Surg Onc

[Eileen]

This rotation was by far my favorite of third year. ;D Dr. Lind is very fun. Dr. Wang is a great teacher. Surg Onc has a nice mix of surgeries: breast cancer, skin cancer, colon cancer, lymphoma, catheter placements. You probably won't get into the thoracic cavity...however you may get to see a Whipple, a few gallbladders, liver, etc.
A neat aspect of this rotation is that you get to see care from beginning to end. There are several afternoon clinics in which patients are diagnosed. (The clinic nurse is great to work with too and will help you get the forms together). Their surgery is scheduled usually for the following week or two. In surgery Dr. Lind will often accompany you to the path lab in the middle to look at the slides. After surgery you may go with him to report the news to the patient. Then you can see the patient in clinic for follow-up.
In clinic you write a note and give a quick presentation. The hours are great as far as surgery goes. You round on only a couple of patients per student in the morning, then OR, then afteroon clinic or more OR. The days last anywhere from 8 to 14 hours with an average of about 10. Usually you leave after the lecture. Some surgeries go very, very long (for example when they are dissecting out every bit of cancer--but they are interesting). Dr. Wang told me to get lunch in the middle of an 11 hour Whipple...I thought that was nice. You alternate every other weekend with the other student. You divide up surgeries with the other student however you both choose to do it (we did every other surgery, but some students divide it into OR or clinic all day).
How much you get to do depends on which resident/intern you are with and how much they are willing to give up. Dr. Lind might give you the bovie or have you drive the camera. Of course you will retract and suction a bunch. Read ahead for surgeries especially with Dr. Wang--he pimps in the middle...and if he's going to be burning the liver for an hour that's great time for questioning you.
Remind Dr. Lind to bring the iPOD...he forgets but he always wants it there.
Do well and very possible to get a nice evaluation/grade.
I miss this rotation already.

[Betsy]

I agree with Eileen, this rotation is amazing. As with all rotations, alot of how your experience is depends on the residents. I usually got there at 6, rounds at 7am. Usually had 2 patients for rounds, but one time I had 6. It really depends on how busy the service is. The week is usually set out like this:

Monday: Grand Rounds, Clinic - Lind, OR - Wang
Tuesday: OR - Lind/Wang
Wednesday: OR - Wang, Clinic - Lind
Thursday: Clinic - Wang, Lind goes to Washington, GA to Wills Memorial
Friday: OR - Lind, Clinic - Wang

Its alot of fun. Read up on the cases before hand, Dr Wang pimps more than Lind. I was mostly asked anatomy questions, so make sure you know this. Thursday, Lind goes to Wills Memorial for 1-2 cases then does clinic for the afternoon. This is a fun trip to make, and you get to know Dr. Lind very well, and he gets to know you. This is good because he does the majority of your evaluation. He usually took one student, but one week we both went because Dr Wang was out of town.

As Eileen mentioned, we split the OR cases. If there was nothing else going on, one of us would scrub and the other would observe. This only happened a few times when Dr Wang is out of town.

I usually got there around 6am, and left around 5-6pm. We always were allowed to go to lecture, and would usually return after lecture to close things up. Weekends were split btw the 2 students. Including overnight call, I would say I averaged btw 80-90hrs per week.

Good things to remember:
Dr Lind's specialty: Breast cancer
Dr Wang's specialty: Liver/Pancreatic cancer

Be sure to read over these topics prior to clinic with either physician. Know what questions to ask the patient in clinic with these cancers, ex: breast patients ask monthly breast exams, family history, pain in breast, skin changes, discharge, etc. You will get to see a TON of breast cancer. I was always confused as to if I should perform the breast exam before presenting to Dr. Lind, as clinic is always very busy. I would just grab a nurse to be your chapperone and do an exam, so you can present it. The only exception is if Dr. Lind is waiting, then I would just present and we would do it together. Make sure the patient is gowned before getting Dr Lind (this happened alot because the nurses forgot to get the patient to undress). This is an incredible experience to get to see a variety of cancer in the different stages. It ranged from non-palpable cancers all the way to end stage disease with nipple retraction with ulceration.

Apparently, there is a new GI cancer guy that is coming in July for those starting this rotation after that time. There is alot of other cancers you will see, and on the wards we occassionally saw non-cancer cases such as appendicitis, cholecystitis, diverticulitis. Overall a good rotation for general surgery, and I think you will really enjoy this rotation. Dr Lind is very interested in student education, and really enjoys teaching and getting to know you as a person. Have a great time!

[drj]

If you want to get your butt kicked during surgery, this is NOT the rotation for you. Sure, you're still working long hours, but not nearly as bad as the folks on other services. Dr. Lind and Dr. Kruze are stand-up guys. They pimp very infrequently, and when they do, it's because they want to help you learn the info. The patients are varied, and the cases are also pretty good -- you'll see hemicolectomies and Whipples, but also lap choles and port removals. Clinic isn't too bad -- Dr. Lind works fast. Just be sure you read up on breast disease for him. He'll give you a good eval as long as you work hard -- I certainly wasn't a superstar, and he kept saying nice things about me.