Lessons & Blessings: First Two Weeks of Surgery Clerkship
I posted the very first day in my last post. Here are the rest from my first two weeks of general surgery. Doing this has really helped me. It’s nice to look back and see that I have in fact been learning things. Another thing I have learned is that HY material for Step 1 has a pretty poor correlation with HY for clinical practice. We did not spend much time learning about the common, “bread and butter” diseases; we didn’t learn brand names for medications; we don’t know how to treat things; and, with the exception of maybe two occasions, all of our physical exam learning was virtual so we don’t really know how to perform physical exams in practice, etc. I am truly thankful for the wonderful team of people I have been able to work with so far. Everyone has been welcoming and has helped teach me things - nurses, residents, attendings, other students, and cleaning personnel. Anyways, I’m blathering. Here are my L’s & B’s:
Today I learned: better knot-tying technique (pulling direction, following knot down with pointer finger). How to insert a Foley. Different graft types and perf ratios.
Today I am thankful for: residents who let me go home early from overnight call
Something I want to look up for next time is: my schedule? Also the reading they mentioned for basics of burn care stuff.
Today I learned: the difference between cholecystitis and cholangitis.
Today I am thankful for: The unexpected break I had in the middle of the day during lunch - I got to catch up with some classmates; my attending for running me through a work-up for abdominal pain; my resident for thanking me at the end of the day.
Something I want to look up for next time is: the reading about critical/trauma burn care recommended to me by my attending.
Today I learned: how to remove staples; what the Trendelenburg position is.
Today I am thankful for: the fact that nobody yelled at me when I made mistakes in the OR; my resident for taking the time to review my notes and give me feedback on them.
Something I want to look up for next time: everything about wound vacs
Today I learned: how a trialysis line is put in; pts with uremia make orange urine.
Today I am thankful for: the compassion with which I saw critically ill patients being treated; feedback I got on my knots.
Something I want to look up for next time is: management of venous lines; management of transplant rejection; urine calculation for expected output. DTI which is some sort of vocabulary associated w/ pressure ulcers. Fistulas in dialysis things.
Today I learned: how to check medication info in UpToDate
Today I am thankful for: my residents doing their best and still teaching me even when it is a busy, understaffed day/week.
Something I want to look up for next time is: complications of spinal injury/surgery
Today I learned: frostbite classification and tx
Today I am thankful for: my family; open communication from my team members (esp my resident!)
Something I want to look up for next time is: how to do a primary and secondary assessment on trauma pts once ABCs covered
Today I learned: how to write a hospital course
Today I am thankful for: feedback my other resident gave me on my charting
Something I want to look up for next time is: CIWA
Today I learned: if applying pressure to stop venous oozing, apply for at least 5 consecutive minutes w/o moving.
Today I am thankful for: my residents!!
Something I want to look up for next time is: trauma assessment algorithm