Surgery was a great rotation. I got to utilize some skills that I learned during my previous rotations and learn some new ones. I spent time in the operating room, seeing patients in clinic, seeing patients admitted to the floor and seeing consults in the ED. I got to experience many aspects of what a surgical PA would do. 

In the clinic I saw hernias, cellulitis, breast disease and breast cancer, venous insufficiency and venous ulcers, peripheral arterial disease and arterial ulcers, gallbladder polyps, anorectal disorders.  In the emergency room I saw surgical site infections, necrotizing infections, small bowel obstruction, pneumothorax, and abscesses. I got to assist with several surgical cases in the operating room. At first I was nervous to scrub in, and practice sterile technique but the more I did it the more confident I felt. I saw and assisted with laparoscopic cholecystectomies, hemorrhoidectomies, creation of an AV fistula with a graft, temporal artery biopsy, fistulotomy with marsupialization, inguinal and incisional hernia repairs, exploratory laparotomy with small bowel resection and anastomosis, bullet removal, laparoscopic appendectomies, exploratory laparotomy with wedge gastrectomy,  colectomy, and lumpectomies. 

I was able to practice many clinical skills on this rotation, the most common one I did was wound care. After most surgical procedures I was able to close incisions with either staples or sutures, and when those patients returned later in the clinic I was able to remove the staples and sutures. I also placed nasogastric tubes, and performed incision and drainage of abscesses. One aspect of this rotation I appreciated was seeing patients in the operating room and assisting with their surgeries and following their care either as inpatient or outpatient in the clinic. 

This was the first rotation that I wrote SOAP notes for, instead of complete H&Ps, for future rotations I would like to hone my SOAP note writing skills. I learned several new suturing skills and knot tying on this rotation, and I will continue to practice that as well. 

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