In a Teaching Hospital....... Surgical Residents

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J

Jkm7

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Oct 15, 2005
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Location
Massachusetts
In a teaching hospital such as Mass General with its association with Harvard, do you suppose the cardiothoracic Residents/Fellows in the OR with our surgeons do sternum wiring/closings? How much of the hands on surgery do you think they do with any given case?

It never occured to me until now that maybe our surgeons don't do the whole surgery. It really doesn't bother me as long as I am sure he was in the OR the whole time and I'm sure he was.
 
I had my surgery at UCLA, a teaching hospital, and I asked my surgeon who was going to do my surgery. He assured me that he was the only one who would replace the valves for me. I was worried about being opened and closed by the Residents/Fellows. He calmed down my fears that those surgeons have at least 5-8 years of experience. And indeed, they did a wonderful job. You have the right to bluntly ask your surgeon who is doing what and how many years of experience his surgical team has. You have a good positive attitude. Good luck:)
 
As someone who has not yet had OHS, this is a great thread to remind me to put this question on the top of my "list" when I do meet with a surgeon. Thank you for bringing this up and sharing your stories!:)
 
There are no "PA's" in New Zealand.

But surgical registrars (residents) assist during surgery - after my surgery the surgeon came once a day to see me but the registrar came twice or three times a day on rounds. He told me he assisted during the operation but didn't say exactly what he did. They have to get their experience somewhere, and I don't mind the thought of them helping out as long as it's under the surgeons supervision:)

Bridgette
 
One of the PA's told me she thought she would be in the OR with me but I never remembered to ask her later.

I have no idea if my surgeon closed me my first OHS but I am sure he closed me the second..... or I think I'm sure.

During my pre-op visit with him, I told him that here I was four years later and I was still sore from the first surgery. I healed beautifully and my sternum was fine but I had soreness and tenderness and could never again lie on my stomach. He was sorry to hear it and told me he would do what he could to make it better this time.

He did!!! I'm now 7 months post op and it is definitely better this time around. So, if he did not personally do it I'm inclined to think he spoke about it with whoever did close me.
 
It depends on where they are in the teaching cycle. If they are about finished with a CV surgery residency, they might do a whole lot of the surgery. If they are toward the beginning of the surgical rotation, they might just watch. Opening and closing is hardly ever done by the head honcho in a teaching hospital. However, he (or she) is always available to supervise.

I read an article not too long ago that talked about how Dr. DeBakey went from OR to OR, participating in about 12 surgeries in a day. Obviously he didn't do it all. The article said what he did depended on his mood.
 
At UAB, the more experienced (second year?) residents do openings and closing on First Time OHS patients. The primary Surgeons do (or usually do) repeat openings.

I've always wondered where (i.e. WHO) the residents get experience doing actual surgery on the heart. (I'll keep my hunch to myself).
 
I did not have my surgery in a teaching hospital, however I asked my surgeon prior to surgery who would open and close and he told me that he would.

He did have an assistant in surgery with him. I don't know what the assistant did. The weekend after my surgery my surgeon was not on call it was the assistant. When he walked into my room for the first time after surgery he introduced himself and said I know you from the inside and now I know you from the outside as well.

The reason I asked about opening and closing was a thread on VR but I don't remember how it was titled. I had it on my list of questions prior to surgery.
 
Now that you say it, Nancy, makes me think of cows and pigs. :eek:

Someone has to retrieve those valves used in tissue replacements.
 
Post op when the nurse saw my incision, she said, "the surgeon closed you up himself".
I asked her what she meant by that, and she explained that since I was a younger woman he would ensure that my incision was very straight and neat. The much older men would more likely be closed by residents.
 
Sounds similar

Sounds similar

Bina
Your experience reminds me of the old MASH moment.
The surgeon in charge inquired of the nurse was he working on an enlisted man or an officer. Enlisted man was the reply--then make the sutures larger.
 
UTMB has a hospital in Galveston where the med students get to learn. There are two sections to the hospital - public and "protected", i.e., prison. All of the inmate cases are paid for by tax dollars. However, it does give the students good practice in all types of surgery, even cosmetic! Seems weird, but think about it. Who would pay good money to have a student practice their very first face lift or tummy tuck?
 
Susan BAV said:
I don't know anything for a certainty but I'm pretty sure it wasn't Dr. Cooley who sewed me up after my first surgery; it was a bit of a mess post-op, the incision opened at the ends, and never did heal up very nicely.

I would hope that sternum wiring is only done by experienced hands though. As it turned out this time, my surgeon definitely closed me up because I saw him a couple of weeks later and he mentioned how carefully he had glued the incision so it would heal in a tidier manner.
Click to expand...

I'm almost sure that was the case too Susan.

When I had my first 2 OHS, Dr. Cooley himself opened & closed me & then when I had my 3rd in 2006, he told me that they had made sure that that incision was neatly over my last two so that you could never tell that I'd been opened 3 times! :)
 
Well, anyone watches Gray's Anatomy on ABC? It had a young intern ( I forget the name, played by Sandra Oh) performing major surgery to save her fiance's (who is the chief cardio-thoraic surgeon) reputation when he had a tremor. Totally freaked me out when I saw a rerun after my diagnosis. I hope that doesn't happen in real life!
 
That's why you pick a very excellent heart center to have your surgery. Only the best of the best and the brightest are accepted to train there. All these very fine surgeons have to learn somewhere and it doesn't freak me at all to think my Mass General Surgeon may have had his Resident/Fellow doing some of my surgeries. I know my surgeon never left the OR and there is no way he would jeopardize his patients.

If you have to travel to go to a very fine hospital, find a way to do so IMO if at all possible.
 
Well I hD THt very question about residents 5 weeks ago at Brigham and womens Boston..I asked before and after surgery who "worked" on me. The residents were there and assisted but my surgeons hands were in the mix all the time from what I understand. You do wonder though ..residents need to learn and practice somewhere on someone!
 
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