At the Mini Med School, transition year students can watch an operation in all its gory detail. But can they handle it, asks SYLVIA THOMPSON
ABOUT 150 transition year students from schools in Dublin and beyond pile into the lecture theatre at Beaumont Hospital, Dublin for their third day in the Royal College of Surgeons’ Mini Med School week.
They have already had lectures on anatomy, chemistry experiments in the laboratory and listened to doctors talk about their experiences as health professionals.
Today, though, will be different. The students will witness an operation on a patient, through a live video link to the operating theatre, and have opportunities to ask questions of the surgeon while he carries out the surgery.
Just before the patient is put to sleep, the surgeon, Prof Arnold Hill, brings her to talk to the students about her condition. The 27-year-old mother of one seems neither shy nor nervous about her impending surgery. Three weeks earlier, she had come to hospital with severe abdominal pain and was diagnosed and treated for gallbladder problems. The pain had gone away but the medical team reckoned it would return so her best option was to have her gallbladder removed by laparoscopic surgery.
The students are fascinated. They ask the patient how she feels and whether she’s nervous about the surgery, to which she replies that she’s not. Minutes later, she is back in the anaesthetic room being prepared for surgery while Dr Mitchell Barry talks the students through the procedures in the lecture theatre.
All scrubbed up and cameras in place, Prof Hill and his team are ready to proceed. The patient has been given a general anaesthetic to sedate her, muscle relaxants and pain relief. Prophylactic antibiotics are also given as a precaution.
The students have a close-up view of both the inside and outside of the body through the video link-up and there are a few intakes of breath as the surgeon makes the four small incisions – the first through the abdominal cavity (the belly button) for the camera port, and then three others to provide access for surgical instruments.
The abdomen is inflated with carbon dioxide gas and the internal camera view offers clear images of the liver, the stomach, the colon and the pelvis cavity – all magnified 16 times onto the screen in the lecture theatre.
The students watch in silent fascination as Prof Hill proceeds to cut off the blood supply to the gallbladder by clipping the cystic duct and cystic artery. Then, he carefully cuts off (dissects is the medical term used) the gallbladder from the liver itself using a hot surgical instrument which clots the blood, preventing bleeding (coagulates is the medical term used) as it cuts.
Some bile oozes from the gallbladder at certain stages and the students utter some signs of discomfort, but overall, they seem able to cope with the experience.
During the operation, Dr Barry asks for a show of hands to see how many students would like to become surgeons, and about a third of them put up their hands. Prof Hill says he would like to see more boys studying medicine.
“Seventy per cent of medical students are female now. We need the guys to consider it as a career too,” he says from the operating theatre.
The removal of the gallbladder from the liver takes about 40 minutes or so but the really difficult part has yet to come. Dr Barry asks the students how they think the gallbladder itself will be removed from the patient’s body. Nobody has any clear idea until they are told that a bag is inserted into which the gallbladder is placed and then removed through one of the ports.
Removing the gallbladder proves to be quite a difficult task due to the number and size of gallstones inside it. The students recoil in horror as the tiny bag is pulled up through the small incision in the patient’s abdomen.
Then, a spontaneous round of applause erupts from the lecture theatre as Prof Hill says the operation is complete.
He then cuts open the gallbladder to reveal all the stones within.
“This patient must have been in a lot of pain.”
Prof Hill returns to the lecture theatre to have a final word with the students. “The operation was more challenging than we would have wanted due to the size of the gallstones but she shouldn’t have any more problems now. This is why I like surgery – it’s doing something very proactive for someone to make them feel better,”
So, how was it for them?
“I loved watching the surgery and how the patient came to see us and was open to our questions. I really want to do medicine. I like the idea of science making a difference ,” says Sadhbh Sheeran from St Columba’s College, Rathfarnham, Dublin.
“I think it was really good how we got to communicate with the surgeon before, during and after the surgery. I liked watching the operation but I really enjoyed the talks on orthopaedics and neurology,” says Laragh Kenny from Holy Child School in Killiney, Co Dublin.
“It was great that the patient gave permission for us to watch the operation,” says Aaron Murphy from Kylemore College, Ballyfermot, Dublin.
“I want to do something that involves saving people’s lives. I have epilepsy myself and I was losing faith in doctors because I wasn’t getting any answers. I spoke to the neurologist this week which was very helpful.”
According to Niamh Egleston from Loreto College in Balbriggan, Co Dublin, “Watching the operation was really like watching a collection of body parts. Only when you saw the person from the outside again did you wonder what they were thinking.
“I’m really interested in neurology. It’s an area we know least about and most of the research has still to be done,” she adds.
Sarah Fitzpatrick from Our Lady’s College, Terenure, Dublin, says, “I’d like to be a GP because I really like science in school.”
Approximately 10 per cent of the students say that they’d like to be GPs which is, in fact, the most popular option among medical students when they complete their studies.
“It’s been really helpful to see what it would be like to work in the different areas of medicine,” says Clara O’Flaherty from Mount Temple Comprehensive School, Dublin.
“I have really enjoyed the week. I like how they have shown us all the different specialities to give us a feel for medicine,” says Aoife O’Brien from Holy Child School in Killiney, Co Dublin. “I’d like to work in a hospital rather than a laboratory because it’s more sociable. My dad is an anaesthetist and I’d like to be one too. It’s been the highlight of my Transition Year so far.”
To find out more about the Royal College of Surgeons of Ireland's Mini Med School programme for transition year students, held annually in Beaumont Hospital, Dublin and Waterford Regional Hospital, Waterford, see rcsi.ie/tyminimed
