A theatre rotation is one of the most exhilarating yet daunting aspects of placements that medical students have to look forward to in their clinical years. They can be notoriously difficult and intimidating to navigate, and we at MUSIG would like to clear the fog as much as we can!
There’s a surgical rotation in my schedule – what does that mean?
A surgical rotation is much more than days in theatre. That being said, there are surgeries happening throughout the day. Usually there are two theatre lists that run each day – one in the morning, and one in the afternoon. It’s a good idea to check with the surgeons on your team as to how to access these theatre list schedules – that way you can get an insight into who the surgeon will be, who the patients will be, and what the surgeries will be. If you feel comfortable, you can come in early with your registrar or resident to talk to the patients for that list, and introduce yourself.
But theatre isn’t all there is! While the morning list happens, there usually is a ward round, where the surgical team will review their post-operative patients, and may also assess new patients. This is a good chance for you to see clinical signs that require surgical intervention, and also follow through with patients’ recoveries post-operation. Some days there may be various clinics, which is a great opportunity to see surgical patients in outpatient settings.
That sounds great, how do I prepare? Do I need to be an expert in surgical techniques?
Generally, it’s always a good idea to have a read about the procedure you will be observing, especially since it’ll help you follow along with what’s happening in theatre. Revising the relevant anatomy can also be useful, because it’ll mean that you can consolidate what you’ve learnt in textbooks and anatomy tutes to real life anatomical structures.
If you’d like, you can watch a YouTube video before theatre on how to scrub in if you’ve never done it before. Don’t be afraid to ask for help about this!
When you get to theatre, it’s a good idea to have a chat to the patients prior to their surgery. Usually they will just be hanging out waiting in the pre-operative area of the theatre, so you can go in, introduce yourself politely, ask for their consent to be present for their procedure, and take a short history if time permits.
Now I’m in theatre – what do I do? Everyone looks the same to me…
This is true – it is hard to figure out everyone’s role, especially when they’re all wearing the same scrubs and don’t wear name tags. With keen eyes of observation, you will notice;
– One or two anaesthetists and usually an anaesthetic nurse, who you will notice will be putting lines in the patient, maintaining their airway, and setting up medication;
– The theatre technician, who will be setting up the consoles, operating table, and the theatre in general for the particular case;
– Scrub and scout nurses, who are usually a pair that may swap roles between cases. The scrub nurse will join the surgeon at the patient and assist with the case, and the scout nurse will be assisting the scrub nurse in preparing sterile equipment and setting up the theatre;
– And then the surgeons – a collection of consultants, registrars, and residents (who you may have seen on the ward).
When you walk into the operating theatre, there will be a whiteboard on the wall. Write your name, identify yourself as a medical student, and if you would like, write your glove size there as well. Introduce yourself to everyone who walks in. Work out whether you’d like to scrub into the case as well as whether it would be appropriate for you to scrub in – ask permission of the consultant / the most senior surgeon on the case, as well as the scrub nurse.
Theatre sounds fun – what else should I do?
As with all clinical rotations, you will get out of your surgical rotation what you give. The more you turn up to ward rounds, the more you turn up to theatre, the more the team will recognise your interest and give you opportunities to get involved, get scrubbed into cases, and will actively teach you very cool things.
Also, remember that surgical patients can also have medical concerns, and can develop these post-operatively (think about UTIs, pneumonia, post-op fever) – don’t dismiss the opportunity to learn about these during your time on surgical wards!
And finally, come to MUSIG events to learn about basic surgical skills and learn more about surgery in general! A sound knowledge of the bare basics of surgical techniques means that you can understand what is happening in theatre, and can also give you the confidence to say yes if offered the opportunity to try certain tasks.
From all of us at MUSIG – we wish you the best of luck for your surgical rotation, and for all your rotations to come!