Practicing Procedures

[504196]

Hey everyone. I'm a third year medical student interested in surgery which was my first rotation. I am just wondering what you all have done to practice procedures in your spare time. I already know to practice the subcutlicular suture on pigs feet and banana peels. I'm doing EM right now and feel pretty comfortable with lac repairs. But I want more practice placing IVs, I&D, airways, ect. I've heard that doing an anesthesia rotation will help a lot with procedures (airways and IVs). My school has a sim center for practicing procedures but I'm not sure if we have "open" days when students can just show up and practice. Any of you ever just show up to your sim center and ask if you can practice? Are there are kits or things at home I could use to practice procedure skills? Anyone ever find a surgeon that let you scrub in whenever you had free time during other rotations? Any advice would be appreciated. I basically am worried that when it comes time to do my surgery sub-i I won't have a lot of these skills down yet. But I've also heard that having a basic understanding of procedures is good and you really get better at them during intern year.

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[Donald Juan]

I don't know how the culture at your place is, but at my program we would highly encourage a student interested in surgery to go to the skills lab and practice in their off time. I also don't know many attendings who wouldn't be happy to have an interested student scrub into a case with them (if there are other students already there and on that rotation, it might be a kind of dick move).

You aren't expected to be very good at procedures as a sub-I. Honestly, I'm very happy when I have a student who can confidently and appropriately instrument tie and also confidently 2-hand tie. If you think that is a laughably easy thing, you probably aren't as good as you think. Laying flat square knots, not leaving air knots, instrument tying in a way to leave short ends so that you conserve suture and don't get your ends all bundled up, are things I see almost all students (and interns) struggle with. Also, make sure you know some basic terminology for different suture techniques. It's a long journey, just keep trying to get practice and you're on the right path.

 

[Osteoth]

I don't know how the culture at your place is, but at my program we would highly encourage a student interested in surgery to go to the skills lab and practice in their off time. I also don't know many attendings who wouldn't be happy to have an interested student scrub into a case with them (if there are other students already there and on that rotation, it might be a kind of dick move).

You aren't expected to be very good at procedures as a sub-I. Honestly, I'm very happy when I have a student who can confidently and appropriately instrument tie and also confidently 2-hand tie. If you think that is a laughably easy thing, you probably aren't as good as you think. Laying flat square knots, not leaving air knots, instrument tying in a way to leave short ends so that you conserve suture and don't get your ends all bundled up, are things I see almost all students (and interns) struggle with. Also, make sure you know some basic terminology for different suture techniques. It's a long journey, just keep trying to get practice and you're on the right path.

What basic terminology?

Also, something I've been wondering about, how much should I be studying on my elective rotation/Sub-I? I was planning to use elective as an M3 to get a first pass of medicine UW since it's 1600 questions, but I can't tell if I would be better spent putting in the hours to get through an Anki deck on my specialty.

 

[Donald Juan]

I just meant knowing what different suture techniques are. If someone says to put a couple vertical mattresses in, or a figure of 8, or a running horizontal mattress don't give them a blank stare. When you are on your sub-I you should be reading up on your patients particular conditions, surgeries, or if there is something in particular you have noticed you have a deficiency in. Your interests and questions during a sub-I should likely be progressing past Pestana's and UW by that time. You shouldn't have a shelf after a Sub-I so no point in studying like you have one.