Current M2, planning rotations next year. I've definitely heard a lot about the Surgery rotation, long hours, etc. But just out of curiosity, for those of you who have gone through it-how bad was it actually? I get it was long hours, and a lot of studying-but did you ever get time to do other things here and there? Anything at all? At my school I know the hours are long, but the weekends are for the most part, off from clinical duties.
Surgery Rotation
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It really depends on your rotation site tbh. I had a site where I came at 6am and left at 12pm after a couple of cases. It was actually a really chill rotation for me. If I was interested in surgery I could have stayed for more cases.
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It was one of the most miserable experiences of my entire life.
And I've been homeless, slept under a bridge, slept in the rain when more violent types took our camping spot under the bridge, eaten food from a dumpster on the regular, that's just the short list for comparison for you.
I'm a masochist and somewhat of an extremist, I enjoy a bit of drama, so it was also one of the more interesting experiences I've ever had.
Most people will tell you it's one of the harder experiences they've had.
It depends on what your rotations are like.
For me, I woke up at 4 am and made it to the hospital around 4:30-5 am. (This gives you enough time to literally roll out of bed, wash face, brush teeth pat hair, make a cup of tea and instant oatmeal to eat on your commute. For me I walked to the hospital but I found I could easily eat oatmeal while walking. I think rounds started at 6 am, so this gave me the time to pre-round and update the list and do a few last minute didactic type stuff, or look up patients. We were usually done around 4-7 pm depending on how the surgeries went, but there was the after rounding to do. I don't really remember ever making it home before 6-8 pm. Because no matter how the surgical day went, with reading up on patients, getting ready to be pimped/the shelf, and required didactic activities like writing up H&Ps and other stuff, there was always enough to do until 8 pm.
I say this, because at that point, this meant in the evening, there was really only enough time for me to handwash and hang to dry my compression stockings, hop in the shower, have a simple dinner/wash the dishes, take care of my cats, perhaps have a short conversation with my partner, and go to sleep, and even then you're getting less than 8 hours a night.
Realistically, I was averaging between 4-6 hours a night. Doing that 6 days a week for a month was brutal. Plus I found surgery very physically taxing. I noted in the other thread there is an ENT resident transferring out just because their neck and back can't take it. Consider that. I talked to a lot of surgeons who had various complaints, some that really affected their career to a huge extent.
Laundry, taking out trash, grocery shopping, anything like that, had to wait for my one day off a week.
ETA: I did mine at the VA... which was known for being "chill" all things compared. Those at the main hospital had it worse, apparently. Those at a community hospital found themselves having the cush off at 12-3 pm schedule.
Main piece of advice for anyone worried about time and starting clinical years, from my mentor... "Buy enough socks and underwear that you don't have to do laundry for a month." Best bit of advice ever.
And I've been homeless, slept under a bridge, slept in the rain when more violent types took our camping spot under the bridge, eaten food from a dumpster on the regular, that's just the short list for comparison for you.
I'm a masochist and somewhat of an extremist, I enjoy a bit of drama, so it was also one of the more interesting experiences I've ever had.
Most people will tell you it's one of the harder experiences they've had.
It depends on what your rotations are like.
For me, I woke up at 4 am and made it to the hospital around 4:30-5 am. (This gives you enough time to literally roll out of bed, wash face, brush teeth pat hair, make a cup of tea and instant oatmeal to eat on your commute. For me I walked to the hospital but I found I could easily eat oatmeal while walking. I think rounds started at 6 am, so this gave me the time to pre-round and update the list and do a few last minute didactic type stuff, or look up patients. We were usually done around 4-7 pm depending on how the surgeries went, but there was the after rounding to do. I don't really remember ever making it home before 6-8 pm. Because no matter how the surgical day went, with reading up on patients, getting ready to be pimped/the shelf, and required didactic activities like writing up H&Ps and other stuff, there was always enough to do until 8 pm.
I say this, because at that point, this meant in the evening, there was really only enough time for me to handwash and hang to dry my compression stockings, hop in the shower, have a simple dinner/wash the dishes, take care of my cats, perhaps have a short conversation with my partner, and go to sleep, and even then you're getting less than 8 hours a night.
Realistically, I was averaging between 4-6 hours a night. Doing that 6 days a week for a month was brutal. Plus I found surgery very physically taxing. I noted in the other thread there is an ENT resident transferring out just because their neck and back can't take it. Consider that. I talked to a lot of surgeons who had various complaints, some that really affected their career to a huge extent.
Laundry, taking out trash, grocery shopping, anything like that, had to wait for my one day off a week.
ETA: I did mine at the VA... which was known for being "chill" all things compared. Those at the main hospital had it worse, apparently. Those at a community hospital found themselves having the cush off at 12-3 pm schedule.
Main piece of advice for anyone worried about time and starting clinical years, from my mentor... "Buy enough socks and underwear that you don't have to do laundry for a month." Best bit of advice ever.
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Wow...thanks for letting me know...thankfully at my school, they give us 7 of the 8 weekends on surgery off
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At my site, it was 6 AM to 6 PM from Mon to Sat on average. Crayola227 site sounds miserable.
I just came off Step 1 then, and all the surgeons that I was with including the GS PD were super nice.
I always got my Sunday off. Honestly, I'm about 3 months away from finishing up third yr. Looking back, the people there including residents from GS, Ortho, and ENT were the best group of people that I have worked with.
Your experience will vary depending on your site.
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Overnight call on surgery isn't always bad.
I did EGS/Trauma q3 call and most call nights were fairly slow (thankfully). This gave us a lot of time to study for our surgery shelf and the attendings/residents/fellows would take more time to teach us as well.
Ask other students at your school how the surgery rotation went and don't be afraid of call.
I did EGS/Trauma q3 call and most call nights were fairly slow (thankfully). This gave us a lot of time to study for our surgery shelf and the attendings/residents/fellows would take more time to teach us as well.
Ask other students at your school how the surgery rotation went and don't be afraid of call.
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Depends on the specific subspecialty, how many attending/cases there are, rotation sites, etc. I would just go in expecting it to be pretty brutal with long hours, and then anything lighter than that is a bonus.
I had one month at the VA and one month at my school's main hospital. The month at the VA was relatively chill from a case standpoint (scrubbed into 6 cases total during the entire 4 weeks) but the cases were also quite long. Otherwise, a decent amount of downtime to study and chill. I got in at around 5:30-5:45 each day depending on when we had rounds and then usually left around 4-5 PM. My intern was nice and let us out early on days when nothing was going on. Weekends were chill because there weren't cases, so I got off one day and the other day I just came in to round, write notes and leave (usually noon).
The month at the main teaching hospital was similar hours but more intense. Went into cases usually 2-3 times a week, sometimes for just a morning or afternoon but other times for the whole day. Got in around 5:30-5:45 to pre-round, and then after rounds rest of day was either OR, clinic, or (rarely) chilling in the workroom helping with updating the list or studying or writing notes if there wasn't clinic and the other student went into cases. Usually got done at 5-6. We also had two overnight calls during our rotation which involved being at our normal rotation during the day and then joining the on-call team overnight and staying until rounds the next day (usually amounted to a 26-28 hour day), with that day being a post-call day where we leave after rounds. Weekends were again chill thanks to no cases, so usually came in to round, write notes and leave by noon or so (this kept me going throughout the rotation).
So overall, I worked about 65-70 hours a week, which was definitely intense. I didn't really even mind the hours at the hospital, it was the constant waking up at 4:15 AM every morning that sucked and I almost overslept the last week. Some people in my class who were on trauma or acute care surgery had very long hours, while others who had rotations at community hospitals or on rotations where attendings happened to be on vacation had it easier. It all depends
I had one month at the VA and one month at my school's main hospital. The month at the VA was relatively chill from a case standpoint (scrubbed into 6 cases total during the entire 4 weeks) but the cases were also quite long. Otherwise, a decent amount of downtime to study and chill. I got in at around 5:30-5:45 each day depending on when we had rounds and then usually left around 4-5 PM. My intern was nice and let us out early on days when nothing was going on. Weekends were chill because there weren't cases, so I got off one day and the other day I just came in to round, write notes and leave (usually noon).
The month at the main teaching hospital was similar hours but more intense. Went into cases usually 2-3 times a week, sometimes for just a morning or afternoon but other times for the whole day. Got in around 5:30-5:45 to pre-round, and then after rounds rest of day was either OR, clinic, or (rarely) chilling in the workroom helping with updating the list or studying or writing notes if there wasn't clinic and the other student went into cases. Usually got done at 5-6. We also had two overnight calls during our rotation which involved being at our normal rotation during the day and then joining the on-call team overnight and staying until rounds the next day (usually amounted to a 26-28 hour day), with that day being a post-call day where we leave after rounds. Weekends were again chill thanks to no cases, so usually came in to round, write notes and leave by noon or so (this kept me going throughout the rotation).
So overall, I worked about 65-70 hours a week, which was definitely intense. I didn't really even mind the hours at the hospital, it was the constant waking up at 4:15 AM every morning that sucked and I almost overslept the last week. Some people in my class who were on trauma or acute care surgery had very long hours, while others who had rotations at community hospitals or on rotations where attendings happened to be on vacation had it easier. It all depends
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PReceptor and subspecialty dependent in my case:
General Surgery: Prerounded in the mornings and had notes written before preceptor got there every day. I was allowed to do it as early as I wanted but had to have it all done before the preceptor arrived for the day, which was anytime between 8am and 9am. Clinic til noon then either clinic or cases in the afternoon depending on what day it was. Got out of clinic by 4pm, longest surgery day was til 10am. Preceptor was out of town on their call weekend so I didn’t have to take call, but I did all consults. I got to close every case but if I had to backtrack my running suture or went through the skin even once I didn’t get a second chance on that case. Also if I got a pimp question wrong for a new surgery I didn’t get to even retract on that case because the preceptor assumed I hadn’t read up on it.
Orthopedic Surgery: Get in at 9am, didn’t even have to worry about rounding. Clinic days we got out at 4pm, surgery days were 7am to noon. Never took call. No pimping.
Vascular Surgery: Have to be in at 5am to preround, change everyone’s dressings, and write notes, then round with the preceptor at 7am. From there to clinic or surgery. I leave clinic to take all consults we get throughout the day, the latest I’ve had to stay doing multiple after-hours consults was 8pm, when I had to do 4 while the preceptor went home, and make the decision to either do the surgeries the same day vs. wait. This preceptor also really encourages skills training so they want their students to put in either the Foley or intubate on every case and make you practice knot tying on downtime. Don’t know the exact weekly call schedule but I think it’s every 7 days plus one weekend per month. Lots of independence on this rotation and you get treated like an intern.
General Surgery: Prerounded in the mornings and had notes written before preceptor got there every day. I was allowed to do it as early as I wanted but had to have it all done before the preceptor arrived for the day, which was anytime between 8am and 9am. Clinic til noon then either clinic or cases in the afternoon depending on what day it was. Got out of clinic by 4pm, longest surgery day was til 10am. Preceptor was out of town on their call weekend so I didn’t have to take call, but I did all consults. I got to close every case but if I had to backtrack my running suture or went through the skin even once I didn’t get a second chance on that case. Also if I got a pimp question wrong for a new surgery I didn’t get to even retract on that case because the preceptor assumed I hadn’t read up on it.
Orthopedic Surgery: Get in at 9am, didn’t even have to worry about rounding. Clinic days we got out at 4pm, surgery days were 7am to noon. Never took call. No pimping.
Vascular Surgery: Have to be in at 5am to preround, change everyone’s dressings, and write notes, then round with the preceptor at 7am. From there to clinic or surgery. I leave clinic to take all consults we get throughout the day, the latest I’ve had to stay doing multiple after-hours consults was 8pm, when I had to do 4 while the preceptor went home, and make the decision to either do the surgeries the same day vs. wait. This preceptor also really encourages skills training so they want their students to put in either the Foley or intubate on every case and make you practice knot tying on downtime. Don’t know the exact weekly call schedule but I think it’s every 7 days plus one weekend per month. Lots of independence on this rotation and you get treated like an intern.
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3rd Year Gen Surg Clerkship: Woke up at 4:15 to chart round on my patients from home, got in around 5:30 am to preround etc, conference + rounds around 6:30 or so, ORs started at 7:30, would be in the OR until cases were done (usually 6-7pm), afterwords, would help the PAs and interns out with scut on the floors, usually left the hospital before 7:30. We had late call until midnight once a week and I think 2 weekend days over the course of the rotation. Call was basically following the junior holding the pager around and helping out where you could. I was on a middle of the road hours-wise service. The toughest service had 3rd years get in around 4 am and generally wouldn't leave until 9 or 10 pm most days (with the same night/weekend call requirements). Probably was getting 6 hours of sleep per night (go to sleep around 10-10:30, wake up around 4:15).
4th year surgical subspecialty sub-I: Got in around 5 am to help out with prerounding, numbers, look at scans, do floor work, whatever (5:45-6 am if on an a lighter service like peds), ORs start at 7:30 am, cases would go until whenever, q4 overnight call (including weekends), stayed for a first-start case on post-call day, got home usually early afternoon, rinse repeat. Call was mostly seeing consults, mostly from the ED, a few surgeries, helping the overnight resident with floor scut, and helping with emergent procedures as needed. Would probably get an average of 5.5 hours of sleep if not on call, and then 3 hours/night on call on my easiest sub-I, and 0-30 mins/night on my toughest.
Definitely had time to do social things once or twice a week, go to the gym, and have at least a little bit of down time to myself on all of these.
4th year surgical subspecialty sub-I: Got in around 5 am to help out with prerounding, numbers, look at scans, do floor work, whatever (5:45-6 am if on an a lighter service like peds), ORs start at 7:30 am, cases would go until whenever, q4 overnight call (including weekends), stayed for a first-start case on post-call day, got home usually early afternoon, rinse repeat. Call was mostly seeing consults, mostly from the ED, a few surgeries, helping the overnight resident with floor scut, and helping with emergent procedures as needed. Would probably get an average of 5.5 hours of sleep if not on call, and then 3 hours/night on call on my easiest sub-I, and 0-30 mins/night on my toughest.
Definitely had time to do social things once or twice a week, go to the gym, and have at least a little bit of down time to myself on all of these.
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DO student experience: Am on my first month of gen surg right now. Normally get in around 630-645 to chart round (preceptor doesn’t expect us to pre round but I try to on pts I’ve been seeing since week 1). Cases start at 730. I am by myself with the attending so end up first assisting on all cases which is great but can get taxing. Get done by 1-2pm. Wound clinic/gen surg Clinic till 430-5. Then round with preceptor which can end between 7-8. I usually end up studying and eating dinner at hospital and getting home by 9-930.
My last week has been harder as preceptor has been covering two hospitals so sometimes will be scrubbed in on 4+ cases most I’ve done in a day has been 8.
My last week has been harder as preceptor has been covering two hospitals so sometimes will be scrubbed in on 4+ cases most I’ve done in a day has been 8.
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Okay, so now that I am on my 6th week... (for the love of God can it be over?)
We’re assigned different services that all have different attendings and the residents all rotate month to month. So hours greatly vary by who your residents are. Colorectal was usually a 6-3 thing (one day I was done at 11), general surgery 6-4ish, vascular 6-5 (and i did a lot lot of nothing most of the day), we also get trauma/STU which is largely 6-5, advance lap 6-5, surgical oncology varies based on case load, we get an outpatient surgical center week which is like..830-12 so sweet gig, and anesthesia and they make you only see one case a day if you want and you can then take off.
They obviously encourage everyone (re: urge) to go in on as many cases as you can. If your team has no cases, or you can’t go in on it, you’re SUPPOSED to go in on other stuff, but I don’t because i hate surgery.
So my experience.
We’re assigned different services that all have different attendings and the residents all rotate month to month. So hours greatly vary by who your residents are. Colorectal was usually a 6-3 thing (one day I was done at 11), general surgery 6-4ish, vascular 6-5 (and i did a lot lot of nothing most of the day), we also get trauma/STU which is largely 6-5, advance lap 6-5, surgical oncology varies based on case load, we get an outpatient surgical center week which is like..830-12 so sweet gig, and anesthesia and they make you only see one case a day if you want and you can then take off.
They obviously encourage everyone (re: urge) to go in on as many cases as you can. If your team has no cases, or you can’t go in on it, you’re SUPPOSED to go in on other stuff, but I don’t because i hate surgery.
So my experience.
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Wound care sounds interesting, but that sounds like long days man— props
P.S glad to see you back on SDN!
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yep this was basically my experience at the VA
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Wound clinic is one of those "I shouldn't look but I really want to" experiences, these ulcers go on for days. But thanks I'm glad to be back! 🙂
Glad to hear you survived it. For some reason he keeps thinking I'm pursuing surgery when I've literally whipped out pocket medicine 5-6 times in front of him to hint at the fact that I'm not.
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lol I would advise caution in trying too hard to crush his dreams
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I don’t know if it will be helpful or unhelpful to you but the truth is I don’t remember. Would have been in 2012-2013 period. It was 6 or 8 weeks. Whether it is horrible or not so (I remember it as not so horrible except on a couple occasions when I got stuck in misererable endless fiddle 8-10 hour surgeries) it will be over fast and you never have to go back to the OR or the surgery world again unless you want to.
