Trying to get a job in the middle of a pandemic is less than ideal. Given that, when you get an opportunity to work with residents and faculty one-on-one, it is crucial not to waste that time. Don’t get black-balled before you’ve ever even walked into the hospital!
It’s essential to understand who is usually on a residency selection committee. The committee is composed of representative faculty as well as residents. (If a program doesn’t have residents on their selection committee, you don’t want to go there.) It’s important to remember that you aren’t just doing an audition rotation to impress a faculty member and get a recommendation letter. The residents have a significant say in who they want to work with when a new class joins. A program may altogether remove a student from their rank list after resident feedback.
Don’t underestimate other people in the program. The residency program coordinator and the medical student coordinator (if a program has one) are essential. Same for PAs and NPs, nurses (in the office and on the floors), secretaries, and assistants. Be nice to the janitors! Treat everyone like they are your grandmother. If you are rude to them or don’t complete a task on time, that is likely to get communicated back to the program selection committee, and the result can be not being included on a rank list when the time comes. I know it seems like something that shouldn’t have to be said, but it happens way more than it should.
I’m not writing this to cause fear. You shouldn’t spend too much time walking around on pins and needles. Be a normal person, and things will go well. Here are some more thoughts that I have about excelling on an orthopaedic rotation.
- Show up to the operating room early. Introduce yourself to everyone in the room. Write your name on the board so the nurse can put you in the computer. Write your glove sizes on the board as well. Never assume someone will get your gloves. Grab gloves and a gown for the first case and ask the scrub if they want you to flip them onto the field or give them to someone else to put them on the field. Don’t be surprised if they don’t want you to put something on their sterile field until they trust you to do it correctly.
- When the patient gets into the room, help the team. Don’t stand in the corner and watch. Get in on the action. You may not be invited up to the table. The focus is on the patient at that point, not other people in the room. Go and grab a warm blanket for the patient. Help move the patient to the OR table (not the feet). Get in there and do the heavy lifting. Help turn the patient. Don’t throw stuff on the floor that one of the room staff is just going to have to come behind you and pick up later. If you show you have their back, they will get yours!
- When it’s time to prep the patient, ask if you can help. The person prepping the patient may or may not need it. Again, make yourself part of the team. Everyone in the room is focused on getting the case started and may not be looking around to invite people to help.
- Prepare for cases. Ask the resident or attending that you are working with to go over cases the day before. The resident may be able to prep you for questions. Read up on the anatomy. You aren’t expected by most people to know much more than that.
- When you are asked a question during a case or on rounds/in the office, don’t panic. The purpose of the question may not be to see whether or not you know the answer. It may be to evaluate your thought process. Can you work your way to the solution? I worked a lot with a faculty member as a student where I ended up doing my residency. He loved to ask me questions about musical artists. I almost never knew the answer. It became a fun game. No one was keeping score as to which answers I got right or wrong. Usually, by the way, no one is.
- Practice knot tying and suturing at home. Be able to tie one-handed and two-handed. Practicing using your dominant and non-dominant hand. Learn to use scissors and clamps with both hands. If you have practiced when someone asks you to do something and you can do it efficiently, you will be asked to help more and more. If you aren’t sure, ask the scrub to show you how to hold an instrument or use it correctly. They will show you.
- Have supplies with you that will be helpful. Keep a pen (that you don’t like too much) in your pocket. Have trauma sheers available. Help with dressing changes in the mornings. If you can work ahead of the resident or attending, you will be seen as a valuable team member.
- Be prepared to show up early and work late. This is the same thing a person would do if they got an entry-level job in the business world and wanted to work their way up the ladder.
- If you are on call and slept during the night, be prepared to stay and work the next day. You only get so long to work with the residents and faculty. Please take advantage of it. If you worked all night, that’s a different story. The team should be sending you home in that scenario.
At the end of the day, just like the residents and faculty are trying to decide whether you might be a good fit for their program, you should be doing the same thing. Try to talk to as many residents as you can. Get a sense of what their life is like. Are they miserable? Is it just that they are on a particularly busy and challenging rotation, or is every rotation at a program miserable and difficult? Get a sense from the faculty whether or not they enjoy their job. If the faculty are miserable, there’s a good chance the residents aren’t going to be much happier. Talk to PAs and NPs if you are helping them close. They can give you useful information about the program.
There are more applicants than spots. Except for a few people, almost everyone is mashed up pretty close together. Applications are surprisingly similar, with similar-sounding letters of recommendation and personal statements. Everyone has good clinical grades and an acceptable test score.
The best way to distinguish one applicant from another is to see their work-ethic in person.