Olivia Straw ’22

The Foundation for Surgical Innovation and Education, Portland, OR

I didn’t know quite what to expect from my internship with the Foundation for Surgical Innovation and Education. I knew that I would shadow surgeons, work on a clinical research project, and get some hands on experience. But when I saw our schedule, I was amazed at the scope of what the five other interns and I would do. We would shadow in the operating room and the clinic, watch procedures, work on a research project, and get hands on experience culminating in performing operations on a live pig! I was amazed and a little daunted by the opportunities before me.

The surgeons I shadowed at the Oregon Clinic specialize in minimally invasive and gastrointestinal surgeries. I was able to observe open, laparoscopic, and robotic surgeries. I saw a variety of surgeries such as a delicate thyroidectomy and a total gastrectomy where I learned that it is possible to live a relatively normal life without a stomach. It was interesting to see the wide variety of surgeries performed even within a group of surgeons with similar specialties. I have yet to take an anatomy course, so to first be exposed to in depth anatomy during a live surgery was incredible.

Along with exposure to anatomy and surgical technique, I learned the importance of collaboration and communication in the OR. During the first week of the internship, we learned proper technique unwrapping sanitized gloves, towels, and other surgical tools. Even this tiny task had a specific method and a dedicated nurse. In the OR, each person has an important role, and no one can do their job without the other people. I was surprised about how much of the surgery is not just about the surgeon’s technique but also about their ability to work with their team. In addition, many of the surgeons coached fellows. As someone who is interested in both teaching and medicine, I found it fascinating to see surgeons integrate teaching into their day.

Not only did I get to shadow in the OR, but I also shadowed during clinic. In clinic, different surgeons had very different styles of communication, but they all seemed to prioritize their patient’s understanding of their disease or condition as well as treatment options. One surgeon created a special clinic where she brought in all of her patients with gastroparesis to explain their disease in depth. The careful dedication to patient understanding and patient involvement in decision making was admirable. In addition, the surgeons were committed to helping the five other undergraduate interns and I learn. I was grateful for how often they stopped in their busy days to ask if we had questions or to explain something in more detail.

In addition to observing patient care, I worked on a research project that resulted in a manuscript that is being submitted for publication on which I am the second author. I have done benchtop research before, but this was my first clinical research experience. Much of clinical research is data manipulation, so I got a lot of practice with data entry and critical analysis. Each week, I presented my progress to the surgeons which allowed me to practice presenting and discussing research.

The project studied the use of virtual reality devices as an alternative to opiates for post-operative pain control. Studies have shown that virtual reality is an effective pain management strategy as a form of distraction as well as for chronic pain management. We studied the effect of six mediation sessions using a virtual reality headset. Surgical patients were randomized to either use or not use the virtual reality device. All patients were then allowed narcotics and other pain medications at their request. The satisfaction with their care (as indicated by a questionnaire), morphine equivalents, and other variables were compared between the two groups. After recording and analyzing the data, I was able to think about conclusions as well as limitations to the study.

I worked on this project with one of the surgical fellows who was an incredible teacher. She coached me to carefully conduct each analysis, to make a clean datasheet, and to write a credible and thorough manuscript. I appreciated her dedication to helping me learn the different aspects of clinical research as well as to writing a good paper.

Even after shadowing in the OR and in clinic, working on research, and more, what made this internship so unique was the hands on experience I gained. My cohort of interns learned to suture and tie surgical knots in a workshop with a few of the surgeons from the Oregon Clinic. We were also trained on simulators and pig explants in the fundamentals of laparoscopic surgery and endoscopy. All of this hands on practice culminated in a day of lab work with high schoolers who had participated in a one week version of the internship. We trained the high schoolers in the fundamentals of laparoscopic surgery, and then participated in a pig lab. I performed a per-oral endoscopic myotomy (POEM) on a pig explant as well as a laparoscopic bowel anastomosis and laparoscopic cholecystectomy on a live pig. Going into this internship, I did not feel confident in my ability to perform surgical tasks because I have shaky hands. However, this hands on work helped me to gain a lot of confidence in my ability. It also helped me to understand and appreciate the level of technique needed for the careful maneuvers that the surgeons did in the OR during laparoscopic surgery.

This internship was an unusual and unique opportunity. The group of surgeons I worked with goes out of their way to spend time creating an internship dedicated to education and helping undergrads better understand what it is truly like to be a surgeon. This group is kind, inclusive, and dedicated to careful research. They promote education at many levels, creating opportunities for high school students, undergrads, medical students, and beyond to become involved with their work. I was worried that being a doctor or working at a medical internship would be sad since so much time is spent around sick people. Of course, there were sad stories, but this internship made me hopeful. The doctors who work to help these patients are so incredibly caring, dedicated, and intelligent. If anyone can make people healthier, happier, and comforted, it is this group of surgeons. I applied for this this internship hoping it help steer me towards or away from medical school. Because of this experience, I have decided I will apply to medical school in hope that I can one day be as wonderful, caring, and dedicated as the people I met at the Oregon Clinic.

Thank you so much for this incredible opportunity. This experience has greatly influenced my future plans as well and helped me to gain numerous skills.