Nearly Half Way

Next Friday, I will submit by term paper for my Justice Ethics class and I will take my final exams for my Psychiatry clerkship. It is hard to believe that Friday is the half way mark for my third year of medical school, making me 5/8 of a doctor. It’s also the half way mark of my Masters of Arts in Bioethics and Health Policy program. Scary.

I’ve been consistently followed by the thought that I will go into surgery. There is still half a year left of clinical rotations, including internal medicine, obstetrics/gynecology, and pediatrics, so the jury is not out quite yet. But on that note, I don’t know that I can avoid the operating room. I really miss it. The most likely rotation to sway me is Ob/Gyn (esp. urogynecology or gynecological oncology), however, I’m not sure that I want a practice limited to women. There are so many factors to consider. I kind of wish that I was drawn to something with fewer hours and stress, but at the same time, I don’t want to enter a practice that I wouldn’t find wholly satisfying.

I’ve been consulting with several surgeons and residents at my institution. They have been really helpful in giving advice and helping to give me some direction. I’m particularly pleased that they have offered to write me letters (which will be an important component of my application) and continue to provide support.

One surgeon directed me to the American College of Surgeons wibsite, which has been helpful: So You Want to Be a Surgeon: Residency Search. It allows you to search for residency programs by region. The location of my residency will be particularly important, since most doctors practice where they were trained. It includes information on the number of surgeries completed by residents, call schedule, vacation time, family leave policies (which would include maternity leave), childcare access, etc.

Medical Student, Heal Thyself

Take Note: this post is graphic. If you’re a person who gets quezy over blood and whatnot, you may not wish to continue.

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Yesterday, I gave myself 5 stitches in my foot. It didn’t hurt as bad as I thought it would when I was doing it. Today, though, my foot really hurts…

Why did I need stitches? Because I was getting into the shower and somehow hit my foot on the bottom of the shower door, slicing a deep flap of skin off. It was really gross looking and bled all over the shower.

I’ll add some pictures later.

Surgery Clerkship Highlights

Like I said previously, I intended to keep track of my experiences this year, so it’s time to play catch up.

I started the clerkship on June 30 and ended on September 19. I worked with several groups: pediatric surgery, ENT (ears, nose and throat = otolaryngology), the surgical consultation service (mostly hepatobiliary surgeries), and the dedicated hepatobiliary service.

Pediatric surgery was amazing. I got to work with a wonderful surgeon who is incredibly nice and encouraging. She is a talented teacher and has the patience of Job. I was luck y to be paired up with a great resident and intern, both of whom taught me a lot.

Surgeries: hernia repair, pyloric stenosis repair, ostomy placement, central line placement, and Wilms tumor resection.

ENT was pretty cool. The clinic is a lot like a dentists office because there are a lot of tools in each room and you can do a lot of procedures in the clinic. There are a lot of interesting surgeries, but many of them aren’t that great to observe because they are done with scopes and viewed over video. It is the first time I ever worried I would fall asleep in surgery. The rooms are really cold, and since there was no point in scrubbing in, I would put one of the warm blankets over my shoulders to keep me from freezing to death.

Surgeries: Lacrimal tumor resection, ear tube placement, mastoidectomy, tonsilectomy, adenoidectomy, thyroidectomy, repair of deviated nasal septum, nasal turbinate reduction, and pituitary gland tumor resection.

The consult service was really fun because I was paired up with a great 3rd year resident and a good chief resident. They taught us all sorts of stuff whenever we had spare time. I worked with three other students. I became very good friends/study partners with one of them. The other two were difficult to work with, but it turned out all right in the end. There weren’t any big blow ups, we all pretty much avoided as much confrontation as possible. I worked with several surgeons on that service. Most of them were fun to work with. One of them showed us a bit of medical capitalism that was a bit disturbing.

Surgeries: lots of inguinal and ventral hernia repairs, ostomy placement, sigmoidectomy, partial thickness skin graft.

My last service was OK, but not nearly as fun as the consult service. I think I was getting tired at that point. I worked with two other students – both of whom were great. One of the surgeons scared me (I just found him unnerving), but the other surgeon really took me under his wing. The second surgeon, Dr. F, really likes teaching students and thanks to that, let me do a lot of sewing and cutting. It was awesome!

Surgeries: lots of inguinal and ventral hernia repairs, laparoscopic ventral/umbilical hernia repair, ostomy placements, sigmoidectomies, liver resections, appendectomy, and abdominal washouts.

All in all, I had a great experience. I really enjoyed it. I like scrubbing in, cutting, sewing/suturing, the tools and toys, the OR banter. I like the short notes and the focused care. I like that there are some things in medicine that are fixable. Certain conditions that would otherwise kill a person can be put to rest through surgery. Organs can be altered or removed to alieviate pain and disability.There are lots of negatives to being a surgeon too: long early hours, long residencies, emergency surgeries, etc.

I’m not sure if I’ll be a surgeon or not, but at least I have found something that I enjoy. If I had to choose right now, I would be a surgeon, but I’m trying to stay open minded for the rest of the year.

Surgery Clerkship

I had intended to journal throughout my surgery clerkship, but the hours have been so extensive and I have been so tired that I haven’t done so.

That said, 10 weeks into a 12 week rotation: I LOVE surgery. I have had so much fun with it. It has been a great service to start out with. I love to operating room, scrubbing, wound care, cutting, sewing, etc.

More to come later, but it’s been a very positive experience and I hope that I have half as much fun on my future rotations.

I have family medicine next (after a much needed week long vacation, of course). I have signed up to rotate at a Spanish speaking clinic.