I remember feeling how you felt as a MS-3. I choose a specific rural surgical rotation site as a MS-3 with no surgical residents so I would get to first assist every case with the attending. There is nothing more frustrating than being an observer for someone who likes working with their hands. Being a MS-3 on the surgery rotation is not representative of what being a resident or attending surgeon will be like, try to watch your attending's and see what their life is like and if you would like being them in the future. As someone in a surgical sub this the timeline to becoming a surgeon.
- MS-3's are more work than they give back to the team 99% of the time. So if you feel like you are a burden as a third year that just means you have an accurate perception of your situation. That's okay, we all know and expect third years to be extra work, we are just happy if they have a good attitude and are on time. If we teach them something and they retain it, that's a bonus. We were all in their shoes at some time point. Some of us remember it better than others or just have more bandwidth to deal constructively with medical students. Other residents/attendings don't remember what it's like to be a MS-3 or are overwhelmed with their workload, as the student you should avoid these people as much as humanly possible - they don't teach and they usually just hurt you one way or another.
- Sub-i's are when about 80% of people get it. We love having sub-i's on our team because they contribute in a meaningful way. They have the bandage bag ready for rounds without asking, they help the intern with the list. They set up and participate in doing ER procedures. They are an extra set of hands in the OR for retracting and splinting. They start to anticipate movements and shift their hands for retracting during surgery and splinting. They go out with us residents for dinners and social events. They study the material in their free time and ask intelligent questions that aren't googleable. We know most of them will be our future colleagues which changes the dynamic.
- Intern year is your buy in year, you are still a lot of work for the rest of the team members. You mess things up. You need to learn a thousand little things to become good and efficient at your job. You do all the jobs none of the seniors want to deal with: nurse pages, admit orders, discharges, paperwork, med recons, follow up appointments, social work meetings, UR phone calls, and family discussions. You are spending more time in the hospital than you thought was humanly possible. Every day you have the best parking spot in the building because no one else except the other surgical interns are there. By midway through the year you start getting so efficient at the intern work that the work that use to take you til 8pm you are now finishing by 2pm. Then you start shadowing the R2 seeing consults and really getting ready to transition from intern to surgical resident.
- R2 year you are seeing consults. The attendings start to learn your name and recognize you by face. You start to develop a reputation as someone is through, honest and hardworking, or the opposite. You start spending a little time in the OR when you aren't seeing consults. Learning how to safely position patients. How to help move the OR day along by having correct orders in. Making sure correct trays and instruments are there. You start seeing why some of the cases are operative vs non-operative in person which helps you better talk with patient's when you consent them for surgery. This is still a buy in year. You are putting massive amounts of work and time in doing jobs nobody else wants to do: ie in the ER seeing consults, dealing with pages from other services and consenting patients for surgery. You find out how exactly hard 30-hours in a row in the hospital is when you see the ER residents and nurses leaving from their second shift while you've been in the hospital the whole time. You Uber home from work because you are too tired to drive.
- R3 year, you are often the most junior member of the surgical team operating. This means your chief and attendings are usually walking you through how to do the simple cases and you retract for them for complex cases. You may get bumped out of the more interesting cases by fellows (this is why you want a program with as few fellows as possible, surgery is still a hierarchy), and senior residents. This year you learn that 10 hour cases in lead will leave you drenched in sweat, dehydrated and test your bladder strength. You will see floor errors, consult errors and ER errors negatively affect your patient's care and you will start to understand the importance of the things you learned in your prior years. You will start to develop surgical skills you are proud of once you do enough cases. You will start teaching juniors on a regular basis once you feel comfortable with certain procedures. This year you really start to gain the technical skills of a surgeon. However, the responsibility for patient care on the rotation still falls to the chiefs and attendings so this is a nice year to learn technical skills without being under monumental amounts of stress that staffing intern questions, consult questions, and operating room staff questions brings.
I'm in my R3 year, so I can't speak to future years yet, but as you can see, each year in the training of a surgeon brings new challenges, experiences, joys, and hardships. Hopefully this post will help you realize what a small percentage of surgery you experience as an MS-3, and how you shouldn't let a bad MS-3 rotation discourage you from being a surgeon.
