Suppose a surgeon or doctor is going to perform surgery tomorrow. Is it typical for this person to study up on what he will be doing the following day? Does it vary according to the complexity of the surgery to be performed? I would ask one in real life, but I was afraid I might offend them as if I was saying “do you know what the hell you are doing?” Thanks guys.
I’ve known OBs to review charts and sonograms before performing C-sections that I circulated on, so I could see other surgeons studying up.
Cyn, OB/GYN RN
It depends. If it’s a surgery they’ve done dozens/hundreds of times, probably not. If they haven’t done it in a while, or are trying out a new technique, sure. A surgeon friend of mine told me this past weekend how a study sheet on 9 Easy Steps to a Whipple flew out of her car while she was driving, so obviously she keeps stuff like that around. (It’s a pancreatic operation, but isn’t it fun to say?)
Veterinarians study up for surgeries all the time. In a practice like mine, I do all sorts of soft tissue, ophthalmic, thoracic, orthopedic, etc surgeries. Some I may do once every few years. Sometimes I will even make copies from a textbook and tape them to the walls in the OR.
The other option available to veterinary surgeons is doing practice surgery on a cadaver. I don’t think my friends in human medicine do that very often.
Here surgeons spend years (and I mean 2-4 years) assisting in theatre before they’re ever actually allowed to operate as the primary surgeon. That means that they’ll have seen most common procedures in their chosen field several times, if not several hundred times, before doing it themselves.
Sure they’ll have been cutting, tying, suturing, holding clamps etc, but there will have been a senior surgeon telling them what to do.
The rule generally is that you don’t do something you’ve never seen done at least once, you refer the patient to a surgeon who has done it before, and you ask to assist so you can do it the next time. The only exception is if you’re trying out a radical new technique, and NO-ONE has done it before!
If it’s been a while since you’ve done something, then sure, you’ll read up on it beforehand, but most of the time it’s going to be something routine and they could probably do it with their eyes closed.
Is that really how they do it in Ireland? In the US, a surgery resident will be primary surgeon on nearly all of his/her cases by the time they are a 3rd year resident and primary on some more common cases (hernia repair) when they are a 1st or 2nd year resident. The attending surgeon is typically first assistant and is providing retraction (if there isn’t a medical student) as well as advise on technique, etc.
Yup. You normally pass the membership exams and are a Registrar before you’re the primary surgeon. Only Consultant are considered fully trained surgeons, even Registrars are still considered trainees.
At least at some pediatric hospitals, when there’s a tricky/hazardous procedure, surgeons will do a practice surgery on a dog, which is then given an anesthesia OD. So, sometimes a dog that is unplaceable can do a noble last service. Such hospitals accept donations. Note that a young animal would probably be of more benefit than an aging one.
<slight hijack, sorry>
Yup, sounds gruesome, but IMO considerably less gruesome than placing an unkeepable dog with a questionable home, where it could be abused, neglected, starved …
And yes, I consider that we have enormous responsibility towards animals we own, especially animals which are born to our households. Humane euthanasia is heartbreaking, but is always preferable to letting an animal go to a home that may not care for it. If the animal can also serve a higher purpose, its death has some redeeming value.
</hijack, with more apologies>
But they operate on just one species, while you probably cut into all kinds of creatures. I often wonder how you folks can handle such pressure.
Yet again tygerbryght things are different in different countries.
No one here would dream of practicing surgery on an animal. Partly because we have more stringent laws about the manner in which animals can be used for research, and partly because human anatomy isn’t considered sufficiently comparable with a dog or pig to make it worthwhile.
All our cadavers in medical schools have been donated by written consent of the deceased person too. It is also illegal for unclaimed bodies to be used by medical schools/hospitals, as it is presumed to be against the wishes of the deceased.
Unclaimed bodies get a paupers burial, but they don’t spend 18 months being dissected first.
The cadavers we do dissect are returned in their entirety to their families (and I mean EVERYTHING is returned, including bits of tissue paper with particles of fat on them). In addition there is a multifaith Service of Remembrance in the college chapel every 5 years for our donors.
My colleagues have many ways of dealing with stress. For some, it’s a hobby. For others it is exercise. Some rely on their spiritual beliefs and seek help with clergy. Personally, I’ve always found drugs and alcohol to be a help.
Wow. Most of the advanced cardiac surgeries including transplant, were pioneered using the dog as a model. The skin of the pig is so similar to human skin that many researchers use pigs as their reasearch model.
Yep, animals in RESEARCH is fine.
Taking a dog from the pound to practice paediatric surgery would be considered animal cruelty and illegal.
Ahhh. Actually, most situations I’ve come across have not been pound animals. They are purpose bred lab animals from a licensed supplier. In fact, many shelters would refuse on ethical grounds to supply animals slated for euthanasia.
From a licensed supplier would probably count as animal cruelty too.
The laws surrounding animal research are that
- Minimal numbers of animals be used.
- They must suffer minimum distress and suffering and anaestheasia used if practicable.
- Animals used only when absolutely necessary.
Practising human surgery on animals breaks down on point 3. You can read from a book. You can watch a more experienced surgeon. You can use a model. You can watch a video.
Using a dog or pig isn’t absolutely necessary, so it’s not legal.
Quite obviously, we have different definitions and laws. I defer to no one in my opposition to animal cruelty. I refer you back to what I said about options. Here in the U.S., it’s very hard to get most pet owners to see that it’s kinder to take a pet to its own vet and have it put down there than to take a chance on its getting adopted (in most places, there’s almost none; some few places have no-kill policies, and adequate financial support - they campaign vigorously to raise funds - so they can take proper care in the interim, and carefully screen applicant homes). For most animals, going to the pound or the humane society is a one way trip, and it dies among strangers, frightened and alone. I know this, and it’s why I advocate taking the responsibility and seeing to it oneself that the animal is humanely euthanized, when an owner can’t find a home s/he knows is a good one.
First, please note what vetbridge said last.
Second, perhaps you didn’t understand that when animals are used for surgery practice, it is invariably for operations which are rare (no chance to watch somebody else do it, until/unless they start hospital network viewing over the new fast internet, and even then some surgeries just aren’t done everyday, period - frex, some heart defects are quite rare) and difficult. And, as I stated in my earlier post, the animal is given an anesthesia overdose when the procedure is complete. That’s even more surely painless than the fastest, etc., shots available for the purpose.
And that’s all from me. This is, after all, a bit of a hijack.
There are quite a few procedures I do in the emergency room once in a while – certain fractures, disclocated hips and elbows, etc. I have done many of these procedures 20 times or so. However, since I do them infrequently, I often make a point of reviewing the fundamentals despite having a pretty good idea what I am going to do. I wouldn’t review things that I do commonly. I work in a small town without direct access to an orthopedic service but feel quite comfortable handling the small to medium problems.
Yes, if the doctor is young and/or new to a procedure. My sister always studied before surgery when she did a rotation in that department during med school, and the residents she worked with often did too.