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Part of the bigger picture: How to make the most of being a medical student in the OR



Friday, September 4, 2015

What should I do during the summer after my first year of medical school? – A question that all medical students ask themselves in the time leading up to the end of this first milestone. Some people decide to work in research or other areas, while some take the time to travel, visit family, and unwind.

Being from Alberta, I decided to spend the summer enjoying some much needed family time and a bit of travel. However, in true medical student fashion, I also took the opportunity to explore a couple of surgical subspecialty electives through the Meds 5010 program.

Meds 5010 allows Schulich Medicine students to participate in pre-clerkship, non-credit electives during the summer with a more hands on experience than a regular observership.

I completed electives in cardiac surgery with Dr. John Mullen at the Mazankowski Heart Institute, and neurosurgery with Dr. Matthew Wheatley at the University of Alberta Hospital.

Despite doing both electives in surgical subspecialties, my experiences could not have been more different.

My first elective was in cardiac surgery. I learned quickly that the OR can be a hectic place, especially in cardiac surgery. I was amazed by the sheer volume of people and number of machines that are crammed into one room for each procedure. Scrub nurses, a surgical nurse, the anesthetist, residents, the surgeon, a perfusion technologist to run the cardiopulmonary bypass machine and techs to collect blood samples throughout the surgery. And that does not even include all the medical students!

It sometimes felt like I spent most of the time learning how to be as unobtrusive as possible, becoming skilled at picking a good place to stand or being able to jump out of the way of the people doing the real work. However, I was still able to see some incredible surgeries. It was incredibly validating to see a mitral valve or tricuspid valve replacement and be able to draw on knowledge I learned in class to understand the procedure.

One of the most valuable aspects of this elective, however, was not watching the surgeries themselves but getting to work with an amazing resident, Victoria, the first female physician in the Mazankowski cardiac surgery program in the past 24 years.

At morning rounds, she let me check on a couple of patients on my own, which was an exciting yet terrifying prospect. I definitely felt like I was slowing her down with my turtle-like speed of finding information in the charts. She had only one hour each morning to see all of her post-op patients, but she soldiered on, teaching me an organized and efficient way to check in on the patients and to write their progress notes and medication orders in the short time available.

Victoria taught me that residents can be your best ally. Since their medical school experience is fresher in their minds, they can really empathize with what you are going through and be an invaluable source of information and advice. Never underestimate the value of what you can learn from residents!

My second elective was in neurosurgery. My first impression was that the OR is significantly less crowded than in cardiac surgery. It was much easier to find a good location to stand (or maybe I was just better at sussing them out by this point). I also already felt much more comfortable with the culture and practices of the OR.

In this elective, I was able to put into action an important lesson from my first supervisor, Dr. Mullen. He had told me to always introduce myself to everyone in the OR because they each have something important to teach me. I’ve found that people are also much more likely to teach if they can put a name to a face rather than just the title of “random medical student.” Embracing this philosophy gave me the opportunity to help put in spinal screws with an orthopedic surgeon and have a better view of the surgeries when the scrub nurses would make sure the overhead camera was not blocked by the surgeon’s head.

It was an amazing experience to watch the procedures on the brain and spine. I felt like a child with a new toy when I was allowed to scrub in and help suction and irrigate. But similar to my time in cardiac surgery, it was the lessons I learned about working in the OR environment that I will take away as the most important.

We discussed the importance of interprofessional teams in depth throughout first year, but when I was there in the moment, I really saw how important it was for everyone to have a good working relationship in the OR.  The nurses taught me some great tricks to not fog up my glasses (make a crease in the plastic on top).

Overall, my biggest lesson was to take advantage of the knowledge and experience of everyone around me during electives or at any time during my training. Focusing solely on the lead physician can limit your learning, as you can learn an extraordinary amount from residents, nurses, and upper year medical students. It’s not just about seeing amazing cases, or learning all the steps in a surgical procedure, it’s important and necessary to learn how to navigate the system.

Thank you so much to Dr. John Mullen and Dr. Matthew Wheatley for taking me on and to Victoria and all the fantastic nurses who taught me how to look a little bit more competent.

-Jacqueline Luhoway, Medicine Class of 2018

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