MD & DO Stupid question, how do surgeons actually learn surgery?

[ohmanwaddup]

So I'm watching medical drama as one does and these interns seems to know how to do surgeries from day one, which I do not believe is how the real world works.

It got me thinking though, when/how do surgical residents actually get the time to learn various surgeries and what not? is it piecemeal? you learn how to open a gallbladder case, after a few of those they let you isolate the vessels, a few of those and you are allowed to make the cut, etc.

Do they practice on cadavers? Just seems brutal to try and deal with the time commitment of residency and learn a intense entirely new skill

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[OrthoTraumaMD]

So I'm watching medical drama as one does and these interns seems to know how to do surgeries from day one, which I do not believe is how the real world works.

It got me thinking though, when/how do surgical bunnies actually get the time to learn various surgeries and what not? is it piecemeal? you learn how to open a gallbladder case, after a few of those they let you isolate the vessels, a few of those and you are allowed to make the cut, etc.

Do they practice on cadavers? Just seems brutal to try and deal with the time commitment of residency and learn a intense entirely new skill

Textbooks, practice in OR, cadaver labs. As you rise in residency you are allowed to do more.

 

[M&L]

Textbooks, practice in OR, cadaver labs. As you rise in residency you are allowed to do more.

When we were doing a tour in one of the medical schools in the cadaver lab, there were three ppl standing around a donor body, and we were told one of them was a resident practicing hysterectomy I think .

 

[ohmanwaddup]

Textbooks, practice in OR, cadaver labs. As you rise in residency you are allowed to do more.

Sounds like it would be easy to become deficient in your skills if you are not diligent, given all their other responsibilities.

 

[Doctor-S]

Textbooks, practice in OR, cadaver labs. As you rise in residency you are allowed to do more.

This.

Another good reason to pay attention to anatomy and physiology, and understand the steps of surgeries, and know what to do. Over time, and with one-on-one mentoring in the OR, you should learn good technical skills. Practice for sure!

 

[OrthoTraumaMD]

Sounds like it would be easy to become deficient in your skills if you are not diligent, given all their other responsibilities.

Yes. Thats why it’s a 5 plus year residency. And when i havent done a specific surgery in a while, i can always open a book. It is like any other complex skill.

 

[Lem0nz]

We punch holes in humans for funsies then realize that if we don’t fix those holes in a way that is moderately compatible with normal life someone is going to be *incredibly* pissed at us, and we really can’t tolerate any more whining, so we teach each other how to fix those holes on the fly as the path of least resistance and maximal happiness for all.

 

[deleted1097413]

Follow step by step videos on YouTube in the OR

 

[stickgirl390]

I know the interns at my institution get to learn bowel anastomoses on pigs.

 

[Cauchy]

See one, do one, teach one.

 

[ACSurgeon]

You see a bunch and assist a bunch and ultimately get gradual autonomy doing cases. The anatomy you learn outside the OR and by seeing the cases done. The skills and principles used are similar for a lot of cases e.g suturing, delicate handling of tissue, hemostasis, tension and counter tension, dissecting along a plane, NOT inventing operations, and knowing your bail out options to name a few.

 

[ACSurgeon]

I know the interns at my institution get to learn bowel anastomoses on pigs.

Skill sessions are fine. However, sometimes you get a random opportunity and the next time you’re in a similar case you try to replicate that experience and it works sometimes and leads to more experience. I vividly recall the first attending who let me suture on bowel, do a lysis of adhesions, do the actual dissection of the cystic plate etc.

 

[Dr. Death]

At least in my residency they just hand you the knife and walk you through it. If you're uncomfortable you can ask to watch the senior or attending to do it once before you do it yourself.

 

[sloop]

I always just figured that their surgery powers grow stronger every time they chew out a consultant, anesthetist or med student.

 

[SurfingDoctor]

Except they have an additional person hitting their hand with a retractor saying “Stay off the damn sides”


But since I know the OP was sincere, just like everything in medicine... it’s a matter of practice that breeds experience.

 

[Wrinklebottom]

See one, do one, teach one

 

[operaman]

For me it was gradual increase in the level of cases over the five years. This began with intern year doing mostly soft tissue/skin stuff and gradually adding more layers of difficulty and complexity. Early on my attendings would hold hook for me and talk me through level appropriate parts of a case and then demonstrate next level steps. This progressed to them holding hook for most of the cases. This was sort of a false sense of security that got ripped away when I started operating more totally alone in complex cases or taking juniors through them. Then I realized how much of the case my attending was still doing with the retractors and the marking pen! Then I started observing more with newly appreciative eyeballs started doing a lot more hook holding for juniors. Our chief year had a nice VA component where you got to basically fly solo. By the end of residency there really wasn’t anything I felt uncomfortable doing within the boundaries of my specialty. I was fortunate to go to a very strong program as well that gives a level of training in some areas that’s beyond the norm.