Starting Surgery

Well the first two days have been pretty anti-climatic. The rotation isn't really ward-based as I had hoped. It's more like a preceptor-based rotation that happens to have Residents as First Assist or Surgeon at one of the four hospitals we work at. Yes, that's four hospitals to go to for surgeries and to call on patients every morning. Kind of difficult when I have no car and it's fourteen degrees outside. My fellow MSIII student has been kind enough to give me rides so far. And there's absolutely no orientation or Resident teaching, so it feels like flying by the seat of your pants. We do get some didactics, but they seem vastly inferior to the ER lectures from last month.

All the surgeries so far have been gallbladder related. I stayed up late last night studying surgery on the biliary tract for a long open cholecystectomy this morning. Usually gallbladder removal is done with scopes through small incisions, but this patient had enormous stones that had to be manually removed in the bile ducts and all the way up into the liver. It took hours using tiny balloons and mesh cages to fish them out. My job thusfar has been holding retractors, suctioning and a little stapling. I've only rounded on one patient so far. The good thing is that we only have to write short SOAP (progress) notes instead of H&Ps. If we have 8am surgeries, that means days start around 6:30am in order to have enough time to see patients and write notes.

One of the reasons I'm not doing more in the OR is that we have an extra student in our normally two student service. He's off schedule so he's got one more week with us. That means he's been able to help us figure where we're supposed to be and what we're supposed to be doing. But it also means that we have three students trying to scrub in on a limited number of surgeries.

The surgeons themselves seem ok. A little ornery, but certainly not arrogant. So far the teaching has been mediocre, but I hope that it improves as we get up to speed and the third student heads out. I'm holding onto my hope that things will improve after the first week like they did with Peds last month.

Tonight I hope to study some Peds for my test on Monday. At least I have a full weekend to prepare. That also means there won't be too much time to miss the family. Who knows, maybe I'll even get motivated to work out a bit.