Stupid question from an MS3

[Jonathan13180]

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Im an MS3 who starts surgery as my first "real" rotation and i was wondering from others who have gone through it, what should i carry in my whitecoat?

Thanks,

 

[smq123]

Im an MS3 who starts surgery as my first "real" rotation and i was wondering from others who have gone through it, what should i carry in my whitecoat?

- stethoscope (Yes, you will probably actually use it on your surgery rotation. Don't listen to the people who claim that you won't. You're not a chief resident yet, so carry one.)

- packets of surgilube (They look like blue ketchup packets)

- trauma shears (Surprisingly come in handy pretty frequently)

- tape (I personally like transpore. It's up to you, though)

- Maxwell's

- couple of pens

- Xeroxed sheets of things from Case files or Pre-test...because you'll probably have SOME down time while you're doing nothing but standing in a random hallway waiting for your intern to call you back.

Some people carry packets of 4x4s in their pockets too. That's up to you.

Add stuff later as it seems appropriate. Good luck! 🙂

(By the way, this might also be appropriate to ask in the Clinical Rotations forum.)

 

[rmm262002]

Definite yes on the 4X4s

 

[Winged Scapula]

As usual, smq has an excellent answer (still not sure why she pretends to be interested in Ob-Gyn 😉 ).

I would add alcohol swabs - useful to wipe down your 'scope and trauma shears after touching patients.

Some students carry around a book - Surgical Recall is popular, although its big, so some coats will not tolerate it without ripping, so photocopied chapters is a good idea. Which brings to mind...

get some suture material and carry that around (your residents should be able to swipe some for you, or a nice OR nurse [heh...hard to find] might give you some expired suture) so you can practice your ties during downtime.

Granola bars or the like...you never know if you'll get to eat and having something you can eat quickly while running down the stairs to the OR or Trauma Bay is useful (just don't eat in front of other hungry students or residents, unless you have enough to share).

Since this is your first rotation, see if there are cards printed which have commonly called numbers. If not make one for yourself (laminate it if you are really keen) with:

Rads Reading Room (ie, not scheduling number)
Pathology (not department, but where the path people actually are)
Surgery Floors/Nursing Station/SICU
Resident Pager #s
CT Scanner/US/Fluoro (tech area - they will generally be able to tell you when a test is scheduled, where the patient is on the list to be done)
Clinic Nursing Station

 

[smq123]

As usual, smq has an excellent answer

Aww, thanks. 😳

(still not sure why she pretends to be interested in Ob-Gyn 😉 ).

Hey! 😡

It's just as my surgery attending said to me. "OB/gyn is a good mix of medicine and...<gagging slightly>...uh...surgery. *Cough*" 😀

 

[SocialistMD]

It's just as my surgery attending said to me. "OB/gyn is a good mix of medicine and...<gagging slightly>...uh...surgery. *Cough*" 😀

It's a mix of medicine and "surgery," alright; I'm just not sure the word "good" should be in there.😉

 

[Winged Scapula]

Hey! 😡

It's just as my surgery attending said to me. "OB/gyn is a good mix of medicine and...<gagging slightly>...uh...surgery. *Cough*" 😀

I'm not sure I'd call it "surgery", good or otherwise! 😉

(hey, Ob-Gyn was my first interest during 3rd year as well; then I saw the light - literally, those vag procedures don't allow for a lot of "seeing stuff" as a MS. I remember when doing some retracting and the attending was pointing something out. I responded, "uh huh, yeah I see." To which she asked, "Are you lying?". I responded, "Yes Ma'am I am." Fortunately, we both laughed.)

 

[njbmd]

I'm not sure I'd call it "surgery", good or otherwise! 😉

(hey, Ob-Gyn was my first interest during 3rd year as well; then I saw the light - literally, those vag procedures don't allow for a lot of "seeing stuff" as a MS. I remember when doing some retracting and the attending was pointing something out. I responded, "uh huh, yeah I see." To which she asked, "Are you lying?". I responded, "Yes Ma'am I am." Fortunately, we both laughed.)

I could never call it "surgery" much either. I just can't stand that much estrogen. I traded cases with my mates who were wanted to do Gyn when I was a third year. I would drive camera any day on a lap procedure not to have to do va-j-j stuff. 😱

 

[Winged Scapula]

I liked my Ob-Gyn rotation but then again, it was my first rotation of 3rd year, so I was probably bound to like it.

I hated a very lesbian (seriously, not assuming anything), man-hating atmosphere we had. Plus I am not very baby oriented, so while I enjoyed the rotation I could never get all goo-goo ga-ga about the babies like some of my classmates did. Gyn Onc stuff was what kept me going; that and the fact that as the only female student on service at the time, I got to do a lot more because the patients weren't very interested in having a male medical student prodding them.

 

[elr1983]

I would actually add either a pharmacopia or epocrates on a palm/treo. I used my drug reference on every rotation, although moreso on medicine/peds than surgery. I'd especially recommend this b/c since it's your first rotation, you likely won't know what a lot of the drugs are, so it'll be good to be able to look them up on the fly. Also, people in the hospital sometimes use brand names, sometimes generics, and it can be a little hard at first to know what they're talking about if you're used to generics only from second year/step1.

And I hated 99.9% of my ob rotation, but I loved when the babies were born and the fathers got all choked up. 🙂

 

[smq123]

I just can't stand that much estrogen.

Normally, I can't either - but, to be honest, I encountered a lot more "estrogen" on my peds rotation. I used to come home from inpatient peds and gripe to my friends, "Jeebus, someone gets engaged, and half the room turns into dolphins!"

To bring the thread back to the original question - I like to have a good penlight in my white coat. When you're checking elderly Mrs. Smith's dressing at 5 AM, it's sometimes easier (and more considerate to the patient) to whip out your penlight, instead of turning on the light in the room. The penlight came in handy during ENT, too.

 

[Celiac Plexus]

What you need on you at any given time is somewhat service dependent. The above suggestions are good for the basics. Here are some other things that will come in handy depending on what service you are on and how busy it is. (When I was a student on the trauma service I had so much crap on me I was a walking supply closet.)

-suture removal kit
-staple removal kit
-packet of burn gauze
-a few adaptec dressings
-xeroform (vaseline gauze)
-1/2" nugauze
-a pack of 4-0 nylon
-needle drivers
-an 11 blade
-a few packets of antibiotic ointment
-a bottle of local anesthetic
-a 10cc syringe and needles
-montgomery dressing
-ace bandages
-prescription pad
-several one dollar bills (for your vending machine nutrition)
-The combinations to all of the supply rooms on the floor and the units so you can "acquire" all of this stuff.

 

[Winged Scapula]

Good Lord Celiac...Surely you had a cart to carry around all that stuff.

All of this stuff may come in handy at some point in time on many rotations, but it would be ridiculous to carry it all around at all times (which I think is the point of the rotation). We had a dressing cart for Vascular and Plastics which we rolled around on rounds rather than getting everything from the Pyxis.

 

[SoCuteMD]

Most of the day on surgery I carried: surgilube (for traumas), shears (multi-use), stethoscope, and Surgical Recall.

However, in the morning before rounds I'd stick a bunch of pairs of gloves in my chief's size in my pocket as well as some 4x4s, tape, a couple suture removal sets and a staple removal set. That way the room didn't get held up when we needed to pop a couple staples to check for infection. If my chief took down a bandage and wanted me to redress the wound I could do it on my way out of the room rather than having to run back later (and be late for the OR).

 

[Law2Doc]

Most of the day on surgery I carried: surgilube (for traumas), shears (multi-use), stethoscope, and Surgical Recall.

However, in the morning before rounds I'd stick a bunch of pairs of gloves in my chief's size in my pocket as well as some 4x4s, tape, a couple suture removal sets and a staple removal set. That way the room didn't get held up when we needed to pop a couple staples to check for infection. If my chief took down a bandage and wanted me to redress the wound I could do it on my way out of the room rather than having to run back later (and be late for the OR).

I'm not sure how much use you get with the stethoscope on most surgical rotations. I would probably replace it with a couple of power bars. You will miss meals now and then on this rotation.

 

[smq123]

I'm not sure how much use you get with the stethoscope on most surgical rotations. I would probably replace it with a couple of power bars. You will miss meals now and then on this rotation.

I used a stethoscope daily, several times a day. Both as an MS3 AND as a sub-I.

I used it to check for atelectasis, bowel sounds (REALLY important on a gen surg service!), and I did listen to heart sounds on any patient not on a monitored bed.

 

[Law2Doc]

I used a stethoscope daily, several times a day. Both as an MS3 AND as a sub-I.

I used it to check for atelectasis, bowel sounds (REALLY important on a gen surg service!), and I did listen to heart sounds on any patient not on a monitored bed.

The specialty surgeons I worked with told me to lose the "flea collar" on the first day.

 

[SoCuteMD]

I'm not sure how much use you get with the stethoscope on most surgical rotations. I would probably replace it with a couple of power bars. You will miss meals now and then on this rotation.

The rule on our floor was (and yes, this was stated as a rule) that EVERY patient should have their heart and lungs auscultated thoroughly every single day. This was a med student job.

At the very least you'll need it to listen for bowel sounds on general surgery. You will definitely need it on CT surg and most vascular surgery patients have so many comorbidities that someone SHOULD be listening.

 

[lord_jeebus]

I got a used copy of Lawrence, had Kinko's chop off the spine, and stapled the chapters together. I would fold one or two in half to have with me for down time, and by the end of the rotation I had read the whole thing cover-to-cover without doing any reading at home.

 

[smq123]

The specialty surgeons I worked with told me to lose the "flea collar" on the first day.

Which specialty?

If you do ENT or ortho, then yes - a stethoscope is probably not that useful.

But on a gen surg rotation (or even its subspecialties, like trauma, surg onc, vascular - listen for carotid bruits! - or, ESPECIALLY CT), a stethoscope can be really, really valuable.

And never wear a stethoscope around your neck. That's just...gross. All that MRSA right next to your head...blech.

 

[Winged Scapula]

The specialty surgeons I worked with told me to lose the "flea collar" on the first day.

Were you wearing it around your neck? Were these Ortho guys? I STILL carry a stethoscope around (well, its in my office) but don't wear it around the neck. Its valuable for all the reasons given above.

MAJOR faux pas on surgery.😀

 

[Acherona]

you guys are funny. We all wear our stethoscopes around our necks in every rotation. Where else are you gonna put it? It doesn't fit in the coat pocket and anyway I need that for my notes and tools. I'm glad my school isn't so fashion conscious.

 

[Winged Scapula]

you guys are funny. We all wear our stethoscopes around our necks in every rotation.

Sorry, doesn't fly on surgery. Clearly marks you as a flea. Or a Canadian. 😉 (see:http://www.cmaj.ca/cgi/reprint/163/12/1562.pdf).

Where else are you gonna put it?

Don't tempt me!

It doesn't fit in the coat pocket and anyway I need that for my notes and tools. I'm glad my school isn't so fashion conscious.

Are your pockets really that stuffed full? Or are you rocking one of those double barreled HP scopes? If you fold it just right, it should fit into your pocket. Or you could get one of those belt holders, but that's just a totally different type of dorky.

 

[QofQuimica]

you guys are funny. We all wear our stethoscopes around our necks in every rotation. Where else are you gonna put it? It doesn't fit in the coat pocket and anyway I need that for my notes and tools. I'm glad my school isn't so fashion conscious.

I always keep mine in my left bottom pocket. Surgeons have it right on this. It's not even comfortable to wear a stethoscope around your neck!

 

[bjackrian]

Or you could get one of those belt holders, but that's just a totally different type of dorky.

Only if you're an anesthesiologist--at least that's what seems to happen around here. 😉

 

[Winged Scapula]

Only if you're an anesthesiologist--at least that's what seems to happen around here. 😉

I see our EM guys wear them too, but then again, I've seen them use fanny packs!😱

 

[elr1983]

Why is it so bad to wear your stethescope around your neck? Surgeons really seem to get upset about it.....is there a reason? (Other than their deep hatred of other specialists?) And how did it happen that IM/peds wear it around the neck and surgeons in the pocket? If anything, I would think surgeons would have more occasion to wear it around their necks, since they're always taking their white coats off before traumas, etc, although I suppose pediatricians are most famous for losing the white coat any chance they get...

 

[Tired]

Why is it so bad to wear your stethescope around your neck? Surgeons really seem to get upset about it.....is there a reason? (Other than their deep hatred of other specialists?)

This was one of my pet-peeves during internship.

"Get that thing off your neck! We heal with steel!" (direct quote from Neurosurg Chief Resident)

******s.

By the end of internship (once my testicles had fully developed), any time the residents tried to pull that crap on me, I'd come in the next day with my scrubs untucked, stethoscope around my neck, and the mini-Harrisons in my white coat pocket. Man that annoyed them. If they still gave me grief, I'd wear professional clothing to rounds instead of scrubs.

I am (was) an Ortho guy, mutha*****. I do what I want.

 

[Law2Doc]

This was one of my pet-peeves during internship.

"Get that thing off your neck! We heal with steel!" (direct quote from Neurosurg Chief Resident)

******s.

It goes both ways. IM residents sometimes have been known to joke "How do you hide something from a surgeon?







Put it in a book."

 

[Tired]

It goes both ways. IM residents sometimes have been known to joke "How do you hide something from a surgeon?

Put it in a book."

When you stand around in the halls all day, you have time to come up with mediocre jokes.

 

[elr1983]

This was one of my pet-peeves during internship.

"Get that thing off your neck! We heal with steel!" (direct quote from Neurosurg Chief Resident)

******s.

By the end of internship (once my testicles had fully developed), any time the residents tried to pull that crap on me, I'd come in the next day with my scrubs untucked, stethoscope around my neck, and the mini-Harrisons in my white coat pocket. Man that annoyed them. If they still gave me grief, I'd wear professional clothing to rounds instead of scrubs.

I am (was) an Ortho guy, mutha*****. I do what I want.

Haha, would have loved to see that!

 

[Tired]

Haha, would have loved to see that!

Never be afraid of the tools. They can only hurt you if you let them.

 

[Winged Scapula]

It goes both ways. IM residents sometimes have been known to joke "How do you hide something from an Orthopedic surgeon?


Put it between pages 1 and 2 of Harrison's Internal Medicine."

Fixed it for ya (which, despite appearing to be a dig at Tired, is actually the way the joke is supposed to go.)

How do you hide something from a Neurosurgeon?

Tape it to his kid's forehead.

 

[Winged Scapula]

I'm not sure of how the tradition started but its not anymore ridiculous than other rules that go on in other areas of the hospital. Like its ok to wear a scrub shirt with khakis or to have fuzzy animals clipped to your stethoscope.

I frankly find hanging it around my neck troubling - when you bend over to examine a patient (but aren't using it), it dangles and hits into things. Dirty things like wounds and icky body parts. Same goes for nametags on lanyards; the hospital kept trying to make us wear them that way until we showed them how impractical it was when leaning over a patient and having it hit them in the face (or lower).

It gets sweaty around my neck and my hair gets tangled in it.

Putting it around your neck in the trauma bay is pretty practical and most of us would not object to doing it then. But to wear it, like a fancy collar, all day is what we object to.

Surgery just has a lot of rules (can we talk about the "no clipboard" one now? 😀 ); I'm not sure why.

 

[Top Gun]

The specialty surgeons I worked with told me to lose the "flea collar" on the first day.

Maybe they really meant for you to carry the stethoscope in your pocket. I read somewhere in First Aid for the Wards that surgeons prefer that stethoscopes be carried in the white coat pocket, not worn around the neck like a "flea" collar the way internal medicine residents do. You do need your stethoscope on surgical rotations. How else will you detect bowel sounds or look for signs of postop pneumonia?

 

[Winged Scapula]

Maybe they really meant for you to carry the stethoscope in your pocket. I read somewhere in First Aid for the Wards that surgeons prefer that stethoscopes be carried in the white coat pocket, not worn around the neck like a "flea" collar the way internal medicine residents do. You do need your stethoscope on surgical rotations. How else will you detect bowel sounds or look for signs of postop pneumonia?

Tis true.

You definitely need your stethoscope on surgery at least until you are Chief resident. Then you expect to borrow one from the intern on rounds as he/she will have one in their pocket.

 

[elr1983]

I'm not sure of how the tradition started but its not anymore ridiculous than other rules that go on in other areas of the hospital. Like its ok to wear a scrub shirt with khakis or to have fuzzy animals clipped to your stethoscope.

Both things that I think look pretty stupid, but wouldn't really care if other people did. It's the way surgeons seem to get so irate over what seems to be an individual decision that confuses me.

I frankly find hanging it around my neck troubling - when you bend over to examine a patient (but aren't using it), it dangles and hits into things. Dirty things like wounds and icky body parts. Same goes for nametags on lanyards; the hospital kept trying to make us wear them that way until we showed them how impractical it was when leaning over a patient and having it hit them in the face (or lower).

Yea, I'm always scared I'm going to bend over a baby and smack one of them in the face with it. That's why I carry mine in my pocket. No one's ever said a word about it.

Putting it around your neck in the trauma bay is pretty practical and most of us would not object to doing it then. But to wear it, like a fancy collar, all day is what we object to.

Surgery just has a lot of rules (can we talk about the "no clipboard" one now? 😀 ); I'm not sure why.

Me either.

 

[Winged Scapula]

Both things that I think look pretty stupid, but wouldn't really care if other people did. It's the way surgeons seem to get so irate over what seems to be an individual decision that confuses me.

Most of us tend to be micromanagers and control freaks. We like to follow rules, when they are our rules and we don't like it when others don't. That said, I can't imagine getting irate if a student didn't follow this rule or some stupid fashion rule. I'd give them a hard time about it, but as a joke...getting upset is stupid. Who cares?

Some of the rules are tradition which in surgery, like the military, is respected.

Some of them are practical (ie, tucking your scrub shirt in to avoid dragging it in things or contaminating the field).

Some of them are meant to promote camaraderie; members of groups usually do look, dress, talk, and act alike. It promotes bonding.

Yea, I'm always scared I'm going to bend over a baby and smack one of them in the face with it. That's why I carry mine in my pocket. No one's ever said a word about it.

Yeah, the babies are also a problem. Even with the tiny neonate bell, it could still do some damage in the NICU.

 

[Law2Doc]

Maybe they really meant for you to carry the stethoscope in your pocket.

No, they meant not to have it on you at all, and borrow one when you needed it. I didn't make the rules, I just got berated for not knowing them.

 

[Law2Doc]

Some of the rules are tradition which in surgery, like the military, is respected.

Some of them are practical (ie, tucking your scrub shirt in to avoid dragging it in things or contaminating the field).

Some of them are meant to promote camaraderie; members of groups usually do look, dress, talk, and act alike. It promotes bonding.

It's a peer pressure thing. If you want to hang out with the "cool kids" you need to put up with their crap. Lots of fields are like this. In law we gave folks a hard time for lots of stupid stuff.

 

[PeepshowJohnny]

Back on topic:

I'm apparently the only med student who honored surgery without being 1/8 pack camel. I carried 1) Stethoscope 2) Scissors 3) Surgical Recall 4) My PDA.

That's it, the only thing additional over other rotations was the scissors and Recall (but I usually do carry a review book on different rotations).

Now granted, my hospital did tend to keep most rooms well stocked, so needing 4x4's and tape means just a quick few steps to the closet to grab one. And residents never asked me to carry stuff or berated me for not (just borrowed my stethoscope all the time).

That said, if you're on a service where you ARE expected to be the beast of burden, I guess you should do it. But don't load yourself up with all this stuff if you find it's not really necessary.