Week 1

I think for this rotation, I'll describe things week-by-week. Much of the first week was occupied with orientation activities. The clerkship site director, though very direct ("surgeon-like"), seems to be supportive of medical students. We got a tour of the hospital and a quick reminder of how to scrub. There were pretty good lectures on radiology, trauma assessment, and shock as well as cardiothoracic conference, a morbidity and mortality discussion, a grand rounds on hyperbaric oxygen, and a resident presentation on gallbladder disease. I actually get a lot out of the formal teaching; the attendings here are good and focus on the clinically relevant, but they like pimping.

The ward service is made up of mostly elective surgery patients, but occasionally, trauma, burn, orthopedic, plastics, neurologic, oral and maxillofacial, pediatrics, and other patients wander through. It can be pretty hefty at times (on a 24 hour weekend call, we can admit 20-30+ patients, it's ridiculous) and we round at 6 in the morning so pre-rounding begins at 5 or so. I followed a patient with a newly diagnosed breast cancer and a patient who had a ventral incisional hernia repair. I actually scrubbed into that surgery where a mesh was sewn into the abdominal cavity to prevent protrusion of intestines.

We have two clinic days per week and I got to see a standard symptomatic cholelithiasis, a thyroid problem, and a mysterious neck mass (possibly disseminated cocci). I like the clinic setting as I'm more comfortable with the format and expectations, but we have to keep adapting to the logistics. I dictated my first two pre-op H&Ps which was incredibly stressful (I'm not sure why). It was the first time I ever dictated a patient but I later read the transcript for one of them and I think it went okay.