Here are a few tips on shadowing your surgeon. If you have done this before and these suggestions seem simple or patronizing, they're not intended to be that way. We just want to make sure everybody's on the same page and relieve anxiety any of you might have about being in the OR.
1. Please do not feel confined to shadowing in the OR. While admittedly the most glamorous portion of the field, surgery consists of more than just operations. You will arguably see a lot more pathology by shadowing the doctors in clinic, or learn a lot more in one of the surgical conferences than you will in the OR, especially as a 1st or 2nd year. Most doctors would be more than willing to have you shadow them in these alternative venues.
2. Please do not think that shadowing means literally that, in other words, walking in the footsteps of your faculty surgeon for the entire day. Often, his day is filled with paperwork, email, administrative meetings, etc. and it would be counterproductive for both of you to be in each other's way all day long. In addition, if you're shadowing in the OR, the attending will likely not enter the OR until well into the case. The surgery will instead be started by senior residents and fellows; oftentimes, it's easier to strike a rapport with the surgical team if you're in the OR from the start of the case. You'll probably learn more and see more this way.
3. Get in touch with your surgeon as soon as possible! If you haven't done so yet, you need to do so soon. Don't worry about paging your mentor at a bad time; it happens and isn't a big deal.
4. How to get to the OR. The operating rooms are on the 2nd floor of the hospital. Take the link over towards the cafeteria; once you pass the cafeteria and the GI center, there will be a stairway to your right before you come to the lobby. Go up one flight; once you come out the door make a left, another quick left to pass by the elevators, and another left into the OR corridor. Head down this hallway for a little bit until you come to the 2nd set of double doors, which lead to the OR control desk. To get in, place your hand over the sensor to the right of the door.
5. How to get scrubs. To enter the OR, you will (obviously) need to get a set of scrubs. To save your mentor time, here's how to get them. Go to the OR control desk and tell the nurse there that you are a 1st or 2nd year medical student who will be shadowing Dr. X and need scrubs. She'll give you the scrub card, and you have to sign the scrub log. The scrub machines are located on the same side of the long OR hallway as the doors you just came in, so you need to head out the double doors you just came in and back down the hall a little ways. Make sure you return the scrub card to the OR control nurse before changing or she will be coming after you!!
6. Where to change? The entrance to the OR locker rooms are located in the litte room containing the scrub machines, just past the machines. To enter the OR, you will need to be in full scrub attire, which includes, in addition to scrubs, a head cap and shoe covers. The latter two items can be found once you enter the locker rooms. Although you will not be assigned a locker, just put your stuff on top of the lockers, and make sure you have no valuables in them.
7. How to get to the OR. The exit of the locker rooms leads to the operating rooms. Outside each pair of operating rooms is a scrub sink. We won't tell you how to scrub - it's unlikely (but possible) that you will be scrubbing in on your first shadowing experience simply because there is little space for you to fit in the sterile field. So, you can be in the OR without being fully scrubbed. However, to enter the OR itself you MUST wear a surgical mask, which are located right next to the scrub sinks on the wall.
8. What to do when you enter the OR. When you enter the OR, WEAR YOUR ID BADGE and introduce yourself to the nurses and other staff in the room. Tell them you are a 1st/2nd year medical student and that you are here to observe, if that's OK with them. If this is your first time in the OR, tell them so and ask them for guidance/tips on what to do (and what not to do). They will be much more understanding of you if you admit that you are new at this, so they know up front. You might also ask if there is anything you can do to help (a big thing you can do is answer pages for the attendings and residents). For the most part, the staff is very accommodating to medical students, and if they seem a little curt, it's not because you are a burden - it's just that the OR environment tends to be a little high-stress and busy at times. So go in there with thick skin!
9. What NOT to do in the OR Just a couple of big-time no-no's. First, DON'T TOUCH ANYTHING (except the floor, of course!!) WITH ANY PART OF YOUR BODY, particularly anything around the operating table. For safety's sake, assume that everything in the room is sterile (even though it is not) and that you will contaminate those sterile objects if you touch them. The last thing you want to do is break a sterile field (since you are not scrubbed, anything sterile you touch will become contaminated) since that means a lot of extra work/hassle for the OR staff. Obviously, the operating table should be regarded as sterile. Another place to big-time avoid is the “Mayo tray.” This is the table that extends from the end of the operating table out toward the side, and it contains all the surgical instruments. The scrub nurse will generally guard this table quite zealously, but just keep away to be sure. One way to keep the OR staff from getting anxious is to fold your arms across your chest, so that they know you aren’t going to reach out and accidentally touch something.
10. Where should I stand? Typically the best place for you to see the action is at the head of the table, where the anesthesia resident hangs out. This area is not sterile and you can stand here without fear of contaminating the field. Usually the anesthesia residents are pretty cool about having students hanging out there - just be ready to move out of the way if he/she needs to get access to some of the IV lines or the bed tilt control. It’s also a good idea to stand away when the anesthesiology attending comes in. If there is a crisis and the anesthesia resident/attending need access quickly, it is definitely a good idea to make yourself disappear from that area!
11. Some last notes If you need to sneeze, sneeze directly into your mask, and DO NOT turn your head away from the field so that the side of your face faces the field. If you do so, all the stuff coming out of your mouth becomes directed at the field out the side of the mask, and you will not make people very happy! The best thing to do is bend down at the waist and sneeze toward the ground with your head pointed straight forward. Also, it’s probably best not to ask questions during the operation. Sometimes the attending will ask you a question or tell you what’s going on then that’s a good time to ask but, in general, it is best to keep quiet. Save your burning questions until the end of the operation. If you get “pimped” by an attending, do your best to answer but don’t worry about not knowing the answer - he or she is not trying to test you - rather, just trying to make conversation! When you leave, make sure to thank everyone in the room, and don’t forget to return your scrubs to the machine (you’ll need the scrub card again).
12. LASTLY, HAVE FUN! This is meant to be a low-pressure experience that hopefully breaks up the boredom of sitting around all day in lecture and in the library. Make the most of it!
