Medical Student Success in the Operating Room

On your surgical clerkship, you will have the opportunity to spend time watching and scrubbing cases in the operating room. This is a unique experience in one’s medical school education. On a surgery rotation, it is not uncommon that the only time students interact with attendings is in the operating room. Thus, you want to be sure to put your best foot forward when you are in the OR.

view of operating room
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While you may think technical surgical expertise is the way to impress attendings and residents, that is not the case. Medical students have relative little technical responsibilities in surgeries other than basic suturing and retracting duties. A more meaningful way to show your engagement and interest is by looking and acting naturally in the operating room.

Here we will review the basics of what you should be doing in the peri-operative and operative spaces as a medical student. After mastering these, be sure to check out our next level operating room tips as well.

Wear a mask and surgical head covering (bouffant or surgeon’s cap) before entering the room. Don’t be the medical student that walks into an operating room without one of these on. Surgical shoe coverings are optional at most institutions, but some hospitals may require them.

The first thing you should do when you enter the room is introduce yourself to the circulator. Write down the spelling of your name so they can enter you into the computer for being present in the room during the case. Also include your position: “third year medical student”, “visiting medical student”, “first year medical student shadowing”, etc.

Introduce yourself to the scrub tech or scrub nurse. If you are scrubbing the case, ensure that he or she has a gown already on the table for you. Retrieve your own gloves and open them in sterile fashion to the scrub tech or scrub nurse. If the circulator and scrub are in the middle of counting the surgical instruments on the field, wait until a more convenient time.

Be in the room when the patient arrives. Assist in getting the patient positioned onto the operating table. Help get the sequential compression devices (SCDs) onto the patients lower extremities. When there is nothing for you to help with, stand out of the way as to not disrupt the operating room team preparing the patient for surgery. Avoid using your cell phone during idle time.

When the attending or resident begin prepping the patient, go scrub in. Try to be gowned and gloved before the attending is. Once the attending and senior resident are gowned and gloved, the scrub is often too busy passing off drapes and setting up the suction and cautery to assist you. You may be stuck waiting until the timing is right to gown and glove. Keep your hands above your elbows with your hands at shoulder height. Avoid touching anything from the elbow down to your finger tips.

During the case, do as instructed. Stand where told to stand. Hold what told to hold. Suction when told to suction. Be quiet during critical portions of the operation. Do not touch the mayo stand. Do not try to help pass an instrument between the scrub and the attending or resident. Answer any questions directed towards you to the best of your ability. Ask thoughtful questions when the timing is appropriate.

After the case, help take down the drapes and deposit it in the trash receptacles. Do not immediately pull out your cell phone. Stand respectfully and quietly as the anesthesia team wakes up the patient. Do what you can in terms of helping pick up trash. It is your job to bring the stretcher in, but always ask the anesthesia team after the extubation if it is okay to bring it in. Help transfer the patient from operating table to the stretcher. Become comfortable with using the rolling boards and putting sheets or chucks on it to assist in moving the patient. Learn where the warm blankets are kept and be proactive in getting one for the patient. Assist in rolling the patient to PACU and stay while the surgical resident gives report to the PACU team.

After the case, go with the resident to help consent the next patient. Use this as a time to introduce yourself to the patient. State your name and role. Between cases, spend time reviewing relevant anatomy or learning about the upcoming procedure.

Being in the operating room for the first time is an exciting experience. Do these things and you will look like you are a seasoned veteran. Everyone in the operating room will notice.

What other tips do you have for medical students entering the operating room for the first time? Comment below.

Back to more clerkship resources.

Carter J. Boyd, MD, MBA
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