Top Tips to Honor Your Surgery Rotation

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It’s been two weeks since I’ve finished my surgery rotation and man does it feel good. 😀 Clearly you can tell that a future in the OR is not for me. Still, just for you all, I’ll revisit my 8-week experience to give you my top tips to get honors on the surgery rotation (you’re welcome). Also, check out my recent recommend top resources for your surgery rotation here. Enjoy!

1. Read Up On the Anatomy

It’s common sense to be prepared in medical school. This is twice as important in the OR. Know your darn anatomy!

If you know what cases you’ll be scrubbing in on the day before, watch a youtube video or read about what the procedure entails.

For example, during my endocrine service, I would watch videos on thyroid, parathyroid, and lymph node dissections to be more comfortable during the actual cases. It’s much easier to follow what’s going on when you’ve already seen something similar.

Expect to be asked by your attendings and residents about key structures. While you may not get everything correct, patience in the OR can be quite thin. Thus to avoid casting a poor impression, come prepared.

2. Advocate for Your Patients

Surgery is a specialty that demands efficiency. Unfortunately, sometimes that affects patient care.

It’s typical to spend less than 5 minutes with a patient in the morning. Often you may not see them again during the day.

Thus it’s important to take ownership of your patients. While your attendings and residents may be busy in the OR, you have the most time to talk to your patients. Just simply sitting down with them and slowly walking them through their care is all they want and need.

My favorite experiences on my surgery rotation involved talking to patients and families for as long as they needed. While many were surprised at the time I gave them, in all honesty, they deserved nothing less. Once I understood their concerns and hesitations, I could report these back to my superiors and ultimately improving the care and attention that patient received.

Your surgery rotation is truly a time where you can know you’re patients better than anyone else on the team.

3. Learn How to Be Efficient

You have to be quick and effective. This includes your rounding, notes, presentations, etc. Be a quick learner and know what important to know and present.

Elements such as vitals, pain control, bowel function, urine output, electrolytes, drain/tube output (color), abdominal exam, and wound inspection are important for every patient and should not take you more than a minute or two to access. For some patients, you’ll also closely monitor their blood count, creatinine, and glucose.

Once you form the framework of how every patient is doing, present them in an efficient manner.

Example Surgery Patient Presentation:

Here’s an example presentation format.

1. Describe who the patient is (38 yo with SBO, POD #2 s/p ex lap)

2. How they’re progressing (still no BM or flatus)

3. Vitals and Drain/Tube Output (VSS are stable – don’t say normal, NG Output = 500 cc compared to 1500 yesterday)

4. Pertinent Labs and Physical Exam Findings (Abdomen still distended with no tenderness or rebound)

5. Plan (keep NPO, serial abdomen exams, etc.)

You’ll look like a rockstar if you can come up with such a framework for each of your patients! Also, try to keep this within 1-2 minutes. Your attendings won’t have the patience or attention span to wait for a medicine like presentation. Keep it short and simple.

4. Carry Your Study Materials Electronically

You simply won’t have the time or space to pull out your text of choice to study. Thus have an ebook copy of Pestana or Devirgilio surgery on your phone or iPad.

Also have your UWORLD questions and any additional flashcards on your device as well.

Use your resources during any down time or breaks. Often you may be able to finish a good deal of work by the time you’re home.

You can find my recommend top resources for the surgery rotation and shelf here.

5. Predict the Needs of the Team

You’ll learn quickly that as a med student you’re very little help in the OR. Yes, you’ll likely be retracting, suturing, and maybe some cutting. Still, you’re more likely to get in the way and slow things down if anything.

What you can be helpful with is floor work. Do routine abdominal exams on specific patients and report back to your team. Track down that outside hospital op report. Ask the nurse about a patient’s updated I/O’s. You’ll be a big help!

The outside hospital post-op reports is a big one. If your patient presents with a likely complication from a previous operation, then find that op report before your resident even asks. You’ll look like a rockstar if you can pull out a copy of a post-op report during rounds.

On top of that ask and learn how to take out drains/chest tubes, NG tubes, staples, flush drains, and change dressings. Once you learn you’ll be able to do it for all your patients thus saving your residents time.

If you’re on a service which takes consults, offer to go see the patient and begin the H&P. Even if you don’t get very far before the residents arrive, something is better than nothing.

Find little places that you can fill in for your team members and you’ll be appreciated while feeling useful.

6. Sleep > Studying

Your surgery rotation can burn you out. On top of the 12-15+ hour days, you still have the study for the shelf. I’ll illustrate in a future post how to efficiently study for the shelf, but your main priority should be getting your rest.

You may find yourself sleeping at 8 every day to wake up at 3. Just make sure you get the hours your body normally requires.

If you’re on a scheduled call schedule such as Trauma surgery, then plan to study extensively on your lighter days or days off. Get your sleep the rest of the time.

Regardless if you are a future surgeon or not, the rotation will challenge you for many reasons. The time commitment, pace, intensity, and amount of material can be overwhelming. Still, there is much you can take away from the rotation. Come in with a positive attitude more often than not and you’ll enjoy the surgery rotation. Don’t come in being bummed out that you’re on the dreaded surgery rotation. Take a deep breath and understand that everyone gets through it.

Check out similar tips for other rotations below!

Internal Medicine
Surgery
Pediatrics
Family Medicine
Neurology
Ob-Gyn