Preparing for surgery intern year

[Salamechton]

Hello everyone,

MS4 going into General Surgery this summer. Slowly starting to freak out about intern year, especially considering I have not seen a patient for months. I have 2 questions.

1) I do have a month "off" right before graduation to schedule a rotation. Currently thinking about taking Plastics. Would you recommend taking a more traditional General Surgery sub-i instead to best prepare for intern year? Or would Plastics be an okay rotation? My main goal is to be as functional as possible when intern year starts.

2) Furthermore, given the amount of time that I have, I would like to do some slight reading to prep for intern year (I have been having and will still have plenty of time to relax). Do you have any book recommendation? Start reading one of the 4 major textbooks (Sabiston, Cameron etc.)? Start reading the ABSITE review book by Fiser? Review MS3/MS4 surgery material (Pestana, Lawrence etc)? Prep for Step 3?

Thank you all so much

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[TraumaLlamaMD]

I'm of two minds on this...

One mind says that the ideal, fully functional surgical intern will be able to keep track of multiple patients and what happens to them over the day, efficiently get them out of the hospital by coordinating with social work and so on, respond pleasantly and with common sense to common nurse floor pages so I don't have to hear about how "the intern refused to assess the patient I'm worried about" or "the intern ordered 8000mg of Tylenol for Ms. B," communicate effectively with consultants and primary teams for patients on whom we are consulted, start a work-up for basic inpatient issues (chest pain, shortness of breath, low urine output, etc), and evaluate a new admit or consult and write an intelligible H&P or progress note. Honestly, none of that has to do with your surgical skills per se. We have time to teach you those. This mind would recommend something like an ICU rotation where you get experience following complex patients with multiple consultants and procedures so that basic surgical floor patients seem easy to keep straight when you start next year. Or, consider a general surgical sub-I where you take on some responsibility for floor patients (see if your residents will allow you to try answering pages, calling in consults, etc).

My other mind says that the ideal surgical intern comes into residency rested and ready to work from moment 1, and if this means you take a slower rotation or even a vacation prior to starting, go for it. I filled the final months of my M4 year with a few rotations like ID and toxicology with good hours, and subject matter that I was interested in but knew I'd only have time to peripherally study at best once residency began. If Plastics really floats your boat and you think this would be an interesting experience for you, go for it.

 

[mimelim]

You will quickly learn that being a good surgical intern has little to do with how much you have read or even how much medicine you actually know. Book knowledge is vital to what we do every day. You simply can not be a good surgeon without having spent the hours accruing the vast amount of knowledge behind what we do. However, it becomes an expectation that you will keep up with your book learning in the background of your every day job. You aren't a full time student any more, you are part employee, part student and full time 'trainee' however the **** you define that.

I think that MS4 should be busy, but certainly not overwhelming, but I wouldn't add something heavy in May/June just for the sake of it. If you are doing stuff up til then, definitely coast before residency starts. My recommendation is that you make a list of things to do during that month and go out to do them. The best thing that you can do before residency is being in a good place mentally, physically and emotionally. So, for starters, see a dentist, see a PCP, make sure your finances are in order and that you have a plan for loan repayment (if you have loans), if you are married or have a significant other, take the extra time with them. Surgical residency is hard, better than it used to be by a long shot, but it is one of the most demanding jobs out there. Borrow/look up all of the standard textbooks, try to figure out which one YOU will learn best from and either get/download a copy. I wouldn't necessarily read it, but figuring out which texts are not worth your time is as important as actually reading.

I second what @TraumaLlamaMD said about a GS sub-I, but ideally you would have already done those rotations prior to applying. At this point, I don't think that it is a good idea to overload.

 

[dpmd]

I felt my plastics rotation was pretty useful as I got to do a lot of sewing. That said, there is something to be said about having some relaxing time before you start. As for a sub I, I think it is mainly for folks to do before interview season for getting letters and impressing potential programs.