I thought I would write this post, because I remember doing my first ortho rotation and not really know what to do, especially in the OR. Here are some tips on how to be a stand-up student (especially if you are going to do an away rotation) and increase your chances of matching.
1. In the OR, always help move the patient to and from the bed. If the nurse is standing by the patient, ready to help move the patient, ask him/her if they would like you to take their place. The circulator has a lot of stuff to do, and if you do this job, they will greatly appreciate you.
2. When you walk into the room, introduce yourself to the circulator and the scrub. Put on gloves and get ready to help move and position the patient. Stand by the patient and assist the anesthesia folks if they need anything.
3. Learn where things are kept in the room. If someone needs something, offer to go and get it. You have no idea how helpful this can be!
4. If the patient needs a foley to get the case started, volunteer to put the foley in. If you need help, ask one of your residents to watch you. I know you are on an orthopaedic surgery rotation, but nothing says you can't to do this simple/quick procedure to help move the room along. I do foleys all the time as an intern, and I will continue to do them if they need to be done. The goal is to minimize delay and keep the day in the OR moving. The faster the OR is over, the faster you (and your resident/attending) get to go home!
5. Make sure the scrub has gloves and a gown for you.
6. Ask the circulator if they need help prepping the patient and do so before you scrub for the case.
7. If the attending/resident has a piece of suture, you should have a suture scissor in your hand. The worst thing that can happen is the attending/resident takes the scissors from you because you are not in a good position to cut suture.
8. Pay attention to what is going on in the case. If an attending/resident is drilling a hole in bone, ask the circulator for the depth gauge. If you show that you are paying attention during the case, you'll get more opportunity to do things.
9. Look at the approach for the case and LEARN YOUR ANATOMY. If you answer one question correctly, you'll likely not be asked many more questions - and you'll get rewarded with more opportunities to participate in the case.
10. Watch the closure. When you get an opportunity to suture, give it a go, work to do it correctly. You can practice at home with pig's feet, oranges, bananas, and pretty much anything else that has an outer skin. Ask the scrub to give you any extra, unused suture that might be left over at the end of the case.
11. Offer to write notes. I know that this seems like busy work, but it is VERY helpful, and it actually does have some educational value. When I write a neurovascular exam of the lower extremity, I have been asked what the nerve/muscle abbreviations are - many times. It's OK to ask if you don't know. It's amazing how little orthopaedic surgery is taught in medical school - and because of this, there's a ton to learn.
12. Don't be afraid to ask questions, but know the appropriate time to do so.
13. Be the first person in the door and the last one to go home.
14. Be part of the team and don't ever complain!!!!
15. Nothing listed above is scut! These are all jobs someone on the team needs to do and if you volunteer to do some of the less fun jobs, somewhere along the way, you'll get an opportunity to do some of the more fun stuff!
I am very careful to attempt to get students to participate, but not all residents are that way, not even with me as the intern. Unless you put yourself in a position to be helpful, you're not going to get invited to the party. This is your education we're talking about - and you're paying for it. Not to sound to schizophrenic, but you also have to be patient. You'll get opportunities, but there are dues to be paid first. We all have to do it.
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