Secrets to Orthopedic Away Rotations

Here is a quick rundown of what I've learned and been told about how to thrive while on an orthopedic away rotation.

First and foremost, as I'm sure you already know this is a tryout. It's a chance for you to try a program on for size, but moreso it is a chance for them to see what kind of resident you might be in their program. It's easy to slip into the mindset that just because you graced them with your presence for a month that they are going to think better of you. Not so. In fact that is why on average it is a lot easier to hurt your chances of getting into a program by doing an away than it is to help your chances. The all encompassing first rule of away rotations is: always work hard.

What are some of the ways you can shine? You can prepare the notes before the resident's arrive in the morning. Perhaps it is just where I am at, but unlike general surgery, it seems that the residents do not care (and may even prefer otherwise) if you see a patient in the morning before they get there. They seem more concerned that the actual rounding process is streamlined. Regarding the OR and pimping, the most important thing to know is anatomy. Most commonly you'll be asked questions such as "What nerve is in danger with this incision," "What muscle is this," etc. Expect more nerve-muscle questions than insertion, origin and action questions.

When in the operating room, assume that once you are given a role once, they expect you to fill it from that time onward. For instance, some common tasks are adjusting the lights, sponging up blood in the field, and using the suction. Additionally, one should be familiar with deep tissue, subcutaneous, and skin closure so that when the attending asks if you are comfortable doing so you don't respond by saying something like "we'll I only saw it once..." Another thing to mention: when the resident or attending moves towards where you are standing, you should move to the other side of the table, they won't always take time to say "Hey can you switch positions with me."

Another OR tip: when retracting don't worry about them repositioning the retractor frequently. It is likely nothing but them wanting it in a specific place and not a commentary on how you are doing. You'll likely notice them doing the same thing with the residents.

The biggest thing that programs are looking for is hardworking, teachable medical students that appear to be engaged in the case or lecture, with whom they can get along with on a day-to-day basis. Most of the time they would rather have the above student as a resident than one that is just the best at answering all of their pimping questions.