How to Rock Your Surgery Clerkship

Written by Clementine Young, MD

Now that I am 4 months into intern year, I have worked with a few medical students and figured out where they can be helpful and how they can make the most of their time on a surgery clerkship. You may already know you don’t want to pursue surgery as a specialty and that is entirely fine. Regardless, you can have a great time on the clerkship and learn what you need to know so you can refer your future patients to a surgeon when it is indicated.

Fun fact, I entered my surgery clerkship not knowing I would fall in love with it. You might too!

1. Come early

The first rule of surgery is that we are early risers. Come early, print the list with all the patients on it, and be ready to present the patients you were assigned by the team 5 minutes before they told you to be ready. Have a method to chart-check patients and follow it every time. I like to do vitals, I/Os, cultures, labs, notes.

2. Be brief

We do not like lengthy presentations. “Mr. X is a 62-year-old male here with acute cholecystitis, now post-op day 2 status post laparoscopic cholecystectomy.” Short and to-the-point. Many questions can be answered with yes or no.

3. Have a plan

It’s always nice when medical students have a plan for the patient and want to be involved in their care. Advance diet? Change the PRN pain meds? Consult social work for discharge planning? If you are not confident with your plan, talk to your intern before rounds to make sure you’re on the same page. If your plan is wrong, that’s ok, move on with your day, you’re here to learn and so are we.

4. Bring wound care supplies

There are not enough pockets in the world for the amount of gauze we use on surgery rounds. Take notes each day and try to bring supplies the next day. Does a patient need 2 rolls of Kerlix, one 10cc saline syringe, and one ABD pad every day on rounds? Bring those! It saves your residents so much time and will be appreciated.

5. Have the interpreter on the line

Wherever you attend medical school, chances are not every patient will speak English. Make note of each patient’s language on your list and have the interpreter on the line as soon as you reach the patient’s room. You will look like an absolute rockstar.

6. Write everything down

As you go through the day, make note of everything your residents say. Mr. X needs a GI consult today. Mrs. Y needs her diet advanced. Ms. Z needs wound care supplies for home. If there are tasks you can accomplish, ask your intern if you can tackle them.

7. Go to the operating room

Chances are your attending will be in the operating room all day. At my institution, attending physicians very rarely round with the medical students and interns. You need to maximize face time with them so they know who you are when they write your evaluation. So go to the operating room and be prepared to answer some anatomy questions.

8. Be nice to the OR staff

When you walk into the OR, introduce yourself to the circulator and to the scrub tech. Ask if you should pull your gown and gloves from the closet. Ask how you can help prepare the patient, for example, you can shave the area we’ll be operating on, help tuck the arms, take the bed out of the room... Try to be there before your residents, and definitely be there before your attending.

9. Take care of yourself

Carry around some snacks. Drink between cases. Pee between cases. Try to study at the hospital when there is downtime so you can get adequate sleep at night. OR days go by quickly and it’s easy to forget about bodily functions.

10. Never lie

One thing that will torpedo you very rapidly is lying. If you didn’t feel pulses, just say you didn’t but you will know to do it next time. If you didn’t look at the patient’s foley output, don’t say that you did. Lying can result in patients getting hurt, and there is no way to gain trust back after you’ve knowingly put a patient at risk.

Have fun on your surgery clerkship and in the operating room. If you don’t end up pursuing a surgical specialty you may never get to be in there again. It’s a unique privilege.

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