Getting involved in clinical activity

If you are keen to pursue a career in colorectal surgery you need to enjoy being in theatre, but don’t forget that over half a surgeon’s working time is spent on activity outside of theatre. Colorectal surgeons will see patients on-call, on the wards and in outpatients. Here are some ways medical students can learn more about colorectal surgery:

Theatre

You will get more out of a list if you interact with the surgeons and sometimes scrub in. It is all too easy to turn up to a list, not really know what is happening and stand in the background for the day. Here are a few tips:

  1. Read up. Phone the secretary a few days before and get a copy of the list. Ask which are the big cases and try and do a bit of reading beforehand. You’ll learn much more from the day and the surgeon can illustrate the things you’ve read and they’re likely to be impressed!
  2. See the patients. You should ask the surgeon’s permission or accompany them as they see the patients before the list. Again, ask the secretary where the patients will be- usually it’s in the pre-admission suite. Consultants will see patients there from 07:30am to go through the consent and discuss their operations.
  3. Scrub in. Ask the lead surgeon at the start of the list if you can scrub in for any of the cases. They may need a hand and you’ll see so much more.
  4. Logbook. Try and keep a logbook of the cases you’ve seen. It’ll help with your learning and during your attachment show it to your supervisor. It will show you are taking the attachment seriously and they can point you in the direction of other cases or lists that will develop your knowledge.

Outpatients, on-call and wards

  • Keep a record of some of the cases you’ve seen.
  • Read up on conditions and management options that you encounter that you find you don’t know much about. When you return to the clinic another day, you can then discuss these in more depth with one of the medical team.
  • If a case interests you then keep a note of it as you’re likely to need to write a case report during your attachments. If the topic is slightly unusual and illustrates a clinically important point then you may want to consider publishing it, but first ask one of the consultants or registrars if the case is suitable. Then read some case reports (try BMJ Case Reports) to see the style. Most registrars or consultants will be happy to help you, make sure you acknowledge them in the report if it’s published.
  • The Royal Society of Medicine offer a prize for the best case report – John Dawson Medical Student Prize

Electives

An elective is a rare opportunity to experience medicine outside of your normal environment. If you are particularly interested in colorectal surgery you could:

  • Go to a centre that has an international reputation for its work. Talk to your consultants about good places to go. Centres in the USA, Canada, Australasia and Europe are popular and may have strong reputations for work in cancer, inflammatory bowel disease, pelvic floor disorders, laparoscopic or robotic surgery.
  • Go to centre in the developing world that you may not have the opportunity to visit again. You may see some fascinating places and diseases. You may not be able to specialise in the same way but tell them in advance you have a particular interest in surgery and see if there is a little project or audit you could do out there that will help them focus your experience.

Wherever you go, keep a record of what you see. See if there is a small audit or project you could complete while you’re out there.

Funding can be hard for electives – the Association of Surgeons in Training offer an elective prize specifically for medical students interested in surgery.

Enjoy your time in surgery as a medical student. Get a flavour of what it has to offer and what surgeons do. If you think it’s what you want to do as a career try and keep a record of what you’ve done. Applications in your future career will often ask about ‘commitment to specialty’ and if you can give some examples from the above it will help.