As a followup to my last post, I wanted to describe a typical day during clinical year. In general, clinical year was much less stressful. Perhaps the biggest difference is just how active you are throughout the day. Rather than being holed up in your room studying all day, you are spending most of your time interacting with patients and being social again. Yes, you still have to study constantly, but you get to set your own schedule. Rather than worrying about 5 exams each week, you manage your time to prepare for one exam every five weeks (so much better for your mental health!).
I had a blast during rotations. And I probably learned a lot more than I did during didactic year.
A Day in Clinical Year
I wake up at 5:45 am and jump in the shower. I have just enough time to make coffee and scarf down a bowl of cereal before I am racing out the door. It takes 15 minutes to get to St. Luke’s hospital from my tiny apartment in Coledale, PA. By 7 am, I have checked in with my preceptor and am dressed in scrubs, ready for a day with the GI surgical team.
I check the schedule board to see if our first patient is on the way.
This is the schedule for the day:
- 08:00 – Laparoscopic Appendectomy
- 10:00 – Incisional Hernia Repair
- 11:00 – Laparoscopic Cholecystectomy
- 13:30 – Explorative Laparotomy
- 15:00 – Inguinal Hernia Repair
The first patient is marked as being “in transport”. I go ahead and do an initial scrub, spending a full 15 minutes debriding the skin on my hands and arms with a surgical scrub brush. Then I dry my hands and get my gown and gloves ready for the scrub nurse.
For the laparoscopic procedures, my job is to operate the camera (no small thing)(also not an easy thing). Both operations go smoothly. In addition to the camera, I get to operate the bag that we use to pull the appendix/gall bladder out from the body. I also get to assist the other PA in closing by injecting lidocaine and suturing a few of the incisions shut.
For the hernia repair cases, I am often first assist, working opposite the surgeon to provide retraction, suction, and assist in some of the suturing. Having spent three weeks with this crew already, they have grown comfortable with me. The anesthesiologist even lets me intubate a few of the patients when we are not rushed for time. In between cases there is usually about a thirty minute time window that I spend studying in the lounge.
After the cases are finished, my preceptor and I head out to the floor. He gives me a few patients to round on and progress notes to write. Nothing too difficult. Everyone is recovering and hitting their objectives for discharge. Then I head home.
I am home at around 5:30-6 pm. Often I am whipped out enough to take an hour long nap before I start studying. There is no specific plan to my studying, just get through as much of the material as possible before the end of rotation exam. Before bed, I call my girlfriend (now wife), Tiffany, and we exchange stories about our days. I have more exciting things to say than I did first year (when all I did was study). In general, we have better conversations. I am in bed by 10 pm for a healthy seven hours of sleep. In contrast to last year, I generally feel happy and relaxed.