Community Surgery is a relatively new rotation at Davis. The idea behind the rotation is to give students the chance to practice their surgical skills so as to enter the job market with more than just 3 surgeries under their belt. The focus is on spay & neuter, but you will probably have 1-2 other surgeries for each 2-week rotation.
GOURLEY vs. CCAH: On this rotation, the majority of students spend their time in Gourley, while 2 students per week do their surgeries in the CCAH building alongside Community Medicine. The difference is that in the CCAH you are almost always doing spay & neuter only, but doing it every day, with Fridays being cat neuter days with the other students in Gourley. Your patients go home the same day as surgery, so you don’t have to come back in the evenings to care for your patients.
# of Students: 6-7
# of Residents: 0
# of Faculty: 1-3 (usually only 1-2 faculty on non-surgery days)
And some fantastic techs to help you with just about anything & everything!
Hours: Varies from day to day.
Intake days: Mondays and Wednesdays. Usually arrive by 8-8:30. Leave once all animals are taken care of (usually by 4 or 5m). Must return in evening (between 8 and 10pm) to walk, clean and remove food from kennels prior to surgery. Usually groups will divide these responsibilities so not everyone has to make the trip in on both days.
Surgery days: Tuesday, Thursdays and cat neuters on Fridays. On surgery days, you need to be in by 7:30am to walk your patients, give pre-meds and make sure everything is set up for surgery to start. You stay until all surgeries and subsequent rounds are completed. All students must return in the evening to check on their patients, give pain medications, feed, etc. Fridays are early days – once everyone is done with their cat neuters and rounds are completed, you are free to go (usually between 11am and 1pm.
Rounds: Rounds are typically on surgery days, following the completion of all surgeries. Typically students will present their cases and go over the surgeries, what they learned, etc. Instructors may also cover additional topics pertaining to surgery or they share practical information regarding job searches, interviews, contract negotiation, benefits, etc.
Caseload: Expect to do either a spay and a neuter OR a non-sterilization procedure on each surgery day, with Fridays being for a single cat neuter per student.
Your Role:
Intake days: More often than not you receive a patient from a shelter or rescue, so history is limited, but you may get some paperwork regarding vaccinations & deworming that has been done. You are to perform a physical examination with assistance from your classmates if needed. Bloodwork is performed and analyzed and you formulate your anesthetic plan. You present the case to the instructor and they examine the animal as well. Later in the afternoon, an anesthesiologist comes by and you present your case to them like you would on the Anesthesia service and go over your plan. They may make some suggestions or changes and you are set! You must set up your animal in the kennels, walk them 2-3 times per day, clean up after them, feed them, etc. You must also get your anesthesia equipment set up and ready for the morning and get your non-controlled drugs drawn up too.
Surgery days: Walk & clean up for your patients. Administer pre-anesthetic medications. Induce and prepare patients according to the schedule with the assistance of an RVT (some RVTs make you do virtually everything and will only take over when you have to scrub in, while others will put on a Doppler while you are clippling the surgical area, etc). Perform surgery (doctors will be floating between the 4 surgery tables to assist). Recover your patient from surgery. Repeat for your second patient, if applicable.
On Call: No on call shifts for this service but you may be on-call for other services in the hospital.
Records: You are responsible for history, physical exam, daily SOAPs, discharge instructions and summaries, and preparing vaccination records.
Weekends: Your weekends are yours (unless you are on call elsewhere in the hospital)!
Pros:
- Chances are you haven’t done surgery in a while, so it will be great to get your hands “dirty” again. You are held to some of Davis’s standards for how to perform surgeries, but you are allowed some freedom, such as using a spay hook and not retroflexing the bladder.
- It’s a more relaxed atmosphere than the rest of the hospital.
- You get to perform surgeries than you haven’t yet performed! I did a mass removal, gastropexy, limb amputation and tail amputation and loved researching & learning the new skills!
Cons:
- Less freedom to perform surgeries the way you want. At that point I had performed tons of cat spays and the doctors prohibited self-ties for cat spays, despite the fact that shelters throughout the country are using them as an efficient and effective way to spay.
- Some of the doctors play favorites and are buddy-buddy with some students and not with others, making for an awkward, high-school like feel at times.
- Too few surgeries per day. Understandably some students are able to perform more surgeries than others, but having someone perform a single spay & neuter and wait around for the rest of the day is not the most effective use of time for students. Even if they spend all their down time in the surgery suite watching other surgeries, it would be nice if they could increase the capacity of the service to include more surgeries.
Highlights:
- Performing a pelvic limb amputation by myself on a kitty with a deformed limb. It was an incredible review for anatomy and a fantastic result seeing the kitty so much more mobile and less painful post-op!
- The first gastropexy I performed with a classmate and went great but was not an easy surgery on a 150 lb Great Dane. It was a great learning experience nonetheless!
- Taking home the sweet kitten that I spayed but was intended to be released by the shelter into a feral colony AND adopting her out to a loving home!