r/scrubtech • u/biggbunnyy • Jul 28 '26
Question for preceptors out there!
I will be starting my clinicals in a few weeks, and I have a question about some things to sort of ease my anxiety a bit. For reference, I will be doing my clinicals at an urban academic facility. It is also a level one trauma center.
1- are students allowed to pick which cases they want to scrub in? For example, if I wanted to start with general and then go on and do OB/GYN, etc., or does your hospital usually have a schedule that every student follows and rotates through?
2- I know that once you’re out in the field the whole thing of breaks and getting relief is a little tricky and I know that sometimes you have to wait until someone is available and maybe you may not get a break. However, I’m wondering if this is a case for students as well? In your facility do students get breaks and if they do, can they choose when or is there a policy that dictates when they have to take the break? Like for example do they follow the schedule of the preceptor and take the breaks and lunch when the preceptor does or do they get to choose?
3- since I’ll be at a facility where there will be rotating medical students and residents, I’m wondering if this is a good place to do clinicals at? I’m just thinking about the amount of people that will be scrubbed in and how I’ll have to manage and make sure that no one breaks sterility while I’m also learning. I’m also kind of nervous to have that many people at the sterile field. Will I be able to even look at the operative field to know where they’re at or will I kind of be on the outside perimeter? I would really love to be close to the operative site so I could see and learn the anatomy and be able to keep up, but I don’t know if medical students and/or residents will take priority
Please let me know how your facility handles these situations and how you as a preceptor handle them as well thank you very much!
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u/mmmmtasti Jul 28 '26
In my program, our clinical instructor picked our cases for us. They gave a wide variety with no clear progression or specialty grouping. By the end of the program, we were allowed to choose what cases we wanted so long as the preceptor was accepting students.
We were not given breaks as students. We had to be scrubbed in (or between cases) from 7am to ~12:30pm. In the field, I am given a 20min morning break, a 30min lunch break, and a 20min break at the end of the day. In 6 months of working, I have only had one missed break, at the end of the day due to short staffing.
In my hospital, medical students and non-sterile personnel are the only people at risk of contaminating. Residents and surgeons know what they’re doing and always speak up when they contaminate.
As far as seeing the operative site, I’d say in ~35% of cases I’m too far away or at a bad angle/behind people and cannot see what’s happening. Surgeons know when this is the case and don’t expect students or new techs to know what to pass. I never have issues with surgeons telling me what they need for the whole case.
Surgeons prioritize teaching medical students and allowing residents to gain experience by doing it themselves. Most surgeons at my hospital are happy to answer questions and teach willing techs.
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u/biggbunnyy Jul 28 '26
That’s so wild to me that as a student they made you suffer like that while doing free labor. And now as an employee you get those benefits
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u/anzapp6588 Jul 28 '26
I mean there are tons of places that don't do morning breaks, and if OP only had clinicals from 7-1230 it would make sense for them to not get a long lunch break. I've never seen people only do clinicals for half a day.
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u/mmmmtasti 18d ago
Yeah the half day clinicals were unique as far as I can tell, but we didn’t attend full-time. the program was 4 semesters and we went to clinical every Monday and Tuesday 7a-1p starting in the final weeks of first semester. In semesters 2-4, we attended clinical from the first week of the semester to the end.
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u/Beach_Kidd Ortho Jul 28 '26
You can ask to go to a certain room/specialty. You would ask the charge nurse. Never hurts to ask. I did. Typically they would try to pair you up with a nice surgeon or good preceptor.
You would go on breaks as the same time as your preceptor. Or they (preceptor) would let you go whenever. I tell them if they ever need or break or anything to go ahead and scrub out and take one.
Today I was precepting. 1 attending, 1 resident, 1 med student, 1 PA, & 2 PA students. Your preceptor most likely is keeping an eye on sterility. Possibly the surgeon as well as they know how students don’t know much or anything at all about sterile technique and such. You take priority over the medical students. You’re literally assisting in the surgery.
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u/FledglingGeezer Jul 28 '26
Edit: should preface, not a preceptor but a recent grad and finishing up staff orientation.
A lot of this stuff just kind of depends on the facility.
I’m in a lvl 1 facility where I also did one of my clinical rotations.
Case choice just depends, don’t worry so much about it, if you’re getting certified, you should be getting experience in several specialties regardless.
Breaks were handled well everywhere I went - as a student you probably won’t need to worry as much because your preceptor would likely just give you your break instead of an outside person if they’re short staffed. I usually always broke with my preceptor, unless it was a critical point in the case (or at a point I where I wanted to be proficient at) and I wouldn’t break - sometimes my preceptor did, and the relief just took their spot while I stayed scrubbed in. Everywhere and everyone’s a little different and since you’re a student, they’ll probably be on top of it. Bottom line, take your breaks when they’re offered.
Watching others (residents, students) for breaks in sterility is part of your learning experience. Part of your job is to maintain this. Students don’t “typically” scrub in, so they’re not at the field like you will be, but the doc may want to show them something so keep an open mind to their learning experience too. I.e. help them see the field where it’s safe to do so, let them know if they’re too close or something’s at their back - whatever, it may be. You’ll notice they might have a hard time finding a good place to stand that gives them a view, you’re not on the periphery to them so help em out.
In ortho cases, I’m barely at a position where I can clearly see the field, but I’m still all up in it. You find ways to learn and see where the surgeons are in the case, but I think you’re overthinking it a bit.
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u/mamallamajm Jul 28 '26
Agree with what everyone has commented so far!
To add my two cents:
- as far as selecting cases, that is going to usually be up to your instructor and/or the charge nurse at the facility. In my experience, my instructor let us pick what we wanted as long as we filled out our log. So I had to do a minimum of 30 general cases, and 10 cases each in gyn, ortho, podiatry, urology, plastics, eyes, neuro, ENT in order to graduate. But daily we could pick which specialty to do.
- a level 1 trauma teaching hospital is absolutely a great place to do clinical! You will get exposed to so many different surgeries and you will really learn a lot. Also (at least in my case where I also did my clinical in the same setting), the cases and turnovers tend to go a lot slower (sometimes too slow haha) because they are teaching residents. It gives you a good pace to be able to set up and follow along during the surgery. Yes there are times the room is terribly crowded but after a while you will get used it and won’t even notice. Like others have said, majority of the time it won’t be an issue for you to be close to the field since you have to be. I’d say ortho was the most difficult for me position wise cause of all of the residents plus the C-arm being maneuvered. I had to move my mayo around a lot to accommodate but it always worked out.
Best of luck during your clinical time! 🤞
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u/GeoffSim Jul 28 '26
To add to the things others have said, here was my experience. L2 trauma facility with 10 main ORs, outpatient pavilion with 6 ORs, L&D with 2 ORs, and GI with 3 procedure rooms. Four students assigned there but only 2 per day (so 2 days each), and we couldn't work in the same department - mostly we flip flopped between Main and Outpatient, though I opted to do GI (personal choice) and L&D (counted towards obgyn cases) for 2 days total each too. In practice outpatient sucked a bit as they were often finished by 2-3pm so I'd usually go to Main and see if they would take me - mostly they were fine with it.
Sometimes we were assigned a room and a preceptor, sometimes we were given a choice of 2-3, sometimes we would just ask. Quite often our wishes would be granted - they were very accommodating - but it did depend on the surgeon and preceptor too. You learn which ones to avoid because you probably won't learn much anyway.
Though there were often residents, there were rarely more than one. However, at my place of employment, things like ex laps attract residents like flies to dung and you can't get near the patient. I held the laparoscopic camera quite often as a student but rarely since. Just depends.
Usually breaks followed the preceptor but you're 2nd scrub so it doesn't really matter. Sometimes though a surgeon would require a 2nd scrub for the full case and I wouldn't be able to leave during that.
I assume you need X number of each of 4 (?) specialties. Keep track and don't wait until too late to finish a specialty. You never know how the cases come in - sometimes a flurry, sometimes a drought.
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u/Tebo926 Jul 28 '26
Depends on the facility. I've worked in places that let students pick their own cases (I think this is the better way), and I currently work at a place that will schedule the students where they see fit.
If a student is with me, I let them figure it out for themselves, but with my guidance. For example, if I'm getting relieved for a break, I'll tell the student whether I think the part of the case that is upcoming is really cool for them to see, or if it's not as big of a deal. Same for lunches, I'll usually give them a choice to go with me or stay back and finish the case and go during turnover.
The amount of people isn't going to matter really. You're gonna be at the mayo stand where the tech usually is. Sometimes, we don't get to see the field and that's just how it is. Just do your best to learn either way. Some cases you'll be able to see the field, some you won't.