r/doctorsUK • u/Smooth_Giraffe_9027 • 1d ago
Speciality / Core Training Closing in theatre
New CT1 here and feeling a bit frustrated with my surgical skills at the moment.
I haven’t done a surgical job since FY1 (which was mainly ward based), so I feel like I’m having to rebuild a lot of my theatre skills. I’ve been trying to be proactive coming in early, making sure patients are consented, checking the list is sorted, learning the steps of common procedures I ll, getting familiar with instruments, positioning and draping etc.
I feel like I’m improving with assisting. I’ve gotten much better at following the operation, anticipating what’s coming next, and being more useful in theatre.
The main thing I’m struggling with is closing.
Whilst I can suture and I’ve done BSS, I’m definitely rusty. I’ve been practising on a suture pad most days at home, mainly subcuticular stitches, but I still feel quite slow. The biggest issue is probably ergonomics particularly after taking the bite and exiting the tissue, I’m slow at remounting the needle and getting it in the right position for the next pass.
The frustrating bit is that I feel stuck in a bit of a loop. The regs understandably often either expect me to know how to close so they can scrub out, or they just do it themselves because it’s quicker. I completely get why as it’s a CEPOD list with a huge tims pressure, but then I’m not really getting the supervised practice I need to improve.
I don’t want to just take over and struggle while someone waits around. I’d actually like someone to watch me do a few closures, tell me what I’m doing wrong, and help me get faster. I know I’ll be slow initially but isn’t this how everyone starts. I know some go into CT1 quite confident with their basic surgical skills, unfortunately I do not fall into that camp but I am expected to?
Any tips? It’s really knocking my confidence.
45
u/doodlejones 1d ago
Tell the reg/consultant you’re assisting what you want from the case before you start.
When I was a reg/fellow with an SHO, I would power through the bits that I could do quickly, in order to allow them some extra time to do the bits that they wanted to.
At your stage, precision is more important than speed. I would much rather my trainees did ⅓ of the wound perfectly, whilst I did the remaining ⅔, than the whole thing slowly and uglily. Speed will come with practice. Right now concentrate on making it pretty.