how should a medical student behave in the OR

[juicyprunes]

Hi everyone,

 

I was just wondering how one is supposed to behave in an OR? i.e. as medical students, can we ask questions or is that too disruptive? should we try to help out? (ie. cleaning up, etc.) If we're present for a very long operation, can we ask for bathroom breaks?

 

I know they might sound like some silly questions, but I just want to know how a person puts on his/her best face if one is interested in surgery.

 

Thanks!!

[Kirsteen]

Hi there,

 

Yes, you can ask questions and many staff will welcome them, but not all, all the time. You'll get a better feel for the atmosphere that any given surgeon or surgical resident creates once you've been in the OR with them a few times. What's key is not to interrupt during moments requiring higher concentration, e.g., if there's an uncontrollable bleeding vessel or delicate work around the porta hepatis, for example.

 

In terms of helping out first ensure that you become comfortable in the OR and don't just start grabbing for things. One crew you don't need against you is the nurses. It often helps to introduce yourself to them and to ask them before you do anything prior to the arrival of the resident or staff member. In short, watch what others are doing and if appropriate, take their lead.

 

As for bathroom breaks, it's not that common for surgeons to head off to the loo during procedures that are a few hours in length. Thus, go beforehand. However, if you're helping out with a Whipple's then you might be offered a break to snag some water or nibblies and use the toilet.

 

Cheers,

Kirsteen

 

Hi everyone,

 

I was just wondering how one is supposed to behave in an OR? i.e. as medical students, can we ask questions or is that too disruptive? should we try to help out? (ie. cleaning up, etc.) If we're present for a very long operation, can we ask for bathroom breaks?

 

I know they might sound like some silly questions, but I just want to know how a person puts on his/her best face if one is interested in surgery.

 

Thanks!!

[Rain]

This may be more applicable to the non-surgical types, but always remember that it is better to excuse yourself and go and sit down/pass out against a wall than to faint into the sterile field. Much better.

[noncestvrai]

As a rule of thumb (in medicine for that matter), it's always good to think before you say something, and often, it's good to shut up. Don't ask things that you know very well you can look up. You basically have to feel the vibe, or whether you're digging your grave...

 

I personnally shut up, retract, and hope that I'm not too much in the way AND the keen resident will be tired of closing the nth procedure of the day...

 

Oh yeah don't faint INSIDE the sterile field.

 

You should eat breakfast, and bring snacks, hydrate yourself too, don't drink too much coffey for obvious reasons.

 

Good luck!

 

noncestvrai

[up doc]

I have found that most surgeons are very receptive to questions, especially if you are the only one assisting as they are always making small talk. It is important to time them right as mentioned before. I've found that the anatomy and physiology that I have learned in the OR has stuck a lot better in my mind than any class. So take advantage of the surgeon's knowledge as its usually the kind of info that you don't find in a book.

 

Cheers

[koft]

To be honest, if you are interested in surgical specialty, tried to be able to withstand the entire length of the operation. In general, you can ask anatomical / physiological questions related to the surgery. IE identifying nerve/vessel, etc. Usually, you will be likely a 2nd or 3rd assist at best if you are to scrub in. If you are feeling unwell, leave the OR remove your mask and rest in the lounge to recover.

 

If you are not scrubbed in, likely you won't be able to see much.

 

most of the time you can eat snack and go to washroom in between cases. Of course depends on the surgery, cataract Sx (1/2 hours) vs. head n' neck Ca removal (6+ hours).

________

FORD SQUIRE PICTURE

[juicyprunes]

yay!!! I just did some shadowing and it was really fun (13-hour head and neck).

 

I was just wondering how medical students can get more experience with suturing/surgical skills in the preclinical and clinical years?

 

Also, is there a good website/text that someone can recommend that outlines basic surgical skills, suturing, wound management, etc.??

 

Thanks!!!

[blinknoodle]

There are some good downloads on the CFMS site (Services, Free downloads). There are 2 surgical files and 1 plastic surgery handbook. Some students said they snagged suture practice kits from Ethicon, so search these forums to see what comes up.

[Kirsteen]

yay!!! I just did some shadowing and it was really fun (13-hour head and neck).

 

I was just wondering how medical students can get more experience with suturing/surgical skills in the preclinical and clinical years?

 

Also, is there a good website/text that someone can recommend that outlines basic surgical skills, suturing, wound management, etc.??

 

Thanks!!!

Hi there,

 

In my experience, one of the more efficient ways of gaining more surgical (OR) experience is to demonstrate aptitude in basic skills while you're in there. Those involve being able to knot-tie efficiently and also being able to use the other tools well. An example of the latter might be being able to use scissors to cut sutures with your non-dominant hand or being able to release a clamp with the same.

 

Regarding knots, contact Ethicon for one of their free knot-tying boards. They used to FedEx those out to anyone who wanted one. Practice knots until you can do them with your eyes closed. Regarding instruments you can ask a resident if you can borrow any device with a clamping mechanism so that you can practice releasing it at home.

 

I found that when I demonstrated some savvy with the instruments, etc., then I was invited to do more and more in the OR. Hopefully that will be your experience too.

 

Kirsteen

[coastalslacker]

I just jacked a suture kit from the emerg. Cheap chicken works well, although it does tear rather easily. For practicing one handed ties, just ask for some thread next you're in the OR. Once you've got the hang of it, do it with gloves on.

 

The reality is that you should have some fundamental skills before you go into the OR if you expect to do anything. Know how to do basic simple interrupred sutures and one hand ties. Subcutaneous is also useful as are mattress sutures. These are all skills that can be learned at home and most medical schools have some sort of a technical skills lab if you aren't comfortable borrowing instruments from the ER or OR.

[JewelLeigh]

I was just wondering how medical students can get more experience with suturing/surgical skills in the preclinical and clinical years?

Use your spare time (weekends, summer) to do an elective with a community (i.e. non-teaching hospital) general surgeon. They do loads of lumps and bumps clinics and relatively short and straight-forward surgeries that are fantastic for medical students to practice simple surgical and OR assisting skills. In a non-teaching hospital you won't be lined up behind the fellow, sr resident, junior resident and upper year clerk to assist in the procedures.