Clinical Objectives
During this 8 week rotation in Obstetrics and Gynecology, medical students will strive to:
- Be competent in performing gynecologic pelvic examinations.
- Be competent in evaluating pregnant patients.
- Understand common ObGyn conditions, disease processes, diagnoses and management.
- Attain exposure to breadth and depth of obstetrics and gynecology.
Clinical Responsibilities
As integral members of the obstetrics and gynecology team, students participate in daily patient care, including ward rounds, the operating room and the emergency department. They work directly with staff physicians and patients in all general and sub-specialty obstetrics and gynecology clinics, as well as gain exposure to the operating room, sterile techniques and the general principles of surgery and post-operative care. Clerks will assist in operative deliveries and gynecological surgeries, and will have the opportunity to see laparoscopic surgeries.
Throughout their ObGyn rotation clerks are responsible for:
- conducting a history and physical exam on new patients,
- writing admission note for new patients, and
- helping the residents with daily charting including lab work, until patient is discharged.
Obstetrics
Clerks gain direct exposure to normal pregnancy care, labour and delivery, and high risk-obstetrics (“maternal-fetal medicine”) in both outpatient and inpatient settings.
ObGyn clerks spend 1 month in the birthing center; by the end of this rotation clerks have the confidence to determine which patients require admission. Clerks will learn how to perform vaginal examinations. However, vaginal examinations for educational purposes will be limited only to patients who have epidurals. Clerks are expected to follow patients throughout labour and participate in deliveries. Participation does not mean that the clerks will deliver these patients – that will be at the discretion of the resident and/or attending staff on-call. Clerkship students usually only deliver multiparous women.
Clerks will also have responsibilities to round and follow patients on the antepartum high-risk unit and the postpartum unit, until discharge. By the end of the rotation ObGyn clerks should feel comfortable managing routine post-partum vaginal and cesarean section patients.
Gynecology
Clerks gain exposure to general gynecology, gynecologic-oncology, urogynecology and reproductive endocrinology and infertility.
Clerks are responsible for all admissions from ER or clinics. Clerks will learn how to conduct a pelvic exam and must ALWAYS be supervised by a resident. After obtaining history and physical exam clerks formulate an impression with differential diagnosis and a proposed plan of diagnostic work-up and care, which is reviewed with the residents/staff. It is the role of the chief resident to ensure that all team members are aware of the issues / plan for all patients on the ward.
Charting
All charting by clerks in patient’s medical record should be supervised and co-signed by the resident or faculty member involved. This is particularly important for any medical orders written.
Reading
Before attending surgery, clinics, birthing centers etc., clerks should come prepared with a basic understanding, which enables them to ask appropriate questions and benefit from the clinical exposure. Any general ObGyn textbook, which can be read from cover-to-cover within 6 weeks, is appropriate for general reading. In addition, clerks should explore in-depth conditions or complications presenting in their patients.