My surgery rotation at HHC Queens Hospital Center was an absolutely amazing experience. Even though the hours in surgery were upwards to 90 hours a week, I believe that I had quite the valuable experience at QHC. My preceptor Scot Baker ensured that this was a structured and engaging learning environment with minimal downtime. I was very pleased to see how physician assistants collaborate with their attendings to run a surgical unit. With seniority there seemed to be a lot more independence in regards to medical practice. I feel as if the physician assistants were treated as valuable members of the healthcare team.

One of my first surgical cases that I scrubbed in for was an elective cholecystectomy in a 24 year old female who was endorsing postprandial RUQ pain for the past 8 years. She had mild remission with a low fat diet, however her current symptoms were too painful to continue with conservative management. I liked this case in particular because while it was a simple case it was good to see how far I’ve come since the beginning of my PA career. It was just yesterday that we learned about the implication of cholecystitis in a patient with RUQ pain. And on this rotation I was seeing a live laparoscopic cholecystectomy. I thoroughly enjoyed participating in this procedure. While the attending and the resident performed the surgery they let guide them using the camera. In the end the attending said I did a fantastic job manipulating the visual field, and helped make their job a lot easier. I was also given the opportunity to suture the wounds closed. Since then I have been allowed to suture for most of the surgical cases that I was scrubbed in for.

Since that initial surgery I have been trusted with the camera for most of the laparoscopic procedures. This ability was put to the test with my first ever 6 hour surgery. Unfortunately it was one of the few days that I did not wear my compression socks. Our patient was a 64 year old male who needed a colon resection due to a tumor that was found incidentally on an abdominal CT. He had been experiencing scant red blood per rectum that has been increasing in quantity for the past 2 weeks. He also noticed significant unexplained weight loss during the past two weeks. The surgery was a pleasure to watch. It was a challenging but rewarding procedure. It was incredible to see the variety of tools that were available to resection the bowel. At certain points the surgeons let me hold the clamps and manipulate the bowel so they could get a better view. After the procedure I followed the patient throughout the day and overnight. He was progressing well. It was a pleasure to be involved in different aspects of his care. It demonstrated the variety of roles that PAs can play within the healthcare team.

Another instance that was particularly illuminating to me was one where I got to see how involved PAs can be involved in surgery. In this particular surgery a PA took lead and another PA was first assisting. A supervising physician was in the OR but he kept his involvement minimal. The PA went on to remove a lipoma from a patient’s back, and throughout the experience he was teaching me and the other medical students about the procedure and the anatomy. In the end he showed us how to throw in horizontal mattress sutures. This demonstrated the amount of trust that can be placed on PAs by their attendings.

Overall I enjoyed this rotation extensively. I learned a lot of practical skills and a lot of important anatomical landmarks. During our consultations of patients in the emergency department I gained experience in recognizing emergent surgical conditions. I was able to help providers write progress notes and with management of floor patients throughout the day. I also learned how to apply a variety of wound dressings. I would consider becoming a surgical PA in the future.