A couple ideas on Surgical Education for medical students

It's been a long time since I was a medical student. I still have miles left to go before I reach the coveted land of Attendings and join my classmates who went into medicine. But as I reflect upon my own education and the education the medical students undergo at this program, I've started to think about how I can maximize the training of my future charges.

As it appears to me now, the students sit through an occasional lecture here and there during their third year rotation, tag along with their interns and residents during morning rounds (if they're interested), and otherwise observe surgeries for the rest of the day - though they mysteriously disappear in the afternoons and between cases. We'll quiz them here and there ("pimping") -- trying to keep them engaged at some level, point out interesting structures and anatomy. I think I can do better. I think we all can do better.


My ideas that follow aren't that complex - a lot of them come from the better clinical educators I've had, in all disciplines of medicine. And the ultimate effect is this: my medical students will spend less time in the OR, but more time seeing patients.

In addition to the traditional set-up of having the students "own" the patients whose procedures they witnessed on a daily basis, I want my students to have the extra step of trying to make the initial diagnosis. Thus, rather than shadowing the interns, who are busy enough with the scutwork, they'd spend a lot more time with the consult residents. On the more basic diagnoses (cholecystitis, appendicitis, hernias), I want the medical student to be actively involved in obtaining the H&P and lab tests - the caveat being, no CT/radiology/imaging -- and then have the student present the patient to me to discuss the differential diagnosis and plan. Of course, the resident would be required to get the imaging as appropriate. I'm hoping that this activity will improve their physical examination skills, an apparently dying art. This is not to say that the students will be out of the OR completely - I want this to be a once or twice a week exercise that augments time otherwise not spent in the OR.

Afternoon downtime will be spent by the chief resident of the service sitting down with the entire team - students and the available residents and interns - to go over didactic topics in diagnosis and patient care, at the very minimum. This would be a great forum to discuss complications and issues that arose during the day in the post-op patients, and a nice little summary of possible events the intern should be wary of overnight.

Pretty Young Thing

In terms of recent events, I went to a Haunted House at a world famous Southern California-based theme park, then a couple days later, I felt compelled to listen to a playlist featuring a recently deceased musician while doing my work in lab. By a couple days later, I meant yesterday. And by recently deceased musician, I meant Michael Jackson. And, if you happened to have forgetten, that is a sweet playlist, especially the older stuff.

Returning home that night, I started flipping through the channels - and by that, I mean "cycling through my favorites so I can avoid turning to Fox News inadvertently" - and all of the sudden I saw "P.Y.T." being covered by the wheelchair dude and the Asian guy on "Glee."

This can only mean one thing: A certain someone's ghost followed me home from the Haunted House. I think he may think that I somehow know how to perform cosmetic surgery on the spiritual level. Or that I have access to ethereal propofol. I hope he runs into the ghost of William Halsted so that he can explain what our different specialties have evolved to do. Well, that, or they can get hooked onto the same crazy ass mind-altering substance they have in the afterlife.

Yea, I went there - and by "there," I'm referring to the late Dr. Halsted's personal demons.

Short-Cut Gourmet: Starting over

Restarting an old hobby: the Short-Cut Gourmet returns

Enchilada Hot Wings

8 frozen buffalo wings
Trader Joe's Enchilada Sauce
Sriracha (the bottle with the green cap with a chicken logo)

1. Preheat oven to 400F.
2. Arrange frozen wings on a baking sheet.
3. Layer enchilada sauce over wings individually. Drizzle sriracha over wings.
4. Cook for 25-27 minutes.
5. Cool for 5 minutes on top of stove. Put on serving dish. Add extra enchilada sauce, sriracha to flavor and desired heat.