Finished With General Surgery

I’ve not written anything for a long… long time. It’s probably the longest I’ve gone without reflecting about my encounters on the wards, but for those who’ve rotated through general surgery, you already know why this is the case – the long hours. I would routinely get home, find any excuse not to study, and then crash before having to wake up at 3 AM.

Wake up alarm during general surgery
In retrospect, I owe it to my fantastic teammates for making this excessively-hyped-month very enjoyable. We took turns scrubbing into our attending’s cases, worked well during our clinic days, and had plenty of patient encounters. 🙂

So what did I learn about general surgery? First and foremost, the notion that surgeons are cold and unsociable is a stereotype which isn’t all-inclusive. While I did see the prototypic “surgeon personality”, I was fortunate to have an attending who broke through the label and routinely showcased a genuine concern for his patients pre/post-operatively; he modeled the type of surgeon I wish to emulate one day in demeanor and technical skill.

This particular surgeon was a pancreas specialist, so we saw many cases of pancreatic adenocarcinoma, a diagnosis that comes with a bleak countdown timer. One of the most difficult aspects of this month was having patients follow-up in clinic for the results of their pancreas biopsy… only to be told that it showed unresectable cancer. 🙁

Since I want to pursue surgery, this was also a great chance for me to see my future responsibilities as a surgical intern. Much to my displeasure, it looks like the first few years of residency are heavily engrossed with floor work with minimal time in the operating room. I now realize that in spite of the tedious training, everything has a meaningful role in educating a surgeon. What’s the point of having technical skills if you can’t manage patients pre/post-operatively? When do you make patients NPO? How do you manage post-operative fevers? Etc. etc. It’s all important!

There’s one thing I couldn’t figure out during this rotation – how can one feel so utterly tired by standing motionless for an extended period of time? It’s pathetic. I would get home exhausted, try to evaluate what activities could have contributed to my fatigue during the day, and I would always arrive at the same conclusion – “Geez Rishi, all you did was stand in the O.R., walk during rounds, and sit in the lounge. Suck it up!” 😀

As far as updates in scheduling, I’ll be doing Family Medicine in January 2012 followed by two months of “vacation” to study for the USMLE Step I (scheduled for March 25th). April will likely be filled with surgical selectives (looking at anesthesiology and neurosurgery at the moment), and then I’ll have pediatrics in May/June.

On Monday, I start two weeks of otolaryngology, the field I want to ultimately pursue – it’s my time to shine! After that, two weeks of ophthalmology and then the surgery shelf exam. Woo. 🙂

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  1. glad to hear you’re still doing well. i remember pulling 80-100 hour work weeks during my med school surgery rotation! our service had 1 senior resident, 1 junior resident, and 60 medical students split into four teams. it was a lot of hard work! good luck with step 1 studying!


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