I’d like to say I’m now officially 10% of the way through my clinical year, but I’m not quite. While I’ve now finished one of ten clinical rotations, I still have to take what’s called an End of Rotation Exam (EOR) and to pass a couple of practical quizzes for this rotation. In addition, before the middle of my third rotation, I have to submit what’s essentially a paper. So, perhaps I’m 8-9% complete.

But, it’s a large step forward.

Each rotation we have is four weeks long. My first rotation was a surgical rotation. From a number of people I’ve spoke to, this is often considered the hardest, both in terms of material and required time. While a rotation is four weeks and generally about 40 hours a week, this one, I estimate was closer to 220 hours.

The first week started off a bit short, only four days, because of the Memorial Day weekend. But I hit the ground running on Tuesday, the first day. My classmate and I did a scrub session at a secondary campus, where we were taught proper surgical scrubbing technique and then later the same day we were allowed to step into an operating room and observe an open abdomen surgery in progress. Honestly, it’s at the point where some folks start to faint. Not my classmate and I. We were fascinated. The next day she reported to the main campus and I remained at the secondary campus for the rest of the week. My experience was generally positive, I was able to scrub into a number of cases and even was able to work on my suturing technique to help close in a few cases.

The second week I moved back to the main campus and did a week with the Cardiothoracic service. This was great because besides the two main surgeons, the rest of the service was all PAs. This allowed me to see how PAs work in a surgical practice. During this week I observed some bypass surgeries and was again allowed to provide some minor help in various, including at one point retracting an aorta with my fingers, and worked on writing up my patient notes.

The third week was in some ways the hardest. It was what’s called Acute Care Surgery. This service has no PAs in it, but I was working along side a number of medical students. What made it tough was two factors: One, I was given very little guidance of what was expected, and the second, students were expected to be on-site by 4:30AM to pick one or two patients to pre-round on. This might not have been too bad, but students were expected to stay until 4:00 PM or later (depending on needs or if you were in surgery). Fortunately, my fellow classmate had done ACS her first week and so was able to give me some tips and pointers. This was a week of very little sleep. I should add to that I had started it with a 24 hour on-call shift the Saturday of the first weekend. So, even though I was able to sleep in a bit on the first Sunday, I went into it a bit sleep deprived.

The fourth and final week, my classmate and I were together with the Trauma Service. Despite it being another week of reporting in at 4:30AM and leaving around 4:00PM, we actually got a bit lucky this week in two ways. Our preceptor of record was the attending for Trauma that week and they were short staffed residents, so we basically were working with the two incoming chief residents. This combination of factors allowed us to see and do a bit more than might have happened otherwise.

But now, the week is over. While I’m fairly confident that surgery is not the field I want to go into, Emergency Medicine is still at the top of my list, I have a newfound appreciation for how interesting and fascinating it can be. Also, as someone who had worked many traumas on the ER side of things, it was nice to see what happens to a trauma patient after they leave an OR. I logged over seeing over 110 patients in this time with my interaction ranging from simply rounding with them with the residents and or attending, to doing actual work-ups on them, changing surgical dressings, or participating in their surgeries. Without going back and counting, I think I was in about twenty surgeries. In one case, it was three surgeries in a row.

Interestingly enough, my upcoming rotation, which starts this Monday down in Wilmington, DE, is in rehab medicine with a partial focus on rehab of trauma patients. This will allow me to see the follow-up to trauma surgery. In a sense, I will see the full process of a trauma patient. This greatly interests me.

And the nice part about the upcoming week is that it’s far more normal hours. This will allow me to get enough sleep and to take evenings to study.

In the meantime, I’m going to take time this weekend to relax a bit.