Surgery, Brockton

Since I think about 12,000 more PAs will be passing through here this year, I thought I might write a little about my time here. First off, it is AMAZING!! There are 5 docs in the group, and they are all very nice. Plus a lot of docs in the OR know you are around and are happy to let you sit in (maybe not scrub every time, but you can always observe) on something if you ask. It is very much a do-it-yourself sort of rotation; you decide which surgeries you want to see, which patients you want to round on, etc. I rarely see my preceptor except morning rounds and when I'm in on a surgery he's doing. There is also another smaller surgi-center plus the home office you can spend time at. Ask for anything and it seems like they will find a way to get it for you.

My day starts at about 5:30 when I get to the hospital and round on any patients I had in the OR the day before, or other patients I have been following. I can write progress reports in the chart if I want to. There are 5 surgical residents who are also assigned to round on patients, so you have to get there early if you want to write post-op notes on the "easier" patients before they do. The residents are also very kind and are happy for the help. Then we have rounds at 6:30 in the ICU, then we can round with the interns or do whatever. Check the board in the OR, see what's on the menu, discuss with Sam who's going to scrub for what, then we're in and out of surgery all day, usually until at least 6 pm, sometimes after 8 pm. I have gone days without seeing my kids (sleeping when I leave the house/get home).

The pimping hasn't been too bad, although the first week there were a lot of anatomy questions -- how long has it been since we had anatomy? I was barely able to identify the gall bladder. Felt like a total moron. Plus working 64 hours that week I literally had no time to study. Second week after I'd spent a few hours with Netter I felt a bit better, but like someone has already said, the pictures in the book really don't look anything like the actual body, plus there is the issue that everything in Netter is in neat planes, where in the body it's 3D. This is the hardest part for me -- I can tell the docs what the branches of the external carotid artery are, but could not identify one to save my (or the pt's) life!

They do a lot of gallbladders, hernias, carotid endarterectomies, breast cancer, bowel surgery, so you should study up on these (the surgery book is very good but the anatomy pictures in there stink), but it can wait until after your first week; I would suggest starting with basic anatomy the weekend before. It is actually helpful to study some of the prep notes. There is frequently time between surgeries so keep books in your locker (better for us gals, as all the docs are male so they won't see you) for cramming for a few minutes prior.

Sam and I have seen tons of great surgeries -- lots of choles, breast biopsies, bowel resections, hernias. Sam seems to get stuck in the (usually vascular) cases that go for 10 hours (literally), made longer by the fact that you have to wear a lead suit the whole time. As time goes on they let us do more and more -- doing more suturing this week, incisions, intubations (chat up the anaesthesiologists!!), injections, stapling the bowel in resections, manning the camera on laparoscopic procedures.

Ask the OR techs lots of questions the first week -- the hardest part is figuring out how not to wreck the sterile field, how to scrub, gown, dry your hands, glove, etc., and they are as Steiner said very protective. But after the surgery is done, ask what you can do to help them clean up, and they will be very appreciative. They are very knowledgeable and also very helpful.

Anyway hope this helps. Be prepared for long hours, but don't be nervous -- it's a great place and you will learn a lot!