectomy... This guy over here even knows"
I kinda feel bad so I just say "Oh, I thought we were doing a pulmonary lobectomy"
And he adds insult to injury - "At least you're watching"

Ugh...I felt bad for her but all I can say is - try to look interested/watch. Some procedures have you doing nothing but at least try to see where they are/what they're doing. Or end up like her.

Same attending as above, Richard Karl. We were doing a Whipple or something like that. The anesthesia resident was trying to get hand lotion out of a tube. There was an air pocket or something in the tube and he was wrestling with the tube to get the lotion. The air pocket clears and a glob of lotion comes shooting out, over the drape, and right into our abdominal field. Karl starts swearing and tearing into the resident. We're irrigating like crazy now. After a few minutes of quiet, Karl starts laughing and says "That's the first time anyone has ever ejaculated into my surgical field". The anesthesia resident starts laughing also which sends Karl off into another fury and he starts yelling at him again.

 

[npappasan]

Holy ****!!! I just saw that this thread was 2 years old.

 

[BamaNicole]

Don't complain about your hours.
Don't be overtly perky if your residents aren't.
Look up the next day's cases and read up on anatomy/surgical technique/attending surgeon's music preference the previous night.
Try to limit the amount of times you contaminate yourself. It'll most likely happen at least once.
Become friends with the scrub techs. They will make you look most intelligent.

DON'T TOUCH THE MAYO UNLESS THE SCRUB TECH SAYS ITS OK, EVEN IN AN EMERGENCY.

The greatest quote to live by while in the OR.....there are two people who can touch the mayo stand. That's the tech and God. The tech would even tell God not to touch it.