Medical Elective: Final Thoughts on Neurosurgery Elective

The Neurosurgery elective was a thoroughly enjoyable experience. The focus of neurosurgery has never been about ward work, and it is reflected in the highly efficient speed rounds that are performed in the mornings. The patient care would have been impossible without the highly capable nursing staff who write down patient issues on clipboards on the top of the chart trolleys, allowing the neurosurgeons to assess and make changes as soon as possible.

Much of the rest of the day is spent doing one of three things – consults (inclusive of the ER), clinics and OR (Operating Room, OT here mostly means Occupational Therapy). As a medical student, there was not a great deal of expectation placed on me, so even though I obtained a pager from the administrative office, it wasn’t really used much. Having a choice and little stress was great.

Neurosurgery is for someone who can make on-the-spot decisions and survive in a high-stress situations. ER consults can’t wait; as the patient’s GCS score starts plummeting from 14 to 3 rapidly. It’s for someone who can put in crazy hours a day and still find balance in life.

Most of the surgeries are either about saving lives (low-risk) or about preventing neurological decline (high-risk). These “risks” are largely because neurosurgical operations are in delicate regions where the risk of creating a neurological deficit are very real. In the comatose patient on the brink of death, this is not as major a consideration (especially in terms of litigation, for the practical-minded) as in someone who’s come in for aneurym clipping or elective laminar decompression. All of them are challenging…

Except for maybe muscle biopsies. Anyway.

It was a fantastic 4 weeks and yes, J.’s would love to be able to do neurosurgery, tough as it is.

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2 responses to this post.

  1. Hi, I would like to ask, where did u do ur neurosurgery elective posting?

    Reply

  2. Actually I am a fourth year medical student from Malaysia, I applied neurosurgery in SGH for my elective course and my application has been approved. Now I am a bit anxious, wondering how I can learn/help as much as possible (since Neurosurgery is a highly specialized field) during my posting in SGH next year in May.

    Reply

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