First Week of Surgery Rotation: CT/Vasc Surgery
It's been a full week since I started my first clinical rotation of 3rd year: surgery. I started on the CT/Vasc (Cardiothoracic and Vascular Surgery) service.
Here's how it went... Well everything that I can remember lol. Disclaimer: I really told myself I'd be super detailed for the readers who are curious about what clinical rotations are like, but as you can see I kinda fell off later in the week being super detailed. Coming home at 5pm, eating dinner & studying, then being in bed by 9 pm so you can wake up by 4:30 and get ready to be at the hospital 5:30 every morning doesn't leave much time for you to make a super detailed log of each day's activities. But here's what I remember.
Monday (7/24): 6am-5pm
6am-8:30: Pre round-Checked on patients from previous night (review vitals and labs)
8:30-10:30 am: Grand Rounds and M&Ms (Mortality & Morbidity) Presentations: resident presentations on complications encountered during recent procedures (e.g. aspiration of stomach contents during echocardiogram).
10:30-noon Guest presentation on the benefits of simulation in resident training.
noon: Lunch
1 pm-2pm Lesson on using Doppler to detect non palpable pulses
2pm-5pm: checking on patients upon resident's request or studying
Tuesday (7/25) 6am-5pm
6am-8 am Pre rounds & presentations- check on surgery consult patients to see how their night was. Review vitals and labs
9am until: 3 procedures in the Cath lab. Scrubbed in and watched a port-a-cath (implanted venous access device for patients who need frequent or continuous administration of chemotherapy) implantation, IVC filter (placed in the inferior vena cava to capture embolism/clots) retrieval , and IVC filter implantation. I scrubbed into the last case and got to cut sutures (I'm basically a surgeon now).
Wednesday (7/26) 6am-5pm
6am-noon: Surgery lectures
noon-1pm: Tumor board- physician led presentation and discussion on tumors found in recent cases
1pm-3pm: Lesson on suturing in the simulation center. Practiced suturing pigs feet and tying surgeon's knots.
3pm-until: reported back to our team to resume normal duties
Thursday (727) 6am-5pm
6am-8am: Pre-rounds & presentations
8am-1pm: Cath lab cases; watched an arterial stent repair and angioplasty with stent placement
1pm until: studied and saw patients at resident's request
Friday & Saturday (7/28-7/29) 6am-7 am the next day (24 hr call)
6am-noon: preround & presentations, resident *pimping/teaching
(in the medical feild the term pimping refers to the resident/attending asking you question after question to pick your brain and see how much you know. It sounds scary, but it's not if you have the right attitude. My resident didn't pimp to embarass us, but rather to assess our understanding and fill in any gaps in our learning.)
noon- 5pm: lunch, studying, and seeing patients at resident's request
5pm-7am (Saturday): Overnight Call
Remained in the hospital overnight to respond to trauma calls in the emergency department (ED). The role of medical students on call is to take the patient's history and physical/ undress the patient while the attending physician and residents tend to the patient, performing the pertinent exams, tests, and scans. Residents & EMT will call out their findings as they examine the patient and students record as much information as they can. It's a pretty fast paced environment, but the more history and physicals I recorded the better I got at quickly jotting down the details. Medical students are also expected to assist in any additional way they can from rolling the patients to get CTs and X-rays to cleaning up bloody patients, and doing alcohol screens.
It was a pretty cool experience I must say. I was impressed at how quickly the team responded and how efficient the team was at giving the patient the best possible care in such a short amount of time.
Our cases for the night included a patient hit by a car while on his bike, a broken nose and eyebrow laceration following a brawl, and a scalp laceration following a fall.
ANDDDD that was my first week!