Clerkship Day 115: Surgery

(Originally written Nov 24, 2015)

Assalamu Alaykum. 

It's the second day of our clerkship rotation in Surgery, and I am on duty. Maybe I will share a few things about what to expect in Surgery as per our orientation...

1. Surgery 251 or Clinical Clerkship in Surgery II is a four week rotation in our academic curriculum. This is our last rotation for the year 2015 and it's the third of the "Big Four" that we already had rotated in (the other two were Pedia and OBGyne).

2. The block which is composed of 16 students will be divided into 4 teams, namely Teams A, B, C and D. I belonged to Team C. As I understood it, the assignment of team members was randomized (?) and each team must have 2 members from Sub-block A (the first half) and 2 from Sub-block B (the second half).

3. Each team will then be assigned to a particular service for a week, and then will rotate to the other services until all team will be able to rotate in all of the four services. The services are: General Surgery I (or GS1) for Upper Gi, Breast and Soft Tissue, GS-II for Colorectal Surgery, GS-III for Hepatobiliary Section and Trauma service. This first week in Surgery, my team will rotate in GS-II.

I know, the "GS" numbering is pretty confusing at times. But this was a long-time tradition in PGH, assigning numbers to different services for General Surgery. I've heard that the administration are trying to change it, and use the conventional "naming" (Colorectal Surgery instead of GS-II), but that is something we are about to see soon.

Meet my team: Byen, Mel, Karl and Me

4. The Clerks (LU6 students) are assigned with ODD-BED patients whom they will be the SICs or Student-in-charge. The SICs will do all the necessary orders (we call "SIC works") from the primary service they are in. Among these are requesting laboratory diagnostics, dropping referrals and completing clinical abstracts and discharge summaries. We are also allowed to input progress reports on our "SIC Notes".

5. The GS clerks are assigned in Wards 2 and 4 only while the Trauma clerks are assigned in Ward 14A. A Clerks' Callroom is provided for them at Ward 2.

The Clerks' Callroom in Ward 2

6. Each GS team will take turns having "duties" every three days. And while one team is "On duty" the other two GS team will either be "Pre-Duty" or "Post-Duty". The Trauma Service have a slightly different schedule that the GS teams. More on that when we get to rotate in Trauma :)

The Daily tasks

7. So what do clerks on-duty do? Well, it's pretty similar with the other teams aside from the 6AM-6PM duty at the Emergency Room. The Pre-Duty and Duty team are the first on deck for OR Assists to allow Post-duty team to rest. They are also assigned in monitoring patients in Wards 2 and 4. The Post-duty teams on the other hand, will be assigned with the Phone Duty (PD) who will receive all incoming calls for requests on OR assists or SIC procs.

We do daily chart rounds, checking new orders and SIC works to be carried out

8. Each team must have a Team Captain (TC) who is assigned to make sure all the chart orders for that service are taken cared of by the end of the day. The TC will check the daily ward reports for new admissions or discharged patients. He/She will also deck and assign patients to respective SICs in their team/service. The TC will never be called to assist in OR unless all clerks are already assisting. If all of his members are already in the OR, he/she will be the one to carry out the orders of all SIC works in his/her team. This is perhaps the most exhausting task.

When the Team Captains for Day 2 are these guys...

2  busy clerks inside the callroom...

These are the usual tasks in a day under Surgery Clerkship. We take turns being TCs of our team and as I see it, it is very important to have a very good team dynamics. It's the best time to train your teamwork capabilities as Surgery, they said, is a team game, not a solo game.

Looking forward to learning new things and having new experiences here in Surgery :D 

Salam Kasilasa!

Ahmad ibn Hajiri