Jump to content

Surgical rotations


Recommended Posts

Depends on the rotation and time of year. I've found that residents tend to get priority for procedures and early on they will be looking to fill in their procedure logs. Obviously, if there are no residents and/or you are 1:1, then it's a completely different story.

 

Surturing, bovie-ing, driving the laproscopic camera, and retracting was about the extent of what I did. In clinic, I was also able to do some biopsies, I&Ds, and excisions. 

Link to comment
Share on other sites

  • Administrator

I got to hold the camera on lap procedures a lot, retract on open ones, suture trocar sites, use Dermabond, do stab phlebectomies,  Place foleys and intubate under direct nursing and anesthesiology supervision, respectively. Got to use the bovie on a live patient getting a tummy tuck.

 

In clinic, changed dressing on wound vacs and pulled drains, but that was mostly H&Ps.

 

On rounds, assisted with central lines (as in, hand stuff to the resident sterilely), dressing changes.

 

On overnight call, got to run around all over the hospital dispatched independently by the intern when we had a boatload of work to do, so I did all the initial overnight postop checks on the low-risk surgical patients of the day.

 

General surgery was my first rotation, and still one of my funnest.

Link to comment
Share on other sites

I'm currently 3 weeks into my surgery rotation which is with a CT surgery group. Week 1 I scrubbed in and mostly observed, held the heart back so they could graft the PDA and other coronary arteries, watched the 1st assist harvest the GSV and other secondary vessels if needed and assisted in preparing them to be grafted later in the procedure. I focused a lot on learning what the procedure entailed and what the next step was.

 

Week 2 I got more freedom and earned more trust and got to first assist also in Thoracotomy cases, helped with the opening incision and chest tube placements, got a lot of suturing / stapling in week 2 as well and towards the end of that week started to help with the first assist roles in CABG / valve repairs during opening and closing. Holding and sometimes very minimally operating laparoscopic scopes when they need both hands.

 

Week 3 (which I'm currently in) I got to perform a lot of debriedment for an empyema decortification case, lots of suturing, rounding on patients and have become more involved in the 1st assist duties still building and adding to my student duties from the previous two weeks. Got to use the caudery to help control bleeding. Got to first assist in making a pericardial window for a suspected pericardial effusion. Between cases a few other surgeons from different specialties had me scrub in and assist.

 

Some times they'll let me briefly use the equipment so I can get a feel for it if the patient is stable and there's no risk to the procedure. I also spoke to the anestesiologists and they've allowed me to Intubate stable patients as well as assist / perform various arterial and venous lines. I think it really depends on your preceptor and what they're comfortable with and how much you're willing to do and how you approach asking then to do various tasks. Anytime there is a line to be placed or removed I'm asking if they feel comfortable if I could do it. Sometimes I get a yes, most the time I just watch and then ask if my preceptor seems comfortable with that patient or not.

Link to comment
Share on other sites

I was in a small rural hospital without residents. I got to cut, drive laparoscopic camera, insert trocars/tools into trocars, pull out trocars, retract of course, holding liver out of the way during lap chole, making surgeon knots, suture by myself after the MD left the room, staple, remove sutures in the office, suction, chest compressions, assisted with central line placements.

Link to comment
Share on other sites

I was in a small rural hospital without residents. I got to cut, drive laparoscopic camera, insert trocars/tools into trocars, pull out trocars, retract of course, holding liver out of the way during lap chole, making surgeon knots, suture by myself after the MD left the room, staple, remove sutures in the office, suction, chest compressions, assisted with central line placements.

That is very impressive! It seems like you can never get such exposure in a large academic center

Link to comment
Share on other sites

That is very impressive! It seems like you can never get such exposure in a large academic center

I did all of that and more at a large hospital outside Chicago affiliated with a major medical school. The trick is to find surgeons without residents, really befriend the nurses, and show the anesthesiologists that you're capable of learning quickly.

Link to comment
Share on other sites

I did all of that and more at a large hospital outside Chicago affiliated with a major medical school. The trick is to find surgeons without residents, really befriend the nurses, and show the anesthesiologists that you're capable of learning quickly.

The keyword was large academic institution where there are no surgeons without residents and fellows. Maybe it is state dependent.

Link to comment
Share on other sites

  • 1 month later...

I had a pretty neat experience. Rotated in a small town. 

Got to do about everything: first assisted all procedures (including lap surgery, cutting, retracting, suctioning, irrigating, clamping, cauterizing, ligating with sutures, etc), closed every case, removed nevi for bx, breast bx, I&Ds,  colonoscopies, polypectomies and bx of colon, EGDs, bronchoscopies with BAL, central lines (IJV and femoral), paracentesis, thoracentesis, chest tubes, debridements, wound Vac, . I even got to do a lap appy all by myself (with supervision of course). Rounded, admitted, discharged, put in orders for labs, imaging and meds. 

 

I agree with previous comments. Getting a surgeon willing to teach and without other students is the key. 

Link to comment
Share on other sites

  • 1 year later...

I did all of that and more at a large hospital outside Chicago affiliated with a major medical school. The trick is to find surgeons without residents, really befriend the nurses, and show the anesthesiologists that you're capable of learning quickly.

 

I am a PA student looking for rotations in the Chicago area? Which hospital did you do your rotations in? Thank you for any advice!

Link to comment
Share on other sites

Archived

This topic is now archived and is closed to further replies.

×
×
  • Create New...

Important Information

Welcome to the Physician Assistant Forum! This website uses cookies to ensure you get the best experience on our website. Learn More