During my surgical rotation, I encountered a case involving a direct inguinal hernia. The patient was a 56-year-old male with a past medical history significant for hypertension, hyperlipidemia, and benign prostatic hyperplasia (BPH). Initially, the resident and I discussed that the next best step in management would be a laparoscopic hernia repair with mesh. However, the attending disagreed. In this case, the more appropriate next step was to first address the patient’s BPH. BPH can cause patients to strain during urination, which increases intra-abdominal pressure. If the hernia were repaired with mesh without addressing this issue, the persistent straining could significantly increase the risk of recurrence.

This case emphasized the importance of considering a patient’s current medical conditions and comorbidities when planning management. While it may seem straightforward to treat the immediate clinical problem, it is equally important to evaluate how underlying conditions may affect surgical outcomes, recovery, and long-term prognosis. This experience reinforced the need to assess whether a patient is an appropriate candidate for surgery and to optimize any contributing conditions prior to proceeding with operative management.

While on my surgery rotation, I had hoped to gain the opportunity to suture or close during procedures. However, I was unable to do so since medical students and residents were given priority for these opportunities. Despite this, I was able to assist in wound closure and observe new suturing techniques, such as the subcuticular suture, and later practiced these techniques independently at home. Although observation was helpful, gaining hands-on experience would have been more educational and beneficial for skill development. Moving forward, I plan to continue practicing my suturing techniques and seek additional opportunities to improve these skills during future rotations, such as in emergency medicine, urgent care, or possibly internal medicine.

Overall, my second rotation in surgery was better than I initially anticipated. Prior to starting the rotation, I had heard many stories about surgical residents and attendings being cold or harsh toward students. However, my clinical experience with the general surgery and orthopedic teams at Woodhull was a very positive learning experience. I was able to scrub into many surgical cases and even gained hands-on exposure with the robotic laparoscopic system. Despite the long shift hours, waking up at 3:00 AM Monday through Friday, and dealing with the unreliable MTA, this rotation helped build my confidence and improved my ability to present patient cases.

The first case I presented was challenging, as I was very nervous and worried about missing important information. However, the surgical team was supportive and willing to teach, which helped ease my anxiety and allowed me to improve over time. By the end of the rotation, I felt much more comfortable presenting cases and discussing management plans. Overall, this rotation was a valuable experience that strengthened both my clinical knowledge and confidence in a surgical setting.