Surgery is not for everybody. I can say with certainty that it wasn’t my favorite rotation. Our introduction to surgery was the surgical clerkship director stating that we should only “go into surgery only if you can’t see yourself doing absolutely anything else.” That was sound advice.
Regardless of which field you enter, you must complete medical school, including your surgical rotation. Even if you’re not planning to go into surgery, it’s important to learn the situations in which surgical consults are necessary. Learning how to function and not offend anyone in the OR is a skill that will serve you in more fields than you think. You also get more opportunities to work with your hands!
The day in the life of a medical student on a surgical rotation differs drastically from that on a medicine rotation. Even among different surgical subspecialties, the day-to-day varies greatly. By the end of your surgery rotation, however, you’ll have stronger life skills, resilience, and empathy for your surgical colleagues.
Put your shelf exam knowledge to the test with this FREE shelf exam practice quiz of the most commonly missed shelf questions from the Rosh Review Shelf Exam Qbanks (one for each specialty)! Each question includes a detailed explanation and visuals to help you retain anything you may have missed. How many questions can you get?
My Experience as a Medical Student: Surgery Rotation
I chose to describe a “day in the life” from one of my hardest surgical rotations when I was a medical student: transplant surgery. Even though I did not pursue a surgical residency, this two-week rotation had a profound effect on me. It taught me how to have perspective, adapt, and even thrive in unfamiliar and stressful situations.
Mornings
My least favorite part of the day—waking up. It’s not so bad on a regular day. It’s just that on this rotation, I have to wake up at 4 a.m. to try and get to the hospital by 4:45 a.m.
I’m lucky because my co-medical student, who is interested in pursuing surgery, wants to do well and is willing to drive me to work with him. Otherwise, arranging your own transportation to the hospital during these hours can be an extra hurdle.
We get into the team room by 4:45 a.m. and print the list before the residents get there. The team consists of two medical students, two surgical interns, an upper-level surgical resident, usually a PGY-3, and a transplant fellow in addition to various attendings.
Rounds
We usually follow about two or three patients to present on rounds. Chart review can take some time since a lot of patients are quite sick in the SICU. There are parameters and lab values that I’m still not familiar with, and new details that I need to know for rounds. Pre-rounding is usually quicker, though, because that happens around 5:30 a.m. or 6:00 a.m. and most patients are asleep. Surgical rounding is notoriously short, and my pre-rounding experience lives up to that stereotype. I run in, look at the surgical scar, ask the patient if they’ve pooped, and move on.
Rounding is also a lot more stressful than it is on my medicine rotation. The attending tends to be very no-nonsense, and short on time, and when they ask you a question they expect you to know exactly what they are looking for. There’s not much time for didactics, and most likely there will be pimping. All in all, it goes quickly, and if all goes well I’ll only emerge with a little bit of road rash.
Clinic
Some mornings, you’ll follow the residents to clinic where there will be quite a full schedule. For the transplant rotation, this is mostly a postoperative clinic for patients months out from their transplant surgery. In other surgical fields, there will be more pre-operative surgical consult visits to discuss potential or planned surgeries. Clinic tends to be the most “relaxed” time, where we get the most teaching from an attending or the transplant fellow.
Clinic usually goes up to noon, and sometimes runs late. I usually spent lunch with the team, as there’s not always time to have a leisurely lunch, especially if there are cases in the afternoon.
Afternoons
Afternoons are prime operating time. If there’s no clinic that day, OR time starts even earlier, usually immediately after rounding. Most cases I see during my transplant rotation are after the organ has already been harvested (usually by the fellow), and is being transplanted into the recipient. Organ harvests can be from across the region, and medical students sadly are not allowed to ride the helicopter and observe the harvest. The transplant service serves both the pediatric and adult hospitals and bounces back and forth for different cases.
Operations
Being in the OR is a definite learning experience. After appeasing the circulating nurse, there’s the scrub nurse. I try my best to not touch or bump anything I shouldn’t, dodging tables and trays and movie machines. I’m also working on introducing my role confidently, retrieving my gloves, scrubbing in a timely manner, and not stepping on anybody’s toes, literally and figuratively.
As a medical student, my role during a case is mostly holding a retractor, standing very still, and trying hard not to ruin the sterile field. Sometimes I listen to the attending surgeon and the residents gossip and banter. Other times I’m taken by surprise by a pimp question or teaching moment here and there. The transplant cases can take hours, and it is an exercise in patience. It’s fascinating, however, to have a front-row seat as the surgeons anastomose vasculature and implant a new organ into the recipient. I’m always in awe of the precision and expertise.
Once the difficult part is over, the attending usually leaves and allows the fellow and resident to “close,” i.e. sew the patient up. Sometimes if I’m lucky, I’m allowed to throw a few stitches. Be wary of time when doing this—there are additional constraints of turning over the OR for the next case and minimizing patient exposure to general anesthesia. Practicing knots at home will make everything run smoother when the opportunity arises.
Evenings
Depending on the case, the day can definitely run late. The longest day I ever had was probably 3 a.m. to 7 p.m., but it was an outlier. If cases finish earlier, the students may leave a little earlier. Most days, I left around 4 p.m., as the team does keep the early wake-up times in mind.
My two weeks on this rotation were definitely exhausting. Keeping in mind that I had the surgery shelf exam to study for, I would usually have the bandwidth for 10 to 20 practice questions per day. Most of my studying was accomplished on my day off, which was one in seven.
During my transplant surgery rotation, I remember primarily focusing on sleep and feeding myself. I was essentially in survival mode. However, the experiences I got from this rotation were unparalleled and will stick with me forever. It takes a special kind of person to be a surgeon and being able to witness this firsthand as a student was definitely an opportunity I won’t forget.
