Courtesy of Dr. Jason A. Parker

Assistant Professor Clinical Clerkship Director

UTHSCSA

Clerkship Structure Most OB/Gyn clerkships are 6-8 weeks in length

You will be exposed to both obstetrics and gynecology

Each clerkship varies on amount of exposure to subspecialties within OB/Gyn

The breadth of OB/Gyn Four year residency program

Womens’ Healthcare Maintenance

Obstetrics

Pelvic organ prolapse

Gynecologic surgery

Gynecologic Oncology

Urinary Incontinence

Infertility

Endocrinology

OB/Gyn Subspecialties Gynecologic Oncology

Maternal Fetal Medicine

Urogynecology

REI (Reproductive, Endocrine, Infertility)

Pediatric and Adolescent Gynecology

Family Planning

Minimally Invasive Surgery

Breast Surgery

Orientation Required for all clerkships

Expectations

Abundant information

Go home and review clerkship material after orientation

Ask questions at orientation

Start preparing for your next day

What, when, where, and why me? Labor and delivery

OB Triage

Wards and rounds

OR

Clinic

Labor and Delivery Communication among students

Meet your patients prior to delivery

Be around and be prepared

Booties, hat, mask, gloves

Be proactive

Grab some of the same things above for your intern

Play well with others

Be sure not one student is getting all the deliveries

Introduce yourself to nursing staff, scrub technicians

OB Triage The “three” interviews

Not sure why I put quotation marks there

Patient interviewed by nurse, then student, then resident

Poach some information off the nurse interview

Focus, focus, focus Focused HPI based on chief complaint

Focused ROS- no leading the witness

Focused physical exam

Common things are common in OB triage

Wards and Rounds Strive for continuity of care

See the patients you helped deliver, assisted in operation

Be prepared… and if you’re not arrive earlier Your notes guide your oral presentation and vice-versa Your performance in this area is a reflection of your

residents Your residents want you to succeed Always have your residents review your presentation or note

before you go public

Practice Your oral presentations are like a speech, practice in front of

each other or in front of the mirror

OR Be prepared

Meet the patient, read about the surgery the night before Gloves and gown given to scrub technician Scrub- Ask about the timing of this at your program Introduce yourself to nurse, scrub technician

Actively participating and anticipating It’s OK to ask questions?

Yes, but the timing of questions and their context is what is important

Some questions are best asked after the surgery

What if you feel sick in the OR Say something and ask if you can sit down or scrub out

Clinic Be prepared

Watch your game film

Ask your resident for their expectations of you Every resident and attending varies slightly in what they

expect from students in this setting

Oral presentations, note writing, and physical exam are all important aspects of the ambulatory setting Develop an assessment on every patient

Do something while you doing nothing During downtime prepare for upcoming patients

Themes for success Preparation

My last workday always ends with preparation for my next workday

Communication Student-student, student-resident, resident-student

Proactive The more you do the more you will get to do

Teamwork You are only as strong as the weakest member of your

team

Themes for success Feedback

How do you ask for feedback?

Critically apply feedback received

Know your role

Medical hierarchy

Flexibility

First and second year of medical school very structured, third year much more variable from day to day

Above and beyond

Your Do List Show up on time… show up early, stay late

Good attitude

Ask for expectations

Help residents and students on your team to complete work

Take ownership for the care of YOUR patients

Read throughout the rotation

Ask questions

Your Do List Be around

Educate colleagues when opportunities arise

Be respectful of patients and their rights

HIPPA compliant

Be compassionate

Get your money’s worth

Your Don’t List Be lazy

Be late for clinic, rounds, and especially surgery

Appear uninterested

Argue with fellow students or with residents

Text

Substitute reading for patient interaction

Fear being wrong

Complain

Use social media as your venue to vent frustrations

Resources APGO

ACOG

Fellow students

Former students (some are now residents)

Final Thoughts OB/Gyn clerkship involves some of the most focused

weeks of your entire 3rd year clerkships

Utilize your resources and apply them to patient care

Be humble when receiving feedback and make appropriate adjustments to improve patient care

Enjoy the time and privilege you have earned to provide healthcare to YOUR patients