General Surgery Sub I


I did my surgery elective at two different hospitals. Before my elective I went over surgery recall thinking I should at least know the basics. That was a good idea, as it put me on par with everyone and allowed me to answer expected questions. 

When you get to the ward you're usually paired to a team that is lead by a chief resident and includes two or three interns, one categorical second or third year, and you. Sometimes there may also be medical students from the affiliated medical school on their third year rotation or another fourth year doing an away rotation. If you're lucky your team will be composed of nice people that will teach you and also tell you what you need to do. In general you will have to show up early for morning rounds where you will usually help change dressings as well as present your patients to the chief resident. Of course, to present your patient on morning rounds you must preround yourself, so you will have to be on the ward earlier then everyone else to prepare. At first it may be a little difficult because you may not have learned to preround properly during your surgery rotation, but as a whole its really a simple presentation that you will get very quickly (trust me on that its not too complicated).

During the day you are usually paired to surgical procedures where you either observe or help out depending on how much the surgeon likes you (I got to suture in a cranial free flap). Regardless, every patient you "operate" on is your patient and therefore you will present them during rounds. Before procedures do try to read in recall, it will help you if you're pimped and allow you to ask intelligent questions if you're not - very important. If you're not in a procedure, you'll be on the ward helping out the interns. I found this time very useful because it really taught me how they manage patients.

If you're smart you'll use this time to learn how to get things done. Of course, you want to be useful, so always offer to help out the interns and the team in general. By the end of my rotation I was managing my patients, running around the hospital taking out stitches etc., and even doing some consultations by myself for the team.

Finally, throughout your elective you will attend various departmental meetings like M&M (morbidity & mortality), teaching conferences, and student lectures. I was never bothered to attend too many of those and when I did they never really involved the students so you can generally sit back and listen, its usually quite interesting. Do not fall asleep, it shows weakness of character and will be seen very negatively by your teammates. Do not fall into the trap of thinking the interns, categoricals, etc. are your friends (I never understood people who were foolish enough to think that). They may be nice, but the moment you let your guard down too much you'll see that they catch you. They will be asked about you later and you want to make sure they give a positive opinion.

General Surgery

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