Clinical Year: Surgery Rotation as a PA Student

Surgery was by far my favorite rotation in PA school. I'd already gotten a taste of the OR during my OB/GYN rotation, where I learned I could handle blood and invasive procedures without passing out, so I walked in excited and ready.

My preceptor was a general surgeon who specializes in breast cancer, and he's just a great person. He was kind to his staff, spent real time with his patients, and was excellent at what he does. He even helped me land the job I have now. Having a preceptor like that is a huge part of why I loved the rotation so much. It really shapes the experience when the person teaching you genuinely cares.

Surgery was also one of my busiest rotations. During 12-hour days I'd rarely sit down, maybe 30 minutes total. After the first week my body felt like it wasn't going to make it, and that's where I learned that good shoes and compression socks actually make a difference. Danskos are a solid option, or supportive tennis shoes with good insoles if clogs aren't your style. Compression socks take getting used to, but I still wear them daily.

This rotation is also where I really learned to suture and got a ton of practice, which I'm so thankful for. In the OR we did lots of lumpectomies and mastectomies, plus some gallbladder and lipoma removals and hernia repairs. I got to make incisions, suction, help remove tissue, and suture. The worst day was when the AC broke in one OR and it hit about 80 degrees, with hot tools, gowns, and masks. That was the only time I almost passed out in the OR.

Before this rotation I didn't know much about breast cancer, but my preceptor was great at explaining the types, how hormones play a role, and the surgical options. I became proficient in breast exams and really came to value self-exams. One case sticks with me: a 35-year-old who found a lump on vacation. Mammograms generally aren't recommended or covered until age 40, so she'd never had one. [VERIFY] We did an ultrasound, then a fine needle aspiration, and both showed worrying signs.

My preceptor told me he can often tell by feel during a biopsy whether tissue is cancerous, and I can confirm that's true from working in derm, where a basal cell or squamous cell carcinoma feels friable and almost falls apart. Watching a patient receive that kind of news is hard, and everyone reacts differently. Surgery is interesting because you have to be ready for complications and able to think through problems. I loved it, but it's not for everyone.

Surgery might just become your favorite rotation too, especially if you love working with your hands and thinking on your feet. Take care of your body, find a preceptor who teaches, and get all the suturing practice you can. If you want help navigating clinical year, we're here for it. This is part of our Clinical Year series, so check out the OB/GYN and pediatrics rotations too.