Before clinical year even started and we were all filling out our forms in preparation for rotations, I remember writing in a note saying, “please do not put my in surgery first!” Of all the rotations on the list, surgery was definitely the one that scared me mostly because I had never had an experience in an operating room and I was worried about my fine motor skills getting me in some trouble. I joke that I don’t know how to use my hands sometimes, so something so “hand-heavy” was really terrifying for me, especially in surgical gloves! That, combined with the fear of breaking the sterile field and expectations of standing for hours on end while holding a retractor put the idea into my head that I this would be the most difficult experience of PA school.

Surgery was definitely the most challenging rotation so far, but mostly only because of the scheduling. Between the 12-hour shifts Monday through Friday, during most of which I was scrubbed in to cases, one 24 (or really 26) hour shift, and the assignments that had to get done, time management was extremely important. Even with my best attempt, however, I found myself exhausted most of the time; but that was nothing a cup of coffee couldn’t fix!

My rotation was structured so that I did 2 weeks in general surgery on Team A Green and 2 weeks split between urology, neurosurgery, and vascular surgery. I was informed that the specialty surgery experiences were newly added, and I am so glad for that because these were experiences I likely would not have had otherwise. Also, we learn about the pathologies of these subspecialties, but it is a whole different experience and learning tool to see them and their interventions. Additionally, I found that I really enjoy urology, which I probably would not have realized.

Everyone- PAs, surgeons, residents, nursing staff, and other staff included- was extremely kind and welcoming to me, and so willing to teach. I recall on my first day I scrubbed into a laparoscopic cholecystectomy with a surgeon and senior resident and they told me to suture the port incisions closed with buried sutures. I explained that this was not a technique that I was familiar with and it was my first day, and the resident very kindly showed me on one of the port incisions and very patiently guided me through doing my own. He did not appear to get frustrated with me when he kept telling me to hold the Adson forceps “like a pencil,” especially when I thought I was because I do not have a conventional pencil grip and then laughed with me when I explained that I did not realize what he meant because of that. After the demonstration, I was able to pretty competently place buried sutures. I was also given several opportunities to place subcuticular sutures, but luckily I had gone to Professor Lopez’s suture workshop back in January where she taught us this technique.

I was also fortunate enough to be able to scrub into cases with just a surgeon several times, which gave me the opportunity to do much more during the cases. The first time this happened was during a laparoscopic appendectomy, where I got to make port incisions, drive the camera, and close the incisions. My favorite time was on the urology service where I got to assist in a few back-to-back circumcision revisions with the pediatric urologist and I got to suture the mucosa-skin line with the simple sutures I had become extremely comfortable with during my ambulatory care rotation.

Since a main point of my anxiety for this rotation was my self-proclaimed poor fine motor skills, I made sure to go home and practice buried and subcuticular sutures and hand-tying with gloves on. By the last week of the rotation I saw a major improvement in myself. Getting comfortable with the movements and developing the muscle memory is extremely important in these situations, so that is something I will carry to future rotations.

Before this rotation I felt like surgery was something I would never enjoy, but I was pleasantly surprised and proven wrong. I learned so much during the rotation that was directly applicable to the end-of-rotation exam and I could reference in my head to specific patients and was able and encouraged to actually participate in the cases, which is really the best-case scenario for any rotation.