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Clinical & surgical exploration

Over the past few years, I’ve immersed myself in diverse medical specialties, observing hundreds of hours across operating rooms, outpatient clinics, and hospital departments.

Each specialty has shaped my understanding of patient care, surgical precision, and the teamwork that drives modern medicine. The individual sections below highlight the specialties I’ve engaged with most deeply, each offering remarkable mentorship, unique systems of care, and invaluable lessons in collaboration.

While many moments were captured during these experiences, not all photos are shared here out of respect for HIPAA guidelines and to preserve patient confidentiality, instead of blurring multiple parts.

Urology Surgery with Clinical Scribing, Documentation, and Specimen Handling

Memorial Hermann-Affiliated Private Practice, Houston Area

Gained extensive clinical exposure to both operative and outpatient urology, observing a wide range of diagnostic and surgical procedures. Developed familiarity with the continuum of care, from consultation and imaging to postoperative recovery, while also assisting with medical scribing, documentation, and specimen handling under HIPAA compliance.

Procedures Observed

Oncologic & Reconstructive

  • Nephrectomy (partial and total)

  • Adrenalectomy

  • Retroperitoneal lymph node dissection (testicular cancer)

  • Kidney-sparing and reconstructive surgeries

  • Bladder removal (cystectomy) and neobladder reconstruction

  • Genitourinary reconstruction and urinary diversion

Prostate & Male Reproductive

  • Prostatectomy (open, robotic, and laparoscopic)

  • Transurethral resection of the prostate (TURP)

  • Prostate biopsy and ultrasound-guided imaging

  • Prostate laser surgeries (Holmium, PVP)

  • Penile implant procedures and urethral bulking

  • Vasectomy and vasectomy reversal

Minimally Invasive & Ablative Therapies

  • Cryoablation, radiofrequency ablation, and laser ablation for cancer

  • Brachytherapy and radiation therapy planning for prostate cancer

  • Robotic and laparoscopic surgeries across genitourinary organs

Bladder & Urinary Tract

  • Ureteral stent placement and exchange

  • Ureteroscopy and urinary sling procedures

  • Bladder augmentation and neurogenic bladder management

  • Urodynamic evaluations and voiding studies

Gender-Affirming & Hormonal Care

  • Masculinizing and feminizing surgeries

  • Hormone therapy monitoring and counseling sessions

  • Supportive care coordination for transgender and nonbinary patients

Imaging & Diagnostic Modalities

  • PSMA PET scans and Choline C-11 PET scans

  • Diagnostic ultrasound and intraoperative imaging

  • Cystoscopy and biopsy specimen evaluation

Key Experience Highlights

  • Observed complex multidisciplinary cases integrating urology, oncology, and radiology.

  • Assisted in clinical documentation, note-taking, and procedural scribing.

  • Strengthened understanding of perioperative care, physician-patient communication, and procedural sequencing in urologic surgery.

Orthopedic Surgery with Clinical Scribing, Documentation, and Specimen Handling

Multiple Baylor College of Medicine, Memorial Hermann, and Houston Methodist-Affiliated Private Practices, Houston Area

Observed the full spectrum of orthopedic, spine, and reconstructive surgery, focusing on musculoskeletal biomechanics, surgical precision, and the integration of robotics and imaging. Supported cadaveric lab sessions, clinical data collection, and literature review, while assisting with procedural setup and surgical preparation.

Procedures Observed

Joint & Arthroscopic Surgery

  • Knee, hip, shoulder, and ankle arthroscopies

  • ACL, PCL, and multiligament reconstructions

  • Meniscus repair and transplantation

  • Labral repair and cartilage restoration procedures

  • Partial and total joint replacements (hip, knee, shoulder, ankle)

  • Revision and robotic-assisted joint replacements

Spine Surgery & Reconstruction

  • Cervical, thoracic, and lumbar spine fusions

  • Laminectomy and decompression for spinal stenosis

  • Diskectomy and artificial disk replacement

  • Spinal deformity correction and vertebral column resection

  • Sacroiliac joint fusion and sacrectomy

  • Tumor and metastatic spine reconstruction

Pediatric & Limb Reconstruction

  • Guided growth correction and Mehta casting for scoliosis

  • Femoral and acetabular osteotomies, limb lengthening

  • Limb salvage and deformity correction procedures

  • Rotationplasty and bone reconstruction following trauma or cancer

Upper Extremity & Hand Surgery

  • Carpal tunnel and nerve decompression surgeries

  • Ligament reconstruction of wrist, hand, and shoulder

  • Tendon transfer, toe-to-thumb transfer, and microvascular free flaps

  • Fracture fixation, external fixation, and spatial frame corrections

Oncologic & Reconstructive Procedures

  • Soft tissue sarcoma and pelvic tumor resections

  • Limb-preserving tumor excisions and vascularized bone grafting

  • Free muscle transfer and microvascular reconstruction

  • Bone grafting, biopsy, and nonunion repair

Robotic & Minimally Invasive Techniques

  • Robotic-assisted partial knee resurfacing

  • Minimally invasive joint and spine procedures

  • Intraoperative imaging and navigation-guided surgery

Key Experience Highlights

  • Participated in cadaveric anatomy and orthopedic simulation labs on spine, shoulder, and knee reconstruction.

  • Observed integration of robotics, implant design, and surgical navigation in complex reconstructions.

  • Developed understanding of musculoskeletal anatomy, surgical planning, and post-operative functional recovery.

Oral & Maxillofacial Surgery with Clinical Scribing, Documentation, and Specimen Handling

Multiple Texas Children's Hospital & Houston Methodist-Affiliated Private Practices, Houston Area

Observed a broad range of oral, maxillofacial, and reconstructive surgeries, gaining insight into both the functional and aesthetic aspects of craniofacial care. Learned about anesthesia protocols, tissue management, and interdisciplinary coordination between surgeons, anesthesiologists, and prosthodontists.

Procedures Observed

Reconstructive & Orthognathic Surgery

  • Maxillary and mandibular osteotomies (Le Fort I/II/III and BSSO)

  • Maxillomandibular advancement and jaw alignment procedures

  • Mandibular and maxillary reconstructions following trauma or tumor resection

  • Distraction osteogenesis and costochondral rib grafts for facial structural restoration

  • Fibula and radial forearm free flap reconstructions

Oncologic & Reconstructive

  • Oral cancer screenings and biopsies

  • Tumor resections with immediate bone and soft tissue reconstruction

  • Oroantral and oronasal fistula repairs

  • Vascularized bone grafting and microvascular flap transfers

TMJ & Joint Reconstruction

  • Total temporomandibular joint (TMJ) replacement

  • Arthroplasty and joint realignment procedures

  • Management of degenerative joint disorders and ankylosis

Aesthetic & Facial Implant Surgery

  • Chin surgery (genioplasty) and cheek augmentation

  • Facial implant placement and double-chin correction procedures

  • Cosmetic jaw and dental surgeries for alignment and symmetry

Dental & Intraoral Procedures

  • Tooth extractions and complex wisdom tooth removals

  • Bone grafting for implant placement

  • Laser-assisted soft tissue surgeries and sublingual gland removals

  • Tracheostomy exposure for airway management during extended resections

Key Experience Highlights

  • Observed integration of oncologic, reconstructive, and aesthetic surgery within a single specialty.

  • Gained exposure to microsurgical reconstruction, free flap anatomy, and nerve preservation.

  • Strengthened understanding of facial anatomy, occlusion, and functional restoration following surgical intervention.

Pediatric and Adult Gastroenterology with Clinical Scribing and Documentation

Multiple Memorial Hermann & HCA Houston-Affiliated Private Practices, Houston Area

Observed diagnostic and therapeutic procedures across both pediatric and adult gastroenterology, gaining insight into endoscopic imaging, gastrointestinal physiology, and the multidisciplinary management of chronic digestive disorders. Learned about patient preparation, sedation, and post-procedure recovery while shadowing physicians and nurses in both outpatient and hospital settings.

Procedures Observed

Diagnostic Endoscopy

  • Upper and lower endoscopy (EGD and colonoscopy) for adults and children

  • Capsule endoscopy and transnasal endoscopy for minimally invasive diagnostics

  • Bravo capsule placement for reflux monitoring

  • pH impedance study for esophageal function assessment

Pediatric Gastroenterology

  • Colonoscopy and endoscopy adapted for pediatric patients

  • Functional bowel disorder evaluations using anorectal manometry

  • Biofeedback training sessions for motility and continence management

  • Supportive care for pediatric patients with chronic inflammatory and metabolic diseases

Therapeutic & Surgical Procedures

  • Fundoplication for gastroesophageal reflux disease (GERD)

  • Liver biopsy for diagnostic and staging purposes

  • Observation of pre- and post-operative protocols for liver transplantation

Key Experience Highlights

  • Strengthened understanding of GI anatomy, motility, and mucosal pathology through endoscopic observation.

  • Gained familiarity with diagnostic technologies such as manometry, capsule systems, and pH impedance monitoring.

  • Observed the compassionate, family-centered approach of pediatric care teams, emphasizing communication and comfort.

Ped GI

Pathology & Histology - Multispecialty Exposure with Clinical Scribing, Documentation, and Specimen Handling

Multiple Houston Methodist, Memorial Hermann, and HCA Houston-Affiliated Private Practices, Houston Area

Worked alongside pathologists and clinical lab teams to understand how tissue diagnostics guide surgical and medical decision-making across urology, orthopedics, and gastroenterology. Observed the full cycle of specimen handling, from intraoperative collection to histological analysis and reporting.

Specialty Focus Areas

Urologic Pathology

  • Prostate and bladder biopsy processing and slide preparation

  • Tumor grading and histologic differentiation in renal cell carcinoma and prostate adenocarcinoma

  • Examination of transurethral resection (TURP) specimens for benign prostatic hyperplasia vs. malignancy

  • Assessment of surgical margins in nephrectomy and cystectomy cases

Orthopedic Pathology

  • Analysis of bone and soft tissue specimens for osteomyelitis, sarcomas, and degenerative disease

  • Histological study of bone graft integration and prosthetic interface in joint replacement samples

  • Exposure to frozen section analysis for intraoperative evaluation of tumor resections

  • Identification of inflammatory and neoplastic patterns in cartilage and connective tissue pathology

Gastrointestinal Pathology

  • Observed biopsy preparation from upper and lower endoscopy, capsule, and colonoscopy procedures

  • Recognition of mucosal inflammation, dysplasia, and malignancy in colorectal and hepatic tissue

  • Exposure to liver biopsy interpretation for fibrosis staging and hepatocellular injury

  • Studied GI histology slides correlating structure with function in pediatric and adult cases

Techniques & Methods Observed

  • Fixation, embedding, sectioning, and hematoxylin-eosin (H&E) staining

  • Cryosection preparation for intraoperative consultation

  • Immunohistochemistry (IHC) overview for tumor marker identification

  • Gross specimen orientation and macroscopic documentation

  • Slide digitization for pathology archiving and teaching

Key Experience Highlights

  • Linked surgical procedures with their histopathological outcomes, reinforcing clinical-pathological correlation.

  • Developed foundational understanding of cellular morphology, tissue architecture, and diagnostic workflow.

  • Strengthened precision, documentation accuracy, and appreciation for pathology’s role in precision medicine.

Multispecialty Exposure with Clinical Scribing, Documentation, and Specimen Handling

Multiple Memorial Hermann, HCA Houston, and Houston Methodist-Affiliated Private Practices, Houston Area

Beyond focused surgical rotations, I gained multidisciplinary exposure across core and specialized medical domains, observing how diagnostic precision, interdisciplinary collaboration, and patient-centered care integrate within modern medicine.

Surgical Domains

Observed cases within oncologic, general, neurological, plastic, and vascular surgery, emphasizing coordination between specialties during complex procedures.
Representative procedures observed:

  • Tumor resections and reconstructive grafting

  • Carotid endarterectomy and vascular bypass

  • Craniotomies and microvascular decompressions

  • Abdominoplasty and wound reconstruction

  • Laparoscopic hernia repair and colectomy

Internal Medicine Specialties

Shadowed physicians in cardiology, hematology-oncology, and primary care, learning longitudinal care and multidisciplinary decision-making.
Representative procedures observed:

  • Echocardiography and cardiac catheterization

  • Chemotherapy administration and port maintenance

  • Inpatient rounding, case review, and interdisciplinary handoffs

Pediatric Specialties

Observed child neurology, pediatrics, and med-peds teams in both clinic and hospital settings, focusing on communication, empathy, and family-centered care.
Representative procedures observed:

  • Pediatric lumbar puncture

  • Neurological examinations and developmental assessments

  • Routine vaccinations and well-child visits

Diagnostic Disciplines

Gained hands-on observational experience in radiology, interventional radiology, and diagnostic imaging, connecting imaging modalities to clinical decisions.
Representative procedures observed:

  • Ultrasound-guided biopsies

  • CT and MRI interpretation sessions

  • Interventional catheter placement and venous access procedures

Specialized Medical Fields

Observed subspecialty care in anesthesiology, ophthalmology, otolaryngology, emergency medicine, and psychiatry, noting how focused expertise improves outcomes.
Representative procedures observed:

  • Endotracheal intubation and anesthesia induction

  • Sinus endoscopy and tympanoplasty

  • Ophthalmic exams and cataract removal

  • Psychiatric consults and crisis management

Focused Care Specialties

Gained exposure to outpatient and procedural care in dermatology, obstetrics & gynecology, and radiation oncology, learning how preventive and therapeutic care align.
Representative procedures observed:

  • Skin biopsies and lesion excisions

  • Pelvic exams, ultrasound, and prenatal consultations

  • External beam radiation therapy planning

Pain Management

Shadowed interventional pain management specialists across orthopedic and anesthesiology settings, learning how multidisciplinary pain control improves recovery and quality of life.
Representative procedures observed:

  • Epidural steroid and facet joint injections

  • Lumbar and cervical medial branch blocks

  • Radiofrequency ablation for chronic pain syndromes

  • Spinal cord stimulator implantation and follow-up evaluation

  • Multimodal pain rounds focusing on pharmacologic and procedural balance

© 2026 Yuvraj Parmar. All rights reserved.

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