The Student Room Group

Shadowing a Cardiothoracic surgeon next week: What to expect?

Hi, I'm a med student and will be shadowing a surgeon for a month starting next week. This is my first shadowing experience with a surgeon so I dont really know what to expect: For any medical students who've done this, can you tell me:
Will I be asked to wear scrubs (If so, do I have to buy my own or will these be provided at the hospital? If first option, where can I buy my scrubs from?)
As I'll probably be observing quite a few surgeries, what's the likely hood I'll get to actually "scrub in" to watch or be able to assist in any way (holding clamps, cutting sutures, wiping off blood)? Or will be able to watch the surgery from outside the scrub zone. As a med student am I covered under insurance for these sort of things or is that not the case until clinical years (3rd year)?
What kind of experience should I expect in general? Would love to hear from anyone with recent shadowing experience with a surgeon

Thanks
(edited 8 years ago)
Reply 1
Original post by insert-username
Hi, I'm a med student (year 1) and will be shadowing a surgeon for a month starting next week. This is my first surgeon shadowing experience so I dont really know what to expect: For any medical students who've done this, can you tell me:
Will I be asked to wear scrubs (If so, do I have to buy my own or will these be provided at the hospital? If first option, where can I buy my scrubs from?)
As I'll probably be observing quite a few surgeries, what's the likely hood I'll get to actually "scrub in" to watch or be able to assist in any way (holding clamps, cutting sutures, wiping off blood)? Or will be able to watch the surgery from outside the scrub zone. As a med student am I covered under insurance for these sort of things or is that not the case until clinical years (3rd year)?
What kind of experience should I expect in general? Would love to hear from anyone with recent shadowing experience with a surgeon

Thanks


If you're going to theatre you'll need to wear scrubs and they will provide them, might be worthwhile buying your own cheap clogs though (Sports Direct does cheap ones).

Expect a LOT of CABGs.

I'd hold off and just watch the operations for the first week, then ask the surgeon (and then ask the theatre sister) if you'd be allowed to scrub in after that. They might say no, but it's always worth an ask.

Good luck :smile:
Reply 2
With my cynical hat on, expect to get either ignored or shouted at a lot.

More practically, the hospital will provide scrubs - they will be in or near the theatre changing rooms. Some places provide shoes/clogs but not all. Might be worth buying your own. On your first day, find someone to let you in and show you where the changing rooms/lockers are. Make sure you know the rules on where hats/masks can/must not be worn, and if you need to cover your scrubs to leave theatres. Don't bring too many valuables with you as it is likely you won't have a locker and changing room thefts are common.

I am not sure if you'll be allowed to scrub in - cardiac surgeons tend to be quite protective of their space and not necessarily that nice to their assistants. We had to be taught to scrub by our clinical skills tutors before we could scrub in, your local rules may vary. Don't touch anything in the sterile field if you value your life.

Top tip: make friends with the cardiac anaesthetists - the best place to watch if you can't scrub in is at the head end, so if they will let you stand there (don't get in their way if they need to do stuff to the patient though!) you might actually get to see what's going on.
(edited 8 years ago)
I am currently shadowing a consultant cardiothoracic surgeon for my 2nd year SSM.

I attend ward rounds at 7.30am in the mornings till about 9am. Depending on the day, I attend multidisciplinary meetings to discuss complex cases. I sit in with the consultant when they do their private clinics.
I normally observe surgery, as pointed out before mainly CABGs with a few angioplasties thrown in and the rare valve repair. You won't be able to scrub in unfortunately.

Make sure to familiarise yourself with theatre etiquette like staying away from the sterile field. Make sure when suiting up you don't forget eyewear, i forgot once and got slated.
(edited 8 years ago)
My golden rule in medicine is if you don't ask (politely), you don't get. As a medical student (and as an FY), its rare that you get invited to scrub (or do a procedure etc depending on the context) but if you ask, you may well get the opportunity. Even if its not possible for you to scrub in on that particular day or have a go on doing that line (etc), just by asking you are showing an interest and people tend to bother a bit more about you.
Reply 5
Expect less theatre time and a lot more ward round and OP clinics. Maybe the odd cancer MDT depending on hospital. They may let you scrub for a closer look but I doubt you will be able to do anything, that's what registrars are for :wink:
Original post by DrID
Expect less theatre time and a lot more ward round and OP clinics. Maybe the odd cancer MDT depending on hospital. They may let you scrub for a closer look but I doubt you will be able to do anything, that's what registrars are for :wink:


erm, last time I checked cardiac cancer is rare...
Reply 7
Original post by twmffat_twp
erm, last time I checked cardiac cancer is rare...


True, but lung cancer isn't. You don't know what cardiothoracic covers do you?
Original post by DrID
True, but lung cancer isn't. You don't know what cardiothoracic covers do you?


yeeees, its just that for some reason (which I m not sure where I got this) I thought that the post was about shadowing a cardiac surgeon, and in the place I've worked you had Cardiac and Thoracic surgeons operating seperately under the general umbrella of cardiothoracics. But fair point though :smile:
Thanks so much for all the replies, everyone! Really appreciate all the help and advice, feeling even more excited now! I'm definitely looking forward to observing surgeries/whether or not i get to scrub in as well as the non surgical aspects (ward rounds, consults etc)
Original post by DexterM
If you're going to theatre you'll need to wear scrubs and they will provide them, might be worthwhile buying your own cheap clogs though (Sports Direct does cheap ones).

Expect a LOT of CABGs.

I'd hold off and just watch the operations for the first week, then ask the surgeon (and then ask the theatre sister) if you'd be allowed to scrub in after that. They might say no, but it's always worth an ask.

Good luck :smile:



Hey Dexter, thanks for the advice! You're probably right about just watching operations for the first week before asking about scrubbing in, I'll look into getting some clogs this weekend, any particular type you recommend?

Thanks! :smile:
Original post by Helenia
With my cynical hat on, expect to get either ignored or shouted at a lot.

More practically, the hospital will provide scrubs - they will be in or near the theatre changing rooms. Some places provide shoes/clogs but not all. Might be worth buying your own. On your first day, find someone to let you in and show you where the changing rooms/lockers are. Make sure you know the rules on where hats/masks can/must not be worn, and if you need to cover your scrubs to leave theatres. Don't bring too many valuables with you as it is likely you won't have a locker and changing room thefts are common.

I am not sure if you'll be allowed to scrub in - cardiac surgeons tend to be quite protective of their space and not necessarily that nice to their assistants. We had to be taught to scrub by our clinical skills tutors before we could scrub in, your local rules may vary. Don't touch anything in the sterile field if you value your life.

Top tip: make friends with the cardiac anaesthetists - the best place to watch if you can't scrub in is at the head end, so if they will let you stand there (don't get in their way if they need to do stuff to the patient though!) you might actually get to see what's going on.


Thanks so much for all the info and advice! Great advice about befriending the anaesthetists!
Original post by Killuminati1989
I am currently shadowing a consultant cardiothoracic surgeon for my 2nd year SSM.

I attend ward rounds at 7.30am in the mornings till about 9am. Depending on the day, I attend multidisciplinary meetings to discuss complex cases. I sit in with the consultant when they do their private clinics.
I normally observe surgery, as pointed out before mainly CABGs with a few angioplasties thrown in and the rare valve repair. You won't be able to scrub in unfortunately.

Make sure to familiarise yourself with theatre etiquette like staying away from the sterile field. Make sure when suiting up you don't forget eyewear, i forgot once and got slated.


Hey, thanks so much for all the detail/info! Great to read about your shadowing routine, sounds like a great experience! Just to clarify, by SSM you mean student-selected component? If so, can I ask what your SSM is and how you arranged it?
I'm also curious to know how your shadowing has been arranged around your medical school routine? Have you been given specific time off medical school/classes to attend your shadowing or has your shadowing been fit around your medical school timetable/classes? For example: you have ward rounds from 7.30 - 9 with surgeon, then back to medical school for afternoon classes (lets say 9-2 for example), then back to hospital for surgeries etc?
Or do you just not have any classes to attend and just have all day during the week to spend at hospital with your surgeon?
I did 4 weeks of shadowing one of the cardiac surgeons in my 4th year. There's way too many assistants around for a med student to scrub in. There will likely be both an anaesthetist and an anaesthetics registrar. I really liked anaesthetics so this essentially became an anaesthetics SSM. Think about going to cardiac ICU as well.
Forgot to say, if you have been taught to do cardiovascular examination, try to see the pre-op valve patients if you can - lots of murmurs!
Original post by Helenia
Forgot to say, if you have been taught to do cardiovascular examination, try to see the pre-op valve patients if you can - lots of murmurs!


Thanks for the tip! Will definitely keep that in mind!
Reply 16
They say you get as much as you put into every clinical opportunity you get.

As a first year, it's great that you'll be shadowing a surgeon, but it may be difficult to engage much with the experience as you may not necessarily have been taught a lot of the things related to cardio-thoracics/ surgery.

For a start, you could go over the anatomy and physiology of the heart. Learn the vessels that supply the different chambers of the heart and go over some of the physiology of the cardiac cycle. This should give you a good grounding to understand what you'll be observing in theatre, and also might give you a few intelligent questions to ask the surgeon (or answers to his questions if you get grilled!)

From a clinical perspective, go over cardio examinations and history taking. Surgeons love medical students who see their patients BEFORE the surgeries, so try and make your way up to the ward and ask the junior docs if they have the theatre list for the day / the following day and ask them if you can speak to them when they come in for their surgeries.

In addition, you could ask the surgeon you are shadowing if it's possible to sit in during a pre-op assessment clinic. This is probably going to be the most useful thing for you as a junior medical student as you'll observe important things that will be more relevant to your future OSCEs e.g. Medical assessment of a patient pre-operatively, obtaining consent for a procedure. Also, this is where the surgeon will usually explain the procedure to the patient in layman terms, so it's a great way of learning a little bit about the procedure, as well as how to communicate with your future patients so that they will understand you.

Hope this advice helps! Don't feel like you have to be on top of all the knowledge of things though. You are still in 1st year and you really should enjoy it as much as you can!

TL;DR: Skim over cardio anatomy/physiology before attachment. Try and speak/examine patients before their operations. Attend pre-op assessment clinics if possible. Don't stress, enjoy med school! :smile:
Original post by zaps90
They say you get as much as you put into every clinical opportunity you get.

As a first year, it's great that you'll be shadowing a surgeon, but it may be difficult to engage much with the experience as you may not necessarily have been taught a lot of the things related to cardio-thoracics/ surgery.

For a start, you could go over the anatomy and physiology of the heart. Learn the vessels that supply the different chambers of the heart and go over some of the physiology of the cardiac cycle. This should give you a good grounding to understand what you'll be observing in theatre, and also might give you a few intelligent questions to ask the surgeon (or answers to his questions if you get grilled!)

From a clinical perspective, go over cardio examinations and history taking. Surgeons love medical students who see their patients BEFORE the surgeries, so try and make your way up to the ward and ask the junior docs if they have the theatre list for the day / the following day and ask them if you can speak to them when they come in for their surgeries.

In addition, you could ask the surgeon you are shadowing if it's possible to sit in during a pre-op assessment clinic. This is probably going to be the most useful thing for you as a junior medical student as you'll observe important things that will be more relevant to your future OSCEs e.g. Medical assessment of a patient pre-operatively, obtaining consent for a procedure. Also, this is where the surgeon will usually explain the procedure to the patient in layman terms, so it's a great way of learning a little bit about the procedure, as well as how to communicate with your future patients so that they will understand you.

Hope this advice helps! Don't feel like you have to be on top of all the knowledge of things though. You are still in 1st year and you really should enjoy it as much as you can!

TL;DR: Skim over cardio anatomy/physiology before attachment. Try and speak/examine patients before their operations. Attend pre-op assessment clinics if possible. Don't stress, enjoy med school! :smile:


Wow, Zaps! Thanks so much for taking the time to write so much detailed advice and information! I'v definitely been brushing up on my cardiac anatomy and I'v also started learning about/watching some common cardiac surgeries (CABGs etc) just so I know at least bit of what to expect beforehand. I'v taken all your tips to heart and will definitely ask my surgeon about sitting in on pre-op clinics, also see about getting the theatre list from junior docs

Thanks so much!
Original post by insert-username
Hey, thanks so much for all the detail/info! Great to read about your shadowing routine, sounds like a great experience! Just to clarify, by SSM you mean student-selected component? If so, can I ask what your SSM is and how you arranged it?
I'm also curious to know how your shadowing has been arranged around your medical school routine? Have you been given specific time off medical school/classes to attend your shadowing or has your shadowing been fit around your medical school timetable/classes? For example: you have ward rounds from 7.30 - 9 with surgeon, then back to medical school for afternoon classes (lets say 9-2 for example), then back to hospital for surgeries etc?
Or do you just not have any classes to attend and just have all day during the week to spend at hospital with your surgeon?


Hey

Yes by SSM i mean student selected module. My module is a special study module which encompasses a self directed approach. Basically i set up an observership in a field i'm interested, keep a journal and write a reflective essay at the end. I corresponded with many consultants in a couple of fields (most won't answer you so its best to play the field) from plastics, endocrinology and cardio via email and telephone.

With regards to scheduling. I met with the consultant first and told him what i intend to do and what im looking to gain. Make sure you set learning objectives. Then i told him when im free.
So Wednesday I have class from 12am till late afternoon. I go straight from hospital to school. Once i get into a routine I kinda change the schedule when it suits me. At first I had to miss a few classes so I could get to know people then afterwards I showed up when it was convenient for me.
Original post by Killuminati1989
Hey

Yes by SSM i mean student selected module. My module is a special study module which encompasses a self directed approach. Basically i set up an observership in a field i'm interested, keep a journal and write a reflective essay at the end. I corresponded with many consultants in a couple of fields (most won't answer you so its best to play the field) from plastics, endocrinology and cardio via email and telephone.

With regards to scheduling. I met with the consultant first and told him what i intend to do and what im looking to gain. Make sure you set learning objectives. Then i told him when im free.
So Wednesday I have class from 12am till late afternoon. I go straight from hospital to school. Once i get into a routine I kinda change the schedule when it suits me. At first I had to miss a few classes so I could get to know people then afterwards I showed up when it was convenient for me.


Thanks for all the info! Hope it's all going well!

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