After two days of ortientation both to the hospital and the surgury rotation in general we were finally able to start getting our hands dirty learning the basics of general surgery. I was both extremely nervous and very excited, nervous that I would make some glaring mistake, nervous that I would ask stupid questions and be thought of as a student not deserving of the trust that was placed in me, nervous that I would not be able handle the long hours associated with the surgical rotation, but most of all just nervous that maybe I was not going to be able to cut it as a clinical medical student. At the same time I was also very...
Excited. Excited that I never again would spend days on end studying for a (mostly worthless) biochemistry test. Elated that I was now going to be working with real patients. Overjoyed that I was going to play some small role on a team that was working to help heal patients. Needless to say it was a time marked by dramatic mood swings.
Before I get too far, I should give a little more background.
The surgical rotation that I am on does mostly common general surgical procedures, for instance gall bladder removals, appendectomies, thyroid and parathyroid surgeries, some melanoma removal and emergent surgical cases.
The service that I am on is specifically a trauma service, so over the course of the next 6 weeks I'll be helping to take care of a lot of patients who have been in a car accident, or fallen and broken bones, or patients that require an emergency appendectomy or other urgent procedure.
I found all this out during the first two days of orientation, but nothing that they tell you during orientation could prepare you for the experiences and emotions that you will feel as you walk into the hospital on your first day of work.
Immediately I met the chief of the service--for the unindoctrinated, the chief of the service is a doctor who is in the final year of their residency, in general surgery this means that they have been out of medical school for 5 years. In my situation the chief resident had been a doctor for 6 years as she had taken a year to do a fellowship in critical care.
Also on the trauma team was a first year resident, aka an intern. At many hospitals, about half of the interns are on a track to become general surgeons while the other half are either in a year-long "preliminary surgery" program or are in a "transition year". For the most part, those in those in the "preliminary surgery" program are either US or international students that didn't match into the surgical specialty they wanted to (ortho, ENT, general surgery, etc). Students in a transition year have already been accepted into other programs, but as part of their training they rotate through different specialties for their first year. For the first month we had a transition year student who was accepted into the Radiation Oncology program, and the second month we had a Preliminary Surgery resident.
I was very fortunate in that I was on a relatively small team for my surgery rotation. In other hospitals, 4 medical students would be assigned to teams of 10 residents. The major difference between our 3 person team and the larger teams seen at other hospitals was the lack of mid-level residents on our team. In other words the 10 person team would have a number of 2nd, 3rd, and 4th year residents sharing the workload. The downside to a small team is that when there are 40 patients on the rounding list for a Saturday you only have the three of you to see them all. The upside is that many times in the OR it was just me, the attending and the chief resident doing a case. Which for me was the most interesting.
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