Clerkship Day 72: OB-GYN Weeks 1 and 2

Assalamu Alaykum! (Peace be with you)

It’s 11:50PM in my clock and I am about to hit the bunkers but decided to write a short post about the recent events. (PS I need to keep it short coz I have another 24-Hour duty tomorrow ^_^)

I am now rotating in OBSTETRICS and GYNECOLOGY (OBGYN) for two weeks already and we have another two weeks remaining until the next rotation. And believe it or not—as much as I hate the bloody business in OBGYN—I am actually enjoying the clerkship in OB :) I do not know there’s just too many things to do that are not that dragging. I mean, I can now actually feel and call myself a part of the medical team working for the benefit and well being of our patients!

Anyway, here's a quick run-down of the usual days in OBGYN:

The OB Services. 

Students rotating in OBGYNE will be divided into 3 services: A, B and C and they will rotate on duty schedules. There will be at least 5 clerks on each service with one service having 6. Interns have a separate system of assigning students per service. Your block can decide if you will be divided alphabetically or you can choose which team to join. We did the former but with a few members swapping teams as agreed by the body. I belong to the awesome Service B ^_^

With Service B after our OBAS duty

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7AM Summary Rounds

Weekdays (Monday to Friday) at 7AM, the Summary rounds for OB happen. You must never ever be late! The Obstetricians on duty (OOD) will present the summary of admissions and cases during the summary rounds and in that span of 30-minutes, they will be grilled and questioned regading the unresolved and problematic cases they handled the night before. Special mention to those post-duty interns and clerks from the LRDR (Labor Room, Delivery Room). If you are on duty in LRDR and your case is pretty complicated or unresolved by 7AM the next day, might as well consider yourself a tribute to the burning fires of SR’s the next day. Read on your cases!

The dreaded daily summary rounds

24 Duties (7AM to 7AM) 

The duties happen every three days on two alternating posts: OB Admitting Section (OBAS) and LRDR. The other days (Pre and Post) are mostly used charting your SIC patients or floating around wards. Maximize your time in Pre and Post duty days, read on cases for SGDs or your Gyne Cases while waiting for procedures to be done.

OBAS Duty: 

Receive new patients, interview them and fill up their OB-, Abortion or GYNE Emergency Sheets. Necessary laboratory and diagnostic studies are also prepared by the student in charge (most of the time though your team will work together). When the Admitting Resident decides that your patient is for admission, you prepare her “Flags” and insert IV lines. 1 to 2 students (clerks or interns) will be assigned to be the “Service Master” for UTZ (Ultrasound) and PERI (Perinatology studies). The Service master will conduct patients under his/her service until his/her rotation ends (which usually lasts 2-3hours). There is also an assigned Monitor to do the round-the-clock vital signs monitoring (also lasts 2-3 hours per duty). And lastly a Lab Master (one of the interns) who will process the lab requests ad results for the whole duration of the duty.

LRDR: 

Receive patients admitted by OBAS. There will be assigned decking of patients per team. Clerks usually receive the OB Normal cases and uncomplicated Abortion cases first. Interns receive Ectopic Pregnancies and OB Abnormal cases first. Students will be assigned as SICs for their patient and will be responsible for all the needs of their patients. He/she conducts tocometer tracing, do labor watch, and assist during labor or cesarian section. He/she is also expected to fill up the Clinical Abstract and prepare the Discharge forms before his/her patient is admitted to the wards. If the case is unresolved (have not yet delivered the baby) the next day, he/she is expected to answer questions by the residents regarding his/her case during summary rounds.

GYNE Cases

Each clerk will also be assigned with new Gyne Cases for elective surgeries. Most of the time the cases will be Myoma uteri. You have to visit your patient for SIC works and know the schedule of their operation. You will be required to attend and assist during the surgery regardless if you are duty or post-duty. (Post duty are only required to attend until 12nn, you can scrub out and let the floater cover for you). I already attended only one of my two cases (both myoma uteri for elective surgery, total hysterectomy). My second case was rescheduled a lot of times until it was scheduled during my post-duty. It started around 12nn and I still have an SGD by 1PM so I wasn't able to scrub in. Better prepare all the necessary papers especially the Surgical Pathology paper for the specimen to be submitted to patho. To avoid problems for you, your resident and yourself as well.

Others

SIC works are done during Post, Pre and even during duty before 7AM. This includes visiting and examining the patient, assessing and extracting any subjective complaints, processing necessary papers, and taking note all necessary findings in the patient’s chart (aka “charting”). Laboratory procs are more often than not done by the Intern on duty in the wards.

SGDs: Several SGDs will be held throughout the rotation. Cases are: Gestational Trophoblastic Diseases (GTD or Hydatidiform Mole/Molar Pregnancies, etc.), Cervical Cancer, Placenta Previa, Ovarian New Growth (ONG) benign, and Ethics. You will be asked to choose a case from your patients and submit a protocol days before the scheduled SGDs. The block will be divided into 2 groups. This is graded individually by performance and will comprise 15% of the Final grades (if Im not mistake. It’s a pretty big chunk so better prepare well for this).

PHL: Public Health lectures on 3 topics divided by services. Topics are: Post-Partum Myths, Surgical Wound care and Breastfeeding.

There will also be an end-of-rotation Exam and an OSCE. But it seems we are not that “afraid” for these two as they are pretty fair. Meaning: So long as you did your job during the one-month rotation, you can almost always pass. In sha Allah.

Hmm That’s all for now ^_^ Will continue updating after a few weeks

Sorry I know I promised to keep it short but whatever haha.

Realizations:

"2nd week in OBGYN Clerkship.Realizations:
"Never say women, particularly mothers, are weak.Just the mere experience of those excruciating pain during labor is simply one thing no single man alive could ever imagine to survive."

#OBGYN #Clerkship #UPPGH #LifeinMedschool #LU6"

Salam Kasilasa!

Ahmad ibn Hajiri