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How to Ace Your Surgery Rotation

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

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  1. How to Ace Your Surgery Rotation Karen Horvath, MD, FACS Professor of Surgery Residency Program Director University of Washington

  2. Objectives • Goals of rotation • Role as student & ‘performer’ • Insights into the other side • Practical tips from UW

  3. What are your goals?

  4. Goal #1 • To learn as much as you can • What you learn is mostly dependent on you • Requires YOUR active pursuit of knowledge Knowledge

  5. 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!

  6. Goal #2 for your surgical rotation is to make a contribution – over and over and over again.

  7. 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

  8. 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

  9. Surgeons • Value patient ownership • Attached to patients in unique way • Bond of trust from surgical event • Value ‘appropriate’ initiative Surgery is a team sport!

  10. The interns / residents as your ‘audience’.

  11. A primary goal of internship is learning to avoid sabotage.

  12. 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!

  13. 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!

  14. Practical Tips

  15. SIESyndrome of Inappropriate Enthusiasm • Displays of useless energy akin to entropy • Aka ‘Smoke blowing’ • Includes brown nosing Substitutes for hard work

  16. 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.

  17. 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

  18. 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

  19. Rotation Expectations: Presentations • Present with purpose & quality, NOT Quantity • Plans • Always make one • Make your own • Concise • SO…….AP • Read every day

  20. 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

  21. 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

  22. 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

  23. 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

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