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How to Ace Your Surgery Rotation. Karen Horvath, MD, FACS Professor of Surgery Residency Program Director University of Washington. Objectives. Goals of rotation Role as student & ‘performer’ Insights into the other side Practical tips from UW. What are your goals?. Goal #1.
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How to Ace Your Surgery Rotation Karen Horvath, MD, FACS Professor of Surgery Residency Program Director University of Washington
Objectives • Goals of rotation • Role as student & ‘performer’ • Insights into the other side • Practical tips from UW
Goal #1 • To learn as much as you can • What you learn is mostly dependent on you • Requires YOUR active pursuit of knowledge Knowledge
Knowledge in Surgery • Experiential = active participation • Hands-on, concrete • Changing dressings • Writing notes • Collecting labs • OR & clinic • Surgical concepts acquisition • Reading for patients • Prep for OR • Studying for test • Pub Med searches ad infinitum!
Goal #2 for your surgical rotation is to make a contribution – over and over and over again.
Goal #3 • To obtain an outstanding ‘performance’ evaluation • You are performing • ‘Deans Letter’ = MSPE comments • Clerkship grade • Letters of recommendation • Know your audience! • Attendings, residents, nurses, patients & families
Who is Your ‘Audience’? • Surgeons are….. • Detail-oriented • Direct • Concise • Practical • Logical • Linear • Efficient • Organized • Committed • Multi-taskers • Type A (perfectionists) • Strong work ethic • Awesome
Surgeons • Value patient ownership • Attached to patients in unique way • Bond of trust from surgical event • Value ‘appropriate’ initiative Surgery is a team sport!
What are Saboteurs? • Intern’s mission: • Take good care of patients • Prevent problems & complications • Facilitate care (get pt home ASAP) • Get the work done efficiently • Look out for team members (pain prevention tactics) • Look good in the process • Saboteurs are people who unwittingly try to kill your patient, your mission – or you!
No Suprises Please! • Potential saboteurs • Medical students • Other residents • Nurses • Faculty! • Methods of operation (med studs) • Not being 100 % reliable • Say you’ll do something & not come through • See a problem & not tell resident • Cause a delay in care SURPRISE!
SIESyndrome of Inappropriate Enthusiasm • Displays of useless energy akin to entropy • Aka ‘Smoke blowing’ • Includes brown nosing Substitutes for hard work
SIESyndrome of Inappropriate Enthusiasm • Includes back-stabbing • “Some kings stand taller by making their subjects kneel” (an illusion) • Don’t promote yourself by stabbing others • Obvious even when ‘subtle’ • Support your colleagues • Be seen as a team player You don’t want to go here.
Rotation Expectations: General • We expect your best • Push yourself • Surgical care = balance & efficiency • “Asked to do more than you think you can do in as little time as possible. • Try. You may fail. You’ll get better.” • Jump in • Good attitude • Menial tasks count for the team as much or more than ‘important ones’. • No task too menial “Cleaning latrines: it's one way to learn that each man's labor is as important as another's.” – M. Gandhi
Rotation Expectations • Have a card system for your pts • Know EVERYTHING • Pretend you are patient's only doctor • Make patients rely on & trust you • Write notes • Rounds = Anticipate, Anticipate!! • Prepare • Dressing supplies ready • Help takedown dressings • Write orders & get co-signed
Rotation Expectations: Presentations • Present with purpose & quality, NOT Quantity • Plans • Always make one • Make your own • Concise • SO…….AP • Read every day
Rotation Expectations • Track patients throughout day • If patient having test... Help make it happen • ‘Bird dog’ labs, tests & consult notes • Events = notify residents • If you have left over time – help others
Rotation Expectations • Go to OR whenever possible • Tie knots & ask for help • On-call • Help with notes, consults, post-op checks & evaluating patients • Stick to intern ‘like glue’ • Don’t disappear – people notice • Notify someone • Mid-rotation, ask for feedback
Summary • To get the most……give the most • People notice & the rest falls into place • Don’t worry about competing • Actively participate in all functions of the team • Most of all….Be kind Patient
Bruce C. Gilliland, M.D.Professor of MedicineDivision of RheumatologyProfessor of Laboratory MedicineAdjunct Professor of MicrobiologyAmerican College of Rheumatology Master 1931 - 2007 “If I’d known what it was like to be a patient, I’d have been a much kinder doctor.” Bruce Gilliand, MD