OBGYN Rotation Advice for Medical Students

BOOKS TO HAVE

SOAP OBGYN–great book to use when you’re in clinic, it has a DDx, H&P, labs, treatment, etc. for every imaginable presentation you will see in clinic; Blueprints–a must read, read a chapter or more after you’ve seen a patient (it sticks better); Case Files–A fun read if you have extra time, good for problem solving; Obstetrics, Gynecology and Infertility: Handbook for Clinicians-Resident Survival Guide Paperback by John D. Gordon (the little red book)– It was somewhat helpful. Good b/c you can carry it in your pocket, but the information is disorganized. I thought the best part was at the back of the book, it gives you an outline for different op notes (C/S, GYN surgeries,etc), it also has lots of charts and algorythms. I saw a lot of the residents use it but it wasn’t particularly helpful to me.

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KAISER San Francisco

OBGYN rotation at Kaiser SF medical student review

1. Tell us the rotation AND site you just completed (ex. OBGYN, Kaiser Oakland)
OBGYN, Kaiser SF

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2. What books/tools did you use for this rotation? Tell us which ones were absolutely necessary, somewhat helpful, or total waste of money. Also tell us how you used them.
SOAP OBGYN–great book to use when you’re in clinic, it has a DDx, H&P, labs, treatment, etc. for every imaginable presentation you will see in clinic; Blueprints–a must read, read a chapter or more after you’ve seen a patient (it sticks better); Case Files–A fun read if you have extra time, good for problem solving; Obstetrics, Gynecology and Infertility: Handbook for Clinicians-Resident Survival Guide Paperback by John D. Gordon (the little red book)– It was somewhat helpful. Good b/c you can carry it in your pocket, but the information is disorganized. I thought the best part was at the back of the book, it gives you an outline for different op notes (C/S, GYN surgeries,etc), it also has lots of charts and algorythms. I saw a lot of the residents use it but it wasn’t particularly helpful to me.

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3. Describe your call schedule. Ex. # days on call, what time you realistically got out, etc.
When you’re on call, you serve on Labor & Delivery. There is a some flexibility for setting up your call schedules. i.e. we could trade our assignments with other students, and make adjustments if we had special engagements. A 24 hour call scheduled for a Saturday could be broken up into Friday 5:30pm – 7am AND Sunday 7am – 9pm (leaving you with Sat off). This flexibility is resident dependent so approach with caution. My call schedule was: Week 1: Sat 24hr (7am-7am); Week 2: Fri 5:30pm-7am AND Sun 7am-9pm; Week 3: Fri 5:30am-7pm; Week 4: No call; Week 5 No call; Week 6: No call. So it was pretty crazy the first 3 weeks, but more chill the last 3 weeks.

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4. How did you prepare for the finishing exam/shelf exam. How would you prep differently if you could do it again.
Finishing exam is 100 question shelf exam, plus two essay questions straight out of the objectives section. I tried to read as much Blueprints as possible, and then did all of the questions at the end of Blueprints; Did the UWise questions (which are similar to the Board style questions). If I had to do it differently, I would start doing questions a lot earlier.

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5. Comment on one or more aspect of the rotation as it pertains to: 1) How you survived the rotation 2) What you felt you did well and how you did it 3) mistakes you made and how to avoid them 4) What you did to make the residents’ life easier 5) If, when, and how you found time to read 6) Pointers on how do well on: H&Ps, oral presentation, record keeping, professionalism, self-improvement, and working well with the health care team. 7) Best and worse aspects of the rotation How often you were pimped and how 9) Names of awesome teachers to work with 10) Clinic vs inpatient experience 11) medical contitions or surgeries you saw 12) Anything else that comes to mind
1) Tried to be enthusiastic, Used SOAP OBGYN in clinic, accepted the fact that in clinic some MDs will let you do stuff and others won’t so best to just go along with the flow, very helpful to ask chief resident for feedback, read during down time 2) I got along well with the nurses and medical assistants and ended up learning a lot from them 3) Would recommend following more than 1 patient when you are on L&D to ensure a delivery that day – ok to ask to see more patients than you’ve been assigned only 1 4) fill out op notes, discharge notes, L&D labor notes (every 2 hours), help set up in the OR, look up articles related to a question the residents might have or question on the management or prognosis of a unique patient, type up dry labs (GYN), ask to do PM checks on other resident’s patients (GYN), volunteer to do stuff, ask to do stuff 5) I read most when I was on clinic (went home and read up on a patient or an MD’s specialty like infertility or urogynecology), read least when I was on GYN service, read during downtime when I was on L&D. Always had my Blueprints near by. 6) For H&Ps, I just made a copy of a resident’s note and used that as my guide, just ask for feedback 7) Best aspects are the attendings and many of the residents. I thought overall they were great teachers and good people. The Tuesday conferences/didactics were very good too and focused on the objectives of the class. If the first topic is fetal monitoring, make sure to read ahead for that one, especially if you’re not starting out on L&D. Worse aspects is that there’s a lot of jargon and acronyms in OBGYN and figuring it all out took some time. The hours were ok. I was pimped in clinic (screening and diagnostic tests in pregnancy; vaginal discharge, etc), I was pimped in GYN (abdominal layers, GYN anatomy, arteries/vein/ureter), and I was pimped on L&D (stages of labor, pre-eclampsia diagnosis and management, fetal heart monitoring, ddx for variable and late decels, etc.). I didn’t feel I had a ton of pimping at all, but I sure as hell read up on patients as they were being discussed if I sensed pimping in the air. Each Friday there is pre-op conference with many attendings and residents. The medical students are expected to attend. Expect to get pimped that hour and a half. They like to target innocent med students with cruel questions (j/k) No, actually, it’s all in fun so just try your best to answer the question. 9) There were so many awesome people at Kaiser SF. Awesome Attendings: Jacobson, Sklar, Weiss, Masters, Tseng, Fracchia, Kendrick, Hall, Feigenbaum (interesting character), Sweeting (retiring), Dorward, Fields (I didn’t work directly with him but you will learn a lot from him during antepartum rounds) Best Chiefs: Tsai, George-Wells Best Residents: Lantzman, Tien, Longinotti, Gogia, Tam, Wright, Savage, Kam-Castro. One bad chief resident but she’s moving on so you guys don’t have to worry about it. 10) The 2 weeks of clinic were chill. 9-12, 1:30-5. Went home and read. fast paced during clinic (15-20min/pt), infertility clinic and urogyn were the most laid back, did most H&P when I worked with the residents. Jacobson has interesting way of incorporating you in clinic so don’t be surprised. Just follow along. Inpatient was more fast paced, rounds started at 6am +/- 1 hour. Sign out was at 5:30pm. 12) Just be yourself, be enthusiastic, don’t be shy, ask questions, read often, be prepared, do the best that you can, punctuality on rounds takes priority over all else, don’t take things personally, come in as early as needed to preround so that you’re not shot down during rounds (an R2′s personal motto), have fun and get to know your patients. The patients totally make it all worthwhile. Stay close to the helpful residents and stay away from obviously bad ones. And… be happy when the pimping is aimed at the residents b/c it’s just fun to watch.

OBGYN rotation at Kaiser SF medical student review