Wednesday, March 11, 2009

Rotation Block 5: General Surgery

During late November through Mid December, I had my general surgery rotation at Banner Del Webb Hospital with Dr. Marco Canulla and Dr. Kathleen Koerner. The best thing about this rotation—it was right by my house!!! The past few months I had been traveling to Scottsdale and Wickenburg every day! The hospital was less than 10 minutes from my house!

This was a pretty sweet rotation. I realized that I really liked surgery and enjoyed the OR more than I expected. What I did not like as much is the sometimes crazy hours they worked and the ridiculous turn-around time from one case to the next. There were a few days were we got there at 5:30 or 6 am and were there until 10 or 11pm! It was nuts! I am very happy that I decided to do a preceptor/department based surgery rotation as opposed to a ward based rotation. Ward based rotations (at teaching facilities with residencies) are important for students looking into surgery residencies. It is great exposure, you typically see some pretty cool cases, and any ward based rotation is good to get more comfortable with the residency environment. The downside, though, is that it is with residents who are training and therefore get to do most of the work, leaving the student to watch or do very minimal participation in the case. On my rotation, I was able to scrub in to most of the cases, and many times was the 1st assist on the case! I had a ton of opportunities to run the laparoscope, make incisions, use the electrocauterizer, use laparoscopic tools, and do closures! And as I am a hands-on learner, this was very helpful to me!

Another student, Stephenie Sterrenberg, was on the rotation with me, and we usually both scrubbed in on the surgeries or took turns. We also rounded on all the surgical patients each morning and wrote notes, so we still got a lot of hospital experience. And the learning was good too. Dr. Canulla is a laid back, hip-hop lovin’, get-er-done kinda guy who would perform 25 minute lap cholecystectomies. He seemed absolutely fearless! There wasn’t a case he would turn down, and he did general and vascular surgery. So in addition to the GI surgeries, I was able to assist on a lot of AV fistula grafts and revisions, which got extremely bloody sometimes! He took a genuine interest in our learning, quizzing us on things like fluid maintenance in addition to surgical knowledge. He was always looking for ways to improve the rotation as well from our perspectives. He was a great model of a preceptor. Dr. Koerner was an AZCOM grad and was fresh out of her surgical residency. It was awesome to get her perspective on things, and she was really patient and easy going in the OR. She remembers what it was like to be a student, so she made sure that we had a lot of opportunities for hands-on involvement. I was also able glean some osteopathic surgical philosophies from her. Nothing crazy or anything, but just thoughtful methods that perhaps took an extra few minutes, but showed that they improved healing time and patient comfort, as well as enhanced post-surgical performance. This mostly involved different types of irrigation, different methods of closures and so forth. True, being fresh out of residency translated to some longer cases, but she always seemed happy that we were there! It was a really strong rotation, but I was very grateful that we had a 2 week winter break afterwards! And then there was the shelf exam. That did not go as well for me. True, I passed, but it just took me longer to get through the questions. And as we only have 2 hours 10 minutes for 100 questions that are all clinical vignettes. Needless to say, I had to bubble the last 15 questions in with “C.” So thankfully I still passed!

2 comments:

KFinley said...

So are you moving back to Cedar?

FYI...I changed by blog to private. If you want to look at it you'll have to email me your email address at c-k-guest@live.com.

marco canulla said...

Thank you for your kind words it was a pleasure having on our service. Good luck in the future don't sweat the test so much you passed. You have a good bedside manner and the patients liked you that will get you father than knowing a few esoteric facts.
Marco Canulla