'Typical' day in Surgery rotation??

[Blitz2006]

Whats the schedule like of a day in surgery for a 3rd year student in surgery rotation?

Just curious as I'm doing my elective in Gen Surg next April in the U.S and want to have an idea of what I should expect?

Report to hospital at 4.30am? Ward rounds at 5.30? How many hours in OR? 7-12? Outpatient clinic 1-6? Done by 7? 15 hour days?

Thanks!


P.S. Roughly how many hours of sleep you get a night? 3? 6? 8?

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[2012mdc]

Whats the schedule like of a day in surgery for a 3rd year student in surgery rotation?

Just curious as I'm doing my elective in Gen Surg next April in the U.S and want to have an idea of what I should expect?

Report to hospital at 4.30am? Ward rounds at 5.30? How many hours in OR? 7-12? Outpatient clinic 1-6? Done by 7? 15 hour days?

Thanks!


P.S. Roughly how many hours of sleep you get a night? 3? 6? 8?

Varies a lot by program so find out from students or residents familiar with it.

But to give you an idea

Rounds at 6, depending on patient load got there between 430 and 530. On OR days we were done usually by 6 or 7 but there were times it went till 8 or 9. Clinic days ended around 5 or 6. This was on general service. On trauma service we had more patients so we got there earlier but there was less clinic time and less OR time (outside of call days of course). We sometimes got out as early as 12

 

[vicinihil]

My general surgery was done at a VA and like all US govt institutions, things shut down at 5pm pronto.

I usually carried 3-4 patients, so I would show up at 5am and have roughly 1 hour to preround and rounds with residents start at 6 and that would end by 7. Depending on if it's a clinic day or OR day you'd start at 8am regardless and it would go until 5. Then you sometimes have afternoon rounds to make sure pts are still alive and that day's OR patients have all their orders in. So I would say a typical day is 5am-6pm.

 

[badasshairday]

My general surgery was done at a VA and like all US govt institutions, things shut down at 5pm pronto.

I usually carried 3-4 patients, so I would show up at 5am and have roughly 1 hour to preround and rounds with residents start at 6 and that would end by 7. Depending on if it's a clinic day or OR day you'd start at 8am regardless and it would go until 5. Then you sometimes have afternoon rounds to make sure pts are still alive and that day's OR patients have all their orders in. So I would say a typical day is 5am-6pm.

Ouch. I am use to 9am rounds on IM and getting to the hospital by 7:30am. 5am is gonna suck...............🙁

 

[Blitz2006]

Cool, thx for replies.

Is there a lot of scutwork done on surgery rotations, like cannulas, bloods, Injections, etc., or is that done by the nurses in the States?

 

[cpants]

Cool, thx for replies.

Is there a lot of scutwork done on surgery rotations, like cannulas, bloods, Injections, etc., or is that done by the nurses in the States?

Uh, that's not really scutwork. Practicing IV placement, blood draws, injections, foleys, etc is actually important to build your competence. That said, in most US hospitals these tasks are handled by nurses or technicians. Scutwork is things like slipping CT scans, transporting patients, picking up meds from pharmacy, etc. Yes, there can be a lot of it. It depends on the quality of the school and hospital.

 

[Blitz2006]

oh right, my bad. I thought scutwork = clinical procedures. Didn't mean it in a derogatory way.

Cool,

Uh, that's not really scutwork. Practicing IV placement, blood draws, injections, foleys, etc is actually important to build your competence. That said, in most US hospitals these tasks are handled by nurses or technicians. Scutwork is things like slipping CT scans, transporting patients, picking up meds from pharmacy, etc. Yes, there can be a lot of it. It depends on the quality of the school and hospital.

 

[2012mdc]

Ouch. I am use to 9am rounds on IM and getting to the hospital by 7:30am. 5am is gonna suck...............🙁

Surgery was my 1st rotation and I really didn't know what I was doing at first and I carried 4-5 patients so I would get there at 4 for rounds at 6.

The hardest part about surgery is not the actual time spent at the hospital but trying to study for that beast of a shelf after 15 hr days

 

[illixir]

Usually med students get assigned a few patients to preround on before the residents round on the whole service at 6 so thats why you'll hear about people coming like at 5. It's very service specific. On some services it doesn't make as much sense to follow patients, actually for my wks of gen surg, i would come at 540 to get the vitals/labs/daily plan for the service to present them to round at 615 with residents, and then write all the notes after rounds right before OR or clinic days go to clinic. Walking around seeing patients and trying to write the notes before you know their plan can waste some time or what i found since thats what i did in my first surgery rotation. There was often downtime during the day and then out by 5, as late as 9-10 though if in the OR.

 

[LifetimeDoc]

4:30 Wake Up
5:15 At Hospital, Print out Patient List
5:30 Round on Patients (2-3)
6:30 Rounds with Residents
7:30 To OR (or M&M conference or some clinic)
...
Afternoon, round on patients or more OR.
Maybe admit new patient, go back and see your patients, do procedures, etc.
Done by 6pm usually, sometimes earlier, sometimes later. Varies
Go home and study for an hour, eat, goto sleep.
Repeat Monday-Friday.
On Saturday or Sunday, half day of the same thing.
The other day and a half of the weekend is to pull your life back together or study.

The fun part is when you are in the OR. Playtime! 😀

 

[Perrotfish]

The fun part is when you are in the OR. Playtime! 😀

'Hold this and don't move for three hours' has always been one of my favorite games at playtime.

 

[turkeyjerky]

'Hold this and don't move for three hours' has always been one of my favorite games at playtime.

my best experience in the OR was being told to scrub out and order jimmy johns for the team

 

[jdh71]

You have all missed the FIRST thing every day . . .

1. Alarm goes off. Suicide considered as viable option to pre-rounding at 4:00 AM only to have Cheif breath fire up your ass on every single patient you see . . .

Then the rest of the lists I've seen here follow fairly predictably.

😀

 

[Perrotfish]

You have all missed the FIRST thing every day . . .

1. Alarm goes off. Suicide considered as viable option to pre-rounding at 4:00 AM only to have Cheif breath fire up your ass on every single patient you see . . .

Then the rest of the lists I've seen here follow fairly predictably.

😀

See, no one is breathing fire up my ass on Surgery. Actually no one is talking to me at all, and to the best of my knowledge no one reads my notes either. I'm not so much working with my residents as I am stalking them.

 

[IDBasco]

A lot of truth in this thread.

 

[45408]

See, no one is breathing fire up my ass on Surgery. Actually no one is talking to me at all, and to the best of my knowledge no one reads my notes either. I'm not so much working with my residents as I am stalking them.

Haha, I do feel like our students probably feel this way at times.

 

[Perrotfish]

Haha, I do feel like our students probably feel this way at times.

Actually I feel like this is becoming a serious problem. I'm two weeks in to my four weeks at this site, and I have yet to present a single patient. The physicians really won't respond to me, even to simple pleasantries like 'how was your weekend?', even when they have absolutely nothing to do and are staring at eachother in the call room. No one asks me any questions in or out of the OR, and I mean not a single one. No one has told me to follow patients or assigned me patients to follow. I do write 3 notes/day from force of habit (I randomly pick a new patient from the census when one of my old ones is discharged), but to the best of my knowledge no one reads them.

At this point, should I go talk to someone? Talk to the residents directly? The attending? The clerkship director? My gut feeling is that the residents and attending aren't going to change their behavior here. I honestly would only be a little annoyed at the situation (I learn pretty well from textbooks) except I feel like my grade is going to get screwed. How can they possibly evaluate me when I'm not even 100% sure they could pick me out of a lineup?

An added issue is that we get a midblock evaluation back in a few days. I'm worried if I don't act quickly it's just going to look like I'm whining about a bad evaluation.

 

[kneegrows]

Actually I feel like this is becoming a serious problem. I'm two weeks in to my four weeks at this site, and I have yet to present a single patient. The physicians really won't respond to me, even to simple pleasantries like 'how was your weekend?', even when they have absolutely nothing to do and are staring at eachother in the call room. No one asks me any questions in or out of the OR, and I mean not a single one. No one has told me to follow patients or assigned me patients to follow. I do write 3 notes/day from force of habit (I randomly pick a new patient from the census when one of my old ones is discharged), but to the best of my knowledge no one reads them.

At this point, should I go talk to someone? Talk to the residents directly? The attending? The clerkship director? My gut feeling is that the residents and attending aren't going to change their behavior here. I honestly would only be a little annoyed at the situation (I learn pretty well from textbooks) except I feel like my grade is going to get screwed. How can they possibly evaluate me when I'm not even 100% sure they could pick me out of a lineup?

An added issue is that we get a midblock evaluation back in a few days. I'm worried if I don't act quickly it's just going to look like I'm whining about a bad evaluation.

they probably just think you're a douchebag

 

[DrDrToBe]

Actually I feel like this is becoming a serious problem. I'm two weeks in to my four weeks at this site, and I have yet to present a single patient. The physicians really won't respond to me, even to simple pleasantries like 'how was your weekend?', even when they have absolutely nothing to do and are staring at eachother in the call room. No one asks me any questions in or out of the OR, and I mean not a single one. No one has told me to follow patients or assigned me patients to follow. I do write 3 notes/day from force of habit (I randomly pick a new patient from the census when one of my old ones is discharged), but to the best of my knowledge no one reads them.

At this point, should I go talk to someone? Talk to the residents directly? The attending? The clerkship director? My gut feeling is that the residents and attending aren't going to change their behavior here. I honestly would only be a little annoyed at the situation (I learn pretty well from textbooks) except I feel like my grade is going to get screwed. How can they possibly evaluate me when I'm not even 100% sure they could pick me out of a lineup?

An added issue is that we get a midblock evaluation back in a few days. I'm worried if I don't act quickly it's just going to look like I'm whining about a bad evaluation.

Say to the resident or attending "hi Dr. X, I have been trying to improve my notewriting, especially my A&P, etc, and I was wondering whether you can review it with me when you have a few minutes, like at the end of the day or something." Whenever you phrase it in a way that lets them know you're trying to learn and are asking them to help you learn, and give them adequate heads up (i.e. don't expect them to drop what they're doing and read your note right then), I find most people are quite helpful. I just started outpatient medicine, so most of the attendings and residents just had me shadowing because they are so pressed for time and I was getting bored to tears. The second day, clinic was busy and they had a patient waiting in the room and the intern was behind schedule, so I asked if I could go interview the patient by myself until the intern was ready- attending was like sure go for it. I not only got to do the H&P, but got to present to the intern, she was able to see the patient in a much shorter time, and she let me take the lead on presenting to the attending. I know they probably say this to all med students, but the attending was like "nice work getting a thorough but focused H&P , med student." Today, 4th day in clinic I got to see and present 3 patients. On the downside, now that Attending knows who I am he called me in on a couple different cases to listen to a weird case rheumatic heart disease and later a carotid bruit and I totally got pimped both times and wasn't able to answer a lot of his questions, so now he probably thinks I'm a total dunce.
Anyway, I'm imagining it's different in surgery in terms of how many patients you get to follow etc, but from what I've heard, most of the times you have to ask if you want them to let you do something. If you want to present, say "hey resident/attending, I've been trying to work on polishing my presentation, when you have some time can I do a 5 min presentation with you and get some feedback?" Again, not suggesting you be a nuisance, but if you ask a couple times a week they probably wouldn't mind.

 

[FlowLimited]

they probably just think you're a douchebag

Epic first post.

 

[OpalOnyx]

Say to the resident or attending "hi Dr. X, I have been trying to improve my notewriting, especially my A&P, etc, and I was wondering whether you can review it with me when you have a few minutes, like at the end of the day or something." Whenever you phrase it in a way that lets them know you're trying to learn and are asking them to help you learn, and give them adequate heads up (i.e. don't expect them to drop what they're doing and read your note right then), I find most people are quite helpful. I just started outpatient medicine, so most of the attendings and residents just had me shadowing because they are so pressed for time and I was getting bored to tears. The second day, clinic was busy and they had a patient waiting in the room and the intern was behind schedule, so I asked if I could go interview the patient by myself until the intern was ready- attending was like sure go for it. I not only got to do the H&P, but got to present to the intern, she was able to see the patient in a much shorter time, and she let me take the lead on presenting to the attending. I know they probably say this to all med students, but the attending was like "nice work getting a thorough but focused H&P , med student." Today, 4th day in clinic I got to see and present 3 patients. On the downside, now that Attending knows who I am he called me in on a couple different cases to listen to a weird case rheumatic heart disease and later a carotid bruit and I totally got pimped both times and wasn't able to answer a lot of his questions, so now he probably thinks I'm a total dunce.
Anyway, I'm imagining it's different in surgery in terms of how many patients you get to follow etc, but from what I've heard, most of the times you have to ask if you want them to let you do something. If you want to present, say "hey resident/attending, I've been trying to work on polishing my presentation, when you have some time can I do a 5 min presentation with you and get some feedback?" Again, not suggesting you be a nuisance, but if you ask a couple times a week they probably wouldn't mind.

I don't know how you'd prep for those types of pimping scenarios though. If a pt randomly comes in with a rare condition or something you haven't yet seen before (and alerted yourself to prepare for), there's not much you can do. I don't think an attending should think badly of you b/c you didn't respond correctly to the sudden pimping. Questions from what I hear are a good way to learn. And when it comes time to evaluate you, he's going to note how helpful you were (and not just whether you knew an answer to a question)

 

[Day man]

Epic first post.

I lolz-ed at that; his star burned too bright and he has left us...what a shame.

 

[Sweetpotatoguy]

I love it. Getting a lot of useful feedback from med-students and residents.
I am applying soon 😀

I also Lol-ed at the epic 1st. But best to keep those comments to ones self. jeje. I think about those comments sometimes to give me a good laugh.

😉