I'm alive!!! It's hard to believe that I am nearly done with my third year of medical school and yet I've barely written about any of it. Whoops.
Well for starters, I just finished up my month on General Surgery. Which actually turned out to be more Bariatric Surgery, less general. Confession time: I have been DREADING this month since day one. For one, February is a pretty miserable month weather-wise. And for two, Surgery is about as far down on my list as it can possibly be...
...I actually ended up really enjoying this month more than I expected. Not in a "drop-everything-and-become-a-surgeon" way but I did thoroughly appreciate and enjoy learning more about the specialty.
What were your favorite aspects of the rotation?
First of all, I worked with a Bariatric surgeon and his PA who were absolutely fantastic and super nice people! Even though the days were sometimes pretty busy and long, having good people around to laugh with and learn from makes it worth it.
I love the patient population in Bariatrics. Many of our patients have struggled with their weight and health for years and years. They go through a long journey to get to the surgery day - counseling, classes, medical weight loss, etc. I enjoyed hearing their stories and seeing how well people did after surgery. Their lives are forever changed!
Many times, if a Bariatric patient requires surgery down the road for things like hernia repairs, gallbladder issues, etc. we would do those surgeries also so there is a healthy amount of continuity as well as an opportunity to create long-term connections.
What were your least favorite parts of the rotation?
Because the surgeon I was with did mostly Bariatrics, I missed out on seeing more "General" type surgery (including the pre/post-op management) which could negatively affect me for boards. Hopefully I will be able to make up the gap with Internal Medicine and some studying.
Most surgeries are done laparoscopically now so there wasn't a lot for me to do aside from hold the scope camera and close the incisions at the end. (I did come to enjoy suturing!) It can be really nerve racking because you don't want to move the camera or make things harder for the surgeon. I did get to assist with procedures and even got to place a couple PEG tubes.
Since I enjoyed the patients so much, I enjoyed things more than I expected to. Unlike many med students though, I don't find the actual surgeries all that interesting. Anatomy was never too thrilling for me and working with my hands isn't a high priority either. Generally, I felt more anxiety being in the OR than excitement or ease. Especially if things started to go wrong...
While the hours were much better than typical General Surgery, it's still a pretty unpredictable lifestyle. Also, bariatric patients require a lot of follow up and are susceptible to complications so I felt like the PA and doc were constantly getting pages/phone calls.
What advice would you give for how to do well/survive the rotation?
- Carry healthy snacks in your white coat pocket (protein bars, nuts, etc.) because you never know when you'll get a chance to eat! In general, we were pretty good about getting lunch but there were a few times that lunch just didn't happen.
- Be kind to everyone! Get to know your scrub nurses. Offer to get your own gloves and gowns. If you don't know what to do, where to stand, how to do something, just ask!
- Know your anatomy! Things look a lot different in a live human than the cadaver you worked on in anatomy lab. I was so thankful I went over some basic anatomy before our first surgery...it shows that you are prepared and interested in learning.
- Don't get down if you don't know the answer to a question. Most doctors are asking you questions to help you learn or get you thinking, not because they want to embarrass you. Take it as a learning opportunity. If you miss something, just say "I'm sorry, I don't know but I will find out." Then go find out either between surgeries or when you get home.
- Read on your patients and surgeries for the next day. You don't necessarily need to know how to perform the surgery (you'll be retracting or holding the scope) but you should be familiar with the general steps, anatomy, indications, possible complications, etc.
- Find ways to be helpful. Sometimes as a medical student, it can feel like you are being less than helpful or in the way. (I think it just comes with that short white coat). Print the patient list for the team before rounds. Be on the lookout for important lab results or imaging studies on your patients. Offer to go round on a patient the doctor was concerned about.
Did this rotation change what you see yourself specializing in?
If I were single and didn't have geographical restrictions in mind, I MIGHT consider exploring Surgery further. But at the end of the day, I know that my personality and my goals for the future do not mesh well with the surgery lifestyle. That said, there are plenty of hard working, dedicated people who make families and anything else work - to you, I bow down!
This month I gained tremendous respect for the skill set required to be a good surgeon - it's something I'm sure I could cultivate if I truly wanted to but my calling and my heart is somewhere else in medicine. I do feel a little sad that I will probably never get a chance to do surgery again. :(
What resources did you use for studying?
I used First Aid for the Surgery Clerkship & COMBANK question bank. And Dr. Wikipedia + UpToDate. I haven't gotten my COMAT exam grade back yet but I felt pretty good about the exam.
So that's Surgery in a nutshell. Great month but glad to be moving on!
What questions do you have about Surgery?