Most medical schools around the UK lack adequate surgical skills teaching. As a result, anyone wishing to learn basic suturing and knot tying is forced to look for opportunities outside of their regular classes. This is a situation that turned us both to ESSS for experience and from thereon out, we’ve improved our skills from both inside and outside of the society. Below, we outline some tips on how to build on your surgical skills as an undergraduate medical student from our personal experience. Personal Suturing Kit
Buying your own suturing kit is probably the best place to start, especially in the COVID-19 era. The Internet is full of suturing kits; some simpler, some more elaborate. This may come off pricey at first, but if you can find a good one, it can last you a long time in comparison to a kit that may malfunction within a couple months of use. Of course, this doesn’t mean that an expensive kit would guarantee excellent quality. My tip would be to read through the reviews and ask others which kit they found useful. You may even want to convince your friends and family to get you one for your birthday or holidays! For a basic beginner’s kit, it will be absolutely enough if you could just get these: a needle holder, Gillies forceps (‘toothed’ forceps), Debakey forceps (‘flat’ forceps), scissors, some sutures and a skin pad. When choosing the skin pad, pay attention if it has colour-coded skin layers. Colour-coding will help you navigate, especially when practising subcuticular or deep dermal suturing. Foam pads can be a good beginning, however as you advance, they tend to break easily upon pulling the suture. Silicon pads are a good alternative and you may even lean towards those that are pre-cut to provide you a clean wound with a variety of cuts (i.e. straight or curved). Now onto sutures. There is a wide range of suture width and type and usually a kit comes with one or two varieties. Overall, this wouldn’t affect your practice much, but it would be good to try them out as you would have to adapt your movements accordingly. For example, monofilament suture can curl up or fail to sit properly. As getting hold of sutures can be a little more challenging, an ideal start would be the sutures that your kit includes. However, these will not last you too long if you intend to practice regularly. After you run out of your sutures, there are two main options of getting hold of more. Option A is to simply buy some suture packs off Amazon or some medical company, but that can be a little (or a lot) expensive. Option B is to ask some surgeons / ED doctors for expired sutures. Being successful here oftentimes requires having good contacts, however, this is the option you would normally want to go for. In the hospital nobody will have much use of expired sutures, but for your practice they will be perfect. Surgical Societies and Organisations Most surgical societies run their own surgical skills clubs or at least organise ad hoc suturing sessions. Keep an eye on their social media! Follow different surgical societies across the UK - many skills related events are now available to external audiences (one of the few upsides about the pandemic). Most of such teaching is aimed at complete beginners, and if you’re new to suturing any sessions delivered by your local surgical society will be a good introduction and can provide personalised feedback. In-person sessions can also be a good place to use tools that you would otherwise be unable to get, such as an expensive laparoscopy kit. Don’t limit yourselves to university societies as there are other organisations which provide great demonstrations and advice! Though they may be at a higher level, they can provide a good insight to different setups, materials, and more advanced skills. These sessions are also a great gateway into learning when these sutures and knots will be appropriate and how to decide which suture and skills to use. If you’re reading this, you are most likely to be a (prospective) medical student from the University of Edinburgh. We hold fortnightly surgical skills sessions for all members which usually consist of a Tuesday evening led by surgical trainees. They can provide demonstration and feedback to aspiring surgeons at all levels! For updates, make sure to join the Facebook ESSS Surgical Skills Club Group: https://www.facebook.com/groups/2325177807796846. Hospital Surgical Skills Clubs I cannot recommend them enough, especially if they’re led by surgeons passionate about surgical education. Unfortunately, in current epidemiological circumstances the number of places at hospital skills club sessions is very limited. Junior trainees and doctors are prioritised, and clinical years students are occasionally allowed in. As of now, no hospital surgical skills clubs allow pre-clinical medical students to come but keep an eye out for when COVID-19 restrictions are lifted. Twitter has a huge medical community, and this is where updates from most Edinburgh hospital surgical skills clubs can be found. Follow them to stay updated:
External Resources If you feel your surgical skills are a little more advanced, there are plenty more resources online. These are some that we have personally used and loved:
Real-Life Practice It’s difficult to get real-life experience in early years of medical school. Be patient. Use your early years to practice suturing on your kit, bananas, fish and tying on your mug or Pringles tub. Find surgeons you feel like you can learn from and one day, if you are lucky, you can get your hands-on experience. Opportunities like these are hard to come by, so make sure you actively seek them out, demonstrate how keen you are, and the results of your practice. At some point you might be allowed to, for example, close a small wound on a patient. Finally, the most important tip: enjoy learning surgical skills! It can really be great fun. One of my (Violet) favourites include doing a C-section on a tangerine. I (Liza) have had a string on my water-bottle for the longest time, letting me practice knot tying whenever and wherever until it becomes muscle memory. Authors: Violet Borkowska and Liza Chong Your Surgical Skills Club Co-leads
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11/29/2023 09:36:58 pm
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AuthorsArticles are written by Edinburgh-based students and doctors, for the benefit of those interested in surgery. Archives
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