Surgery (256-551-4570)
Overview
 Director: Dr. Rony Najjar
 Attendings: Drs. Najjar, Katyal, Moran, Smith, Walker (all trauma attendings), your general surgery preceptor, and your
elective preceptor. Andrea is the nurse practitioner for the trauma docs.
 Coordinator: Cindy Giles (256-551-4570)
 Rotation is split between General Surgery (4 weeks), Trauma (2 weeks), and Elective (2 weeks).
 Electives include Cardiothoracic, Neurosurgery, Ophthalmology, Oral/Maxillofacial, Orthopedics, Pediatrics, Plastics, and
Vascular. Request your choices for your elective at least 4 weeks before your rotation (Cindy will email you).
 Typical day varies greatly among preceptors. You will take call according to your attendings schedule
 Trauma call lasts until 11:00 pm most nights. If you live nearby, you can take call from home.
 Lecture 1-2 mornings per week and lecture/student presentations with Dr. Laughlin every Monday afternoon. Professional
dress (no scrubs) required for Dr. Laughlin’s lectures.
o Every week with Dr. Laughlin (starting the 2nd week) a different student will present a patient they have seen
while on surgery (he asks that you pick a pt with a common surgical issue like pancreatitis, breast cancer, etc).
Schedule/Duties
General Surgery / Elective:
1. You will work one-on-one with these surgeons in their offices and in the OR (HH, W&C, Crestwood).
2. You will attend all surgeries, and assist with most surgeries. This means it’s you, the scrub techs, and the surgeon. Retract,
hold pressure, “drive” the camera during laparoscopy, suture, cut sutures, or anything else that aids during the operation.
3. Weekend call depends on your surgeon.
Trauma Surgery: 2 weeks done at Huntsville Hospital. Priority #1 is any level 1 trauma, priority #2 is any surgery being done by
the trauma docs, and priority #3 is rounding.
1. Trauma call- Cindy explains all the logistics for trauma when the time comes, so don’t worry about the details. Carry the
trauma pager at all times; when you get a page for a level 1 trauma go straight to the ED (the page should tell you which
room). When appropriate, quietly let the trauma surgeon and nurses know who you are and assist the team with whatever
they need; most likely they will want you to observe. You should follow the patient to CT scans, MRI, etc. You’ll also go to
the OR if the patient goes to surgery. You take call three nights while on trauma. You pick when you’re on call, but you
should do at least one weekend night and one night with Dr. Najjar.
2. A high percentage of gunshot and knife wounds come in on Friday or Saturday nights.
Books
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Hints
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Procedures/Anatomy: Surgical Recall-great to look up the surgeries you will be attending. They often ask questions straight
from the book. Also, YouTube and Access Surgery are great references for specific procedures.
Shelf exam: Dr. Pestana’s Surgery Notes, PreTest, First Aid for Surgery
Cindy Gules is very helpful; direct your questions to her, but be considerate and don’t bombard her
You will get an orientation from a nurse about sterile technique and scrubbing in. Whatever you do, please remember what
you learn. There is nothing more embarrassing than having to rescrub in the middle of a case, or worse yet contaminating the
field! (But if you do contaminate yourself or the field, don’t be too embarrassed to say something! It’ll be a whole lot worse
if the patient ends up with an infection).
Be respectful and considerate of nurses, scrubs techs, and any other staff. Introduce yourself to the scrub techs and nurses that
you’ll be working with, offer to get your own gown and gloves out, and make sure to thank them for their guidance and help.
Write your name and “MS-3” on the white dry erase board. Learn to identify the circulator. The OR staff knows how much
the surgeon allows students to participate, so talking with them can help you understand the expectations.
It’s also helpful to learn how to self gown and glove. If you have down time, help the OR staff prep for cases, or clean up
after the case. If you demonstrate that you are willing to help and have a good attitude, they’re more likely to help you.
During the actual surgery it’s all about knowing when to help out. At first just follow your surgeon’s lead. Later when you
are familiar with your surgeon’s style you can anticipate some of his or her moves (i.e. ask the surgeon if they want you to
follow suture when they are doing a running closure).
Don’t hand sharps back to anyone- just lay them down on the field or tray (make sure the team knows that there are “sharps
down on the field”) and let the person pick them up themselves.
Eat and dress quickly. Don’t take it personally if they forget about Dean’s Conference, Grand Rounds, or any of your other
obligations. Remember, their first priority is taking care of patients, so don’t be overly sensitive.
Learn basic instruments and knots early in the rotation, ideally before your first case. You may obtain practice sutures,
needle drivers, and pick ups during orientation.
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Depending on your preceptor and your level of interest, you might get to “close” a few cases and perform simple procedures
like I&Ds. Every surgeon has a different style and approach.
At HH Main ORs, there is a locker medical students can use. In the female locker room it is #10 and the combination is 8-1812. In the male locker room it is #1 and the combination is 8-26-0. If you cannot remember the combinations, there are hooks
inside the locker rooms you can generally hang your coat up on.
Before you attend a surgery, look up the pt and why they are having the scheduled surgery.
1. Dr. Najjar (Trauma): Laid back, great sense of humor, very extraverted. Great teacher and expects a lot from you in
surgery and in lecture. Rounds on and off during the day, so you may be at the hospital a little late.
2. Dr. Smith (Trauma): very laid back and conversational. Hilarious to be around. He will let you do a lot in surgery. He
likes to take his time on rounds and spends a lot of time talking with patients.
3. Dr. Katyal (Trauma): You may not work very closely with him b/c he usually rounds alone. He is quiet during surgery
and won’t let you do much. The plus side is that he’s very fast and if you’re with him your day should be very quick.
4. Dr. Moran (Trauma). Pretty intense and difficult to keep up with (i.e., will run up 8 flights of stairs routinely). Nice, asks
quite a few questions, and generally will let you help. He does 1 lecture; ask him to show you the PowerPoint on the
“different types of surgeon.” Also, make sure you see the patient before the case if you scrub with him.
5. Dr. Walker (Trauma): the newest trauma surgeon, young (has been mistaken for a med student in the OR before!), laid
back and very easy to work with. He is good about letting students do things (put in chest tubes, etc).
6. Dr. Laughlin (Lecturer): He is an older surgeon with a more conservative approach. He has a vast amount of knowledge.
He expects you to know a lot and doesn’t think it is funny when you don’t know the answers. Also you must dress
professionally for his lectures on Monday afternoons (NO SCRUBS!!!)
7. Dr. Suggs: you will take call with him but won’t have to stay overnight. He is in a large practice and call is distributed
appropriately. He does a considerable amount of gastric bypass surgeries. You will know this procedure backwards and
forwards when you are done with the rotation.
8. Dr. Mailapur: Has office building across the street from UAB, and ~50% of his surgeries are bariatric. He likes to teach
laparoscopic technique, and he often operates with Dr. Najjar and other trauma surgeons on advanced laparoscopic
procedures. He is mindful of medical students in the OR, and he stays very busy, so you participate in a lot of surgeries.
9. General surgeons you might be assigned to: ask around with the 4 th years or other 3rd years that have finished the
rotation. Each surgeon has a different style, some let you do a lot and pimp you pretty hard while others might want you
to shadow and not ask a lot of questions.
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