A Day in the Life of a 5th Year Surgical Student

It’s 6:30am. Your alarm is going off. Because you are a motivated fifth year student, you turn it off, get up and get ready for the day (with no hesitation or snoozing, of course). Before we get into what you’ll be doing today though, let's rewind a bit - because a day on your surgical placement actually starts the day before. 

Preparing the Day Before 

A little preparation goes a long way. While the opportunities for going to theatre in fifth year are more limited, you should plan ahead, ideally at least the day before. Here’s what you should do to get the most out of your day in theatre (and to hopefully impress the registrar/consultant you’ll be with): 

• Check the theatre list: know which patients are scheduled, what procedures they’re having and which consultants/registrars are operating. 

• Speak to the team: if possible, ask the consultant/registrar if you can join them in theatre. Some might want you to speak to or examine the patient beforehand, so clarify this early on. 

• Clerk patients: if the patient is being admitted the day before, ask the juniors if you can clerk them. 

• Revise the operation and relevant anatomy: you don’t need to go overboard, but make sure you have a general understanding of the condition being treated, the steps of the procedure and relevant surgical anatomy (this will help you actually understand what is going on and is another way to get brownie points with your consultant/registrar) 

Now that you’ve maxed out your preparation for a day in theatre, let’s see what a typical day on the ward looks like (disclaimer: this will vary from ward to ward, but this is a standard day on general surgery). 

7:55am - Start of the Day 

Aim to arrive just before 8:00am to catch the handover from the night team. Grab a handover sheet and wheely laptop and log in to TrakCare, HEPMA and PACS, so you’re ready when the ward round begins (do it early to avoid having the consultant stare at you in front of a patient, while you desperately wait for everything to load up). 

8:00am - Ward Round 

Ward round typically starts at 8:00am sharp and is led by either the consultant or registrar on that day. If you’ve grabbed a laptop, you’ll usually document for every other patient, or you’ll be given the jobs book to update. 

Be proactive and have key information ready. Again, this varies between specialties, but have bloods (for inflammatory markers, renal function), HEPMA (for antibiotics), scan/investigation results and any input from other teams (PT, OT, etc.) ready. If you learn to anticipate what your seniors want next, the ward round will go much more smoothly. 

If urgent jobs come up during the ward round (like taking bloods or inserting a cannula), offer to do them straight away and rejoin afterwards. It’s a good way to help the team and get experience with clinical procedures. 

9:30/10:00am - After the Ward Round 

Once the ward round finishes, the team will regroup in the doctor’s office to go through the board. The consultant/registrar will briefly go over each patient, updating plans and identifying jobs for the day, with these added to the board and the jobs book. 

This is a good moment to decide what you’d like to do that day. Don’t wait for someone to assign you a job. Take initiative and volunteer for jobs that you think will be useful for your learning. 

Rest of the Day - Jobs You Can Do as a 5th Year 

As a fifth year the aim is to get comfortable doing the jobs you’ll be expected to do as an FY1, so here is a list of common tasks you can do: 

1. Bloods and cannulas 

2. Clinical procedures → good sign-offs to get during your surgical block: 

3. Pregnancy test (all women of reproductive age coming in will need one; ask nurses/HCSW who do these, e.g. SAC in general surgery) 

4. Medicines reconstitution/dilution (ask the nurses when they do their afternoon medication rounds, usually around 13:00 - 14:00) 

5. Blood glucose (ask the nurses if they have any diabetic patients → usually need BG level taken before lunch) 

6. ECG (especially if > 55 years and abdominal/chest pain) 

7. Subcutaneous injections (can get all signed off in one go during a dalteparin round, usually 17:00-18:00) 

8. VBGs (harder to plan for but will usually need to be done for any unwell patient) 

9. Blood cultures (whenever patient’s spike a temperature) 

10. Scrubbing in/suturing 

11. Clerking new patients (elective or emergency; in general surgery, go to receiving) 

12. Reviewing patients (fluid review, examinations) 

13. Medication reconciliation (can add this onto HEPMA with your student log in) 

14. CDDs 

15. Chasing results (bloods, scans, investigations) 

16. Calling other departments (microbiology, radiology, other specialties) 

17. Referrals (e.g. TPN, OPAT, OPAL) 

18. Prescribing (fluids, gentamicin charts, etc. → under supervision) 

If you’re unsure about a job, ask to try it and get one of the FYs to check your work. This is the best time to learn because you’ve still got a safety net! 

Final Thoughts 

Most of your time will be spent helping out on the ward, unless you’ve planned to go to theatre. Be proactive and support the team, but don’t fall into the trap of just doing tasks no-one else wants to do. Make the most of still being a student: focus on jobs that will help you prepare for FY while still prioritising opportunities to observe and get involved in interesting situations/cases. 

If you can, also try and go in on a weekend or night shift. From my experience, you’ll be given much more responsibility and opportunities for hands-on work, since there are fewer students and doctors around. You’ll get the chance to hold the FY phone and act as the first point of contact, which is a great opportunity to assess patients and come up with an initial plan, before then discussing it with your seniors. 

Ultimately, and I probably sound like a broken record at this point, the more you put in the more you’ll get out of it. Surgical wards can get extremely busy, and no one (except you) will have the time to make sure you’re getting the right experiences and opportunities. If you take initiative and ownership, I can (almost) guarantee that you’ll come away more confident for FY (and you might even enjoy your placement along the way). 

Written by Aurora Sonkin, Final Year Medical Student