PAs are trained as generalists during PA school. As part of McMaster’s PA Program 2nd year PA clinical year, we have six weeks in General Surgery rotation that is mandatory with a two week selective in a surgical subspecialty. My training for General Surgery actually began when I was in clerkship, and I completed my rotation at Sunnybrook. I came in at 6 am daily to round on patients.
Once I was hired on the General Surgery service, orientation took place over a period of two weeks. I spent time in different areas of the hospitals and with different professions – this included wound care, stoma care nurse, and the acute pain service. In addition I also spent time in Surgery Clinic, following and working with Surgery residents, as well as receiving feedback. I also completed an EMR orientation, and a scrubbing session.
In Ontario, PAs in large institutions often require medical directives to function to their potential. If medical directive are not yet developed or in place, PAs require a co-signature from the supervising physician for any orders (prescriptions, investigations, orders and discharges).
When I first started working in the General Surgery service, I did not yet have medical directives in place. Using existing templates, I developed my own medical directives to reflect my scope, Now, I no longer require the supervising physician to co-sign on my orders.
In the Acute Care General Surgery Service where I work, there are many different General Surgeons who rotate through. Therefore each week I work with a different surgeon, and each surgeon may have differing expectations. I started to feel very confident in my role as a PA after 1.5 years of working, especially after medical directives had been implemented and I had the opportunity to rotate with each of the different Surgeons several times.