Surgery

Last updated: Dec 2024

High-yield "What I Wish I Knew”:

  • In general, surgery rounds are conducted in a very brief and focused manner so that the team can get to the OR usually by 7am for their first case

  • Try to keep your presentations very succinct and focused. Also don’t take it personally if you are cut off during your presentation—the team is likely just trying to not run late!

  • There are lots of ways to help out and be proactive in the operating room! Read the room, offer to help people gown up, open doors, help position the patient, grab blankets, get the bed for the patient near the end of the case. It’s these small things that can go along way! Each minute in the operating room costs an average of $37 so anything you can do to expedite the case is a win (and will make you look like a team player).

  • Retracting (helping hold surgical tools/tissue so the surgeons can see better) is an important part of the surgery! However, don’t harm yourself in the process—try to find a comfortable position and if you need to reposition, let your team know. Don’t injure yourself in the process!

  • Carry around snacks in your pockets, try to eat before cases if you know it may be a long one.

  • You’ll encounter a variety of personalities in the operating room. Some surgeons, scrub techs, and circulating nurses can be extremely kind to students, others less so. Try not to take anything personally—they are all likely stressed too and just trying to avoid any accidents and keep the patient safe!

  • Check out The UCSF Surgery Attending’s Perspective for more tips

What to expect for the rotation:

  • 8 weeks long, +/- weekends. Depending on your site, you may have to do a few 24-hour trauma calls, or if you are not at a trauma center, you’ll have to do one overnight trauma call at ZSFG.

  • Expect early mornings! Many sites round at 6am, which means you’ll probably have to get in around 5:30am to preround. You may round with the resident and then scrub-in for cases as early as 7am. If there are multiple medical students, you may get later cases in the day. Case-length will really vary based on the day and the site. Your day may end as early as 2pm or as late as 8pm, it varies a lot!

  • What will you do in the OR? Help position patients and other ways to help (see above section), when scrubbed in, you likely will help retract (to help surgeons see better), cut sutures, help tie knots, close the skin, etc. In laparoscopic cases, you may help hold the camera/probe. If you’re interested in surgery and want to do more, ask! However, be able to read the room, ask at appropriate (non-urgent/busy time), and be okay if the answer is “no”.

  • Surgery rounds are much, much shorter than medicine rounds! Mention post-op day, I/Os, vitals, key labs, nausea/vomiting/diarrhea/passing gas/stooling and just focus on the main surgical problem!

  • Can be helpful to make a pre-rounding template

Helpful studying resources (in addition to UWorld):

  • De Virgilio’s Surgery Textbook

  • Dr. Pestana’s Surgery Notes