Rotation: Pediatric Surgery

  

Name/Location of Clinical Rotation

Pediatric Surgery at the Children’s Hospital (4 weeks)

What did I like most about this specialty?

Pediatric surgery was a lot of fun. I really liked my team. The attendings here were great, their current Fellow is outstanding, and the residents were pretty cool too, for the most part. I’m convinced that if you like your team, you’ll have a great experience.

What did I like least about this specialty?

The hours on surgery are the longest of any of our rotations this year. A normal day started at 5am or before for prerounding, then rounds at 6am and the first surgeries starting around 7:30am. On a normal day, we were told to go home around 5pm. On a call day, we’d still come in around 5am but not leave until after rounds the next day, typically 8am or later. It made for some really long days, a tired and cranky momma, and a family that missed me.

It didn’t take long to figure out that Surgery is a different kind of beast than Internal Medicine. I found that the personalities were a lot different than mine. On Pediatric Surgery, this wasn’t very evident, but it came to light later on. In general, there was a lot more crankiness on Surgery than on Internal Medicine.

What I liked least about this rotation is that I would get maybe 15min a day with patients when I prerounded, which bummed me out because I love talking to my patients and getting to know their families. I don’t count time in the OR or PACU as time spent with patients.

I was also not thrilled about the oral exam at the end of our rotation. Surgery is the only specialty that still does oral exams, and they included one in our rotation. It was intimidating and to me didn’t really seem to serve much function other than letting the students who are interested in surgery get a feel for it.

Did this clinical rotation give me a good sense of what practice in this specialty would be like?

I felt like I got a good overview of the type of workload an intern/resident is subjected to.

Did my interests, values, kills and personality fit with this specialty? If yes, how did they fit? If not, why might they not be compatible?

No. I found that I value spending more time with my patients than what was offered with Surgery. Time in the OR and PACU with patients wasn’t really what I would call quality time, so surgery is definitely last on my list of potential specialties (keeping in mind that that list is currently two specialties deep).

  
What are the possible practice settings exist for this specialty? Do any of them interest me and do I know enough about them?

I only saw academic hospital-based surgeons.

What info do I still need?

None–I think I have all I need to know to make an informed decision about this specialty.

Has my perception of this specialty changed? If yes, how?

Not really. I’d shadowed in surgery many times before and of course there was always my love of Grey’s Anatomy, but other than thinking that performing surgeries is pretty badass, that was where my perception ended and was accurate based on my feelings by the end of the rotation. I’m fine with leaving Surgery in my past.

Did my clinical rotation experience influence the likelihood of choosing this specialty?

Yes. This clinical rotation definitively put Surgery last on my list of possible specialties.

Right now, how interested am I in this specialty?

Surgery is really cool and really helpful to patients and their families, but I’m not sure that’s how I want to spend my career. I yearned for more time with patients.

What information do I still need to evaluate this specialty? Any other comments or reflections?

Cool cases: Wilms’ tumor, Pheochromocytoma, patients on ECMO; I was surprised that I didn’t get to see a single case of gastroschisis or omphalocele the entire time… even the attendings said it was weird, that usually there’d be several every week. I got to drive the laparoscope plenty of times, put in sutures, practice throwing knots, and even put staples in a kid’s head after an MVA (motor vehicle accident). And as I shared before in a local news article, there was a case of conjoined twins being separated that was AMAZING, to say the least.

Surprises: I was really surprised by how many patients we had that were adopted. It was a lot more common than I htought it would be. Also, we had several Amish patients over the course of the 4 weeks I was here, which was pretty cool too. I really liked getting to know all of these families (and my pediatrician-hopeful self loved being at the children’s hospital anyway!).

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