Post by Betsy on Jun 26, 2005 21:53:42 GMT -5
This was posted by KristenDavis from the Class of 2006 Forum.
Trauma Surgery seems to be quite different from the other surgery rotations. This could be a great rotation or an awful one depending on what you are looking for.
-Surgery Load: You won't see many actual surgeries (i.e. where you scrub in on the O.R. suite)--they just don't do that many (especially during the day), but you will see quite a few bedside surgical procedures (trachs, PEGs, central lines, bronchoscopy, etc.). I only saw two real surgeries all month.
-Patients: There are quite a few floor patients on the trauma service, and the students and the intern follow them, so it is a lot like medicine--good thing is, this is also supposedly a lot of what is on the surgery shelf exam. Downside is since most trauma patients come in overnight, you'll never know how many new patients you'll have to pick up the next morning. Upside is you do a very focused H&P since most of these are fairly healthy people and are just admitted for observation overnight.
-Rounds: Drs. Ferdinand and Hawkins are quite intimidating at first, but they are both really good guys. We round on the ICU in addition to the floor and most of rounds are spent in the ICU. Dr. Ferdinand does a lot of pimping (and his rounds last for hours), but you will learn a ton from him. IMPORTANT NOTE: write down EVERY question he asks you because it is very likely he will ask that exact same question again and you don't want to get it wrong twice. You will learn a lot about managing ICU patients as well while on trauma. Something to remember: Dr. Hawkins always likes to know where people live so that things can be arranged at time of discharge.
-Traumas to the ED during the day: You will get some exposure to the ED as well and the students have a trauma pager so that you (the students) can go down to the ED when traumas come in. Many times they will ask you to help do the H&P, be a runner, help with logrolls, etc.
-Clinic: If you like clinic, trauma has a pretty good one. It is only on Tuesday and Thursday afternoons and you'll get to help take out sutures and staples and so on. Be sure to ask each patient if he/she is back to work/school.
-Procedures: One of the coolest things about this rotation is that if you show interest, they'll let you do stuff. I got to try a femoral and a radial arterial line, drive the bronchoscope, and suture up a nice big head lac among other things.
-Recommended topics to know for this rotation: ABG's and associated metabolic/respiratory imbalances and causes; post-op fever; DVT; hyper/hyponatremia; indications for dialysis; when to pull JP drains and chest tubes; how to decrease high intracranial pressure; and numbers, numbers, numbers--Dr. Ferdinand likes to ask you percentages as well as ranges for everything from incidences of complications to lab values--this is why you MUST write down everything he pimps you or anyone else on the first time he asks it
-Things to ask: Be sure to know these things for any patient where it's appropriate: PTD (post trauma day), POD (post op day), antibiotic day, pain, eating, drinking, ambulating, any BMs, passing flatus, hometown, JP drainage and character (sang, serosang, serous), chest tube output and whether it's on suction or water seal and if there is an air leak and all the details from the Trauma H&P which is in the chart (i.e. MVC rollover; passanger/driver side impact, un/restrained driver; +LOC, ABC's intact, +UDS (urine drug screen), etc.) and be sure NEVER to use the phrase "Motor Vehicle Accident (MVA)"--to Dr. Hawkins, it is a "Motor Vehicle Collision/Crash (MVC)"
-Hours: Generally you're there from 6am until after lecture which ends at 5pm or 6pm depending on the day; Monday you have lecture starting at 7:30am, breakfast following in the surgery library, Grand Rounds at 9am, M&M at 10am, and Basic Sciences lecture at 11am (that lecture is only for residents) -- I think that's the order but a lot of times one or the other is cancelled; so on Monday's you'll have rounds in the afternoon; the rest of the week you'll round with either Ferdinand or Hawkins; Ferdinand usually rounds 8-8:30 and Hawkins generally rounds at 9am, but that changes day-to-day; Clinic usually runs Tuesday and Thursday 12:40-3:30 depending; Lectures are at 4pm or 5pm most weekdays; Weekends are split between the students and you generally get out by noon
-Grades: I have heard of both really great and pretty bad grades given out by Dr. Ferdinand for this rotation so don't let what you've heard about bad grades deter you from doing this rotation--it is possible to do well
I know I've probably written too much, but if you have any more questions, do not hesitate to ask! Overall, this was a great rotation and I learned a ton despite the few surgeries I saw.
Trauma Surgery seems to be quite different from the other surgery rotations. This could be a great rotation or an awful one depending on what you are looking for.
-Surgery Load: You won't see many actual surgeries (i.e. where you scrub in on the O.R. suite)--they just don't do that many (especially during the day), but you will see quite a few bedside surgical procedures (trachs, PEGs, central lines, bronchoscopy, etc.). I only saw two real surgeries all month.
-Patients: There are quite a few floor patients on the trauma service, and the students and the intern follow them, so it is a lot like medicine--good thing is, this is also supposedly a lot of what is on the surgery shelf exam. Downside is since most trauma patients come in overnight, you'll never know how many new patients you'll have to pick up the next morning. Upside is you do a very focused H&P since most of these are fairly healthy people and are just admitted for observation overnight.
-Rounds: Drs. Ferdinand and Hawkins are quite intimidating at first, but they are both really good guys. We round on the ICU in addition to the floor and most of rounds are spent in the ICU. Dr. Ferdinand does a lot of pimping (and his rounds last for hours), but you will learn a ton from him. IMPORTANT NOTE: write down EVERY question he asks you because it is very likely he will ask that exact same question again and you don't want to get it wrong twice. You will learn a lot about managing ICU patients as well while on trauma. Something to remember: Dr. Hawkins always likes to know where people live so that things can be arranged at time of discharge.
-Traumas to the ED during the day: You will get some exposure to the ED as well and the students have a trauma pager so that you (the students) can go down to the ED when traumas come in. Many times they will ask you to help do the H&P, be a runner, help with logrolls, etc.
-Clinic: If you like clinic, trauma has a pretty good one. It is only on Tuesday and Thursday afternoons and you'll get to help take out sutures and staples and so on. Be sure to ask each patient if he/she is back to work/school.
-Procedures: One of the coolest things about this rotation is that if you show interest, they'll let you do stuff. I got to try a femoral and a radial arterial line, drive the bronchoscope, and suture up a nice big head lac among other things.
-Recommended topics to know for this rotation: ABG's and associated metabolic/respiratory imbalances and causes; post-op fever; DVT; hyper/hyponatremia; indications for dialysis; when to pull JP drains and chest tubes; how to decrease high intracranial pressure; and numbers, numbers, numbers--Dr. Ferdinand likes to ask you percentages as well as ranges for everything from incidences of complications to lab values--this is why you MUST write down everything he pimps you or anyone else on the first time he asks it
-Things to ask: Be sure to know these things for any patient where it's appropriate: PTD (post trauma day), POD (post op day), antibiotic day, pain, eating, drinking, ambulating, any BMs, passing flatus, hometown, JP drainage and character (sang, serosang, serous), chest tube output and whether it's on suction or water seal and if there is an air leak and all the details from the Trauma H&P which is in the chart (i.e. MVC rollover; passanger/driver side impact, un/restrained driver; +LOC, ABC's intact, +UDS (urine drug screen), etc.) and be sure NEVER to use the phrase "Motor Vehicle Accident (MVA)"--to Dr. Hawkins, it is a "Motor Vehicle Collision/Crash (MVC)"
-Hours: Generally you're there from 6am until after lecture which ends at 5pm or 6pm depending on the day; Monday you have lecture starting at 7:30am, breakfast following in the surgery library, Grand Rounds at 9am, M&M at 10am, and Basic Sciences lecture at 11am (that lecture is only for residents) -- I think that's the order but a lot of times one or the other is cancelled; so on Monday's you'll have rounds in the afternoon; the rest of the week you'll round with either Ferdinand or Hawkins; Ferdinand usually rounds 8-8:30 and Hawkins generally rounds at 9am, but that changes day-to-day; Clinic usually runs Tuesday and Thursday 12:40-3:30 depending; Lectures are at 4pm or 5pm most weekdays; Weekends are split between the students and you generally get out by noon
-Grades: I have heard of both really great and pretty bad grades given out by Dr. Ferdinand for this rotation so don't let what you've heard about bad grades deter you from doing this rotation--it is possible to do well
I know I've probably written too much, but if you have any more questions, do not hesitate to ask! Overall, this was a great rotation and I learned a ton despite the few surgeries I saw.