Sub-I Prep

Back to Basics

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Dr. Mundy discusses tips and tricks for surviving sub-I season with interns Dr. Wickenheisser and Dr. Oleck

Show Notes:

What do you think makes a med student helpful? What makes a good sub-i? 

  • Having a good attitude, and being involved with the team  
  • Be friendly and work well with your co-med students 
  • Try to identify things you can do to move a patient’s care along 
  • Be specific about your asks with respect to asking how you can help 
  • Situational awareness 
    • You are in tune and paying attention to what is happening around you 
  • Reading the room and anticipating what’s needed  
  • Building automatic reflexes 
    • If someone is suturing, think suture scissors 
    • If there is bleeding, look for suction 
  • Remember that no one expects you to know everything on day 1  
  • Take time to learn the daily routine instead of doing things you’ve heard you’re supposed to do 
  • Don’t be afraid to ask! 


Preparing for a case: Pre-OP student expectations 

  • Things to know when you’re preparing for cases: 
    • General anatomy 
    • Basic patient history 
    • Indication for the surgery 
    • Basic steps of the operation 
  • Watch youtube videos which can help you know the general steps and anatomy 
  • Seeing the patient pre-op is attending and institution dependent  
  • When to scrub? Go when the resident is scrubbing and feel free to always ask 
    • Scrubbing is different at each place 


How to help during the case:  

  • Being in the OR when the patient is rolling in and helping them onto the table, help with positioning, help get SCD’s on, get the lights organized 
  • Often won’t be responsible for draping  
  • Help adjust the lights 
  • Grab a lab pad  
  • Help cut suture 
  • Putting dressings on 
  • Try being cognizant about being helpful vs being in the way 
    • Situational awareness is a big key here 
  • Helping move the patient out of the OR (institution-specific) 
  • At the end of the case avoid immediately checking your phone  


Preparing for sub-I at a different institution  

  • Know the faculty at the institution 
  • Review their general specialty expertise 
  • Know the name of the program director and the chair of the program  


  • Having dressing supplies ready 
  • Over time you can start recognizing what is needed for a patient’s dressing changes 


General tips 

  • In the OR introduce yourself to everyone in the room, get your gloves and gown, and offer to open it yourself 
  • Keep in mind that every member of the team has something to teach you so be open to that from everyone  
  • Be respectful to everyone you work with 
  • Ask for feedback and be comfortable with non-positive feedback 
  • Set your own goals for a rotation  
  • Remember that you’re a guest at another institution  
  • Always keep a general sense of professionalism even if the residents are acting otherwise 


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