The surgery rotation was singlehandedly the most demanding and rewarding experience I have had thus far in clinical year. I started this rotation hopeful and excited, as I have always been interested in surgery and enjoyed learning about it in didactic year. This was my opportunity to see if I enjoyed this specialty in practice, if I thrived in the surgical environment, and if I could see myself working in surgery in the future. I figured out the answers to these questions rather quickly, as my journey through this rotation brought excitement, knowledge, and a sense of belonging even while feeling lost and overwhelmed.

A part of this rotation that I knew I would enjoy before even starting was getting to be in the operating room. I have always been drawn to the practical application of medicine through procedures, interventions, and fixing a problem with your hands. I got to scrub into about three dozen surgeries, including appendectomies, cholecystectomies, hernia repairs, exploratory laparotomies, mastectomies, arteriovenous fistula creations, and angiograms. Getting to see human anatomy in real life opposed to a colorful textbook page was fascinating. I was tested on the various structures seen and got to build on my knowledge of anatomy in each surgery I attended. I was able to master scrubbing in and practice focus and concentration in long surgeries.

Being in the operating room also allowed me to understand in much more detail the procedures that we learn about. The intricacies of finding an organ, dissecting your way through various structures, identifying important landmarks and taking precaution to not damage anything on the way is a true skill built on experience and knowledge. I admired the surgeons and physician assistants that were able to skillfully excise or fix a given organ or tissue, all the while remaining focused and being able to teach as they worked through the task. I gained a better understanding of why certain complications arise as a result of a given surgery thanks to visualization of the anatomy and relationship of structures to each other. I got to place sutures and staples and learned a lot about anesthesia and the various types used as well as monitoring parameters.

Surprisingly, the part of this rotation that allowed me to learn the most was not in the operating room. I was fascinated and a bit overwhelmed by how much goes into post-operative care. Every day in rounds I learned more detail about treating infection, monitoring fluid status, measuring ins and outs, nutrition, and the complicated nature of managing numerous medication regimens in post-operative patients. Every single detail of care relied on the others, with medications affecting fluid status, fluids affecting patient symptoms, symptoms affecting healing and discharge dates, and so forth. The physician assistants caring for these patients were so incredibly knowledgeable and focused on all of the details pertaining to the patients outcome that learning from them accelerated my understanding of patient care more than any textbook has done thus far.

The most rewarding aspect of this rotation was the daily dressing changes and tasks that we as students were assigned every day before rounds. What sounded like a simple task at first turned out to be a great learning experience and an opportunity to get to know patients beyond their medical record. I got to see patients every day throughout their hospital stay and hear about their symptoms, concerns, and personal stories in a calm environment before rounds started with a dozen providers and students. Talking to patients one-on-one while carefully changing their dressings or measuring their surgical drain outputs allowed for bonding with patients while expanding my skills in wound care and general post-operative care.

This rotation came with many challenges, adjusting to a grueling schedule and a high-pace environment filled with medical knowledge that was at times hard to understand, but it came with far more rewards. Learning about pre-operative and post-operative care as well as participating in a variety of surgeries that allowed for a greater understanding of not only the surgery itself but the pathogenesis and complications behind the indications leading to surgical treatment. I can see myself applying everything I learned to my future rotations and work as a physician assistant. Recognizing indications for surgical treatment, managing complications, and understanding the numerous details of post-operative care will all be lessons I apply to many patients in the future. I started this rotation questioning whether I would see myself fit into a career in surgery, because despite my interest in the specialty I had never spent much time in the operating room or cared for surgical patients. I realized quickly that this is an environment I could thrive in and am motivated to learn everything necessary to succeed in a surgical career as a physician assistant. This rotation has taught me far more than I expected, and I feel that I will be a better student and future provider because of it.