Medical School Rotation: OB/GYN Clerkship

on
Tuesday, September 16, 2014
Disclaimer: I am aware a lot of my experiences are site-specific. I had the opportunity to go to a very 'hands-on' teaching hospital, and was able to participate A TON!

What I liked:
I loved delivering babies, especially when the attendings let me do nearly everything.
Pregnant women are (usually) super awesome, happy people.
On L&D - Getting to do the entire H&P, and following up with the patient every couple hours. Bonus pts if I was allowed to do ultrasounds.
Babies are freakin' cute!
Gyn Surgery - I enjoyed this a lot more than I thought I would. Surgery is so methodical and meticulous, which appeals to my personality type/character. Also, I got props on my suturing skills (practice at home kids, it really pays off!)
That time I put in a trocar... 
Having rounds at the beginning of the day where we discussed specific topics - it really helped me study ahead for the shelf, even though I spent hours reviewing all the ACOG bulletins the night before.
One particular clinic where the attending let me do all the gyn exams, pap smears, IUD removals and prenatal checks. Booya!
Scrubbing into an emergency ovarian torsion.
Three words: Da Vinci Robot.

What I disliked:
Ridiculously early hours - this has been the only time I literally couldn't function without coffee due to so little sleep.
Since this was my first rotation, and the intern's first month as well; it was very confusing and disorganized and stressful the first couple weeks.
I wish I knew more going into OB/GYN (it's not covered much in the MS2 curriculum or Step 1), and I really disliked feeling overwhelmed/lost, but it was pretty much inevitable at this stage in my education. It was a total ego check.
Standing for 9+ hours straight in back-to-back surgeries, with no food, bathroom or water breaks. I was dying! My arms and back were incredibly sore by the end of the day.
Gyn Onc - I had a really sad experience with one of the patients, and it just made me realize my heart is not strong enough for oncology, ever.
Working call shifts on weekends (womp)
I really disliked how much regular folk & medical professionals underestimate OB/GYN doctors; their job is insane and overwhelming, they deserve much more respect than they get. They're trained in medicine and surgery, work incredibly long hours even as senior attendings, and their malpractice insurance is nuts due to the nature of their job (if any of you have the chance to work in an MFM clinic, you will wonder how some of these little babies end up surviving until delivery. It's so stressful.)

Quick Guide (topics you should know before starting each block)
Labor & Delivery: fetal heart strips, stages of labor, drugs for induction, degrees of laceration, fetal positions
Gyn Surgery - female pelvic and reproductive anatomy, practice tying knots and suturing at home every day
Gyn Onc - know your most common gyn cancers, and the drugs used to treat and prevent reccurence
Clinic - know milestones/guidelines for each trimester of pregnancy, brush up on your STD's & all available contraception, know menopausal symptoms and treatments

How I studied for the shelf (I would recommend getting through all of these; I was unfortunately strapped for time at this location but ended up doing well):
UWorld - 2 passes, written notes on the 'main points', and reviewing all the charts
UWise - 1 pass, only had time to review half my notes afterwards, but I did 4 comprehensive tests
Case Files - only had time to get through 60% of this book, try to do it all at least once
2 NBME exams - underscored me by 10-15% but kicked my butt into studying extra

Final TIP: Prep for rounds every night, proactively see as many patients as possible, and volunteer to stay late on interesting cases. The more patients you see the better, especially since you'll learn a lot of skills on the wards that you can't learn properly from a book (pelvic exam, proper use of speculum, how to talk to the patient when they're in stirrups, learning how to hold & manipulate the baby as it's being delivered, suturing on real skin, etc)
    If your site for this rotation is not engaging, and residents don't allow you to do much then be pushy, ask for patients, and do an ACOG Practice Bulletin every morning/lunch break with other students on your team. 



Cheers,
Chantelle

P.S. If there's anything else you'd like me to add, just leave a comment or send me an e-mail!
image source: geekinsider
5 comments on "Medical School Rotation: OB/GYN Clerkship"
  1. Had your blog bookmarked since having my own long time ago & now I remember how adorable it is as I read couple of posts after a while.
    Even though ob/gyn might not be my thing, I've seen things nothing short of miracles during the rotation, will miss that :)

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    Replies
    1. Totally agree, Sandy. It's such a high pressure situation at times. Glad to have you back on the blogosphere!

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  2. OMG! Your blog is soooo interesting and useful! I'm sooo glad I've found itĄ

    Hugs
    Kamile
    http://ayoungdreamcatcher.blogspot.com/

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  3. Great post !
    What did u use for practicing your sutures ?

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    1. I used a sponge, and suture kit! You can pick up a ton of sutures from the hospitals you rotate at; they may have a stock of expired sutures in an office. The instruments can be bought online, or also picked up in hospitals. I was able to use my boyfriend's stash!

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