Please note:Your preferences will be taken into consideration as much as possible when creating the schedule and every effort will be made to accommodate you. However, to ensure the integrity of the program, a schedule that fully utilizes all of the available sections takes precedence. Therefore we cannot guarantee that you will be assigned your highest preferences.

 

Surgery A rotations:

 

Chapel St Bariatric Surgery

- Average day: 3-5 cases a day, Mon-Fri, maximum 5 hours/case (average 2-3 hours)

- Most common cases: lap sleeve gastrectomy, lap cholecystectomy, lap Roux-en-Y gastric bypass, lap paraesophageal hernia repair/Nissen, all kinds of inguinal/ventral hernia repairs (lap and open)

- Clinic: by request, shadowing

- Student presentation: currently none because team is split over 2 campuses 

- Specific things to know/learn: indications for bariatric surgery and pre-operative evaluation, different types of bariatric surgeries, bariatric Step 1/3 diet, complications after bariatric surgery 

- Additional notes: Quick turnover of patients on the floor due to the generally quick recovery from laparoscopic cases. After rounds, students are in the OR for the majority of the day; in the OR, students predominately hold and maneuver the camera, with ample opportunity at the end of the case to do sub-Q closures and close port sites. 

 

YNHH – York St Colorectal Surgery

- Most common cases/diseases: colectomies, ostomies, colonoscopies, rectal prolapse, hemorrhoids, and inflammatory bowel disease.

- Clinic: mainly shadowing.

 

YNHH – York St Surgical Oncology
- Most common cases: lumpectomies and mastectomies, melanoma excisions, at least one Whipple, probably a distal pancreatectomy or two, a partial liver resection or two, etc.

- Clinicmainly shadowing 
- Student presentation:a 10-15min presentation to the whole team and most of the section attendings. At least one student within a three-week block will be expected to pick a breast topic.

- Additional notes: There is a chief, a 4, a 2, an intern, and a PA on this service. 

 

YNHH – York St Pediatric Surgery

- Most common cases: laparoscopic appendectomy, open hernia repairs (no mesh!), ostomies, port placements. A few times a month there will be NNICU cases (gastroschisis, omphalocele, NEC, biliary atresia, ECMO cannulation).

- Clinicevery day, mainly shadowing

- Additional notes: There is a fellow, a PGY-3, 1-2 interns, 2 APRNs. The case/clinic assignments are always emailed out by the fellow the previous night. Excellent mix of operative experience, trauma evaluations, consults, and clinic. Good opportunity to round in the NNICU, PICU, and pediatric surgery ward and see wide breadth of cases.

 

YNHH – York St Trauma and Emergency General Surgery

- Average day/OR: completely variable, full traumas much less frequent in the winter, often spend the day following the consult pager, whether or not you get to evaluate consults independently first is very patient acuity-dependent and resident-dependent 

- Most common cases: lap cholecystectomy, lap appendectomy, ex lap for high grade SBO/perforated viscus, full trauma (varies), hernia repairs/PEG/trach

- Clinic:Thursday PM trauma clinic, shadow and then see patients independently

- Student presentations: 10-20 min presentation on topic of choosing at Friday AM educational conference to the whole team and most of the section attendings.

- Specific things to know/learn: primary and secondary survey, I&D's, NGTs, FAST. 

- Additional notes: There is a week of nights (Saturday through Thursday, inclusive). The other two weeks are split between trauma and emergency general surgery.

 

Chapel St General and Vascular Surgery

- Most common cases: lap cholecystectomies, laparoscopic and open hernia repairs, colectomies, carotid endarterectomies, wound debridements and amputations.

- Clinic: General surgery clinic: see patients independently or shadow. Vascular clinic mainly shadow.

- Additional notes: Brennan Bowker is one of the White Team PA’s: really guides and teaches the students. Helps organize case assignments. Great variety in terms of seeing a lot of general surgery and vascular surgery.

 

VAMC – West Haven VA General, Vascular, and Cardiothoracic Surgery

- Most common cases: lap appendectomies, lap cholecystecomies, hernia repairs, and the occasional Whipple. You're welcome to ask the CT/Vascular fellows if you can scrub into their cases—so you can also see CABGs, open AVRs, open aortic repairs, EVARs, AV fistula placements, bypasses of all kinds.

- Clinic: You will help with general surgery clinic on Tue and vascular clinic on Fri. You'll see a pt, staff with the fellow/chief or the 3, then present to the attending. 

- Student presentation: A 10-15min presentation.. Dr. Schlessel will want to meet with you weekly, to hear you present a patient that you wrote a note on.

- Additional notes: Meet with Dawn Lathrop (ext 5918) on the first day to review required VA and CPRS orientation activities. Be super-proactive about figuring out how the VA works in the first few days: students can't see the OR board except at the OR/PACU, sign-outs are Word documents that have to be manually created every day, the vitals for non-SICU/SDU patients are available only in the hard-copy binder chart. There is a chief, a 3, a 2, an intern, and a PA on this service. The 2s on Gen Surg, Vascular, and CT will rotate being SOD. The SOD is the consult resident of the day—any and every call to surgery will basically go through the SOD. So the SOD is a good person to follow if no cases.

 

 

YNHH – York St Vascular Surgery

- Most common cases: Amputations, bypasses, carotid endarterectomy, hybrid open and endovascular cases, debridements, large open aortic cases with Dr. Orion. 

- Clinic: Mainly shadowing, good opportunity to learn vascular exam and see the natural progression of vascular disease, lots of teaching in clinic with Dr. Chaar 

- Additional notes: 2 separate teams with variety of chief and junior level residents, each team with separate student, cases allocated equally to each student by chief. Morning rounds with chief where students are expected to present patients. Lots of dressing changes in the morning. Great operative experience for juniors, in fact Dr. Chaar has allowed medical students to sow in patches and take a few bites on the anastomosis. Amputations and fasciotomies great cases for students. Will become proficient attending vascular access. 

 

 

 

Surgery C rotations:

 

 

YNHH – York St Thoracic Surgery

- Average day/OR: 1-2 cases a day for students, Mon-Thurs, range from 1-2 hours (mediastinoscopy/bronchoscopy) to 5 hours (lobectomy) to all day (esophagectomy, complicated resections)

- Most common cases: lobectomy/wedge resection (VATS and open), mediastinoscopy/bronchoscopy, paraesophageal hernia repair, esophagectomy (various approaches), decortication for empyema

- Clinic: Friday all day, see patients independently/write notes with some attendings, shadow with others

-Student presentation: 10 minutes on topic of attending/fellow's choosing at case conference

- Specific things to know: chest tubes (how to place, pull, evaluate for air leak, TPA), CXR's

 

YNHH – York St Plastic Surgery

- Average day: The day begins with morning rounds: students are simply expected to carry a fully stocked bucket of supplies and help with dressing changes. There is no pre-rounding, presenting, or list to prepare prior to rounds. After rounds, students are off to the ORs: cases are assigned at the beginning of the week. 

- Most common cases:reconstruction and DIEPs (up to 14 hours of free flaps) to breast reductions (suturing opportunities) to craniofacial surgery (Le Forts, cranis, & rhinoplasty).
- Clinic:some shadowing, some independent interactions with patients. 
- Student presentation: No student presentation, but meet with Dr Persing and Dr Thomson for students’ didactics sessions.

- Additional notes: Students also attend plastic surgery resident didactics (Tuesday and Wednesday mornings) as well as grand rounds and orthognathic conference (Wednesday evening).

 

YNHH – York St Endocrine Surgery
- Most common cases: total thyroidectomies +/- neck dissections, thyroid lobectomies, MIPs, and the rare adrenal surgery. 
- Clinicmainly shadowing 
- Student presentation: 20-30min presentation in front of the whole team and Dr Carling

- Additional notes: There is a fellow, a chief, a 3, an intern, and an APRN on this service. The fellow will be the one to set the schedule, etc. The PA does floor work mostly. The attendings will often ask questions about biochemical pathways, receptors, etc. Try to learn attendings’ preferences and routines from the residents before scrubbing in with her.

 

YNHH – York St Anesthesia

-Anesthesia - Where the only thing we cut are patient ZzZzZz's

-Average Day: Arrive at 6:30 to meet the resident you'll be working with for the day and leave when your cases are finished.  Cases vary on a day to day basis and there is some flexibility to pair students with clinical interests.

-Clinic: The OR is our clinic!

-Specific things to know: We send out small nightly topics to read about that help you better understand everything we do.

-Additional Notes: Medical students attend resident lectures in the afternoon on Wednesdays.  Students are welcome to attend Grand Rounds on Friday mornings from 7am-8am, however, they are normally excused on Friday's due to their own didactic requirements.

 

YNHH – York St Cardiac Surgery

- Average day/OR: 1-2 cases a day for students, Mon-Thurs, range from 4-5 hours

- Most common cases: CABG, aortic valve replacement, mitral valve repair, aortic surgery, transcatheter valve replacment

- Clinic: Different days depending on team/attending assignment, see patients independently/write notes with some attendings, shadow with others

- Student presentation: No student presentation

- Specific things to know: Four different teams. Adult cardiac surgery A and B, heart failure and congenital surgery. The rotation is very heavily weighted on operative experience. Much of the daily work and patient management is done by APPs.

 

YNHH – York St ENT 

- Average day: Students report to rounds at 6-615 each morning and are not usually asked to pre round on patients. On the H&N service, the rest of the day is spent in the OR, with cases ranging anywhere between 1.5-14 hours. On the specialty service, each day can be comprised of OR time and clinic days, where you are exposed to the whole breadth of ENT, including pediatrics, rhinology, otology, and facial plastics.

- Most common cases:composite Head and neck resections, neck dissections, free flaps, neck mass excisions, T&A

- Additional notes: The 3 week rotation is divided into 2 weeks on the Head and Neck service and 1 week on the specialty service. 

 

YNHH – York St Interventional Radiology

- Average day: Start each day with IR rounds or Vascular Surgery Conference on Monday mornings. Go to weekly tumor board meeting. Otherwise in the IR suite.

- Most common cases: Venous access, drainage procedures, embolization procedures.

- Clinic: Go to clinic 2 half- days per week.

- Student presentation:15-20 minute presentation at the end of the clerkship.

- Additional notes: May also go to SRC or the VA for cases.

 

YNHH – York St Neurosurgery

Neurosurgery 3 week rotation:

- You will spend 1 week on each neurovascular, tumor, and either Pedi or spine (at SRC)

- Average Day: from 5:30am- 5pm but can vary depending on pre-rounding. Rounds typically start at either 5:30 or 6am. You can expect to go to 1-3 cases per day typically, and can help with floor/ED evaluations if there are days without many cases or if these cases finish early. 

- Common cases: Craniotomy for tumor (mets or primary), cerebrovascular angiography, implantation of electrodes, transnasal transphenoidal pituitary tumor resection, and Ventriculo-peritoneal shunts

- No presentations unless asked to do so

- This service does not have much opportunity for “ownership” of your patients. The residents are extremely busy and you tag along but are not expected to formulate plans for the patients you are following. They do expect you to lookup topics on your patients and will ask you about them pre-op, intra-op, etc. Read up on the cases they assign you to attend.

- Learn how to read neuro imaging (chiefly MRIs), general neuroanatomy, management of patients in the NICU (particular focus on intracranial pressure)

- cases are not assigned to you each week, rather you receive an email the night before listing all the next day’s cases and can choose from these which you would like to attend
- you may wear scrubs for rounding all days except Friday when you must wear professional clothes. On Fridays, AM schedule is rounds, followed by M&M or faculty meeting @ 7 am, then Grand Rounds @ 8 am before breaking off to attend our own clerkship didactics
- basic skills expected of students: one handed knot preferred over two handed knot, will have opportunity to make first scalp incision as well as drill burr holes, may be asked to help close scalp incision w suture or staples 
- other tips for students:
* residents are fine/encourage if you scrub out during a case and go to path whenever a tumor biopsy has just been sent; this is a great opportunity to have the neuropathologist explain the path of different brain lesions, particularly malignancies
* no dedicated clinic time as in other surgical rotations, but if you would like to shadow in clinic once that could be arranged.

 

YNHH – York St Orthopedic Surgery

- Will be assigned a subspecialty service, usually either trauma, Recon (joints), or pediatrics

- Average day: AM rounds with the residents, AM education, then to the OR or clinic. 
- Most common cases: Trauma - Open reduction internal fixation of lower extremity fractures. Recon - total knee and hip arthroplasty. Pediatrics - scoliosis posterior spinal fusion, deformity correction
- Clinic: shadowing and independent interactions with patients, drafting clinic notes
- Student presentation: None
- Additional notes: Make contact with the chief prior to the start of the rotation to introduce yourself/exchange contact info. Resident didactics on Mon, Tues, Wed, and Fri mornings, subspecialty-specific conference Thurs morning. Good websites for reference:Orthobullets.com and AOTrauma Reference (https://aotrauma.aofoundation.org/Structure/education/self-directed-learning/reference-materials/ao-surgery-reference/Pages/ao-surgery-reference.aspx)

 

Chapel St Surgical Intensive Care Unit Non-operative rotation.

 

YNHH – York St Transplant Surgery

- Transplant service was split between time on the kidney side and the liver side. Kidney was busier, involving a fair amount of floor management of transplant patients (both recent transplants and older transplants admitted for other reasons), including some interesting immunosuppressive and electrolyte management.

- Rounds were usually between 6:30 and 7:15 depending on the census and cases. Usually business casual with tie expected when outside OR. Sent home usually between 4 and 5:30.

- Students were expected to follow 1-3 patients and sometimes present them to the senior resident (but rarely to the whole team at attending rounds)

- OR time involved planned living donor kidney transplants (donor and recipient operations), deceased cardiac death retrievals, and brain death retrievals. Cases were somewhat unpredictable and there would sometimes be days without any cases. I saw no liver cases while I was on service.

- Attendings taught a good amount during cases, Dr. Haakinson held a once weekly teaching session for residents and students, and there were other conferences scattered throughout the week

- Students performed some retracting and rarely skin suturing during cases, but it was largely operatively observational 

 

YNHH – York St Urology