The summer ended too quickly. Brandeis Shadowing Program gave me a great opportunity to interact with patients and to learn about the life of a doctor or a nurse practitioner(NP). I enjoyed seeing the processes and difficulties that they faced on a daily basis. I learned a lot by shadowing physicians and NP on a daily basis over the summer, and I was able to really experience the general surgery departments in the hospital.
Category: Uncategorized
Yifu Zhang, Midway Point
My Brandeis Shadowing Program is located at Massachusetts General Hospital (MGH). MGH is amazing, and everybody was professional and helpful. I got to review patient’s histories and help with a few clinical research in the general surgery department. I also got to observe and understand the daily lives of a surgeon.
Sasha Gershman, Final Thoughts
I am very thankful to Dr. Sbayi and his OR throughput committee who gave me the opportunity to learn and participate in not only such a fascinating, but very important quality initiative project. This quality initiative project was one that truly merged and connected the various components of medicine from the clinical, technical, administrative, and hospitality sides to better serve the patient community. This quality initiative project, while benefiting the patient community, also helped to promote better work flow in the hospital’s internal system. While I am still working with Dr. Sbayi on this project, I am so thankful that this opportunity has given me such a new perspective on medicine. It has taught me that medicine is not just a product of providing the utmost level of patient treatment and care, but a multi-dimensional field that stresses the importance of coalescing patient care, hospitality, and an internal hospital system that works for both the patient and members of the patient care team.
Sasha Gershman, Midway Point
Through my research rotation with Dr. Sbayi, I am very thankful for the opportunity to not only learn about all of the research components, but for the chance to be able to practice these skills first hand. Dr. Sbayi provided me with the opportunity to join in on a quality initiative project that served all the service lines throughout the hospital. I was first involved in learning how to conduct the IRB process. It was so interesting to see how in-depth and thorough the IRB process is. I learned how to conduct literature reviews in a calculated and methodical manner that helped to ensure that the literature review was comprehensive. As the literature review became more and more comprehensive, it was fascinating to see how the literature review could serve as the initial guide or blueprint for the potential structure of the research paper. Each week, I meet with Dr. Sbayi and we discuss how the paper currently is, next steps (in terms of writing or data), as well as what contacts within the hospital I can reach out to for more information to incorporate into the paper. I am so thankful for the opportunities to meet and talk with so many different people that compose the hospital’s team, from CRNAs, to anesthesiologists, to hospital administration, and to data analysts. I also get to participate in a weekly research meeting and listen in to all of the different projects that are occurring in the hospital.
I am involved in the data aggregation process for the quality initiative research project. It is so interesting to see how telling and reflective the numbers are in presenting how successful the overall outcomes are. Going through the data aggregation process from start to finish and then being able to use those numbers to generate various graphs and figures to represent the outcomes has been very insightful.
I am also learning about the different platforms Stony Brook University Hospital uses to collect and store their data, as it relates to patient’s surgery cases. It is so interesting to learn about Stony Brook’s very own data mining service and how they also use a third party vendor tool to validate the data collected on surgery cases from their own service.
I could not be more thankful for this opportunity to learn about the vital integration between treating patients clinically, as well as from the administrative and hospitality side.
Jenna Ye, Final Thoughts
On the last day of my shadowing experience with Dr. Sher and his PA’s, I had the opportunity to visit the OR personally to experience two types of surgeries, open inguinal hernia repairs and cholecystectomies (which is otherwise known as gallbladder removal surgery). It was an eye opening experience that had also clued into the extensive administrative work associated with the medical field.
Hernia repairs generally fall under the two categories of open repair and minimally invasive (laparoscopic). In open repair, the surgeon cuts open the area, pushes the bulge back in, and sews up the weakened muscle, sometimes with synthetic mesh for reinforcement (which is known as hernioplasty). Minimally invasive repair, on the other hand, is usually done with a laparoscope where one incision is made. Seeing an open repair in person, along with shadowing the doctor through pre and post consultations really clarified the entire process that a patient goes through! It was also fascinating to learn about the different types of hernias, the reasoning behind causation and why it could be dangerous to leave it alone.
For the second procedure, I noted that patients that had cholecystectomies were mostly pushed under the circumstances caused by gallstones, which are these stone and sediment like deposits that form from bile. It was quite interesting to see the removal in person and to feel the gallbladder full of stones, which in the two procedures I got to witness, ranged from tiny granules to one the size of a quail egg. I remembered how amazed I was to see the doctors differentiate the different areas of muscles, ducts, and arteries so quickly in order to ensure that they do not incise the wrong area during removal.
One particular administrative event that I noted was the first few minutes before surgery in which the RN would hold up the color-coded sign to the security camera in the room whilst reading out the associated information of the patient, the legality/oath, and procedure that was to be completed. Which made me wonder if this was to ensure that the correct procedure was performed on the correct patient.
Overall, the entire experience had definitely solidified my goal of heading into the medical field, and opened up the specialization of surgery, which is something I had never really considered to be something that I would enjoy. The shadowing experience has also taught me alot of life lessons in planning preparation and decision making which I will definitely hold onto moving forward.
Jenna Ye, Midpoint
Over the past two weeks, the shadowing experience with Dr. Sher and his PA’s (Maggie and Jonathan) have been very enlightening in regards to the differences in patient interaction and procedure undertakings between the two fields. Physician assistants typically approach the patients first in the clinical office, taking down holistic patient histories (i.e. asking relevant questions in regards to the patient’s visitation, symptoms, previous medical visits, etc.), assisting in the associated medical paperwork (i.e prescriptions, past files), and aiding in medical procedures such as anastomosis and sphincterotomies. Doctors, on the other hand, have a much more intensive hands-on approach during the operations, pre-op, and post-op. On average, the doctor spends approximately double the time that a PA does with a patient. Certain procedures, such as colonoscopies, do not require a PA and are completed with the aid of a nurse and an anesthesiologist.
Viewing a colonoscopy firsthand has been very educational from both a technical and anatomical perspective. During the procedure, I was able to view how the doctor operates a scope. The flexibility of the scope, along with the four directional motion control dials, CO2 pump (blows up the colon), water pump, and suction all aid the process of navigating through a patient’s colon to reach the cecum. It was noted that the doctor spends a minimum of six minutes navigating back out of the colon after reaching the cecum to check for polyps and other potential anomalies such as diverticulosis (common formation of pouches in older people) and hemorrhoids.
Typical medical information and procedures outside his specialty as a colorectal surgeon have come up well in regards to genetic relationships to diseases (i.e Lynch syndrome) and cardiovascular conditions (i.e. valve replacement). I was able to witness an EKG, learn technical terms (A-Fib, V-Fib, heart echoes), and how the team of medical professionals act and react depending on the patient’s reaction and vitals. It was surprising to see how hyperaware everyone was of their surroundings and their quick
decision-making skills. This is a life lesson to hold onto since I am usually quite an indecisive person, which is something I may need to change as I continue down this path. I also found that I was more excited to dive into discussions regarding genetics and things relating to the heart, which may be quite helpful in narrowing down my specific interests in this diverse field.
Kate Wetzel, Final Thoughts
The second half of my shadowing internship was just as rewarding and inspiring as the first. During the second half of my shadowing, I spent more time in the surgery group’s office than I did in the operating room. While the operating room can be more thrilling, I still learn a lot in the office as I get to see more cases and more patients. Most days, I was in the office 9:00am – 5:00pm shadowing all of the doctors throughout the day as patient after patient came in with their various concerns, pre-op appointments or post-op appointments. As stated in my previous reflection, there are a variety of surgeons and surgical oncologists who work in the office, so I was able to see things from anal fissures to breast cancer to skin cancer to hernias. I have learned a lot through this experience, and I was able to make many connections between the anatomy course that I took last semester.
I spent a good amount of my time shadowing a doctor that had not been around the office during the first half of my internship. Dr. Ellenhorn is a general surgeon and surgical oncologist. I was able to observe him in the operating room as he repaired hernias and I also was able to see many different cases in the office, as he is a general surgeon. It was interesting being able to shadow him alongside the other doctors because he is relatively older. This means that he had different perspectives on not only medicine but on his journey to become a surgeon.
My favorite aspects of this internship were my ability to connect with the doctors, their willingness to teach and share information, and most of all the advice that I received about the long road that I have ahead of me as a premedical student. Hearing their stories gave me a better perspective on how I should approach my future including medical school and every step that lies beyond that. This was the most valuable information that I got out of the internship as earlier in the summer I was feeling overwhelmed by everything that was coming my way. The only aspect that could have been improved was that I wish I was given more tasks. For the most part, I was always on my feet observing the doctors and absorbing knowledge but every once in a while, in between patients I would have some downtime and I wish that I could have at least been given some small tasks so that I could help out in any way possible.
I am extremely grateful that I was able to achieve the three goals that I set for myself at the beginning of the internship in my first reflection. I have definitely come out of my shell and learned not to be scared to talk to the surgeons in the office, I learned more than I ever expected I would, and I believe I made connections with healthcare professionals that could help me in the future. Through this experience I not only grew as a student, but I grew as an individual. I gained so much insight on the responsibilities, difficulties, advantages, and lives that doctors experience every day. Throughout my first two years of college, my determination to become a doctor dwindled slightly as I was not able to experience healthcare first-hand through opportunities such as this one due to COVID-19. However, this experience truly renewed my passion for the field and while I am very aware of the work I have ahead of me, I am ready for it.
Kate Wetzel, Midway Point
I am currently working for Surgery Group Los Angeles which is a private practice group of 7 surgeons. Their office is located at Cedars Sinai Medical Center. On Mondays, Wednesdays, and Fridays I am in the office 9am -5pm shadowing the physicians as they have appointments with patients whether they be new patients, follow-ups, pre-ops, or post-ops. On Tuesdays and Thursdays I have been spending 8 hours in Southern California Hospital at Culver City observing surgeries in the operating room. I have been shadowing four of the surgeons: Dr. Elizabeth Arena who is a surgical oncologist specializing in breast cancer surgery, Dr. Yosef Nasseri who is a colorectal surgeon, Dr. Moshe Barnajian who is also a colorectal surgeon, and Dr. Jason Cohen who is a general surgeon.
My couple weeks were so invigorating. In the hospital, I was able to observe colonoscopies, hemmorhoidectomies, massectomies, breast reconstructions, fistulotomies, a flexible sigmoidoscopy, an excision and fulgorarono of an anal condyloma. I have never been in the OR before so this was fascinating to me to learn how surgeries are run and to actually see a body open on the table. I was also so glad that it did not scare me at all. Even being in the office was very exciting and I loved to see patients.
Overall, I have learned so much about breast cancer, colorectal procedures and surgeries, and hernias. After seeing so many patients, I’ve really learned a lot about all of these different medical problems and conditions and how to treat them. Actual medical knowledge aside, I have also gained a lot of experience and advice from the doctors. Watching them, I get to learn how to interact with patients, how to deal with difficult ones or ones in pain, and how to interact with other medical staff. Additionally, I have sat down with all of them and we have had conversations about my goals and their path to where they are now. All of it is very inspiring but at the same time realistic because they do not sugar coat how hard the journey is. Working for a private practice, the physicians have also really explained to me the differences between private and academic settings and the pros and cons to both.
I am so grateful for this experience so far because it really renewed my passion for healthcare and becoming a physician. One thing that I learned about myself is that I am very dedicated to getting to where these doctors are and that I really enjoy the lifestyles that they live, which can be sleep deprived and hectic at times. Therefore, this experience has not changed my post Brandeis plans as I am still premed. In fact, I am even more determined to go to medical school.
All of the doctors I have spoken to have emphasized that it is important to work hard and that I have a long ways ahead of me. But they also all encouraged me to enjoy college and take a gap year after college. Before starting this program, I was on the fence about whether I should or not but at this point I have gained insight that it would be better for myself, my application, and my career path to take a year off. Specifically, one plastic surgeon, Dr. Dean who works close with Dr. Arena told me “you’re in it for the long run so there is no need to rush into anything. Take your time and live a balanced lifestyle while you can.” I will really take this lesson and advice to heart because I can tell it is coming from a genuine place from someone who has lived through it all before.
I still have a good amount of time left here and I am very excited to continue working here. My goal is to continue learning as well as forming connections with these doctors. Therefore, in the future this networking may be able to benefit me in terms of future jobs or letters of recommendation.
Lydia, Final Thoughts
My experience shadowing at MGH this summer has been a thoroughly rewarding one. Throughout my time observing and doing research, I have gained an appreciation for the field of urogynecology and how it helps improve the quality of life for countless women. Since the midway point, Caylee and I completed our work on the perineal tears database. Our new project, case-control matching for a study involving women with Ehlers-Danlos Syndrome and urogynecological symptoms, involves going through many medical records. This differs from our last research project in which we went through fewer subjects but examined each in more detail. Both projects have allowed me to become more familiar with EPIC, one of the main goals I had for the summer.
I asked some of the fellows how they decided to go into urogynecology. My inquiries revealed that all of them had done OB GYN residencies and had then decided, based on their experiences, to subspecialize in urogynecology. I better understood the differences between the Urogynecology and Labor and Delivery workplace environments after observing a C-section. The atmosphere of the Labor and Delivery unit was much more frantic and fast-paced. The surgery itself was also more rushed and less meticulous than those I had observed in urogynecology.
In addition to my time in the OR and clinic, I have been attending didactic and journal club sessions roughly once a week. Similar to observing in the OR, a lot of the information goes over my head. It has still been beneficial to attend these sessions, however, and see how the different doctors process the information and ask questions.
I am extremely grateful to have had the opportunity to observe and do research at MGH this summer. It has been very educational, not just about urogynecology specifically, but also about the daily life of a doctor. Although I knew the importance of continuing education going in, I was surprised by how much the doctors were constantly reading about their field and incorporating it into their practices. This experience has affirmed for me that I wish to go into the medical field.
Chase, Midway-Final
It has been an amazing experience so far at Thomas Jefferson Hospital. So far, I have gotten to witness cool procedures in the operating room, colonoscopies, and office hours. Observing Dr. Isenberg has been such a cool opportunity as he makes difficult procedures look so seamless. My first day I observed Dr. Isenberg perform 10 colonoscopies back to back as he spotted hidden polyps in the colon with such ease. At first it was hard for me to follow, but as he explained certain landmarks, he looks for in the colon I started to be able to kind of keep track of where he was. For example, he explained to me that the transverse colon has more of a triangular shape compared to the ascending and descending colon. I also got to observe a couple of other doctors perform endoscopies, which was also very exciting as I got to see the inside of the esophagus and stomach all the way down to the pyloric sphincter.
In the operating room I have gotten to witness routine quick procedures like hemorrhoidectomies and also a longer surgery called an abdominoperineal resection, more commonly called an APR. The APR is often a last resort for patients who have rectal cancer or Crohn’s disease. It involves the complete resection of the patient’s anus and rectum and ultimately results in a colostomy. It was especially cool watching the surgeons interact during the surgery and decide which planes to dissect on the patient. Also, watching different type of surgeons collaborate during a single surgeon has been really amazing. Within a single surgeon I got to witness Dr. Isenberg, a colorectal surgeon, a plastic surgeon, and a urologist all discuss the best course of treatment for a single patient. In my remaining few weeks I hope to be able to witness more surgeries and try to learn as much about the hospital environment as possible.
I would to thank Dr. Isenberg, Thomas Jefferson University Hospital, and the Brandeis Pre-health department especially Erika Tai for arranging this opportunity. Overall it was an amazing and eye-opening experience. My favorite and the most interesting part of the experience was definitely the opportunity to experience clinic with Dr. Isenberg just because of the number of different patients and cases I got to witness. Even though some of the cases I saw were extremely sad, watching Dr. Isenberg listen to the symptoms of the patients and then examine the affected area followed by a seemingly instant diagnosis of the problem was truly astounding. I also had the opportunity to hear a lot of personal stories from the Medical students and residents about their experiences in medical school and residency that were very informative and helped me decide my future in pursuing medicine. Although clinic was the most interesting part of my experience, watching surgeries and being in the operating room was definitely the coolest part of the experience. It was amazing watching the scrub nurses, anesthesiologist, and surgeons work in unison to accomplish a common goal.
Finally, I would like to thank Dr. Isenberg again and also wish good luck to the fourth-year medical students who I shadowed with as they apply to their residency programs. This site was truly amazing experience and I will be returning to Thomas Jefferson University hospital over winter break to shadow Dr. Isenberg again.
Brandeis Summer Shadowing Program 