...What it takes to get into a General Surgery Residency . . . . By Shirin Towfigh, MD -----------------------------------------------------------------------------------------------------------A word to the wise: Only those who cannot envision doing anything else with their lives should choose surgery. If you can find happiness in any other career, then do not choose surgery. A few statements I stand by (let’s get rid of some myths): 1. It is never too late to choose surgery as a career. Many do not choose until the end of their third year. 2. Though most students who know they are interested in surgery do it as their last rotation in Year III, whether you do surgery first or last has historically had no effect on your grade or outcome. 3. If you are savvy in your rank list, you will likely match in a program. Most don’t match because they did not rank enough programs (or the right programs). Be honest about your prospects and have a mentor. 4. The majority of general surgery programs are very good. You will graduate being a good surgeon and you will get a good fellowship or a job. Now, the facts (from NRMP book, found lying around in the KSOM Student Affairs Office): In 2004: - 1,042 of 1,044 general surgery spots were filled. The remaining 2 spots filled the day after the MATCH. - Of U.S. grads, 885 matched out of 1,230 applicants (72%), the rest were foreign grads. Note that the national average for all specialties is a 93% match rate. - The average student ranked 12.4 programs...
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...Dontavia Zeno English 1157-002 Past the Scalpel Nora Steiger 05/01/2014 Dr. Joshua Landes is a board certified general surgeon, who received his premedical and medical education at Brown University. He completed his residency at Tulane University School of Medicine, and is a member of the American College of Surgeons. He now works as one of two general surgeons for the Hamilton Medical Group in Lafayette, Louisiana; which is where our first interview took place. I remember sitting in his office waiting for him to come in, and staring at a coat rack located in the corner. It held only two white lap coats, which looked as if they hadn’t been worn for some time; there were no rumples or creases out of place, and as crisp and wrinkle–free as they were, you could assume they came straight from the dry cleaners. It also held a green scrub cap that was obviously worn quite often, which actually looked slightly yellow due to it being washed so many times. Directly across from the coat rack stood a bookshelf filled with books that all contained the word “surgery” in its titles. The books were triple the size of a holy bible, and weighed so much that the shelves bent downward, like a meniscus in a graduated cylinder. When he walked in I noticed he wasn’t wearing a white lab coat, so I asked him about it. “I don’t need a lab coat to remind me that I’m a physician,” he said as he smiled and took a seat behind his desk. That’s when I realized my hypothesis of who I thought...
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...Many people with HMO will have a surgery at some point in their lives. This will cause them to have a surgical scar which some people might have a hard time accepting. In Steven Petrow’s article “Learning to Accept (if Not Love) My Scar” he talks about learning to accept his scar. Petrow got his scar after having surgery to remove cancerous lymph nodes from his abdomen. The surgery resulted in a scar along his abdomen. When he first got the scar, he had a hard time looking at it and struggled to take his shirt off infront of others and himself. Eventually Petrow’s scar became a reminder of his survival. It was slow for him to accept his scar but it eventually became a “talisman of sorts, a visual and lasting connection to my own history” (4)....
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...innovations in medicine today is fetal surgery. Fetal surgery is an exciting, accurate, and sharp new technology and in particular the surgery they use to help myelomeningocele. It is more advanced than other surgeries and takes more time. It also uses an extensive amount of doctors. Fetal surgery for myelomeningocele (MMC) needs more specialists and surgeons in the OR compared to other surgeries. Spina Bifida Spina bifida is the most common neural tube defect (NTD) today. According to the March of Dimes, “About 1,500 to 2,000 babies are born with spina bifida each year in the United States.” (What is SB, 5). A defect forms in the spine before birth and causes a hole to be left open in the spine. Spina bifida is broken...
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...Robotic Surgery Technology, Society, and Culture HUMN432 Introduction: Robotic Surgery Robotic surgery is the latest development that uses robots and computer aided apparatus to aid in normal surgical procedures. It is a new technology and mostly used in well-developed countries. With robotic surgery a single surgeon is able not only to perform multiple surgeries but also do his/her work from any part of the world (McConnell, Schneeberger & Michler, 2003). Robotic surgery is a type of procedure that is similar to laparoscopic surgery. It also can be performed through smaller surgical cuts than traditional open surgery. There are small precise movements that are possible with this type of surgery. It gives some advantages over standard endoscopic techniques. Sometimes robotic-assisted laparoscopy can allow a surgeon to perform a less-invasive procedure that was once only possible with more invasive open surgery. Once it is placed in the abdomen, a robotic arm is easier for the surgeon to use than the instruments in endoscopic surgery. The robot reduces the surgeon’s movements. The robot assistance reduces some of the hand tremors and movements that might otherwise make the surgery less precise. Robotic instruments can access hard-to-reach areas of your body more easily through smaller incisions compared to traditional open and laparoscopic surgery. This procedure is done under general anesthesia where you are asleep and pain free. The surgeon sits at a computer...
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...------------------------------------------------- Robot Assisted Surgery: The Evolution of the Surgeon and the Operating Room Abstract The art of surgery has evolved significantly from the times of shaman priests in ancient Egypt and bloodletting barbers of Medieval Europe. This evolution was assisted by the development of new tools that were created as the result of some advancement in technology. These new instruments permitted the surgeons of their day to unlock new possibilities and develop new techniques, each more sophisticated than the one before. Due to the sensitive nature of surgery, moral and ethical obligations were established early on and eventually formed the basis of “The Hippocratic Oath”, which is still relevant to the modern surgeon. We are now in a place in history where robots are being used to assist with surgical procedures that were once only conceivably done by human hands. This paper seeks to detail this evolution as well as describe current and future applications of robotics in the surgery and the ethical implications inherit with this technology. This report will also attempt to identify and discuss the complex legal, political, and cultural issues that have also evolved with this science. A review of the literature was undertaken using Medline. Articles describing the history and development of surgical robots were identified as were articles reporting data on applications. This most recent development in surgical advancement has infinite potential...
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...ranging from the history and development of robots that can be found in surgical rooms, political concerns regarding the Food and Drug Administration and their requirements to approve use of these robots, the legal aspect of robotic technology on how to determine which party is held liable in case of accidents or malfunctions that can lead to injury and a legal case that shows the difficulty to prove fault against a manufacturer. Also discussed will be the economic ramifications on our society, psychological, sociological, cultural, moral and ethical impacts on human life, in particular the patients that undergo surgery involving a robotic surgical system, and the environmental impacts of robotics in surgery. It is our hope that through this research paper that we are able to explain to and educate our readers on the impacts of Robotic Surgery as this type of surgery is becoming more popular with doctors in order to...
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...greater Columbus, Ohio. Twin Oaks is the 2nd largest hospital in Ohio. We are also ranked in the top 5% of the hospitals in the United States according to the U.S. Health Grades website. Twin Oaks has a level one trauma center that has 852 beds in all, to accommodate the patients that need our services. Being a level one trauma center we receive all of the more extensive cases and life threatening illnesses that our fellow hospitals can not accommodate. We have 6 beds set up in the emergency room to be able to perform emergency surgery at the bedside. This helps us give the patient who may not have the time to be prepped for surgery get the care they need immediately. In order to be considered a level one trauma center, we have to have 24-hour in-house coverage by general surgeons, and prompt availability of care in specialties such as orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, radiology, internal medicine, plastic surgery, oral and maxillofacial, pediatric and critical care. At the medical center, we have also incorporated a comprehensive quality assessment program in order evaluate and improve patient care and wait times when they arrive at the emergency room. (http://www.amtrauma.org/?page=TraumaLevels) Twin oaks offers a full range of diagnostic, medical and surgical specialties in areas such as emergency medicine and trauma, heart and vascular, oncology, orthopedics, neurology, and women’s and children’s services. We are committed to...
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...this type of surgery, your Glendora General Surgeon will thoroughly explain the two types of surgery, Vasovasostomy and Vasoepididymostomy, generally performed to restore your ability to have children. Restoring your fertility often depends on how long it has been since the vasectomy was performed. Statistical data indicates that the highest rate for successful reversal is within the first three years since the vasectomy. Fertility is possible after this initial time-frame, but the chance decline with each additional year after the vasectomy. It is important to note that your ability to have children will also depend on the age and fertility ability of your partner. SURGERY OVERVIEW The procedure is performed as an out-patient operation in a clinic or hospital, and you will be able to go home the same day. The type of procedure to be performed will be determined at the time of the surgery. This is because the surgeon will not know the condition of your vas deferens, the sperm carrying tubes, until he is able to view the surgery...
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...Treatment of bosom malignancy Four sorts of standard treatment are utilized: 1. Surgery Most patients with bosom malignancy have surgery to expel the growth from the bosom. The fundamental objective of surgical treatment is to evacuate the growth and precisely characterize the phase of infection. Surgical choices extensively comprise of bosom protection treatment taken after by radiation treatment. Bosom rationing surgery, an operation to evacuate the growth however not the bosom itself, incorporates the accompanying: (a) Lumpectomy: Surgery to expel a tumor (irregularity) and a little measure of typical tissue around it. (b) Partial mastectomy: Surgery to expel the piece of the bosom that has growth and some typical tissue...
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...The career of my choice is an anesthesiologist. I have always found a great interest in the medical field and specifically in anesthesiology. Anesthesiology is the part of medicine that focuses on anesthesia and anesthetics. Without it, surgery would be painful and unbearable. An anesthesiologist is a physician who administers anesthetics before,during, or after a medical procedure. There job is develop a plan for their patient and to be there during and after their surgery. They make sure that their patient is comfortable for surgery by general anesthesia or regional anesthesia. General anesthesia is when the patient is heavily sedated to the point where they are unaware, while regional anesthesia is numbing the part of the...
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...nursing practice. How we practice as nurses is often dictated by new policy and guidelines which are brought about by the evolving healthcare system. For an issue to be contemporary it has to be occurring in the present and in the sense of nursing it would seem that many issues could be deemed as contemporary due to the ever fluctuating nature of our healthcare service. For the purpose of this assignment I am going to address the issue of pre-operative fasting and the tradition of fasting patients from midnight until surgery the following day. Evidence suggests that this practice is outdated and unnecessary but still the practice occurs on many surgical wards. I aim to explore the reasons why patients are still subjected to unnecessarily long fasting times and how we as nurses can change this outdated practice. I have chosen to look at this area of contemporary nursing because as a student nurse I have had practice experience in both a surgical ward and general theatre. I feel that having had experience in both of these settings I would be able to link theory to practice experience. Fasting patients from midnight before day of has long been a time honoured tradition. The main reason for the nil by mouth rule from midnight has been to ensure an empty stomach at time of anaesthesia. If the patient is not fasted, gastric contents could be inhaled by the patient while they are under anaesthetic. Because the contents of the stomach are acidic it is important that regurgitation...
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...Robotic Surgery Review Related Literature Twenty-five years have passed since the first successful minimally invasive surgical procedure and laparoscopic general surgery has grown exponentially with particular regard to certain pathologies and now, besides cholecystectomy , it is considered to be the gold standard for surgery of the oesophagogastric junction, adrenal glands, distal pancreas, and spleen. The expanding role of laparoscopic surgery is closely associated with technological advances, including the advent of flexible fibreoptic instruments and improved laparoscopic haemostatic devices such as clips, endoscopic staplers, and energy-induced forceps (electrical based and ultrasonic based). The most recent innovation in this field has been robotic-assisted technology. Multiple large study series have clearly demonstrated superior outcomes with laparoscopic versus conventional open surgery; the benefits of laparoscopy include decreased postoperative pain, morbidity, and length of hospital stay (LOS), improved cosmesis, and overall cost-effectiveness. Nevertheless, the operative complexity that can be achieved with this kind of minimally invasive surgery has slowed the broad adoption of laparoscopy especially in the most challenging hepatobiliary surgery due to the complex vascular and biliary anatomy of the liver, propensity for bleeding, parenchymal friability, and extremely difficult surgical exposure. Considering the limitations of the laparoscopic technique, it is...
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...consisted of a hernia repair, a colonoscopy, and a hemorroidectomy. The role of the surgeon was to come in and perform the surgery. The anesthesiologist induced anesthesia, and monitored the patients heart and respirations and other vitals during the surgery. They also bring the patient out of anesthesia and extubate them. The circulating nurse job was to monitor during surgery and make sure the patient is safe, and to call the patients family during and after the surgery. The circulating nurse also goes to the pre-op holding area and assesses the patient prior to surgery and brings them into the OR. The surgical technicians job is to assist the surgeon during the procedure and hand him the required tools needed. They also count before and after the surgery to make sure all tools are present and accounted for. The PACU nurse role was to monitor the patient’s vitals and pain after surgery and to administer any medications. They also monitor the patient’s arousal after surgery and the surgical site for any possible complications. The first surgery I saw was a hernia repair. The surgeon made a 6-8 inch incision in the abdomen and repaired a recurrent hernia in the small intestine. He then put in a mesh to keep everything in place. General anesthesia was used for this procedure and the patient was intubated and tolerated/woke up well. Betadine skin prep was used and general draping techniques were used. In PACU the nurse observed the patients level of consciousness and pain level. She also...
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...Perhaps you have heard about minimally invasive spine surgery as an alternative to open spine surgery before, but weren't quite sure what it is or what it entails. True, minimally invasive surgery is an alternative to open surgery, and is becoming more and more prevalent. However, the sudden surge of this type of surgery is not because it is a type of surgery recently discovered and suddenly utilized. In fact, minimally invasive spine surgeries have been performed for decades now, and the practice is well beyond anything that could be considered exploratory or experimental. If you've thought seriously about minimally invasive surgery, you probably want to learn as much about it as possible, and the following seeks to do just that for you. A Few Minor Distinctions Open spine surgery and minimally invasive spine surgery differ in many ways, some of which are discussed in greater detail below. In a general sense, minimally invasive surgeries can be completed on an outpatient basis, meaning that no overnight hospital stay is required; open surgeries typically require at least one night's stay in a hospital or medical center. Furthermore, open spine surgeries tend to require general anesthesia to completely sedate patients throughout the course of the operation; minimally invasive spine surgeries typically use only local anesthesia...
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