The day you get your strings is an exciting day. It is the first Friday back after a holiday break, and we are readjusting to the lecture schedule and thrilled to be reunited with our PA friends. We did not quite know what to expect from this first Friday because previously we were always in “Anatomy Lab” or in “Patient Assessment & Counseling 1”— courses that ended last semester. Half of the class will do casting and half will practice bandaging, but everyone has a block in their schedule for “Knot Tying 1.”
As someone eager to do surgery, I was practically twitching with excitement. Lecture is brief before we are ushered into small groups, where a surgically experienced instructor takes us through the first round of hand ties. Very few of us are naturally good and it is this practice that allows us to remind ourselves that skill is not nearly as important right now as our effort to improve.
Our hard work is rewarded with a white nylon string that is ours to keep, which represents the seriousness with which the instructors expect you to undertake this course. Throughout the semester we were given objects that carried a thinly veiled reminder that we had better be practicing our newly acquired skills lest we forget them before the final.
Not many courses in the Duke Physician Assistant Program span the whole length of a semester but surgery sticks out as one of the few, something the instructors will never fail to remind you of, and rightly so. The hand ties so diligently practiced in Week 1 are one aspect of the multistation final practicum during which one instructor stares intently at your shaking hands as you try to close a gaping wound within precious few minutes. If that sounds absolutely horrifying to you, don’t worry, it’s meant to. It wouldn’t be true to surgery if it wasn’t just a little bit intimidating.
The instructors don’t want you to fail
Despite the heart palpitations you may or may not be feeling right now, surgery also has the saving grace of being a course you will feel well prepared for. This is due almost entirely to the tangible caring of the instructors. They don’t want you to fail and they are not out to trick you. They demand a certain measure of competency to be sure, but they are also actively pushing you and setting you up to succeed.
While this remains true for the whole program it is never more evident than in the development of a tactile skill like suturing. Most Fridays we were in groups of six or less as one or two instructors teach or review suturing techniques, watching closely to make sure your spacing is even or your instruments are held correctly. If you are doing something wrong they will tell you so that when the practicum comes you will know exactly what to do and how to do it.
The surgery course so far has been my favorite course, not just because I think it is interesting or because suturing is a fun know-how, but because it is a different, more direct type of challenge issued from the instructors. We are expected to master particular skills and knowledge for the upcoming test. All that’s left to do is take a breath and pick up our instruments. And don’t worry; everyone shakes a little.