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Day in the Life of a Surgery Resident

4:30am

My alarm clock goes off. I snooze once, then I get up to start my day. 20 minutes is all I need to get dressed, brush my teeth, pour a cup of coffee, and take breakfast to go. It’s Monday morning on the Blue general surgery service, which means I’ve had a chance to review the OR schedule and the list of cases that my chief resident assigned and emailed out last night. Looks like I’ll be doing two laparoscopic inguinal hernia cases today. On my way in, I’m thinking about the anatomy I’ve reviewed, steps of the operation, and the tricks I’ve learned from previous cases.

5:15am

I arrive in the resident room to meet our PGY-1, who is getting sign-out on our list of patients. She hears about all the weekend events and the plans we need to execute today. As the PGY-2, I’m listening in on sign-out, I’m checking the patients’ chart for any major updates. I also review the OR schedule for any changes. I notice that the chief resident has assigned himself an open umbilical hernia repair in the afternoon. Maybe if I finish my two cases on time we can do the afternoon case together as a chief resident teaching case.

6:00am

We meet as a team, including the chief resident, PAs, medical students, the PGY-1, and me. We briefly update everyone on weekend events before efficiently seeing each patient in about an hour. Hopefully there aren’t too many surprises!

7:15 am

Our team splits and we head to preop to make sure everything is ready for the OR: patients are consented and H&Ps are done, preop COVID test results are reviewed, all questions are answered, and the attending is present to mark the patient and sign off on all the paperwork. The attending, medical student, and I head to the OR and run the list, solidifying plans for each of their patients. I relay this quickly to the rest of the team. The PGY-1 also has cases today, but not until the afternoon. Once the plans are laid out, she divides up the notes and floor work with the PAs on service. I’ll help out in between cases. The medical student and I pull our gowns and gloves and go scrub our first case of the day as anesthesia is getting situated. I drape the patient and lay out where I’d like to place my ports. My attending makes a few adjustments, and then we’re underway. We access the abdomen, place our ports, and begin our dissection while identifying the key landmarks I reviewed the night before. Pretty soon the mesh is in and we’re closing the peritoneum. The medical student and I work together to close the ports and apply the dressings. We input orders and review these with the nurse before leaving PACU.

10:30am

I touch base with the intern, who still has a few notes to write. I take them over, so that she can attend daily interdisciplinary point of care rounds with the PAs, nurses and case managers. This is a chance for the patients to get an update on their plan for the day and overall goals of care. My next case is going soon, and the OR will be calling for the patient any minute.

1:00pm

After my second case is wrapped up, I grab a quick bite for lunch and check the OR board. It looks like my chief will be starting the umbilical hernia repair soon. We meet in the preop area and talk about doing this as a teaching case, where he will walk me through the necessary steps and maneuvers. The attending gives us his permission and is happy to advise. I send the medical student to help out the PGY-1 with her afternoon cases, a split thickness skin graft and a sebaceous cyst excision.

3:45pm

It looks like all the cases are done for the day. We meet to run the list as a team to review updates and changes from the day and to solidify plans for overnight. The PAs head home, and the PGY-1 and I confirm that notes are done and make sure all the floor work is squared away. Looks like there’s a drain left to pull and some prescriptions to sign before one of our patients is discharged this afternoon.

5:00pm

The chief resident and I recap our teaching case and identify ways we could each improve in our respective roles. Since the PGY-1 came in early, I offer to stay late for evening sign-out to the night float team. I take some time to review clinical questions with our medical student and complete her rotation evaluation. In my remaining few minutes of downtime, I read up on malignant disease of the colon. This is our topic for Tuesday morning education, which is protected time for lecture, quiz and guided surgical skills practice in the simulation lab. 

7:00pm

After finishing my reading for tomorrow, I sign out and head home. Mondays are always longer days, but I feel pretty good about how my cases went today and how much I learned from my chief. On the other days of the week, I try to catch a quick workout at the local gym on my way home, but this is tough on a longer day. At least I’ve finished my reading before I left for the day.

7:45pm

At home, I make a quick dinner with my wife. We sit together to recap our day and sometimes watch a few minutes of the Monday night NFL game. I’ll look over my cases for the next day, and pretty soon I’ll shower and head off to bed.