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How to study a surgical procedure

As a final addition to my study advice, I want to share my schema for studying a surgical procedure. This is inspired by my format for studying a medical condition. I imagine this is only useful for those studying to become surgeons. Certainly, in Australia, this detail is not required for non-specialty trainees.

This list can be adapted for any procedural specialty, and I recommend you combine it with my Don’t Look Stupid Study Plan.

1. Definition of procedure
2. Indications
Include if relevant:
1. Accepted indications
2. Experimental indications, and evidence for or against
3. Contraindications
4. Complications
5. Consent
Include if relevant:
1. Specific risks to mention, with incidence
2. Diagrams
3. Questions to ask or explain
4. Relevant post-operative management
5. Minor relevant outcomes eg what the scar will be, that they might be able to feel the mesh etc. (All the things that patients really want to know, but we usually forget to say because they don’t affect us)
6. Equipment
7. Positioning and draping
8. Technique (Complete in step form)
For example:
1. Mark site of lesion to be excised (when patient is awake)
2. Measure 1cm clearance, and mark ellipse of skin for excision
3. etc
9. Structures at risk, and potential catastrophes (include short notes on how to deal with each catastrophe)
10. Common variations
11. Surgeon preferences

Include a list of preferences of your supervising surgeons, and why
This is a vital resource daily when setting up cases
Furthermore, when it comes to deciding how you want to do a case, the list provides a useful resource.

12. Alternative management
Include if relevant:
1. Other surgical procedures (link to summaries)
2. Non-surgical management
13. References
Include if relevant:
1. Recent review articles (hyperlink to PDF’s, last 5 years only)
2. Textbook references used for summary (include page number)
3. Pivotal reference articles (occasionally there are some papers that consultants in the area refer to by name because they vastly change practice. Chase down the references so you can look them up if you need to)

Do you agree? Do you have any tweaks for your procedures?

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