Tips for Junior Clerkship (Surgery) in VSMMC (Cebu, Philippines)

Junior Clerkship can be confusing because nowhere in the books is the definite role of the Space-Occupying Lesion absolutely and accurately defined.  Here are some tips to help you make the most out of your Surgery rotation in VSMMC.

1)  Review at least the anatomy of (a) the abdominal wall, including male and female variations; (b) appendix; (c) transverse colon; (d) anorectal region.

2)  If asked to assist in an operation, always read your patients’ charts ahead before scrubbing in.

3)  Observe proper OR etiquette even if not practiced at all times: (a) do not abandon the patient; (b) be on time; (c) be there before the surgeon/s; (d) be courteous to all the staff.

4)  Explore the trees to understand the forest. There are two floors in the OR.  You share these with other cutting specialties (OBGYN/Pedia, Uro/TCVS/Plastics, Neuro, Ortho).  It’s usually easy to identify what department is occupying an area just by looking at the patient’s appearance (e.g. with cast/splint, pregnant, jaundiced) and positioning (e.g. lithotomy).

5)  Know the forest creatures. Except for the senior clerks, it’s pretty hard to distinguish nurses from doctors from utility personnel as they wear similar hides.  If you feel adventurous, be free as a bird and fly.  Otherwise, look for people with the school logo and tag along. The next safest crook is the anesthesiologist’s nest (i.e. anesthesia machine).

6)  Know the forest underbrush. The orange goo for scrubbing makes a brushless wash.  No more irritating iodinated solutions and vigorous scrubbing for those with sensitive skin! Sterile linen comes in the form of a gown.  Don’t look for towels or sheets. Caps can be used to cover shoes, too.

7)  If there’s nothing to do, go up and explore OR-5 (Orthopedics). With permission, go ahead and ask about the procedures and the INSTRUMENTS. Learn what you can.  Your one module in Orthopedics will not prepare you enough to handle patients, assist operations and do paperwork (especially surgical techniques) for such cases in senior clerkship.

8)  When at the anesthesiologist’s area, do not sit on their toolboxes. Familiarize their armamentarium and monitoring schemes. Some machines come with algorithms on malignant hyperthermia. Many patients are unstable or are hypertensive; ask what to do with them. What you will learn here may help you in your anesthesiology rotation next year.

9)  Don’t forget to take a group picture outside the OR.  It’s obligatory.

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