And just like that, I have completed my first clerkship for third year. Reflecting on the past 3 months, it has kind of been surreal. I’ve mentioned many times in my IG posts (Follow me @Karebear109 — shameless plug) regarding how incredibly grateful I am and blessed I feel on a daily basis to not only finally be doing my clerkships but also to be training at one of the top institutions in the world. God has a pretty phenomenal way of working things out when your obedient to Him. That being said, wow. What a crazy, overwhelming, exhausting and incredibly fulfilling the last 3 months have been.
I remember before starting back at the end of March, countless family and friends would ask me if I was excited to which I would reply “Very excited but also very nervous but excited more than nervous”. It was my go to line but that is exactly how I felt. I was so excited to finally be starting clinical rotations, a time I literally have been looking forward to for at least the last 5 or 6 years when I actually understood the organization of the four years of medical school, but I was also freaking out because I for one start to think 1) What if I suck at this 2) What if my residents and attendings think I am a complete idiot? Needless to say, I eventually realized that neither of those two things would end up being the case, but it is definitely how I felt at least after the first week.
The beauty of being one of your last friends to go to medical school is that you can lean on them for advice. I have the privilege to have a few friends who are at the end of their various surgical residencies, so I emailed them all before starting to ask for some advice in what they look for in their medical students. Disclosure: I did not ask for their permission to post this advice but I am pretty sure they will be okay with it but I will obviously keep everything anonymous.
Interest and initiative go far. Being available and teachable goes further than knowing every answer the first time. You should always know things the second time it it comes up.”
Always try to be the next level. As a med student you should be proactive and knowledgeable enough to be the intern.”
Never ask to leave and if there is more work to do- do it.”
Always be on time for rounds in the morning. In fact, make it a goal to be there first. if there are other med students, make a pact to get there 20 mins early and get overnight vitals on the patients on the service.”
Have dressing supplies ready for rounds and carry with you in your coat.
Be on top of the service, know what’s going on with all of your patients throughout the day, and help the intern/PGY-2 out as much as possible. Essentially, try to be a counter-part to the junior resident and make their life as easy as possible. When they are doing consults, take a history, physical exam, and start writing the notes.
Know your anatomy for each case! Anything more is gravy.
Be an extrovert when appropriate. Be CONFIDENT if pimped and when providing information on patients. Wavering is a bad quality for a surgeon.
Don’t ever leave early and always be available. Try to be a great teammate. Bring a positive vibe to the team.
Looking back, I can definitely say that all of this advice was definitely spot on. Definitely do all of the above but I will discuss later (probably the next post) some of my recommendations for how to achieve these things. My biggest issue especially in that first week was that I felt like I really did not have any direction. It was extremely frustrating. I began my surgical clerkship on colorectal surgery which is known to be tough because of the long hours and long surgeries, but what I found to be the most difficult was just finding my place in the team. I had an intern and fellows but because there was little direction to actually what was expected of me aside from just being in the OR, I had no idea of what to do and how to be of assistance and found myself continually saying “Is there anything that I can do” to which the common response was “no, you can go study”. That first week, I felt like a lap dog just following the resident or fellow that I was placed with around but I did not feel like I was contributing in a way that was meaningful to the team. However, I did make sure that I paid attention to what was being said on rounds, specifically how my intern and fellows would present the patients to my attending. I found myself really frustrated by the end of the first week and thankfully I was able to talk to one of my best friends who happens to be a surgeon voicing my concerns to which she responded that it was completely normal. Everyone goes through it, to not worry and to be prepared to go through the same sort of thing when you begin each of your clerkships. Her words definitely helped ease my mind a little bit but I knew that in my second and third week, I had to make some changes…I had to insert myself into the team.
Things no one tells you:
Surgeons speak a different medical language. As physicians-in-training, we have already become accustomed to speaking in medical language, but surgeons speak that language and also their own dialect, haha. You’ll hear words in the OR like: Lithotomy, Trendelenburg (T-Burg) or Reverse T-Burg and then there are all of the instruments (some of which have multiple names) Mets, Hemostats, Army-Navy, Rich, Big Rich, Right Angle…to name a few. You will be overwhelmed. But its okay. I plan to write an entire blog post about resources I used during Surgery, but I will tell you that Surgical Recall (Blackbourne) is my best recommendation for Day-Day on the Wards. It goes through everything from how to present on rounds, to instruments, to a lot of the high yield OR pimping questions students are typically asked.
Presenting Patients is different. I planned to go into depth about this in this blog post but this post is already long, so I will delve into day-day presentation in my next post (I plan to write it Saturday or Sunday). But just know that its different.
Scrub Techs and Nurses are truly your best allies. You probably already know that nurses make the world go round which is completely true, but honestly…I would have been truly lost if it had not been for some amazing Scrub techs and circulator nurses. Befriend them. Always Always Always offer to help in any possible way. You will find that they will truly take care of you (like actually get your gloves for you) if you are just kind and willing.
There are probably some other things that I can’t remember right now but I think I have definitely wrote enough for this entry. As I mentioned previously, I planned to talk about how I started to prepare for day to day on the wards in this blog post, but I think that will have to be its own post as this is already long!
Despite my initial frustrations, I eventually did figure “it” out. And you will too. I had such an awesome experience in Surgery and although I had this feeling that I would like surgery in the beginning, I was not prepared to like surgery as much as I did. It honestly has thrown me for a major loop because prior to starting rotations, I had pretty much been fully on the Family/Internal Medicine train, but now I find it hard to imagine myself not spending some of my time in an OR. Don’t get me wrong, I absolutely love interacting with patients in clinic and building a relationship with them, but I am pretty certain that along with that, I also want to be in the OR. Only time will tell.
Thanks for reading.
Lots of Love,
Up Next: Surgical Clerkship: Day to Day
Up Next Next: Surgical Clerkship: Studying/Shelf Resources