A day in theatre with two students
A day of orthopaedic shoulder surgery with Vasileios Mylonas and Raymond Zhuang, medical students from James Cook University.
What the day covered
The day took in pre-operative planning, the surgical techniques themselves, and the role of post-operative rehabilitation. The cases included arthroscopic rotator cuff repair, reverse shoulder replacement and arthroscopic plate removal.
Seeing the planning and the rehabilitation alongside the operation is the useful part. Students generally arrive expecting the operation to be the whole story, and the sequence of planning, surgery and recovery is a better picture of what determines the result.
With thanks to the theatre team. Mentoring the next generation of surgeons is worth the time it takes.
The operations they saw
Arthroscopic rotator cuff repair reattaches a torn cuff tendon to the bone of the upper arm, using anchors placed in the bone and sutures passed through the tendon, all through small portals with a camera. Reverse shoulder replacement swaps the normal arrangement of the joint: the ball is fixed to the shoulder blade and the socket to the upper arm, so that the deltoid muscle can raise the arm when the rotator cuff is no longer able to. Arthroscopic plate removal takes out metalwork used earlier to hold a fracture, once the bone has healed and the plate is causing trouble. Individual results vary.
How a theatre placement works
Medical students spend much of their degree in clinics and on wards, and a day in an operating theatre is arranged separately. The value is not mainly in watching the technical steps, most of which a student cannot yet follow in detail. It is in seeing how a list is run: how a decision made in clinic turns into a plan, how the theatre team works together, how anatomy that was learned from a textbook actually appears, and what the surgeon is weighing up when something does not look as expected. Students at this stage are also deciding what sort of doctor they want to be, and that decision is usually made by being in the room rather than by reading about it.