Surgery has always been a notoriously intimidating rotation for PA school students. And it’s easy to see why. While you prepare during your didactic year with surgery-based courses that teach you the basics of OR equipment, sterility, and surgical techniques, for many the rotation is their first time in an operating room.
The truth is, there’s just way too much you have to learn in that setting to feel comfortable. So being nervous is completely normal! In fact, it’s a good thing—it shows you recognize the importance of what happens in the OR.
To help you prepare, here are some tips and tricks to set you up for success.
How to Rock Your PA School Surgery Rotation
1. Be prepared!
Just like any other rotation, it’s important to be prepared. Most surgical schedules are set in advance, which gives you the opportunity to review cases the day prior. This is crucial so you can anticipate what you’ll see in the OR!
Leading up to the rotation, be sure to review anatomy, including major organs, their vascular supply, and nearby nerves. While no one expects you to be an expert, be prepared to answer questions about the major structures you’ll see during the case.
2. Know your indications, preop planning, and what to look for post surgery.
Many surgical rotations also feature components of inpatient rounding and outpatient clinical work. This can be exciting for students, as every day looks a bit different.
Make sure you’re well-versed in indications for the surgical procedures, pre-operative planning, and what to look for postoperatively. A lot of these topics aren’t often emphasized during didactic year, so it’ll require some extra research and preparing on your end.
3. Dress professionally.
While you’ll likely be changing into surgical scrubs, I recommend wearing business casual into the hospital unless otherwise instructed by your preceptor. This allows you to maintain professionalism and also be prepared if your plans for the day change.
4. Get there early.
It’s important to show up early for any rotation, and this is especially true when you’re working in the OR. The operating room staff is on a very set schedule and you don’t want to cause any delay for your preceptor.
5. Don’t expect your hours to be the same every day.
Surgical rotations can be unpredictable. Cases may get added on, leading to more exciting learning opportunities and longer days than expected. And while we can estimate how long certain surgeries will take, anything can happen in the OR. There’s no set “end time” to any case, so be prepared to stay later than anticipated.
Since lunch may not always come at a reasonable time, it’s very important to eat a good breakfast at the start of the day! Even if your start time is early, try to at least drink a protein shake or something with sustenance at the beginning of the day. Also, be sure to pack quick snacks you can grab easily, in case your breaks are shorter than expected.
6. Introduce yourself and seek guidance.
When stepping into the OR, the first thing you should do is introduce yourself to the staff. A good start is to introduce yourself to the circulating OR nurse. Tell them your name and purpose for being in the room.
Ask for guidance on where to find your gowns and gloves and be prepared to scrub in independently, unless directed otherwise. You should also ask for guidance on where you should gown and glove. Oftentimes, there will be a spare mayo stand to utilize.
After asking for help the first time, make sure you grab your gown and gloves independently and don’t expect this to be done for you, even though it’ll usually be done for your preceptor.
7. It’s alright if you need to excuse yourself.
Throughout my time working in the OR, there have been many students who had to leave due to feeling faint. This is usually because they didn’t have adequate food and water intake during long surgical days.
If this happens to you, don’t fret. Just quietly and politely excuse yourself to take a food and water break. Your preceptor would prefer you recognize these signs early and step out, rather than risk passing out in the OR.
8. Maintain sterility.
One of the most important things is to ensure you maintain sterility in the operating room. Breaking sterility can cause significant delays because it requires a reset of the sterile field, even if it occurs prior to the start of the case. Setting up the operating room is a tedious task with a stepwise approach that takes time, so many nurses and surgical techs are very protective of their sterile field (rightfully so).
Breaking sterility during the operation could cause infection risks for the patient, so obviously this is to be avoided. When you aren’t scrubbed in, be sure to stay an appropriate distance away from the sterile field, no matter how interested you are in the case. When you are scrubbed in, remember to keep your hands in front of you, and avoid dropping them too low or raising them too high, as those areas are no longer sterile.
What do you do if you break sterility?
As a student, understand that breaking sterility happens often when untrained people enter this environment. In fact, you’ll likely break sterility a few times throughout your surgical rotation.
When this occurs, just make sure you immediately step away from the table, are honest with the team about what happened, , and rescrub into the case without causing disturbance.
In Closing
Overall, this rotation will likely stand out from the rest. Whether you’re looking forward to it or dreading it, I encourage you to keep an open mind. Be sure you’re ready to work in an ever-changing environment, eager to learn, and prepared every day! Soak up these experiences, as many things you learn will be useful throughout your PA career, regardless of the specialty you choose to go into.
Good luck on your rotation, and be sure to reach out if you have any questions!
For more (free!) tips for clinical year of PA school, check out these other posts:
