PGY-2 General Surgery – University of Ottawa
My name is André Martel, currently a PGY-2 resident in General Surgery at the University of Ottawa. Prior to my surgery training, I completed one year of residency in Family Medicine at Western University. I’m originally from Embrun, Ontario and I completed my MD degree at the University of Ottawa. Before medicine, I did my bachelor of science (honours) in Biopharmaceutical Sciences, Genomics option at the University of Ottawa, and worked in basic science studying the SIX family of transcription factors responsible for skeletal muscle development.
Early in my medical training, I was attracted to the fast-pace, high-acuity of General Surgery. After stepping in the operating room for the first time, I was addicted. While I was preparing for surgery during most of my medical school, a last-minute change of heart led me to apply for a residency in Family Medicine with a focus on small procedures. Shortly after beginning my generalist training, I realized that my passion rested in surgery. Transferring into General Surgery confirmed that I love the tremendously wide scope of practice and skillset. This specialty has the unique opportunity to treat very sick patients and greatly improve their lives.
Furthermore, General Surgeons are cancer specialists and there is ample opportunity to advance the field of cancer research. General Surgery encompasses a perfect balance between surgery and medicine, always being stimulating and challenging. We often work in the middle of the night, dedicating our life to improve the ones of others.’
What does a typical day of clinical duties involve?
What kinds of rotations are required in your program?
These depend on the level of training. For junior surgical residents (PGY-1-PGY-2), approximately 12-13 blocks are spent in general surgery with five or six of those on the busy Acute Care Surgery (ACS) team, which covers emergency consults and surgeries. Off-service rotations include one month in each of: Emergency Medicine, Gastroenterology, ICU, Medicine (CTU), Pediatric General Surgery, Thoracic Surgery, Plastics, and Vascular Surgery.
In the senior years (PGY-3 to 5), all rotations are in general surgery, with a mix between academic rotations (70%), community, and elective rotations (30%). All senior residents rotate through the ACS team in PGY-3-PGY-4, and elective services including Colorectal, Breast, Surgical Oncology, HPB, and Bariatric/Minimally Invasive Surgery.
Which of your personality characteristics have been particularly helpful in your field?
First is a calm, positive attitude. My most useful personal trait is an easy-going and positive attitude. General Surgery can be very busy and stressful but I rely on my calm approach to efficiently manage and prioritize issues. Having a positive attitude not only helps stay sane during a busy night on call, but also ensures good communication with team members and allied health.
Time management is also beneficial. Being organized and efficient goes a long way in a busy residency like General Surgery. I developed good habits to manage my work, research, and personal life in a healthy and mindful way.
What are the best aspects of your residency?
My favourite aspect of training as a General Surgery resident is the wide scope of practice, which includes outpatient clinics, pre-operative consultations or post-surgery follow-ups, endoscopy days, emergency surgeries, and even covering the trauma service on call. Patients can be quite sick, but they always place the highest level of trust in the surgical team. When you treat the patient and not the problem, it’s a humbling and positive experience no matter the outcome.
What are the most challenging aspects of your residency?
The biggest challenges are long hours and busy nights.
I have often worked 14-15 hour days and sometimes worked spans of 28 days in a row. This can take a toll on work-life balance. During these times, it is even more important to unwind with family, friends, and loved ones. Keeping some time for myself helps, whether it’s playing the piano, reading, or exercising.
Call shifts can be extremely busy as a junior resident, as you cover a dozen emergency consultations while running back and forth from the O.R. for emergency surgeries, managing sick patients on the floor, and all the while prioritizing frequent pages. This can be overwhelming initially, but surgical residents develop strong time management skills and a technique to prioritize issues. For myself, I created a call template to clearly lay out pending consults, ward issues, and items to handover in the morning.
What is one question you’re often asked about your residency?
By far the most common question I am asked is, “How do you handle the long hours?”
My answer is this: if you pursue a residency in a specialty you are passionate about, the long hours will suddenly not feel like work and the days will fly by. I feel more rested, motivated and happy as a surgical resident than I ever did previously.
The second most common question I am asked is, “How did you manage a transfer into a surgical program?”
It’s important to realize that transfers are more common that one would expect, and nothing is set in stone. There is a good system in place at all the universities to help residents feel supported and successfully transfer. It can sometimes be a lengthy process (nine months in my case), but if you remain persistent and dedicated to your cause, it almost always works out.
Can you describe the transition from clerkship into residency?
My transition from clerkship to residency was unlike most medical trainees. Late in clerkship, a change of heart led me to apply to a family medicine residency. I was attracted to the flexibility, lifestyle, and short residency program. My family medicine training was outstanding and I enjoyed every rotation, but my passion was in surgery. I utilized this as an “intern” year, which definitely helped me when I transferred into General Surgery. Even though the start of my surgical training was occasionally nerve-racking, there was a tremendous support network of residents and staff, which helped me feel right at home.
What are your future practice plans?
Following my PGY-2 year, I am considering entering the Surgeon Scientist Program (SSP) to pursue a two-year Master’s degree in oncolytic basic science research. Following my residency, I see myself continuing my training in a fellowship focusing on cancer work such as Surgical Oncology or Thoracic Surgery, with the hopes of establishing an academic practice with a heavy component of cancer research.
One nice aspect of General Surgery is that graduates can pursue various fellowships leading to an academic practice (Colorectal, HPB, Minimally Invasive Surgery, Thoracics, Vascular, etc.), or have the option to enter practice immediately after residency for a career in community surgery.
What are your fellow residents like and how much do you interact with each other?
If you ask all 36 residents currently in the General Surgery program in Ottawa, you will receive 36 identical answers: the entire group is outstanding. This tight-knit group of residents is a major reason that led me to transfer into the program. We are all very open, always offering a helping hand to a fellow resident. We also have many social activities, such as resident softball and soccer leagues, summer and fall retreats, Christmas parties, winter ski trip getaways, and informal nights out. In a busy training program, it is very helpful to work with such a great group of residents.
What are your academic interests (e.g. leadership activities, research)?
I have a strong interest in medical education as well as research. My surgical training is giving me the opportunities to pursue all the academic initiatives I am passionate about to become a skilled surgeon, writer, and researcher.
In terms of leadership activities, I sit on the General Surgery Residency Program Committee (RPC) advocating for fellow residents. I am also a member of the CaRMS committee, in which I help plan the selection and interview process. In another Med Ed intiative, I am very interested in being a surgeon-writer. I was previously Editor-in-Chief for the University of Ottawa Journal of Medicine (UOJM) in medical school and I am still involved as Copy Editor. I also contribute pieces of writing to online blogs through social media sites, and started writing my own novel.
In terms of research, I am working on various research projects in the fields of Quality Improvement, Medical Education, Thoracic Surgery clinical research and Oncolytic basic science research.
What is your work-life balance like, and how do you achieve this?
Although my surgical training keeps me quite busy, I still find enough free time in my schedule to pursue personal interests. I’m a sports enthusiast and play various sports, including in a resident softball league. I regularly exercise three to four days per week and I think this is crucial to recharge and maintain a healthy mindset. I also enjoy playing the piano, attending concerts and Broadway shows, traveling, and reading novels. Last but not least, I love going out and spending quality time with friends and family.
A residency in a surgical specialty will undoubtedly take a toll on work-life balance and affect one’s personal life. It’s important to plan out my weekly schedule and always be flexible around work hours, which helps me find a healthy balance between studying, research, leadership initiatives, and personal interests.
You can find André on Twitter @amartelmd.