Saturday, March 12, 2011

Surgery Makes Me Sleepy

I originally wrote this back in January, but I present it here with additional comment.

And by that I mean the rotations themselves, not the experience of being in OR. Though watching residents close abdominal incisions for the 12th time is not the most stimulating experience. Getting up at 5:30 daily - as I have been now since last Monday thanks to the Friday/Sunday call monster - requires early bedtimes, something I've managed to get used to. Today I zonked out about 9:30/10 in the morning and woke up suddenly at 11:27. Remarkably I was only about 10 minutes late to meet a friend for lunch at 11:30. But such free time is so rare these days.


I'm not sure why I didn't finish this post, but it was - likely - a matter of time. Or lack thereof. I've enjoyed all of my rotations since the new year began. General surgery was a lot of fun and very, very busy. My evaluation went really well and it remains a serious consideration for me. I enjoyed neurosurgery less - some very interesting cases and a couple great times getting to be first assist in the OR - but the lifestyle is probably among the worst of any specialty and the residents are overworked. I enjoyed working with the staff, though.

Emergency medicine was a good rotation. I did it at a smaller regional hospital with much more limited specialist support. Saw a large variety of patients and presentations, practised some useful skills (LP, more IVs, suturing, reduction of fractures, incision and drainage, MSK exam), and generally learned a lot. In the end, though, I didn't really like it. There's no rhythm to each shift. You just see patient after patient, many of whom don't require further tests or treatment, determining their "disposition" and making that crucial admit or discharge decision. Not much follow-up. Not enough complexity. At least for me.

I started plastics this week and I'm impressed daily by how well organized the rotation is. Lots of formal teaching and ample experience working in fast paced clinics. I can't complain about the amount of OR time either, even though I'm not getting a lot of skills practice there. Fair to say that I like everything about the rotation. I have been interested in plastics in the past - not really sure I still am. It's very interesting, of course, but the competition to get a residency spot is pretty intense and I probably would miss the medicine available in something like gen surg or, of course, internal medicine.

I suppose that leads to what kind of career I'm considering. That can be left for another post though.

No comments: