Like most students in medical school, I was excited to leave the classroom behind when I started clinical rotations. While being in the hospital is certainly more exciting than the library, this new setting requires a shift in learning style. The clear framework of the classroom-based pre-clinical curriculum (syllabi, lectures, PowerPoints, book chapters, labs, etc) is no longer present. Clerkships often lack a clear structure to student education. Outside of your preparation for clerkship tests (“shelf exams”), the best strategies for learning on a clerkship was rarely discussed.
As someone who was frustrated by this ambiguity, I hope to clear the air and provide an example of how I prepared for surgeries in my clinical years as a medical student.
First, identify the cases you will be participating in. The easiest way to do this is to look at the schedule to see what cases you will be observing. If you are on a service that doesn’t have a clear schedule in advance (Ex. trauma or acute care surgery) or you’re uncertain of which attending you’ll be working with, just talk to your resident. Regardless, for most rotations you can identify the surgeries or the types of procedures you will be commonly seeing
This form of preparation is self-guided and won’t be identical for each individual. My framework to prepare for a case involves researching the answer to several questions. While some of the useful information may be present in the electronic health record, outside info may be required. Use learning tools available to you including review articles, textbooks, videos, and other resources.
How did this person present to the hospital? What was their chief complaint, relevant past medical history, and pertinent physical exam findings?
How is this condition diagnosed? Is this a clinical diagnosis, pathologic diagnosis, or a condition diagnosed by a study?
What are the relevant tests that must be done to diagnose and evaluate this condition? X-ray, CT scan, MRI, etc.
Why are we doing surgery? Why are we doing THIS surgery? This step requires you to understand the treatment options, operative and non-operative, and the natural history of this condition (what caused this and how will it progress).
What anatomic structures will be encountered? What structures are at risk of injury? Watch videos (VuMedi and YouTube are great) and study the surgical approach. In my experience, anatomy is the number one thing I was asked about as a medical student. Continually study anatomy.
What’s the recovery, prognosis, follow-up, and limitations associated with this surgery?
This is by no means a comprehensive list of relevant points to consider, but this is a good starting point for preparing for surgical cases and surgical clerkships in general. While learning styles certainly differ, it is important for students to develop the habit of preparing for cases. Furthermore, having a baseline knowledge going into a case will allow you be more engaged and likely a more active participant in the surgery.
If you have any questions do not hesitate to reach out to me. Please let me know if there are any topics you’d like us to discuss.
How do you prepare for surgical cases? Comment below.
- How to prepare for surgical cases as a medical student - August 18, 2020
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- Five Tips to Success on Your Surgery Clerkship - June 24, 2020