When and for how long? 12 weeks, 6 before Christmas and 6 after. SAQ paper in week 13 of Semester 1, and OSCES and MCQ in week 13 of Semester 2.
Where? MMUH or SVUH, Cappagh (1w), Peripherals for 2⁄3 weeks)
General Bits and Pieces:
- Although rounds are early they are really important to attend. You get an idea of which patients are good to examine later in the day. Without rounds the day lacks structure.
- Surgery is a 20 credit module spread over two semesters. This is quite advantageous as the learning you’ve tried to get to grips with in the first semester is consolidated through repetition in the second semester.
- After the whole 12 weeks you will have rotated through every surgical speciality. Some weeks are better than others. There are three weeks of orthopedics (two in the main hospitals and one in Cappagh), which can be a bit much.
- ENT is examined separately though a short pass fail oral exam at the end of your ENT rotation. They are serious about attendance in this week but once you’ve attended you will pretty much pass the week.
- Typical day/Week: Rounds start at 6.45am and 7am. This is tough in the first semester when you have to attend lectures from 4-6pm but easier in the second semester when you don’t have lectures while on surgery. This means an early start and early finish.
- Then to theatre or clinic. Go to theatre as much as possible at the start of the rotation because as exams draw close it simply isn’t an efficient use of time
- There is the odd tutorial, can be difficult to organise because surgical teams are so busy.
- Mr Mulsow was great for OSCE focused tutorials in the Mater last year. Mr Hurson and Mr Deignan give the main tutorials in Vincents.
Surgical case write ups: 20%
- Two in the first semester two in the second.
- Marks given for originality of cases...if you can find something a bit different use that instead of an appendectomy etc.
- Very strict word count, just condense and be selective about what you include.
30% short answer paper: These papers are available on SIS web. Get working on this as early as you can in the semester.
- Very specific way of answering questions, answers must be brief concise and accurate to do well.
- Important to watch timing on this paper, the paper is only an hour and a half.
- IV fluids and safety in surgery are always highlighted as important topics. The first section of most of the surgery books are Basic Prinicples in Surgery - some are crazy detailed. But while topics like safety in surgery may seem self explanatory it’s worth while putting time into learning these topics well
MCQ 20%: Practice old papers beforehand so as you are familiar with the migraine inducing format.
Surgical OSCE: 30%
- Generally regarded as easier than the Med 1 OSCEs. There’s very little variation of topics that come up from year to year so practice is everything. There are 8 stations.
- Attend surgical clinic and get in the habit of describing stomas, goitres, basal/squamous cell carcinomas and feet with ulcers and peripheral vascular disease.
- Hernias are likely to come up, be on high alert if you are asked to examine the abdomen, some can be hard to spot. Examine the groins and make sure you get the patient to cough.
- Consent station will come up. Tutorials will give you good structure for your consents. Learn these of my heart, they are easy marks.
- Suturing and knot tying stations: Can be difficult to get your head around to start off with. Knot tying is easy, supplement what you’re taught in tutorials with practice at home and by watching youtube. Suturing: Attend tutorials and practice coming up to exam. (videos for knot tying and suturing under 'Education' tab.)
- Usually two history taking stations: This is a quick fire round of how many relevant questions you can ask in 5 minutes. Task is to pin down the diagnosis and rule out relevant negatives.
- The actor will present usually with something like:
2. Problem passing urine
3. Change in bowel habit
4. Pain while walking
5. Blood in the urine
6. Abdominal pain
- Orthopaedics: Involves examining the shoulder, knee or hip joint. There is no time for questions once you’ve finished carrying out this exam. Carpal tunnel came up last year. Keep your cappagh orthopedic notes.
- Data stations: Tend to be copied images of abdominal x rays or barium enemas. The image can be quite misleading so pay most of your attention to the history given. Other data stations included wounds and TPN.
What’s good and what’s bad:
- Good: Surgery is not a complicated subject, a good
basic understanding of the topics and you will do fine. There is no need to have any detailed understanding of the actual techniques used in surgery.
- Bad: Requires quite a lot of self directed learning. Surgical teams can be VERY busy, you may be completely ignored, it’s not personal. The interns are usually your main point of contact, and can be good at giving you patients and to practice presenting if they have time.
Useful books and resources:
- Unless surgery is a passion of yours there’s really no need to invest in a large text book.
- Don’t underestimate the surgery section of the oxford handbook for medicine.
- Surgical recall was very helpful coming up to exams, good for MCQs and for the concise answers required for the short answer paper.
- Other students found Surgery at a Glance helpful.
- Again websites like fast bleep, almost a doctor, surgical- tutor.org and surgicalnotes.co.uk. Geeky medics for ortho exams.
If I was to do it differently I would....
- Coming up to exams talking through the topics with your friends is the best way of studying.
- The OSCE is a big predictable act, learn your lines off well and you’ll do fine.
- Do not spend too much time on the surgical cases, just get the bloody things submitted.