My Neurology rotation over, and breezing thru Surgery.

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Hello reader,

First off, belated happy new year. If you’ve stuck with me through all this time, thank you! I started this blog around the time I started applying to medical school. I’m now a 3rd year and on my clerkship rotations. Later this year, I apply for my first job as a doctor.

 

At the moment, I’m on my  general surgery service. I’m on my away rotation away from Boston, the school provides a house near the hospital. I live with two other students from my school, one is on surgery with me, the other is on another rotation. Prior to this rotation, we were all friends, the three of us have a pretty easy going relationship.

On Neurology

What has also been surprising, at least for myself, is that lately I’ve been considering Neurology as a specialty. In context, I haven’t had medicine yet, and my original top choice was leaning towards Ob/Gyn. The reasons are fairly complicated, and probably merits its own discussion. But, one thing I’ve considered is that I have a background in electrophysiology, did well in medical school neuroscience on theory and clerkship, and I had fun. It seems somewhat appropriate to consider it. Really though, who knows what I’ll end up doing, everything have been somewhat “doable.”

Surgery

As I mentioned, right now, I’m on surgery. I just finished 4-weeks of trauma and vascular, hence all that is left is general surgery. While on trauma and vascular, I worked 6-days a week, for a total of about 78-80 hours a week (there’s a rule of not exceeding an average of 80 hrs/week). On this service, there is a week where I’ll go over 80, but the following week I’ll have some time off compensated.

Prior to surgeries, I arrive at around 4:40 AM, I pre-round on my patients (usually three). I write notes on my patients, this hospital uses a paper/computer hybrid system. Sometime before rounds, I have to find their nurses to get the latest updates. To a resident, I present my three patients during 6 AM rounds and make a plan for that patient. Between 7:20AM and 9AM I start scrubbing into surgeries.  a few surgeries a day, mostly “driving” the endoscopes, retracting things, occasionally cauterize a bit or two, tie up things, try not to contaminate things, and brave the emotional OR storm – the latter being the most vital to survival.

If I’m out of surgery before 2 or 4 PM, I go to PM rounds with the residents. This time, because other students are in surgeries, I pick up patients who aren’t mine to present. This time, instead of “short rounds” like the morning, PM rounds are just me saying a sentence about a patient to summarize their admission/course. This also acts as “sign-out”, so the overnight resident gets their updates from you. After this, I typically go home, sometimes I go back to surgery. Eventually, because I live really close to the hospital, I make it home rather early 5:30~PM. Besides that, on this service, I had my first weekend in a month. My roommate and I usually leave together, we sit at the dinner table, study, eat, and again start another day. With that being said, I generally like surgery, and I’ve gained the skills I needed to not get eaten alive:

  • Be able to read the schedule (it’s harder than you imagine, my kingdom for a schedule that is easy to read and accurate)
  • Navigate the electronic medical records at a new hospital
  • Get lost less at a new hospital
  • Cut surgical strings the correct length and tie decent knots
  • Make presentations as short as possible
  • Get really good at asking about pee, poop, passing gas, have few qualms asking people to disrobe, and making doorway assessments

Just a few more weeks of surgery, then I’m onto internal medicine: Renal medicine (2 weeks), Hematology/Oncology (2 weeks), and 4 weeks of general medicine. I really was hoping for 2 weeks of Cardiology, but I didn’t get it – I’ll do it as a 4th year, along with emergency medicine.

Two weeks or so after finishing 3rd year, I take STEP 2 CK. Then, during October as a 4th year, I’ll fly out to Chicago to take another exam (the infamous STEP 2 CS). I’ve spent $1,800 so far on just registering for the exam. Good times, eh?

Well, that’s it for me, back to reading. And thanks for reading!

 

 

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