Many things that are true for your medicine clerkship are true for your surgery clerkship (see our “How to Succeed on Your Medicine Clerkship” for more medicine-specific tips). However, I will outline things that are more specific to surgery in this blog post and provide suggestions on how to be the best surgery student you can be based on my experience as a third-year student.
For me, the surgery clerkship was a huge deal. I knew before even starting it that a surgical subspecialty was likely going to be my future career choice. I spoke to a lot of older medical students, residents, and attendings before starting so that I could not only get a good grade, but also leave a positive impression that could help me in the years to come.
In short, you need to present yourself as a future surgeon.
What are the characteristics of a great surgeon? Punctual? Organized? Well-spoken? Team player? I want you to ask yourself this question because the answer to this question is what you should aim for as a surgical clerkship student. Some of this advice goes without saying, but I will outline a few of them here just to highlight their importance.
1) Always be on time
In general, I always aimed to be at least 10-15 minutes early to morning rounds, meetings, etc. There are times when this may not be possible, and this is okay in certain circumstances, but abiding by this general rule will make you look professional and it is a good habit to keep up.
2) Embrace the “scut” work
Unlike a medicine floor, where as a student you have the ability to perform the major task of the residents and attendings (thinking through a clinical dilemma), you usually cannot perform the major task of the surgical residents and attendings (i.e., perform surgery).
As a reward for contributing good work to the team, students are often granted the privilege of participating in surgery, albeit minor components (suturing, initial incisions, etc.). For this reason, I think that one of the things that set me apart on my rotation was my willingness to do the so called “scut work” so that the team can be more efficient. I think the residents/attendings realized this, and allowed me to experience and do more in the operating room because of it.
In addition to making the team work more efficiently, doing small tasks for the team is a great opportunity to learn. You will likely be doing these tasks as a Sub-I or intern so why not start early in order to become better oriented with what the next steps will entail.
3) Equip yourself with Knowledge
Never go into a surgical case without having read the consult or clinic notes for the patient beforehand. Additionally, it’s important to be familiar with the anatomy and I recommend going over the relevant anatomy before each case.
4) Actively demonstrate your interest, but be concise
As in medicine, you want to demonstrate your interest to your residents and attendings by asking questions that stem from your sincere curiosity to learn. Unlike medicine floors, where rounds can last hours and there is often more time to ask questions and discuss the clinical details of a patient, surgery rounds can feel very rushed. The reason for this is that rounds must be completed by the start of the (often early) first surgery. As a result, rounds may not be the best time to ask questions that aren’t directly related to patient care. It’s important to ask questions, but it is best to save them for times when the team is best equipped to answer them. Sometimes this is best done between surgical cases, perhaps while you’re waiting for the next case to start. If you have a question during a surgery, it’s okay to ask it, but just make sure it’s not during a crucially intricate step of the case (e.g. ligating a major artery, etc.).
As an adjunct to asking questions, a great way to demonstrate your interest to the team is to volunteer to give a brief (5-10 min max) chalk talk on a surgical topic. It is a great way to demonstrate what you have learned if your team has the time for it – again use your judgement to find when this is. Try choosing a topic that is a little more niche and specific so that you can keep the talk focused (e.g. don’t do a talk on blunt force trauma in general, but maybe the effect of blunt force trauma on a specific organ).
Lastly, as in medicine, asking your team for feedback is an important way of not only demonstrating interest, but knowing how to improve. It’s important to ask for both mid-term feedback and feedback at the end of your rotation, at the very least.
5) Be a team player above all else
As a final note, I want to highlight an important feature of not only surgery, but medicine in general-it is a team sport. Always work hard for the team, and never put yourself in front of others. This especially goes for other medical students and interns. Residents and attendings can often sense the team dynamic, so be nice to everyone.
Ricky Ortiz is a third-year medical student at Harvard, as well as a Step 1 and shelf exam tutor for USMLE Pro.