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OBSTETRICS/GYNECOLOGY – UNIT 6L
The goal of the Obstetrics/Gynecology Clerkship is to provide the medical student with experience in Obstetrics/Gynecology problems and instruction on doing an adequate pelvic examination. The student should become familiar with common problems in this rotation; however, each student should try to maximize their opportunities for seeing and learning about the broad spectrum of Obstetrics/Gynecology issues during this clerkship.
The minimum experience of each student will be:
1) Participate in 10 deliveries (performing 3 deliveries)
2) Assist with 5 hysterectomies/major surgeries
3) Assist with 5 cesarean sections
4) Perform 10 pelvic exams (do more)
5) Participate in 2 gynecologic laparoscopies
6) Observe an obstetrical ultrasound
The inpatient experience is similar to the Obstetrics and Gynecology rotations of the 6B medical students (2 weeks OB, 2 weeks GYN).
IN-PATIENT Training (4 weeks)
The Obstetrics/Gynecology clerkship will be at Kapiolani Medical Center for Women & Children. The clerkship is divided into two rotations: Obstetrics (Labor & Delivery) and Gynecology (Surgery) rotations. This schedule provides the maximum possible exposure for the student. A rotation schedule is provided during orientation. Weekly Obstetrics and Gynecology Grand Rounds, resident conferences and student lectures are mandatory.
On the Obstetrics and Gynecology rotations, the student is responsible for reporting to the Chief Resident. The student will be taking overnight and weekend/holiday call. The student call schedule will be distributed during orientation.
If the student was involved with a patient’s surgery, delivery or admission to the floor, they are expected to follow this patient until discharge from the hospital. The student will follow patients throughout the duration of the rotation. The student should NEVER do a pelvic examination without a Resident or an Attending Physician present.
Introduction to Ob/Gyn – Orientation
The student(s) will have a day of orientation to the Ob/Gyn Clerkship. Students will also be instructed in technical aspects and labor and delivery guidelines.
Obstetrics
The service is run by the Obstetrics Chief Resident. Report to the Chief on the first day of the rotation. Sign-in rounds are at 6:45am in conference room #815 with the OB team and sign-out your patients to the student on call at 5:00pm. Student(s) on call will sign-out with the team at 5:30pm in L&D. DO NOT leave the floor without notifying the Chief or Senior Resident. The student will be assigned to the Labor & Delivery suite and postpartum wards. You will perform the initial evaluation of laboring patients, participate in the management of labor and delivery, and follow the patient while in the hospital with the Attending and Resident staff.
Gynecology – Surgery
The student is assigned to the Gynecologic service and will be responsible for the evaluation of patients before, during and after surgery, including both routine and emergent surgeries. You will also participate in surgery and make post-operative evaluations on a daily basis. You should page your Gynecology Chief Resident prior to starting the rotation so that you can be assigned to cases. Sign-in and sign-out times may vary. Your Gyn Chief should know where you are at all times. PLEASE review outpatient surgical patient charts BEFORE scrubbing in on cases; know what procedures are being done and why! NOTE: There is a Chief Resident assigned to each rotation. The students are to report to that Chief and should keep him/her apprised of your whereabouts. If you are out sick, you are REQUIRED to contact your Chief Resident as well as the Student Coordinator. If you are sick and cannot work for more than 1 (one) day, you are still required to call in and you must submit a doctor’s note to the Student Coordinator upon your return.
Evaluation
A written examination will be given at the end of the inpatient rotation. Faculty and Resident staff will also evaluate your clinical performance. OUT-PATIENT Training (23 weeks, ½ day per week) The student is assigned to an Obstetrician/Gynecologist for 23 weeks and follows her/his patients during this time. The student learns about the ambulatory care of Obstetrics and Gynecology patients. The student should learn to do an adequate pelvic examination during this time.
Write-Ups
1 (one) Obstetric and 1 (one) Gynecology patient. Write-ups are due at 3 (three) and 5 (five) months. These write-ups should be full history and physical exams including Ob/Gyn history, pelvic exam and discussion session. This should be sent to our department. Please contact the department for exact due dates at the beginning of your rotation.
PBL Curriculum
PBL problems are covered during the outpatient training. Please contact the department at the beginning of your rotation for details.
Student Skills Cards
All skills cards and pelvic examination check lists must be completed and returned to Lisa by the end of the rotation. If not completed, you will then be assigned clinical activities to complete your required clinical skills. If it’s still not completed by the end of your 3rd year, you will receive an Incomplete for the rotation until you are able to complete the minimum skills and meet the core objectives.
Patient Stats
Beaming of patient stats will be done via Office of Medical Education. You can also email your stats directly to Lisa at kellett@hawaii.edu. The Director of Medical Student Education will be reviewing your stats intermittently throughout your outpatient and inpatient rotations. Please list ALL SIGNIFICANT patient contacts on L&D, Gyn Surgery and Clinic.
EVALUATION
In this clerkship, evaluation is used to reveal your strengths and limitations, determining whether you have mastered course objectives and to assign grades. Final grades are determined from your clinical evaluations (inpatient performance from Faculty and Residents and for outpatient rotation from individual Preceptors), performance in PBL and Ob and Gyn Write-ups, and final written examination.
Recommended Textbooks:
1) Obstetrics and Gynecology, Fifth Edition, Beckmann, Ling, et al., 2005
2) Essentials of Obstetrics and Gynecology, Fourth Edition, Hacker and Moore, 2004
If you have any questions about this rotation, please contact the University of Hawaii, Department of Obstetrics, Gynecology and Women’s Health at #203-6532.
09/14/07