Surgery Core Rotation

At the end of March, I completed my surgery core rotation in Waterbury, CT at St. Mary's Hospital. This was by far my most difficult rotation, not because it challenged me mentally but because it challenged me physically. For 3 months I reported to the hospital around 4:30-4:45am and didn't leave the hospital until 6-6:30, sometimes later, 6 days a week. It was very difficult to come home and then study and even the 1 day we had free a week, all I wanted to do was sleep. The fact that it was winter was a good and bad thing. Good because I wasn't envious of others for getting to be outside, because it wasn't nice anyways but bad because there was very little daylight. I went to the hospital when it was dark and returned home when it was dark. Never really got to see what Waterbury looked like but from what I've heard there's not much to look at anyways :)

The rotation consisted of 11 other students from 4 different caribbean schools, 2 being PA students. This was the first rotation I had the opportunity of working directly with students from other schools which I met some great new friends. 12 students sounds like a lot but 2 were always on the night shift which left 10 others to cover the surgery board each day and there were almost always enough surgeries to go around.  

One of my best friends throughout the rotation!

In the mornings, we prepared for morning rounds with the residents then went to surgery or helped with floor work then afternoon rounds. One benefit of this program is you get to see a lot of different surgeries. They primarily do laparoscopic and robotic surgeries with occasional open surgeries. You are working with the General Surgery team so get to see appendectomies, cholecystectomies, hernia repairs, and amputations galore but also colo-rectal surgeries such as hemicolectomies, hemorrhoidectomies and low anterior resections. There is multiple bariatric surgeons so I saw gastric sleeves and gastric bypass surgeries. There are also many breast surgeons so you will see lumpectomies and mastectomies with reconstruction. You are get to sit in on cardiothoracic surgeries such as valve repairs and replacements, coronary bypass surgeries and aortic aneurysm repairs. They also have many vascular surgeries so you will see fem-fem bypasses, angiograms w/ angioplasty, carotid endarterectomies and AVF formations. Some friends even got to see some neuro surgery for subdural hematoma evacuation and urological surgeries. I was very grateful for the exposure I got. While a majority of these surgeries you are scrubbing, you usually don't get to participate much as the residents are helping a majority of the time. They would let you hold retractors, cameras and maybe even throw a few closure sutures. 

I had a few cool experiences in the OR. Having a surgeon (who is not normally too nice) say that he wanted me to be in everyone of his cases because I held the camera better than any other medical student he had, made me happy! Also getting to help close the chest after an open heart surgery (even though we NEVER get to scrub in on heart cases). Those were God's way of telling me to keep pushing onward even though I know you're tired :)

On the floors we would do a lot of wound dressings, wound debridements, placement of NG tubes and I&Ds. Every Wednesday was academic days where we would have lectures, cancer conference and sim labs. We had labs on Central line placement, chest tube placements and suturing. All were very helpful things that we had not gotten in our Maine semester so I enjoyed it. We also got called to all traumas and suture opportunities in the ER.

Our Team!

Studying for the Shelf:

Everyone will say the Surgery shelf is all Internal Medicine, ummm yes it is because surgery is just operating on medical conditions. They aren't going to ask you specific procedure related questions on the exam so they have to ask questions over the pathophysiology etc. It just makes sense. Learn IM but also postoperative complications. 

Books I used: I used surgical recall through the rotation for pimping in the OR. I knew the surgeries I would have the next day, so I just read that chapter quickly the night before to refresh my memory. For the shelf, I used Pestana's surgical notes. The book not the pdf document. The pdf document is a bunch of cases, the book is short descriptions of a bunch of conditions. And as always I did the uWorld questions. 

For the rotation here, we had weekly quizzes over chapters in Essentials of General Surgery. It's a good book to reference if you want a little more information than what Pestana's offers. 

Operative Anatomy is a great resource for the step-by-step of each procedure. NOT necessary for the shelf but I liked to briefly skim it before each surgery to at least have a generalized idea of what was happening. It included a lot of anatomy which the surgeons would pimp on in the OR too.