The 84-year-old patient is anesthetized on the operating room table and the surgical team is in place.
Brian Zator, in full surgical dress, situates his footstool behind Oak Park Hospital’s chief surgeon, Dr. Donald Nash, who calls out for the scalpel needed to begin the scheduled bowel-obstruction repair.
“And we have liftoff,” Nash says, with a seemingly effortless incision into the woman’s abdomen.
Zator looks intently over Nash’s right shoulder as he works.
“What is this?” Nash asks, handling the freefold in a fatty membrane of the stomach that blankets the front of the intestines. Without pause, Zator shoots back with the correct anatomical identification: “The greater omentum.”
Nash proceeds, and along the way to the obstructed bowel he points out the digestive organs, interspersing his movements with quiz-like questions for Zator.
Sifting through the tubular, coil-like mass that is the small intestine, he asks, “How many feet [long]?” Zator is stumped. “Try 22,” Nash says.
It is only a matter of minutes before Nash finds the cause of the patient’s nausea and inability to eat. He and Vinod Malhotra, his surgical assistant, work to correct the bowel obstruction, a surgery performed routinely at the 216-bed community hospital.
Zator’s eyes are fixed on the procedure.
Zator is not a member of the surgical team and this is not the first obstructed-bowel correction surgery he has observed. He is not a medical professional, a medical student or resident. He is a 20-year-old undergraduate majoring in biology at Dominican University, a private liberal arts school in River Forest.
At Dominican, students considering a career in medicine and the health sciences are paired with physicians or other specialized health-care providers at Oak Park Hospital and accompany them on their daily routines.
The university’s partnership with the hospital offers undergraduates a health-sciences internship that provides more than mere observation and job shadowing; the in-depth structure is intended to help them decide early on if a medical or health-science career is for them.
“It’ll get you all pumped up or take the wind out of your sails. It’s a real wake-up call. It’s a golden opportunity to determine if this is your life’s work and what it takes to get to that point,” said Dr. Louis Scannicchio, director of the Health Science Internship Program. He is an adjunct professor in the Department of Natural Sciences at Dominican and a physician specializing in maxillofacial prosthetics at the hospital.
The internship is offered as a biology science elective to qualifying juniors in good academic standing. For most students, the internship coincides with Scannicchio’s advanced anatomy class; others might have worked in doctors’ offices part time as clerks or volunteered in area hospitals before starting the program.
Participating students receive credit as well as a stipend. The hospital pays the students and is reimbursed by Dominican, which received a federal grant for the program.
Each student must earn a minimum of two credit hours; eight credit hours are the maximum allowed. Forty hours of work equals one credit hour.
The students are screened and interviewed by Scannicchio, who helps place them in a particular hospital department.
On average, three to five students per semester, including the summer term, take the internship.
The internship is in place in the hospital’s operating and emergency rooms, Center for Healthy Living, and in the laboratory, radiology, physical therapy, dentistry, and obstetrics and gynecology departments.
Taking the next step
Since the program began in 1999, several students have taken the next step to a professional school, Scannicchio said. One is at the College of Dentistry at the University of Illinois at Chicago; another is in a doctorate program in physical therapy at Northwestern University in Chicago; a third is in a physician’s assistant program at Midwestern University in Downers Grove.This term, at least two student interns are applying to medical school, Scannicchio said.
About 15 percent of the participants have decided that a career in medicine was not for them, he added.
This fall, Dominican added pediatrics to the program through an arrangement with Loyola University Medical Center in Maywood.
The internship has a checks-and-balances system that goes hand in hand with the student’s experience. Students must keep a journal of their activity, meet periodically with Scannicchio to discuss their experience and present a paper at a symposium in the spring through the Associated Colleges of the Chicagoland Area.
To gain more hands-on experience in such areas of the hospital as the emergency room, students are encouraged to take the certified-nursing-assistant course at Triton College in nearby River Grove. After completing that training they can participate in triage, help arrange X-raysor lab work, and assist with arrangements for moving a patient to the critical-care unit, Scannicchio said.
For Zator, the experience of shadowing the chief surgeon through the entire spectrum of his work–from diagnosis, surgery, postoperative care to recovery–has deepened his interest in the medical profession.
“I was always interested in science, but the internship really put me over,” Zator said. “It gives you a drive like no other. You come home and you want to study.”
Prior to a procedure, Zator is expected to read about the case.
In the operating room, he helps with setup and patient transport. Sometimes during an operation that involves the removal of a gall bladder or an amputation, for example, he is allowed to examine the tissue once it has been removed.
And with up to an hour between surgeries, he accompanies Nash on rounds.
Under the watchful eye of Nash and other medical professionals, Zator also is involved in the intricate details of what a surgical procedure entails, such as accompanying the physician when he meets with a patient and his family, understanding surgical complications, learning about the types of medications a patient will be taking, and handing instruments to the physician during such postoperative care as suture and catheter removal.
“It’s not just to show them anatomy, it’s also about the friendly art of communication,” Nash said. “After going through rounds and seeing a patient from diagnosis, to preop, during surgery and afterward toward recovery, [Zator] knows now why the patient should be well.
Process gives insight
“This gives them a feel for the health-care environment, how disease processes are diagnosed and addressed, how you discuss with families the risks, postoperative care. I think those are some of the principal advantages.”
Zator, who is finishing his internship, has observed about 50 surgeries. He began in July.
The in-depth training experience in a hospital setting also will be a plus when students like Zator embark on the highly competitive task of applying to medical school.
“The high test scores and high grade-point averages are not enough today,” Scannicchio said. “[The internship experience] gives them a lot of confidence. [Zator’s] already been there, and that’s a big deal.
“It gives them a special insight at the undergraduate level of life in a medical setting. As far as their application is concerned, it gives them the advantage of having hands-on clinical experience.”
Ahead of the game
Many of the students in the internship have observed procedures they otherwise would not see until well into medical school or a residency.
Although Zator has never performed a gall-bladder removal, he can give a general explanation of how it is done. The surgery is one of the more common procedures he has witnessed as part of the in-the-trenches approach of the internship.
“It’s all about experience,” Nash said. “You evolve as a professional. Why not during premed?
“I think it broadens these students’ horizons and gives them a chance to see firsthandwhat we do. Seeing the human body open … it becomes an almost indelible impression in your mind, so that when you’re seeing it in a book it becomes more relevant.”
The practical learning experience has helped him improve his grades in the premedical courses he is taking at Dominican, Zator said.
“You keep looking at the books and you really can’t [relate] it to anything you’ve seen until you see it for real,” he said. “Just looking in a book, you can’t get a real idea of what the structures are. Now I’m just flying through this stuff.”
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For more information on Dominican University’s Health Science Internship Program, call David Craig at 708-524-6899 or e-mail him at craigdav@dom.edu.
