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In this video, we’re gonna talk about general surgery residency because, well, I did it. A lot of people ask me about it and what it is and how long it is and what you do and all that good stuff, so that’s what we’re gonna talk about in this video.
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General surgery residency. First, let’s talk about what it is. A residency is basically where you go, and you’re in a hospital. They call it residency because, traditionally, a long time ago they used to live in the hospital or live on the hospital grounds. That’s why. You’re a resident of the hospital. Because you’re working your ass off so much that it doesn’t even make any sense to go home. That gives you a little tidbit of information into what a residency is.
Essentially, this is the time in your life when you’re really learning probably the most about your specialty or sub-specialty that you’re ever gonna learn. You’re making the most advanced leaps in your training and your knowledge and your skill.
Med school is good. You obviously learn…You learn the basics, I guess, of humans and anatomy and physicology and all that good stuff. You don’t really learn how to take care of people. You learn a little bit, but you don’t. Mostly it’s in- during residency.
After a few years of residency, two or so years, I felt like, “Okay, I think I’m- I feel- I’m feeling more like a doctor now.” When you graduated med school and they give you a certificate, an MD or a DO, whatever it is. You’re like, “I don’t feel like a doctor. I’m not doing stuff. Doctor stuff.” In residency, after a couple of years, I felt like, “Hey, I’m a doctor now. This is- I can do doctor (bleep).”
A residency is…Depends on what specialty you go into. Internal medicine is, like, three years. ER is three years. General surgery is five years. Some people do fellowships, which extend it to one or two years, a little over that.
I did a fellowship with NASA and Henry Ford for space trauma, so we did- we looked at ultrasound in space trauma to see can the astronauts use an ultrasound on the space station. ‘Cause the international space station actually has an ultrasound. Can we use that to diagnose traumatic injuries on the space station, and they pretty much can.
I heard a lot of different things. If you- We can use the ultrasound for that. We don’t currently. That’s off topic. Let’s get back on topic.
General surgery residency. Five years. We call them post-graduate years. You call it the intern year. A lot of people say, “Intern- Where did you do your internship?”
An intern is the first year. That’s a little bit- The terminology’s exchangeable. PGY-1 or post-graduate year one is also an intern. They used to call it an intern because you would do an internship in a different place than you did your residency. For my general surgery, I did internship the same place and the same program I did my residency. That’s not always the case.
Some radiology…I think radiology, you do an internship in maybe one program. Then you’ll do your- rest of your program somewhere else. I’m not really sure. Don’t quote me on that.
Let’s talk about surgery residency because that’s what I did. That’s what I know. I’m not gonna talk about the other ones because I don’t know (bleep) about them. Surgery residency, the first year, you learn how to take care of the patients on the floor and maybe in the ER a little bit and in the clinic. For surgery residency, we also operate. It’s not a lot of operating. You really don’t get that good at operating a first year because you’re not doing it that much.
The second year is even less for us because we’re super busy taking care of patients. For example, my first couple months I was on the trauma service. There was a PGY-5, so fifth-year resident. Four, a three. Then a bunch of interns, so maybe five interns. We would have anywhere from 30 to, like, 80 patients on our list in-house. In the hospital. Every morning we would go do a round on those patients.
The intern’s job is to basically get all the vitals. We get a list of the patients, so you wanna make sure you know where all the patients are. Because overnight, there would be new patients come in and yesterday, they would be just turned. You wanna make sure you know, your fifth-year resident knows where the patients are. Your job is to take them to the right rooms. Some dumb shit like that. Make sure that all the patients are on the list, which is- I think is much different now. I think these are computer automated but at the time, we would have to type and it was terrible.
Also, the labs, those may be computer generated now too. A lot of mine are, so yours might be. You won’t have to do that stuff. But going and seeing the patients and seeing…doing a little…your progress notice, essentially. You’re gonna talk to them about what happened overnight, any events overnight, are they febrile, do they- what kind of pain do they have. We’re talking about surgery here. Is it pain increasing? Is it better? Are they having…Are they having (bleep) coming out of their midline abdominal incision? These are the important things you need to know.
Then you learn about the big complications of surgery and the main surgeries that we do in general surgery. You see those patients, and you start to get an idea of their trajectory in the hospital. If you take somebody’s gallbladder out and they had acute cholecystitis, should they stay there overnight or should they stay there for 10 days? Those kind of things. You get a sense of when patients are sick and how to judge physical exams and how to take…You’re doing, you’re learning this stuff in med school but you’re doing it at such a huge repetition in residency. Then you start to get really good at it. That’s where you perfect your skills of history and physical and generally understanding which patients are going where. As in their trajectory. Are they on the right trajectory? Are they on their way out of the hospital, or are they gonna be here for a longer time?
The rotations I did in general surgery my first year were trauma – I did two months, maybe four months, of trauma – which is also acute care surgery. Emergency general surgery and trauma. And then I did colorectal. I did plastic surgery. I did endocrine surgery, so the thyroid, parathyroid, and adrenals.
The second year, it’s really more of the same but then each one is longer. You may rotate through different specialties.
Oh yeah, I forgot. The first year, we did a lot of ICU. We did, like, two months or three months of ICU in the surgical ICU. The surgical and medical ICU is different, obviously.
And then we did…Second year, we did transplant and cardiac surgery and cardiac ICU.
That’s the first two years, and then you’re the – what you call – the junior resident. Then the third year in general surgery, my program anyway, we started to become…Some of the rotations, we were the senior residents so say, plastic surgery. When I was a third-year resident on plastic surgery, I was the senior resident and then we had two junior residents who were interns on that service. Because plastic surgery is fake surgery, so you don’t really need a very advanced resident on that.
I’m just kidding. I like making fun of plastic surgeons. I have a lot of friends that are plastic surgeons. I just like to torture them. Probably just jealous because they make way more money. They drive Ferraris, and I drive…That’s okay.
The fourth year, then you become- you start to become a senior resident. Then in the fourth year residency, you start to become a senior resident. You do all the same rotations but then you’re the boss, sort of. You are in charge of those patients and what’s…You should- well, what you should do is you should take responsibility of those patients. Even though you have an attending helping you and overseeing everything and really it’s the attending’s patients, you should really take on those patients as your own and take responsibility for them. That helps you when you go out of residency. Then you’re not so surprised like, “Holy shit. I’m the only person taking care of this patient. What do I do?” Essentially, you’re the boss on these- in these rotations.
In the fifth year, again, you’re different rotations than the fourth year but you are the chief resident. In surgery, in fifty-year, everyone’s a chief resident and then some people are made administrative chief resident. It’s just how our program went. I know medicine is a little bit different. Only certain residents are the chief residents in medical residencies at the last year, which is the third year.
I hope that gives you a little bit of [an] idea about the surgery residency. Maybe I didn’t explain that very good, but for people that don’t know anything about it maybe that’ll help you. For people that do know some stuff about it, you’ll be like, “What the (bleep). You didn’t say half of the stuff.”
There’s a lot of stuff in- a lot of things to talk about in surgery residency. I didn’t talk about everything, but that’s just maybe scratched the surface of the beginner understanding of surgery residency.
If you have questions about that, put them in the comments below. I’ll answer your questions, or I’ll make a video for you. If you like these videos, you should subscribe to my channel and maybe like the video and maybe even share it with a friend. That would be awesome.
All right. See you in the next one. Take care.
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