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Rediscovering My Home in DC at the Academic Surgical Congress

It took me two hours to find my DC Metro card. I had gone out of my way to get a special edition cherry blossom one during my gap years there, and I definitely still had money on it. I was excited to go back to a place that feels like a home and walk around with familiarity; the hotel where the conference was held was literally two blocks away from where I used to live.

What I didn’t expect, however, was a flood of memories about my journey to medical school. Now that I was here as a visitor to present at a medical conference, I was passing through my old neighborhood as a medical student. The last time I had walked those streets was when I packed everything into my car and drove to Michigan to start this new adventure.

Here I was, living out my dream and more. It was so refreshing to remember the effort and passion that I poured into getting to this moment, especially in the midst of clinical rotations. Not only was I working towards the career of my dreams, I was also discovering new passions I never knew I had. The DC version of me would never have guessed that I would be interested in surgery and be presenting at a surgical conference.

Then I walked into the conference. I was immediately greeted by hundreds of people, all who looked like they just arrived at their old stomping grounds. People were greeting old friends they haven’t seen in a while, chatting excitedly about not only their research but a whole host of new developments in the medical forefront. I was fascinated by this microcosm but also suddenly intimidated. While I knew that this would be a new learning experience for me, I did not fully comprehend how daunting the barrier of entry would feel until then. With my surgery rotation under my belt, I was hoping to come in feeling at least a bit more prepared.

In the face of my growing imposter syndrome, I was lucky enough to run into some familiar faces. The University of Michigan never disappoints with its representation – I was able to catch up with some M3s who I hadn’t seen since they disappeared for STEP studying and I disappeared into clerkships, chat with a few surgery residents who were excellent education fellows and update them on my growing interest in surgery, and feel supported by faculty, both familiar and new. It was such a relief to feel like I had a community, and it felt especially warm because my community was all in DC.

The conference itself was a fantastic flurry of excitement. I was able to see developments that other medical schools and students were making in surgical research, support some of my friends in their incredible presentations, and spend some time chatting with the DaVinci robot rep to better understand the mechanics and try my hand at it myself. It was wonderful to reaffirm that I loved medicine and that I also loved to work with my hands. Even though my presentation was on the last day, my friends still showed up to cheer me on. I had an incredible time learning about surgery, honing my presentation skills, meeting new people, and growing into my UM community and the overall surgical field.

In hindsight, I realized by chatting with U-M people that I had been living right next to a “University of Michigan” bar in DC during my time here. I remember looking out my window and seeing random gaggles of people wearing Michigan gear and feeling a sense of pride and excitement after I found out I got into the medical school here. It turns out that my U-M community had been in DC all along – I just needed to find myself in it.

Michigan’s Surgery Olympics: More Than Just a Game

The Olympic Games are considered some of the most anticipated sporting events in the world, rotating between winter and summer sports every four years in some of the most culturally rich locations. Arguably just as exciting, Surgery Olympics is an academically stimulating event that occurs yearly in one of the best cities, Ann Arbor, Michigan.

In my experience, Surgery Olympics has introduced me to the concept of developing and executing original research projects and has connected me with dedicated mentors, all while having fun with classmates along the way. It has been such an important milestone in my medical school experience and is a program that both students and faculty look forward to every year.

An important concept of academic research and medicine is lifelong learning. There are always new knowledge and methods to be learned with the common goal of improving outcomes for patients. That’s one of the great things about Surgery Olympics: whether a student is starting at square one or has already learned how to construct and publish a vast portfolio of research, this program offers something for everyone.

Surgery Olympics offers incredible opportunities for hands-on experience

Coming into medical school, I had some research experience in a surgical laboratory, but I wanted to learn more about the process of academic writing and how someone can take a novel idea and turn this into work that the community views as valuable. The best place for me to learn this was through Surgery Olympics.

What is Surgery Olympics?
It’s a longitudinal program put on by SCRUBS, which is an interest group that aims to provide mentorship for medical students who are interested in surgery. This initiative is supported by the Department of Surgery and provides students with networking and mentorship with faculty, research and technical skill development, opportunities to bond with fellow classmates and much more.

Does one have to declare that they want to go into Surgery before they can participate in Surgery Olympics?
No! The program typically occurs in the spring/summer of the scientific trunk (M1 year). For many medical students that stage is still too early to know what specialty one might apply into, with lots of soul searching and discovery ahead on the horizon.

This coveted trophy is sought after by Surgical Olympians from the med student to attending level each year.

This is a longitudinal program that lasts the entire summer and is intentionally offered to students after their first year. Students are divided in groups of three to four along with an M4 coach and an attending of a specific subspecialty who serve as mentors. In the past, there has been representation from General Surgery, Minimally Invasive Surgery, Pediatric Surgery, Vascular, Thoracic, Colorectal, Surgical Oncology, Plastics, Hepatobiliary and Advanced GI, Endocrine, Transplant, Urology and many more.

Students typically meet every two weeks over a 14-week period to keep on track with their project. At the very end of the program, students have an opportunity to present their work at the Department of Surgery Grand Rounds. In keeping with the name, there is also a final competition that serves as an opportunity for students to show off the knot tying, suturing and other technical skills they have learned. The winning team gets to take home the prized trophy along with its associated bragging rights.

Other than the fun and games listed above, there are presentations and talks throughout the program delivered by faculty or residents, which I personally found very helpful. Talks could be clinically based or even discuss health and wellness during residency. I also appreciated that the timeline afforded me opportunities to regularly check in with my teammates and mentors. It kept me grounded, focused and excited to keep pushing our project forward.

Michigan medical students learning technical skills that will help them prepare for the annual competition.

I felt compelled to share my reflections on Surgery Olympics because it has been one of the most helpful experiences in my medical school journey. I was placed on the Urology team as an M1, and now I will be applying into that very field. I was extremely fortunate enough to be connected with my mentor, Dr. Kate Kraft, through Surgery Olympics. She has been a constant source of guidance and support throughout my four years at Michigan. It would be hard to imagine my medical school experience without our regular check-in meetings and being able to share my highs and lows with her.

One of the incredible things about the faculty participation is just how excited they are to welcome students onto their research teams and to teach them more about their respective field. It’s important to note that faculty at Michigan Medicine view mentorship as a two-way street, and they gain just as much from mentoring students.

“Surgery Olympics provides a chance for surgical faculty to introduce students to their specialty early in medical school, creating an enriching mentorship opportunity. We’ve been extremely fortunate to have a number of Surgery Olympics students pursue urology as a career – and urology is much better for having them in the field!” – Dr. Kate Kraft

In fact, I think the commitment to mentorship that faculty at Michigan Medicine demonstrate is something that sets this institution apart from all the rest. No matter what field your interests lead you toward, Michigan Medicine is composed of so many powerhouse leaders who want to help you discover your path to your future career in medicine. It can be daunting to make such a big decision, but it is one that we all have to make, and the support along the way has been invaluable. For this reason alone, I am so thankful I took part in Surgery Olympics. As I’ve shared above, the faculty at this incredible institution are so passionate; but don’t just take my word for it, read more from them:

“Surgery Olympics is one of my favorite annual events. It’s the first interaction many of our M1 students will ever have with a surgical faculty. This offers a unique opportunity to not only teach a couple of technical skills and work collectively on a research project, but more importantly a chance to debunk some of the circulating myths about surgeons. It’s a chance to share our own ‘origin stories’ and what fuels our passions, in hopes that it would inspire a young student as they begin their own journey. In return, I am constantly awed by the creative solutions my students come up with to sometimes challenging problems and how they push me to higher levels of empathy and social justice. I’m a better surgeon because of the work I get to do with my students!” – Dr. Gifty Kwakye

Dr. Kwakye is our very own clerkship director for the M2 Surgery and Applied Sciences rotation. Her work and dedication to medical student education speaks for itself, and her passion and positive demeanor inspires students to learn more about the incredible field of surgery. I have early memories of my surgery rotation where I was initially nervous about learning in the OR environment; however, after routinely bumping into Dr. Kwakye in the pre-op area and exchanging a friendly wave or a brief conversation about our days, I felt ready to take on the day’s cases.

In reflecting on my Surgery Olympics experience, I interviewed the Department Chair of Surgery, Dr. Justin Dimick. I asked him what he thinks the importance of this program has on a student’s education and trajectory:

“Academic surgery is about using the scientific process to improve our profession. At Michigan, we strive to pursue a diverse portfolio of scientific discovery, including basic science, education, clinical trials, health systems, organizational culture, and more. The SCRUBS program is intentionally designed to involve medical students in conducting research in one of these areas. For students, this will allow them to start to envision their own career trajectory in academic surgery, where they craft a path to being excellent clinicians and also begin to think about how they might pursue scientific discovery to improve the field of surgery in some way.” – Dr. Justin Dimick

These events also help students hone skills that will prepare them for their surgery, OBGYN, EM and other rotations.

I believe this answer reiterates to just how committed the faculty are in improving the outcomes of medical students as they discover their own path to becoming the best physician they can be.

How can one learn more about SCRUBS?
If you are interested in learning more about SCRUBS and the other opportunities offered by the program, please consider following SCRUBS on Twitter, visiting the homepage or contacting the leadership team by email.

Current SCRUBS Leadership:
Class of 2023: Cameron Harter, Aurelie Tran, Davis Argersinger, Lauren Hoff
Class of 2024: Ally Grossman, Tianyi Wang
Class of 2025: Kailyn Koh, Emily Roney
SCRUBS Directors: Dr. Paige Meyers, Dr. Seth Waits

Connect with faculty on Twitter: Dr. Kate Kraft, Dr. Gifty Kwakye and Dr. Justin Dimick.

Starting to Think Like a Surgeon

Learning how to be a doctor is a lot like learning how to bake. You read the book, learn the steps, try it out, and then you end up with cookies. But the best bakers (aka my grandma) will tell you that the real learning comes when the cookbook is taken away. It forces you to think about the individual ingredients and steps in a new way. And you start to appreciate how each individual step can make an impact on the final product. It can be frustrating, but once you grasp this new way of thinking you can make more than just cookies. 

In medical school we spend our first year learning the basics: anatomy, physiology, pathophysiology, and numerous treatments for countless diseases. We also learn to apply this knowledge to clinical vignettes through our doctoring and chief-concern courses with the help of faculty members. All of this learning and practice is in preparation for the clinical clerkships when our book is taken away and replaced with a pair of scrubs.

Once we took our first steps into the clerkship year, we quickly learned that patients almost never present exactly how the book teaches us. This is especially true in surgery. While we were primed to recognize standard surgical pathology during our M1 year, decision-making in surgery remained a mystery to us. We have learned how to diagnose a patient with acute cholecystitis, but how can we determine if he is a safe and appropriate surgical candidate?

We thought it would have been helpful to begin learning these critical thinking skills earlier in our medical training. This is how the idea of ‘Think Like a Surgeon’ came to be. Our goal is to provide students with early exposure to surgery and give them tools for success when they are on their surgery clerkships. We wanted to create an interactive learning experience to help students build a mental framework for surgical decision making. 

At Michigan Medical School you do not have to go further than an email to get connected with leadership to start making your idea a reality. We were connected to Maia Anderson, a PGY-4 Surgery Resident, who not only wanted to make our idea happen, but supported it with her time and knowledge to help improve it. We created the sessions together with Maia and Ryan Eton, another PGY-4 Surgery Resident, who selflessly offered their time to moderate the sessions. They also made sure we, Allyse and Quintin, ran the majority of the session while they provided the group with higher level knowledge as the session progressed. 

We hold monthly sessions that are split into two groups: Pre-Clinical (M1) and Clinical (M2/3/4/MSTP) students. We split the sessions into pre-clinical and clinical because trainees are at different parts of the curriculum and therefore have different needs. Pre-clinical trainees take a deeper dive into the pathophysiology, while Clinical trainees go deeper into the decision-making and treatment process. In each session we include relevant anatomy, physiology, and imaging. 

‘Think Like a Surgeon’ offers an informal, educational environment to interact and gain exposure to the field of surgery through discussion between surgery residents and interested medical students. We hope for trainees to feel inspired to consider surgery early on and, even if students are not planning for a career in surgery, we hope for them to gain useful skills and knowledge they can apply to their interests. For future sessions, we are looking for student volunteers who can design and lead the sessions with the support of our residents. Our first few sessions have received positive feedback from students and we look forward to many more! 

 

 

Finding Mentorship Through Surgery Olympics

One of the best parts about being a fourth year medical student, in my opinion, is being able to pay forward all of the help I got from older students when I was an M1/2/3. This can be done both formally – in the role of a leader of a student org, or informally – over coffee (I’ve heard this. I don’t drink coffee), or simply over email/phone/text.

Alongside fellow fourth year students Kristen Kolberg and Jesse Kelley (and M2 Yoonhee and M3s Caleb and Jessica), I help run SCRUBS – the surgery interest group. Our primary goal is to get students excited about the possibility of a career in a surgical field by providing opportunities to interact with surgical faculty and residents in both professional and social settings. One way we are doing so is through Surgery Olympics, which Kristen wrote an awesome post about a few months back. Briefly, Surgery Olympics is a totally voluntary program that connects teams of three to four M1 students with an M4 coach and a surgical faculty member to learn surgical skills and complete a research project.

We were blown away by the amount of student interest in Surgery Olympics this year, with 84 M1 students (about 1/2 the class!) applying for the program. To put this in perspective, when I participated in Surgery Olympics as an M1, there were about 30 participants. To achieve teams of only four students, this meant we would need to recruit 21 faculty members. Within days, we had recruited all 21 faculty from a wide variety of surgical sub-specialties (trauma, colorectal, transplant, thoracic, endocrine, cardiac, surgical oncology, minimally-invasive, ENT, urology, and plastics). The fact that we were able to do so speaks volumes to the level of commitment from surgical faculty to medical student education and mentorship here at Michigan. We also could not run this program without 21 M4 students who agreed to coach a team, and a number of surgical residents who have volunteered their time to help teach surgical skills throughout the summer. Mentorship from all levels is truly accessible at UMMS.

Two teams go head-to-head in a suturing relay at the Surgery Olympics Championship. Dr. David Hughes (one of the SCRUBS faculty mentors) officiates the race.

After running skills training sessions all summer, we just wrapped up the skills competition portion of Surgery Olympics. Teams competed in knot-tying, suturing, and laparoscopic surgery skills. Dr. Reddy’s (thoracic) team won, followed by Dr. Kwakye’s (colorectal) and Dr. Kraft’s (urology). The points that each team earned will carry forward to the research competition, which will take place at Surgery Grand Rounds in April.

Some teams have already submitted abstracts to national surgery conferences and are working to prepare manuscripts. Others have taken on larger projects that they will continue as time allows throughout the clinical year. The great thing about getting involved in a research project early on in medical school is that it allows for longitudinal mentorship throughout the curriculum. These mentors are invaluable as you try to figure out what specialty to apply to regardless of whether or not it is surgical.

It has been a ton of fun for me to help teach surgical skills to the (now) M2 students, a number of whom will be starting their core surgical rotations within weeks. I know that the other M4s who have been coming to teach surgical skills all summer have really enjoyed it as well. Throughout medical school, I have reached out a number of times to the M4 coach and faculty member I had when I was an M1 in Surgery Olympics for advice. I still consider them to be mentors and role models. I hope our current Surgery Olympians find similar value in this experience and that this program continues long after I have left UMMS.


Follow SCRUBS on Twitter to see which team takes home this awesome Surgery Olympics trophy (designed and built by Kristen)

Surgery as a Specialty

An impromptu lesson in the finer details of suturing at the end of a case brought back memories of childhood violin lessons in which my violin teacher would explain the finer mechanisms of producing a spiccato. “Relax your wrist,” he would say while demonstrating. I would go home and practice the same bowing technique hundreds to thousands of times, gradually taking incremental steps towards improving the technique until eventually, it became second nature.

In some ways, it was an odd payoff. I would spend months, equating to thousands of minutes, practicing the same musical piece for a single 10-minute performance at a recital. Yet, there was immense satisfaction at the end. I imagine surgery is much the same. Surgeons too take time to develop, which might explain why there is a sense of order and hierarchy innate to surgery. Experience and effort matters. I find the order and structure calming.

Someone asked me recently whether it was tough making it through a Whipple procedure, a notoriously long surgical procedure used to treat pancreatic cancer. I was somewhat caught off-guard by the question as I had never really considered the issue. The act of actively participating in the case made time pass faster than the clock on the wall would suggest. The field of surgery is not for everyone, but for those who do love it, it has an irresistible draw.

Relaxing after shelf exam at Tomukun Korean BBQ

The third year of medical school is a truly unique experience in which students get to sample a variety of medical specialties. While on service, I often like to ask residents and attendings why they have chosen a certain specialty. It can be incredibly informative. I asked my resident how he knew surgery was the right choice, expecting to hear that he had known from the very start that he wanted to be a surgeon. I was surprised by his answer.

His journey into medicine began innocuously enough, he explained. He had studied economics in college and while completing a summer internship discovered that it was not for him. Coincidentally, his roommates who were both pre-meds recommended shadowing a surgeon. On a whim, he decided to check it out. Even 10 years later, he vividly recalled his first encounter with Dr. X. While he had no idea what the surgery was about, he loved how simple the explanation for the heart worked. I listened enthralled as he described the technical intricacies of fixing a child’s aortic valve. As he talked passionately about how this experience led him to think that at age 40, he wanted to be like Dr. X, and I couldn’t help but to think that in 5 years I wanted to be like him.

Surgery is a paradox in some ways. Despite requiring more years of training and working longer hours than most specialties, I’ve yet to have seen people more passionate about the work they do. If you ask a surgeon about why they chose surgery, they will tell you that there was no other option for them – that nothing else would satisfy them. Perhaps this makes sense. It requires intense study and practice!