Living the Gen Surg Life

by Justin Perez, MD

Greetings from the other side! Spoiler alert: so that “big scary intern year” thing… well, turns out it’s very doable. In fact, I’m happy to report that my year to date has been quite positive (dare I say fun?). So for those of you about the enter the match and embark on your new journey in a different corner of the country, get excited because good times lay ahead – if you’re willing to take the bull by the horns, that is.

When I was on the interview trail there was this constant buzz going around about which programs required more general surgery time. Some even talked about their future months on gen surg services as some kind of “sentence” to be served. But for those of you coming down the pike, I urge you to avoid taking a negative outlook on this aspect of your training. Time spent on “off service” rotations can be a huge opportunity for growth, and my month on cardiovascular and thoracic surgery speaks to that.

Initially, I thought I had little to offer on a thoracic surgery service. My knowledge about chest tube management or chest physiology was practically zero– hardly even touched a chest tube in med school. My first day on service my attending Dr. Kernstine (now a mentor) pulled me aside and said “you can either take the reigns on this rotation, or you can let this rotation ride YOU. Your choice.” So moving forward I decided to seize every opportunity to gain some independence.

I recall my first Saturday on call sitting in the CVICU with one of the anesthesiologists. “Ever done a bronch?” I’m pretty sure my blank face was sufficient answer. And by the end of the day I’d done three. By the end of the month, I was doing bronchs on my own with little assistance.  I felt a similar pang of panic the first time I stood scrubbed with the thoracic fellow trying to remember the course of that saphenous vein. “Ever taken vein before?”  My blank face was back (apparently, I don’t hide it well behind a surgical mask). And by the end of the day I had taken three vein lengths (albeit with some small venotomies made along the way).  But by the end of the rotation, I had taken nearly fifteen vein lengths myself and the attending trusted me to teach other interns how to take vein.

Don’t get me wrong, there will definitely be those days when you’re a frustrated, urine output-scribbling scut puppy, consenting your patient for the UMTEENTH time because the “the consent got lost” – again. That’s just the nature of being an intern. But when you’re presented with the opportunity to act independently –like when the fellow had to travel to California for STS and I was running ICU rounds on our patients, proposing surgical plans, and positioning the patient for every case – then step up and enjoy that responsibility!

Intern year also offers a great opportunity to bond with your fellow interns. Make friends! Lean on them. This will certainly come in handy when you’re on call overnight in the burn unit admitting the victims of a house fire and need someone to bring you some cheer-up Cheetos…

My take-home message? Don’t fear intern year!!  Embrace your gen surg experience because it’s doable, it’s livable, and you’ll never forget it.

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