Everything You Need To Know Before Your Surgery Rotation
I just finished my general surgery rotation and have SO much to say I don’t even know how I can put it in one blog post! I will start by saying that I am not really a “surgery” type. It was the rotation I was most dreading, I didn’t feel like it really fit into what I wanted to do as a provider, and I have just never been pulled in the surgical direction. So, with that being said, here is my recap from a “less-surgical-y-girl’s” perspective.
Let’s just say, if I can get through this rotation, you can too! And if I came out *relatively* enjoying it, then you most certainly can too!
To begin, surgery is just a different beast. It is completely different from any other rotation you will do and truly is a separate entity from medicine all together. You often hear, “There is medicine or there is surgery”, and that is kind of accurate! Medicine (internal med, specialties, family med, primary care, etc) is so very different than surgery.
Not that it’s “one or the other” or you can “only like one” but I feel like if you kind of want to do surgery, you go into surgery and you stay in surgery. Similarly, if you want to go into medicine, you start in medicine and kind of stay in medicine.
Then, there are those specialties that have a little medicine and a little procedure in them (ER, urgent care, derm, ob/gyn) which might be perfect for other people! However, this concept was something I learned quickly. Surgery is so different from medicine.
I was most concerned about the OR experience. Again, the OR is one of a kind! There are so many unwritten rules in the OR and it’s important to follow them. Furthermore, the whole scrubbing and sterility and all that jazz was intimidating. I basically didn’t want to do anything wrong, make a scene, or ruin a whole case! More on this below. So, here are some honest thoughts about the surgical rotation, and some helpful tips to know before beginning it:
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1. Operating Room Tips
Before your first day, watch a video or two to refresh yourself on how to properly scrub, how to gown yourself, and how to suture. When you walk into the room, introduce yourself to everyone and write your name on the board (they need this to document that you are a part of the case). Ask the scrub tech if you should get your gown and gloves. I never opened my gown and gloves on to their sterile field, I always handed them off to the surgical nurse (the sterile way). This was my own preference because it just felt more comfortable to me and I wanted to stay as far away from their sterile field as I could. I then waited either in the lounge or outside of the room until the patient arrived. While the patient is coming in, the anesthesiologist is doing his/her thing with them, the nurse is getting them situated on the bed, and other people are helping with other things.
Here are some ways to be helpful:
(a) When the patient transfers to the surgical bed, take their hospital bed out of the room and put it on the side of the hallway.
(b) Strap on the IPCs and hook them up to the patient’s legs- don’t forget to power on the machine.
(c) You will see the repetitive dance that goes on in the OR, they strap the patients arms, they get extra blankets, etc etc. Watch it happen a few times, then do it with them- help with strapping the patients arms, get the lithotomy leg straps, belt them onto the table. Just watch the process for the first few days, then help with your part.
2. Scrubbing Tips
Just know how to scrub. Your preceptor will teach you and then you’ll be great at it. Also know how to gown yourself- I tbh was so nervous about that (the weird little glove flip thing!) and never had to gown myself, I just stood there and they always helped me. But that’s kind of annoying, so maybe ask to do it one of the first days so you can practice it and get it out of the way. You won’t have to do it much, but it’s a skill you should know so you aren’t in week 4 begging they don’t ask you to gown yourself.
Here is a good self gowning and gloving video.
Here is another good one.
3. Suturing Tips
YOU CAN DO IT! The main sutures you will need to know are the running subcuticular for longer sutures such as hernia repairs or breast lumpectomy’s, and the simple subcuticular for lap incisions (smaller holes after surgeries such as an appendectomy). There are others you may try, but those are the main two!
Here is a good running subcuticular suture video.
Here is a good simple subcuticular suture video.
4. Study Tips
I thought Surgical Recall was absolutely AMAZING. It pretty much gave me every answer I needed to know when the surgeons would ask me questions in the OR. It’s an easy read, breaks up chapters by system, gives you the main anatomy and important structures to know, and is just all around great. I would HIGHLY recommend picking it up (I thought this was much better help in the OR than Dr. Pestana’s Notes, though I know many people like that book as well.)
5. Rounding Tips
I felt that the rounding process was much quicker (duh) than in internal medicine or other hospital specialties. The notes are shorter and amount of time you spend with patients is quicker. Feel it out the first few days with how they want you to do things, but let’s just say that I was able to round on 16 patients by myself in the span of 3 hours and write comprehensive notes on all of them with minimal questions. I am not that smart. I promise. Post-op patients are just (for the most part) so much easier to figure out and round on than patients you have rounded on in other rotations such as medicine specialties or IM.
**Bonus Tip**
Speak up in the OR! They may not always tell you what to do, so make sure you stay engaged, ask questions, and ask to suture or close or whatever you feel comfortable doing. It can get a bit monotonous if it is your 12th hernia repair of the week, but try to remain as engaged with questions as you can, offer to help as much as you can, and always try to suture something in a case! The more you practice, the better.
Final Thoughts
Overall, I had a really great experience and sincerely appreciate everyone who helped me along the way (let’s be honest, I was a hot mess for a good 1-2 weeks!) You will be so great! Plus, it was SO cool to see the human body being cut open and fixed and patients feeling better. Surgery is really such a special area of medicine and I’m thankful to have experienced it for a month.
Good luck to all, and have fun!
