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  • 4 Tips to Do More in the OR


    In medical school, did you ever ask yourself or hear another resident ask, “Why won’t the attending surgeon let me do more?” Follow these four tips, and you will get to do more in the operating room and accelerate your surgical training.

    Be Yourself, But Know Your Institution’s Policies

    Review the cases at least a week before the OR day and schedule a time to discuss the cases with your attending. This will allow you to ask questions to the attending surgeon about the cases coming up and prepare for potential complications or new techniques. The attending will see your effort and your preparedness and know that you deserve to be operating.

    Be a GREAT Surgical Assistant

    If you can predict the needs of your attending when assisting, they will see you know what you are doing and will let you operate more. Know the steps of the surgery and the names of the instruments you are using — there’s nothing worse than hearing, “Please hand me the second instrument,” during cataract surgery. Know what you want and verbalize it. Watch videos. Go through the operation in your head the night before and the morning of the operation. When you do this, the attending will see that you are ready to do more.

    Practice Like You Play, and Play Like You Practice

    The OR is not the place to learn how to use your loupes, how to sit at a microscope or how to throw a “3-1-1” knot. You need to do this at home or in your wet lab. Attending surgeons want to feel like their patients are safe when you are operating. If you cannot tie a surgeon’s knot, how will you handle two hands in the eye? Come to the OR practiced, with confidence, and with questions: “I’ve been practicing this, but I can’t quite get it. Can you give me some tips?” Your attending will be thrilled to hear this.


    At the end of an OR day, don’t let your attending escape! Talk about the cases — what went well, what didn’t go well and what you need to practice. Self-reflection and self-directed learning go a long way to earning the trust of your attending surgeon. When your attending can’t stay after the surgery day, schedule a time to go over the cases. If you can, record your operations and watch them back (either with your attending or on your own). Watching yourself is a great way to learn. You can also debrief between cases if you have time.

    If you follow these four steps, you will gain the trust of your attending surgeon and get to do more in the operating room.


    Evan Silverstein, MDEvan Silverstein, MD, is a pediatric ophthalmologist, assistant professor of ophthalmology and associate residency program director at Virginia Commonwealth University in Richmond, Va. He joined the Academy in 2008 and chairs the Academy’s YO Info editorial board.