2.4 Understand the indications, contraindications and potential complications of common clinical procedures and perform the basic clinical procedures expected for a new PGY-1.
Coming into medical school, I knew that I wanted to go into orthopaedic surgery. Growing up I loved watching sports and always wanted to take care of athletes. This coupled with my fascination with procedures and working with my hands made orthopaedic surgery an easy choice for me. During my first year of medical school, I was paired up with Dr. Goyal, an orthopaedic hand surgeon for my LP. During LP, I had a lot of opportunities to work on my suturing, put on splints/casts, remove sutures, and perform other basic procedures. In this process, I was able to understand the basic principle for how to consent patients, how to reassure patients during a procedure and most importantly how to perform procedures safely. During my third year, I actively sought out procedures to improve my confidence and to ensure that I had some proficiency before starting intern year. This is evidence in my third year evaluations referenced below.
Artifact 1: Third year evaluations highlighting proficiency with procedures.
My 3 away rotations earlier this year marked the culmination of everything I learned during my first three years of medical school. I worked really hard before starting my away rotations to work on splinting/casting techniques, suturing, basic reductions, bedside I&Ds, and other routine orthopedic procedures. As a result on my aways, I was treated as an intern and was given opportunities to perform procedures and triage patients independently in the ED. I remember my first such experience at the University of Iowa. It was a young IV drug user who presented with a superficial abscess on his forearm. After initially seeing the patient and staffing it with the resident, I was given the opportunity to perform a bedside I&D. As this was my first independent procedure I spent a lot of time going over my technique. In the back of my mind, I was very conscious of the patient and not wanting to do any harm. I consented and performed this procedure with the help of a resident. The evaluations below highlight my ability to perform procedures in acute orthopedic trauma patients at several institutions.
Artifact 2: Away rotation evaluations.
This experience marked one of the proudest moments of my medical school career, but it also taught me a lot of important lessons. Looking back, I remember the trust and the confidence that the patient placed in me to help him out. For the rest of my career, I want to make sure that I have the knowledge and ability to perform a procedure effectively without harming the patient. I also want to be realistic with myself and admit when I need help in the future as an intern. Although as a resident my primary goal is to learn the skills necessary to become an orthopedic surgery, my goal is always value patient safety before performing any procedures. Due to these experiences I feel very confident to perform basic procedures and help in the OR as an intern.
Examples of various procedures I performed are noted below. All patients were asked for permission to take pictures.
Artifact 3: Examples of suturing, casting, and external fixation that I performed.