Surgical Procedures

[Treebles]

Hey guys; just debating some life changes/job changes moving forward. Wondering where you learned (and perfected!) simple surgical procedures suchs as I&D/simple ellipse excisions/recon techniques? My supervising doc doesn't seem to want to train me in surgical procedures and I think he wants to keep me on the medical side of our clinic; but I want the skills moving forward since I am so young into my career. Did you learn them as a student (did my program fail me?), or did you have an understanding supervising provider/mentor to train you?

[TheDude]

Most of the time I learned things while on rotations in school.  And I've also learned some while on-the-job so to speak.  And then I've learned a lot by being thrown into the fire.  I'm in CVT Surgery and when it came time to learn vein harvesting, one of the other PA's in the group taught me the basics, and eventually got me comfortable to be on my own.

Basic office surgical skills can be studied from books and all, but honestly doing them over and over and over is what will help.  

I don't think your school failed you, it's sometimes up to you to dive in when on rotations to get exposure.  Learning to be eager and not arrogant to get to do something cool takes students a long way, as well as when you're a PA in general.  

Just kindly ask your attending to let you watch and then do a few things under his/her guidance to "help make me a well rounded PA" to better help when we get busy etc...

[jlumsden]

Youtube has tutoring on suturing and some minor procedures.  

[mgriffiths]

I did learn some of my procedures from being taught during PA school rotations, some when I first started working by one of the other providers - but honestly youtube, uptodate (actually does describe how to do some procedures), and common sense have served me well.  Of course don't tell your patient you've never done it before and that you just went and watched a youtube video before trying something - but of course that doesn't mean you watch a heart replacement on youtube and attempt in office!  Have to also be smart regarding your capabilities, what your comfortable with, and what the office can handle.  I tend to think of it as, if the worst thing possible (within reason) happened during this excision/biopsy/whatever, could our office handle it?  If not, I'm probably not going to do it and will refer or send to ED (assuming it's an emergency).

I will never forget during my first ED rotation - first day on the "job" and we had a minor laceration that needed suturing.  My preceptor asked if I wanted to do it and of course I gleefully accepted.  Walk into the room and it's the Chief of Medicine's wife - she immediately knows I'm a student and asks if I have ever even sutured before.  "Of course!" - I just didn't tell her that my only experience was on pig's feet, jeans, etc. at home.  Went decently well and actually was told by her husband that I did a good job!  One of my proud moments and fun memories from PA school.