sub-I rotation: Week 1

by Andre Alcon, MD

The first week of my first sub-I rotation is over and it’s been an abrupt transition from my research year in the lab. Gone are the days when I could set my own hours and work at my own pace. At the same time, however, I was looking forward to getting back to the OR and working in the hospital. Nonetheless, I had some anxiety as my rotation approached. There’s a lot riding on these four-week auditions; around 75% of students who match in plastic surgery do so at a place where they did a rotation.

Unfortunately, things started out a little slow for me after being in the lab for so long. Everything moves so quickly on surgical services; it was as if I had moved from New Hampshire to NYC. Not surprisingly, anticipation is key in this type of environment. During the first week, I spent a lot of my time figuring out how the team operates. Easier said than done no doubt, and finding the right balance between taking the initiative and biting off more than you can chew can be delicate. However, after a couple of days, I had a pretty good understanding of what needed to be done and when, which will hopefully put me in a good position moving forward.

Sometimes residents will tell a student to scrub in on a case that isn’t theirs, but talking about it with your colleagues can minimize any unnecessary drama.

Also on the team are two other sub-I’s, two third year medical students and a PA student. That’s a lot of people to share valuable OR time with. Luckily, all of them are friendly and understanding, but establishing ground rules early with fellow students has helped to avoid any confusion or poaching. Of course, sometimes residents will tell a student to scrub in on a case that isn’t theirs, but talking about it with your colleagues can minimize any unnecessary drama. Ultimately, two or three sub-I’s who function well as a team is much more impressive than each one competing with the others. Moreover, it shows that you’re a team player and that you’re not afraid to lay down a bunt to advance a teammate.

If there isn’t much going on, I’ve also found it helpful to take the third year medical students aside to talk to them about any cases or lectures they might have in the coming days. I can give them tips on what to expect and how to prepare, which can be extremely helpful for them and keeps them occupied so that the residents can focus on other, more important things. The med students usually return the favor later on, which has been enormously helpful at times. It also shows the residents that you can be a leader and that you take an interest in teaching, which is a great skill to have during residency.

A lot of what sub-I’s do is a reiteration of third year, but with higher expectations and more responsibilities. The last week has been a whirlwind and I’ve already learned a ton. Rotating at my home institution has undoubtedly made the transition easier.  The next three or four months will definitely be a rollercoaster when I leave for my away-sub-I’s, but for now I’m just focused on the next three weeks.

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