Thursday, October 23, 2008

Surgery 110

In sum, the surgery experience involved a lot of practical learning and growth. The positive aspects of the rotation encompassed the operating room and procedures. Compared to stories I've heard from others, I got to do as much or more hands-on things in Fresno than students at other locations. I feel pretty good about my suturing and I really enjoy it; even though stitching can be tedious and repetitive, I like using my hands. I got to place two chest tubes, an arterial line, attempt some femoral artery sticks, and put in a Foley catheter, which is quite good for a third-year medical student. I was given a lot of responsibility and felt that I really was the caretaker and advocate for my patients. I got to rotate through multiple services, see common surgeries (I've had my fill of hernias and gallbladders) as well as complex cases (thoracotomies, cancer surgeries), assess clinic and ER patients for surgical intervention, attend trauma activations, care for patients with traumatic injuries, see plastic surgery, and learn about burn management. I really appreciated the diversity of experiences they offered.

However, I found that the formal didactics were mediocre. I did not think I learned a large body of knowledge, though certainly I nibbled at the entity that is general surgery. I found some personalities to be abrasive and arrogant, and I experienced some less-than-optimal situations. Tensions and stress were high with the patient load we had, and I often felt that teaching was secondary to more urgent needs. I didn't find myself connecting with any particular surgery attendings or residents. Students were too busy to study outside the clerkship; though call was a unique experience, it was incredibly draining. Through much of the rotation, I did not feel appreciated, and at times, I felt like I was doing more scut (busy work) than necessary. I recognize that Fresno had a lot of constraints and acknowledge that investing in students is a tiring and difficult business, but I wish student learning was more valued.

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