I had never scrubbed a vascular surgery operation until my first day on the job.
I know I know, quiteee the leap of faith to say the least…
While I did shadow with the group i’d be working with prior to accepting my position, this was still new territory to me by a large margin.

Regardless of the specialty, making the jump from learning by the book to practicing medicine IRL can be intimidating. But here’s the thing, being a new provider comes down to knowing that you have the tools to succeed, but being eager enough to utilize these tools in the most efficient way will make or break you. I’m not going to lie, being a new grad especially in surgery is like eating the biggest slice of humble pie- but it’s a process we all encounter.
Applying these tips when learning on the job will prove to your colleagues that despite your lack of experience- you’re ready to excel in your new position!

1. Self Teaching:
When you read or study *before* exposing yourself to a certain disease process or surgical procedure, you’re more likely to retain & understand your learning experience when presented.
PRO TIP: you’ll be able to ask more in depth questions that will help solidify info & it’ll show your enthusiasm to learn.
Look up or ask about common operations/diseases you will be seeing- study these before starting the new job! This demonstrates that you’re proactive about your learning/succeeding in your position (and let’s face it, the period between credentialing and actually starting your job can be boring af).
Once you’ve started your new job: LOOK AHEAD in the OR schedule to know which cases you’ll be in so you can educate yourself on what to expect. For those in surgery, I recommend looking up anatomical exposures and step by step guides on each operation- this will help you in predicting the appropriate prepping areas/positioning AND expect the surgeon’s steps throughout the procedure (AKA. less room for surprises)
Resource example linked here:

ANATOMICAL EXPOSURES IN VASCULAR SURGERY

And of course, when I’m on the go I typically use my UpToDate app to references medication doses, contraindications, or interactions when needed.
PRO TIP: If you don’t already have a subscription to UpToDate, check with your employer before purchasing as most hospitals will provide you free subscription so you can access at any time.

2. Emulating your colleagues in the same level/position

⟼ Learning from someone with the same or similar responsibilities will reflect what is expected of you & will likely set the stage of a routine that you can begin to follow. Learning from colleagues, ESP those with extensive experience in the respective field will provide you with a better understanding of your role as a provider + insight into how to perform at the most *efficient* level through their already tried & true methods.

3. Direct Exposure
This may seem obvious (esp. if you’re like me) but tbh no other factor will teach you more, independently. Surgery in particular is a ‘sink or swim’ kind of field, so real life hands-on experience is the fastest way to acquire knowledge to succeed.
This will certainly test you the most (& at times, scare you) but with each successive test, you’ll continually build confidence in yourself AND your skills! There is no greater learning environment than the real-life patient setting. Adding more experiences each day will provide you with vital information to learn and grow from as a provider.

4. Take Notes:
Another obvious, but I noticed that when starting a new position the amount of new information you try to retain is so overwhelming that it’s very unlikely you’ll retain in the long run if you don’t write it down & review it a few times thereafter. This is why I stress taking notes & USING THEM. Personally, I take notes in my ‘Notes’ app of my iPhone because if I need a specific reference, I can search the word in the app and it’ll usually lead to me the exact note I was looking for. Plus I can add to or transfer any information to my laptop when I’m at home through the Cloud.
Since we’re taking about note taking, here’s a few basic templates for your Pre-Op/Post-Op rounds to give you a starting ground to work from.

I hope this helps provide a bit more clarity into how I personally learned – as a brand new PA jumping into a very high yield + high intensity surgical specialty – as I know many of you specifically requested I cover it! As a PA this will often be the situation with any new job and feeling overwhelmed or underprepared is just the nature of the beast. Just try to keep a healthy balance of confidence in the information you DO know and the willingness to be taught new information – & you’ll do great!
Find below a few helpful resources for those of you starting a new Vascular Surgery position, residency, or rotation!
As always, please leave any comments or questions you may have. If you found this blog helpful please let me know on Instagram (@withashleykay) or here in the comments!
Xx,
AK

VASCULAR COMBAT MANUAL BY GORE MEDICAL

VASCULAR AND ENDOVASCULAR SURGERY