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Clerkship Series: OBGYN

At SheMD, we strive to provide resources for women in all stages of their medical education. Recently, we realized that we needed to fill a void in resources for students currently in their clinical clerkships. We have reached out to students across the country to help us help you all. They will offer you the ins and outs to several different rotations that you are either currently in or are looking forward to starting some day.

For our first post, one of our editors, Kristen Stringfellow, is writing about what the Obstetric and Gynecology Clerkship entails.

Hey everyone! I am so excited to be a part of the new series on clinical clerkships. I am currently in my third year of medical school and completed the OB/Gyn clerkship in August. I am currently preparing to apply to OB/Gyn residencies this coming fall. My goal is to help you all prepare best for your own OB/Gyn clerkship. Many of my friends in several different schools were nervous going into this rotation. This rotation involves women and their families at some of the most vulnerable times of their life, and the respect for these times is necessary going into this rotation.

A week before this rotation started, we got to use the pelvic trainers in the SIM lab to learn and practice performing pap smears and pelvic exams. We practiced these for hours and really got good at finding that little plastic donut. This made performing pelvic exams during clinic and the OR muscle memory from all of our practice. If your school has pelvic trainers or a SIM center, I strongly advise doing this. Being efficient in pelvic exams will help you get more exposure during clinic, further increasing your confidence in the skill too.

Some schools that perform robotic assisted surgeries will have time to allow you to practice on the robot. We did not have time set aside for this kind of practice, but the scrub nurse that worked with the robot every day helped a couple of us learn how to put the robots into a demo mode so that we could play games on them and even demo some low level surgeries on it too. This made me much more confident in my ability to learn how to use the robot.

As 3rd year students, we are not the ones assisting with the robot even at the bedside, but if your clerkship has you “drive the uterus” knowing how the robot moves and works can be really helpful to make you impressive and make you able to anticipate next moves (if that is something your attending is okay with). If this is something that you are interested in, you should ask the attendings who commonly use the robot if your school’s robot has simulations on it and if you could ever practice with it.

Here is my biggest advice on how to excel on the wards and in the clinic while on this rotation:

1. Relax.

Attendings and residents that you are working with know that this is one of the first times that you are exposed to women’s health in a vulnerable way. They know that performing pap smears and pelvic exams are not a natural skill that we learn. So relax, learn the steps. Fall back on muscle memory from learning on the pelvic trainers. This will help you be able to perform exams more efficiently and more confidently.

Ask questions when you do not understand. This will help mitigate your nervousness from honestly not knowing, and it will also open up those you are learning from to strong teaching opportunities. Patients and attendings will be more willing to let you do more and let you see more if you are calm. No one wants a nervous nelly in the room, so take a deep breath!

2. Step up.

As a student, one of the best pieces of advice I ever received was that interested students are the students that attendings, residents and nursing staff enjoy teaching and including in different learning opportunities. Clerkships can be boring. You can go your entire labor and delivery shift following a patient who does not progress in her labor at all. This is not time wasted. This is time that you can step up and ask about other things that you can do to help out.

Are there patients who you could try repositioning? Are there patients who need ice or fresh towels? Are there patients you could take for a walk? Offering to do these small tasks not only shows that you are interested, but also shows that you care. These are the things that evaluators can talk about in your evaluations. These tasks take work load off of nursing staff and residents. This will give them more time to sit with you and teach you things such as suturing or take a stab at practice questions.

3. Prepare.

This advice really goes for all rotations, but one of the best ways that I feel I am able to make a good impression is by preparing well for the day. Take the time the day before to pilfer through the clinic schedule for tomorrow. Are there any interesting patients with disease processes that are more rare? If so, this is a great opportunity to look at UptoDate and study up on this process. You will be more ready with knowledgeable questions, and also prepared for different questions that you might get from residents and attendings trying to test you.

Take the time to know the routine things too. Some things that pre-clinical years don’t always expose us to are guideline directed care plans and preventative care timelines. Review these before going into clinic, and you will be more apt to make a good impression.

Before going into the OR, make sure that you know the case, the implications for the case, and that you have read through the patient’s chart as to what implication they have that has lead to their current operative plan. This may seem like a “duh” statement, but you will be surprised to hear of your own peers who do not do this. There are also so many resources where you can watch the planned surgery online. This is great for anatomy review, which will be many of the potential questions asked of you.

All in all, knowing what your day tomorrow looks like will make you more knowledgeable for how you can be helpful and give you insight to the potential questions you may be asked.

I hope that this is helpful to you all! We are really striving for this to be informative and useful! If there is anything that we could do better with this series, please send us a message! Good luck on your rotations!

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