Tuesday, January 05, 2010

Surgery Part 1

It's been a month since I last posted, and it's because I haven't figured out how to talk about my experience. The sub-rotations that I participated in were, in order: pediatrics, pediatric urology, general adult sugery, and orthopaedics. In general, I think my experience suffered from a lack of hands-on learning. Medical students generally round on patients before the team rounds, finding out how patients did overnight, what changes occured, and formulating some semblance of a plan for the day. They then present their findings to the team during rounds and any modifications or additions are added before the workday begins.

Surgery differed from this in several regards. On pediatrics we would pre-round in the usual manner, but the residents did not make any use of our information, but at least wanted to hear what plans we had come up with. The afternoons on pediatrics, however, differed from other rotations in that the medical students were not really included in the floor work. Normally students follow labs, help write discharge orders, follow up on consults and imaging studies, additionally, if there are any OR cases happening, the students would scrub in for those. The two weeks I was on pediatrics did not have very many cases, so the afternoons were often devoid of any OR time. Rather than include us in the floor work and teach us about medical decision making, the residents would just tell us there was nothing happening, and tell us to sit and study. I have nothing against study time, but if there is nothing happening for 5 straight hours, to me it makes sense to let some of the students go home or to the library if they want because there is truly nothing happening.

Pediatric urology was interesting in that it was an inpatient rotation, but we had only 2 patients who stayed overnight, so really it was more like a day surgery rotation since we never had to round on patients. I did learn a lot from Dr. P, the peds urologist. His clinic was the smoothest running with the lowest percentage of no-shows of any clinic I have yet assisted in. He also was the only attending who actively taught about how to relate with patient's families and about non-medical aspects of satisfying patients and their families.

More to follow in Part 2

1 comment:

cfg said...

I read this every day hoping to find an up-date. More, please