General Surgery II Rotation Summary

Okay, so I have finished two months of rotations and have taken my first exam. All in all I think I have done okay, at least I'm not any worse for wear, and I have actually learned a few things. I was even surprised in my exam today to actually know some of the answers. :)

So this is the summary of my latest rotation. Plastic Surgery with Dr. Carl Williams. It was a good experience. We were a little slow, sometimes really slow, but that is in the stages of changing. He will be moving to Valley soon and so students will be able to do a lot more. Here is an outline of an average week.

Monday's were surgery days at Seven Hills Surgical Center. Make sure you take a packet with you or you won't be able to observe. It isn't listed as a place that you need to badge, but Dr. Williams spends 2 days a week there. It is a very nice facility. Privately owned, as Dr. Williams said it "the Ritz-Carlton of surgery centers." Very nice, and wonderful staff. Mondays are a hand surgery day and they start at 9:30. No need to be there early, just be there on time. They have their own scrubs that you can change into. It is then your job to do the H & P on the pts undergoing surgery that day. Dr. Williams will show up and mark the hand or arm. You are allowed to scrub in at Seven Hills, but Dr. Williams has his own assistant who aids in the operations, all you really do is look over his shoulder, ask questions, and listen to what he has to say. You will also have lunch on these days. The Dr or surgery center (not sure which one) buys the students lunch. Mondays it comes from the Spicy Pickle, a good sandwich place. After lunch you head to the office and see pts for the afternoon. Usually their aren't a lot on Mondays.

*Okay, so as far as seeing pts goes, you will observe for a couple people and then Rob, the Dr's assistant will have you do most of it. There are forms in each chart that are to be filled out. You just ask the questions. It is pretty basic. Not sure if it helps prepare us for the physical exam portion of next years board exam, but at least you get some practice asking questions, even if they do all have to do with pretty much the same thing.

Tuesdays are another Seven Hills day, but that is the cosmetic surgery day. Same thing as before, same time, same routine, but this time Dr. Williams nurse Sandy comes in to assist. She does all the cosmetic consults in the office (you won't be in on those) and then assists on the surgeries, as well as taking before and after pictures of whatever is being done. Lunch is El Pollo Loco and then onto the office to see pts again.

Wednesday is another hand surgery day at North Vista Hospital. Badging was a pain there, I never got my actual badge, but it really doesn't matter. I don't know why they even ask for the packet and scrub class certification; you aren't allowed to do anything, not even scrub in, so it makes it very difficult to see and know what is going on. Just ask lots of questions regarding what he is doing. Dr. Williams is great at explaining and teaching if you ask. On Tuesday you will be given a packet by Judi (she is scheduling and authorization at the office), this packet contains all the info on the pts having surgery that day, their release forms as well as MRI results and other things that Dr. might want to see. You are in charge of making sure it gets there and into the hands of the Dr. Surgery starts at 7:30 am, so be there around 7. They also have their own scrubs that they have you wear. When you get there, change and do the H & P on the first pt. Dr. Williams will get there around 7:30 or 8:00. He will mark the pt and then off you go for breakfast. He takes you into the Dr's Lounge. Technically we aren't allowed in there, only Dr's, but Dr. Williams doesn't care, he said in the beginning that the one thing that wouldn't happen during my rotation with him is that I wouldn't go hungry. After breakfast we all go to surgery, you observe and then you have lunch in the Dr's Lounge. In the afternoon there are 2 things that can happen, either you stay at North Vista and see pts at the satellite office, or you go back to the Anthem office and see pts there. It switches every week. Wednesday night Dr. Williams is on trauma call at UMC, if he gets any cases he will call you. I never got a call, but oh well, I got my sleep. :)

Thursday is an office day, all day. You start at 9:30 usually, but it might be later depending on the schedule. You will see a lot of trauma pts, and a lot of follow ups from trauma. It is cool to see the different stages of recovery from the various surgeries, especially since we aren't there long enough to follow one pt all the way through recovery. Some of these pts follow up for up to a year depending on the trauma or surgery that they had.

Fridays are hand surgery at UMC. Unfortunately I only had one day there, my very last day of rotations. UMC is great because you can actually do stuff. Dr. Williams will teach you to suture. I was able to place a pin in a guys hand. It is a great teaching environment. You will also have breakfast and lunch there in the Dr's Lounge (he will have you take off your badge so they don't know you are a student, they are really strict there, even the residents aren't allowed to eat there). After surgery you are done for the day, no office hrs on Fridays.

So that was a typical week. I think I learned quite a bit. Dr. Williams was great at talking about real world stuff as well, having a private practice and what comes with that. Health insurance and how they worked. Did you know that when an insurance company authorizes a procedure it doesn't mean they will actually pay you for it? Yeah, crazy huh, he said that around 1 in 10 operations won't be paid for.

Oh, you wear scrubs every day. No white coat, and they introduce you to most people as a resident, otherwise some of the high end clients that he has wouldn't let you in the room. It is a nice work environment, kind of a family thing. Rob (the hand assistant), his wife Candi works in the front office. Sandi (the nurse) is Rob's mom, and Judi, well there is no relation. :) They are all very nice and fun to work with. I ended up observing 18 different operations, only 3 of which were cosmetic. Most were hand, carpel tunnel releases, ganglion cyst removals, nothing super exciting, although I did see the Dr. sew the median nerve back together on a pt, that was cool, and then my UMC day was great. If you have Dr. Williams, I hope you enjoy him, oh, and tell him I said hi! :)