General Surgery is a very busy service, especially in Northern Ontario.
My days are usually booked as: Outpatient Clinic, Ambulatory Care Hospital, Endoscopy, OR, Rounding (when on-call).
Call Shifts – When I was on-call for one week with my physician preceptor, I would usually start my day with pre-rounds on the wards. I would usually arrive 30min-1hr prior to the physician (6am arrival for me) in order to go over blood work, vitals and nursing shift reports to get a good handle on what was happening. It is always challenging on your first day, because you are getting to know all the patients from scratch. After pre-rounds, I would meet the physician, and then we would visit select patients together. When on-call, we are also expected to handle all emergency room consults, and emergent surgical cases/endoscopies. Around 5pm the physician would leave the hospital and place me on-call overnight, where I would respond to emergency room and ward calls, and conference with them over the phone. If I found a complex case, I would page the physician to return to hospital. Call is very busy, especially in the north, as you are at times covering three inpatient wards with 40+ patients due to limited coverage. In down periods overnight I would catch-up on rest, eat, and study conditions from the previous day.
Endoscopy days would start around 7:30am. I would arrive 30mins prior in order to go over our patient list and greet the first few arrivals in day care. At first, I would wait for the physician to arrive to do anything. As I learned and developed a good rapport with the physician, I would bring in the patients, explain the procedure, handle any concerns and prepare the medications. When the physician would arrive, I would confirm the medication dosages and administer the medications to the patient. I was also responsible for all documentation for the endoscopic procedures.
OR days, I would arrive about 30mins prior to the first case (I would review the conditions and procedures the night before) and introduce myself to the patients in day care. It is always important to do this so there are no unfamiliar faces in the OR. After greeting the patient, I would go to the OR control room and grab my size gloves and gowns for the day and bring them to the OR. I would introduce myself to the nursing staff, write my name on the report and open my gloves and gown for the scrub nurse. Once the patient arrived to the OR, I would assist the attendants and anesthesiologists in positioning the patient and prepping. Most cases in Northern Ontario placements, I acted as the first assist.
Ambulatory Care Hospital days I would arrive close to the start time, about 8:00am. These days were for quick visits and minor procedures not requiring an OR- such as suture removal, anoscopy, hemorrhoid ligations, lipoma excisions, etc. These visits were mostly performed with the physician present.