what you need to know before general surgery rotation

During my third-year, there were two rotations that I initially struggled with–full general surgery and OBGYN. As far as clinical practise in the commencement two years of medical school, much of it was based on doing history and physicals and performing well in an outpatient clinic. We were given a couple of clinical labs to prepare for surgery (i.due east. scrub labs, suturing, etc.) simply I managed to forget everything the kickoff day in the OR and subsequently was critiqued for how I was scrubbing in, suturing, and answering "pimp" questions. Luckily, I've grown a lot since my starting time general surgery rotation. Looking dorsum, I wish I had a cheat canvass of what I should take done to prepare for surgery and now that I have had a handful of surgical rotations,  I've decided to compile my best tips to smooth on a surgery rotation!

1. Know your patient
   • No matter what rotation you are on, getting to know and intendance for your patient is very important. What is their primary complaint? What got them to the bespeak of surgery? What are their allergies? Do they smoke? What are their comorbidities? Accept they previously had surgery? Etc.Some means yous can get to know your patient in surgery:
     • Before surgery: await at their electronic medical record for their past medical history, past surgical history, etc.
     • Pre-op: visit them in the pre-op surface area and introducing yourself is a slap-up style to go to know your patients if you don't take access or fourth dimension to review their medical record. A great fashion is to say something along the lines of, "Hi Mr/Mrs. ___, my name is Amanda and I am a medical student with general surgery. I volition exist observing your surgery today and just wanted to innovate myself. *You tin enter questions hither*." Often, their medical chart will be bedside so this is a neat way to review their history, likewise.
     • Post-op: follow and round on them if they are admitted to the hospital. I really enjoyed having a pupil md-patient human relationship with them and it helps when they see a familiar confront.
2. Know proper scrub-wear and how to scrub in
   • If you lot are rotating through a new hospital, ofttimes times you will be taken through "scrub grooming" to ensure you have proper scrub-wearable and proper scrub techniques.
   • Always wear a hairnet or bouffant as well as clean scrubs from the hospital. Some hospitals have scrub machines where you need an ID to access but this should all be shown to y'all when you begin your rotation. Shoe covers and eye-wear are two things you might non see on anybody but every bit a student, I feel like I will be scolded less if I wear more. Also, ever accept your ID on because you will most likely be asked who you are and why you lot're there.
   • Do a "morning scrub" before your first example then that you lot can opt to use the Avagard antiseptic in subsequent cases. Merely, as a general rule, follow what your preceptor does. If he/she likes scrubbing each case, follow conform. If they don't have a preference, the morning scrub + Avagard combo is easiest.
3. Offer a helping hand
   • A medical educatee can simply do so much during a surgical rotation only 1 of the nearly important is to assistance those around yous especially during surgery.
     • On your first day in the OR, observe what the nurses and surgical techs are doing and then that you can get a handle on things you can assist with.
     • Walk with your patient's bed from pre-op to the OR and help move them from the bed to the OR table.
     • Write your name on the whiteboard to help the circulating nurse identify you as he/she are documenting the surgery. Also, introduce yourself to the nurses, scrub techs, CRNAs, and anesthesiologists.
     • Enquire where the warm blankets are so that you can provide them to the patient pre-op and mail service-op.
     • Attach/disassemble sequential pinch devices (SCDs) for DVT prophylaxis when necessary (especially for laparoscopic surgeries).
     • Help gown those who are scrubbing in (i.e. tie their gown).
     • Catch a step up if you can't see and offer to grab i for anyone working in the surgery (i.e. attendings, residents, fellow med students, etc.).
     • Grab your gloves and gowns equally soon every bit y'all know you are scrubbing in.
4. Exercise makes perfect
   • Suturing: ask around for expired suture and tools to practice suturing. Often times, you volition discover a collection of expired suture in the OR. Suture boards are helpful but I find the most realistic ways to do subcuticular stitches are on pigs feet, chicken chest, and bananas.
   • Manus tying: ask if y'all can take a pair of sterile gloves (to acquire how to glove yourself) and to hand necktie. Some preceptors will teach y'all how to practice the one-handed tie but information technology is best to observe a video on Youtube and practice with gloves and dish lather to simulate how you will exist tying in an bodily case. Information technology may likewise be good to know how to two-paw necktie. Again, ask if y'all tin find expired suture to practice with.
5. Don'ts:
   • Don't take anything off the Mayo stand (the tray that holds the tools for surgery) unless told to.
   • Don't bear on anything that is blue = sterile.
   • If you don't know how to unwrap sterile instruments/gowns/gloves, definitely ask how to practice so before trying to unwrap onto a sterile field. Information technology also helps to know how to gown and glove yourself if the scrub techs are busy.
6. Resources:
   • Surgery Call back: for your everyday "pimp" questions.
   • Purse Surgery: a great tool for general surgery knowledge. Best for those of you who want to pursue general surgery.
   • Youtube: for videos on surgeries you might run into.

I hope that these tips will aid those of you lot starting on surgery rotations! I hope to bring a part-two mail service on surgery advice for those who want to pursue surgery!

Read more from Dr. Ly.

Amanda graduated from the West Virginia School of Osteopathic Medicine in 2018 and blogged for Merck Manuals during her fourth year of medical school. She is currently a general surgery resident in the metro Detroit area. She looks forward to the next five years of training and hopes to specialize further. Her interests include photography, blogging, and eating her way through new cities.

Continue following her journey at www.CoffeeAndScrubs.com.

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Source: https://medstudentstories.merckmanuals.com/tips-for-shining-on-your-surgery-rotations/

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