Surgical Skills

[DrVanNostran]

So I just finished my Surgery Clerkship and I think I got the shaft. I did well in the clerkship overall grade wise. But, I didn't even get a chance to close. I was able to tie one or two knots here or there. But, I pretty much either retracted or stood with the Gas folks during laproscopic procedures.

While I probably am going into IM, surgery is still in the back of my mind. When did you learn your surgical skills, 4th year, intern year, God blessed talent.

Also, it was pretty impressive to see how surgical anatomy seemed much different than cadaver anatomy. When did the green light go off when it was easy to recognize everything?

Thanks.

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[DoctwoB]

So I just finished my Surgery Clerkship and I think I got the shaft. I did well in the clerkship overall grade wise. But, I didn't even get a chance to close. I was able to tie one or two knots here or there. But, I pretty much either retracted or stood with the Gas folks during laproscopic procedures.

While I probably am going into IM, surgery is still in the back of my mind. When did you learn your surgical skills, 4th year, intern year, God blessed talent.

Also, it was pretty impressive to see how surgical anatomy seemed much different than cadaver anatomy. When did the green light go off when it was easy to recognize everything?

Thanks.

Your school doesn't let you drive the camera for laproscopic?

 

[ESU_MD]

But, I didn't even get a chance to close. I was able to tie one or two knots here or there.

In general, you should have at least practiced tying some knots on towels, etc and have already practiced(and been shown) how to hold a needle driver and pickups prior to coming to the OR.

If you have never thrown a stitch on a living human, fine we all have to start somewhere and I will assist you-- but you better have practiced something prior to coming to the OR or we assume you dont really care.

 

[plauto]

I was never asked if I wanted to close. I always asked them if I could close, and usually they let me. After they knew I could close, I was always the one to close and was offered advice on how to improve.

 

[MossPoh]

My school is a bit different in that it is an apprentice model, but each surgeon has their own way of doing things. One of the general themes was that you have to show initiative and desire to do it. Point blank ask if you can rather than waiting to be asked. You just have to be somewhat aggressive with everything.

 

[Buzz Me]

Agreed that if you're interested, you have to ask if you can participate...first cut, then tie, then suture.

I would have scrubbed into every case possible...only stand and watch the laparoscopic monitor if there were other students scrubbed (otherwise you look disinterested).

 

[DrVanNostran]

Great stuff everyone, thanks.

I am definitely partly to blame. I should have been more aggressive in asking if I could tie, suture. Our school basically has is a model where we have 3 blocks: 2 General Surg, 1 speciality (for me neurosurgery). I essentially had 3 attendings, and all on the first day said that they wanted either the resident to tie/close or they want to do it themselves. I should have been more aggresive in the middle and end.

I was allowed to hold the camera and become a retraction machine. I just wish I was able to get the hand motions down.

At home, I have been practicing tying on an arm chair and throwing in a piece of chicken. But on the rare rare occasion I was allowed to go on a human, I noticed the stark difference. Wet sutures and new needle holders are a force to reckon with for a beginner.

I had a long talk with my brother who is neurosurgeon, and he keeps saying that as along as I practice at home, things will come together once in the OR more consistently and it is my responsibility to do these things.

If I want to improve or at least in my part, acquire these skills. What is the best thing to do at home since I won't be in the OR until my next rotations? Even if I don't go into surgery, I would like to think after medical school I can suture decently and tie a knot properly. Any good learning videos or books you guys recommend? Should I keep practicing with some dead meat or buy a suture board?

Also, about the anatomy. What was the best tool, surgical atlases?

Thanks again!

 

[Gpan]

One thing I want to add is that being in a small hospital really gives u a huge advantage on these kinda things. I was in one. What does that mean? First assist in ALL CASES. I got to do more than some of the surgical residents get to do from what I've heard. I closed almost all the cases I assisted my attendings. Heck I even did a couple of simple lap. kinda by myself, of course with my attendings watching like hawks lol. So much fun

I second the other ideas: be assertive yet respectful, proactive, ASK and have fun

 

[ESU_MD]

If you are practicing tying on a chair and suturing chickens at home then this is very good. I would gladly help someone like you get to the next level in the OR. Keep up the good work.

Great stuff everyone, thanks.

I am definitely partly to blame. I should have been more aggressive in asking if I could tie, suture. Our school basically has is a model where we have 3 blocks: 2 General Surg, 1 speciality (for me neurosurgery). I essentially had 3 attendings, and all on the first day said that they wanted either the resident to tie/close or they want to do it themselves. I should have been more aggresive in the middle and end.

I was allowed to hold the camera and become a retraction machine. I just wish I was able to get the hand motions down.

At home, I have been practicing tying on an arm chair and throwing in a piece of chicken. But on the rare rare occasion I was allowed to go on a human, I noticed the stark difference. Wet sutures and new needle holders are a force to reckon with for a beginner.

I had a long talk with my brother who is neurosurgeon, and he keeps saying that as along as I practice at home, things will come together once in the OR more consistently and it is my responsibility to do these things.

If I want to improve or at least in my part, acquire these skills. What is the best thing to do at home since I won't be in the OR until my next rotations? Even if I don't go into surgery, I would like to think after medical school I can suture decently and tie a knot properly. Any good learning videos or books you guys recommend? Should I keep practicing with some dead meat or buy a suture board?

Also, about the anatomy. What was the best tool, surgical atlases?

Thanks again!