My first open surgery was a trans abdominal hysterectomy on my general gynecology rotation. After retracting at the abdomen for three hours, the attending asked the senior resident to allow me to close the wound. My breath stopped for a moment. I had only gotten one day of suturing practice during orientation week and did not have any sutures to practice at home. After several failed tries at suturing and knot tying, I asked my senior resident if I could take some sutures home. I wanted to master the art of suturing before the next surgery. I did not want to miss another opportunity to close an incision because I did not know the basic steps of tying a knot. I considered it my professional responsibility to acquire and master the skills I was expected to learn as a medical student.
Sutured Cushion Cover
My senior resident was unable to find any sutures for me so I started practicing knot-tying with my shoe laces during free time. I watched YouTube videos to guide me and every morning I tied my shoes with a surgical knot. I started enjoying the hand motions and it became an exciting way for me to begin my day on surgery rotations. But I still had no practice suturing. I did not have a needle driver or sutures to practice with. After gynecology came my plastic surgery rotation. To my relief, I was never asked to suture on the rotation since patients trusted plastic surgeons to close their incisions in the most refined manner. The rotation was going smoothly until the last week of rotation, when my attending physician asked me to close the incision for a Trapezius flap. Once again, my breath stopped. He handed me the needle driver. I looked at it from all directions, holding it in my hand in all angles, trying to find the most feasible way of starting the suture. My attending, seeing me struggle, asked if I had any sutures at home to practice. I reported that I did not. He requested the scrub tech to lend me a needle driver and some expired sutures. That night, I took the needle driver home and practiced suturing on my cushion cover. With every subsequent stitch, I could see my skill improving. I was unearthing the secrets of suturing long hidden from me. It became a nightly routine to come home and practice suturing my cushion cover before going to bed. In less than a week’s practice, I felt comfortable to start my obstetrics rotation and was ready to be asked to close a wound.
End of Rotation Feedback- OB/GYN, Highlighting the Improvement in my Surgical Skills
To my excitement, my intern resident allowed me close every cesarean section I was in with her. Suturing thick, stretchy skin after a pregnancy was very different than suturing cotton. My intern resident and attending physicians demonstrated how to manipulate the skin and the angle of my needle to facilitate easy strokes. After practicing subcutaneous sutures on long cesarean section incisions for two weeks, one inch incisions after robotic surgery on gynecology oncology rotation seemed far simpler. The surgical nurse mentoring me on gynecology oncology commented “look at those fingers tying away those knots; someone’s been practicing their knot tying.” My senior resident on gynecology oncology remarked “your suturing is really good.” The chief resident on my general surgery rotation allowed me to close an abdominal incision with deep dermal sutures. Observing my work, he commented “that’s looking good.” I had come a long way in my suturing and knot tying skills. Every stitch felt fluid, my feet were firm, I could breath. I looked forward to hearing the words “you’ll close this incision.” More importantly, I was now enjoying surgeries and wanted to pursue a surgical subspecialty.
I demonstrated a strong sense of professionalism by making effort in overcoming my deficiency and striving to meet expectations set for me as a medical student. I foresee that during ophthalmology residency, I will be expected to learn numerous surgical and exam skills. Mastering those skills will require practice and determination. I look forward to utilizing wet labs and every surgical opportunity to gain the skills that are essential for me to become a competent ophthalmologist. Furthermore, being able to take feedback from my seniors and implementing it in my practice will allow me to improve my skills. Even as new technology arises after I become an ophthalmologist, I will seek training in them. As a physician, I feel that I am accountable towards my patients and my profession. I see it as my ethical obligation to excel in the knowledge and skills set out by my profession in ophthalmology.