frustrating ob rotation

[nightowl]

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my rotation has been really disappointing. I went to med school in my home state because I was told it was a great clinical program and I would have the opportunity to "deliver ten babies if I wanted".

well, I haven't delivered one. I have only assisted in ONE vaginal delivery. As in, clean up the patient and hand the patient the clamps for the cord. So how am I supposed to know if I want to do ob/gyn when I haven't even gotten to see anything?!

ps. I have told my resident that I really want to do a vaginal delivery. I have scrubbed in on everything I can. I take more patients than anyone else. I write my notes on time and do all of my work. Just a disclaimer for those who may think this is somehow my fault for being a lazy student or something...

 

[prince1]

my friend i am the same as u but i am from egypt
i work very hard and even i found new data by history taken which is not documented and ask my seniors


may be there are other things for work we dont know

 

[goodsamob]

If you are presently on rotation, you are most likely experiencing the July phenomenon. All of the interns are brand spanking new. They don't know yet exactly how to do these things, which makes it really hard to hand deliveries over to someone else. Most likely, it's not that you are doing anything wrong, it's that they wouldn't know how to help you if you were doing something wrong.

What I used to advise the med students at this time of year, is to keep an eye out for deliveries that may be done by upper levels (the intern is off in a c-section or other delivery, etc.) If the senior is doing the delivery, they should be more than happy to teach you how to do one.

Most of all, if you do think you like this field, don't let this discourage you from it. L&D is a very overwhelming place for a new intern, and sometimes this translates into little time for med student interaction. Things can go down hill very fast and we have to keep our eyes on the patients.

My other advice would be to do a 4th year elective next year in Oct or later, once the interns have settled in a bit.

Good luck.

 

[Cholinergic]

my rotation has been really disappointing. I went to med school in my home state because I was told it was a great clinical program and I would have the opportunity to "deliver ten babies if I wanted".

well, I haven't delivered one. I have only assisted in ONE vaginal delivery. As in, clean up the patient and hand the patient the clamps for the cord. So how am I supposed to know if I want to do ob/gyn when I haven't even gotten to see anything?!

ps. I have told my resident that I really want to do a vaginal delivery. I have scrubbed in on everything I can. I take more patients than anyone else. I write my notes on time and do all of my work. Just a disclaimer for those who may think this is somehow my fault for being a lazy student or something...

Are you at least able to watch the deliveries or are you saying you just want to do the delivery? OB/Gyn is about a lot more than delivering babies. . .

I also didn't get to deliver more than 2 babies on my rotation, but I'm still planning to go into it. I'll say that L&D was the one time during the whole rotation where I felt useless. Then I had to get smart and figure out what I could do. See the patients as they are coming in with contractions or bloody show or whatever. Try to get a good history and do the physical. If you are following a laboring patient, do the hourly cervical check, assess how the labor is progressing and write a small note. Try to meet the patient and introduce yourself before the actual time she starts pushing. Show your residents that you are truly interested in the entire process and not just want to show up for the delivery.

Disclaimer: I am *just* a 4th year, so bear this in mind. 👍

 

[THP]

If you are presently on rotation, you are most likely experiencing the July phenomenon. All of the interns are brand spanking new. They don't know yet exactly how to do these things, which makes it really hard to hand deliveries over to someone else. Most likely, it's not that you are doing anything wrong, it's that they wouldn't know how to help you if you were doing something wrong.

What I used to advise the med students at this time of year, is to keep an eye out for deliveries that may be done by upper levels (the intern is off in a c-section or other delivery, etc.) If the senior is doing the delivery, they should be more than happy to teach you how to do one.

Most of all, if you do think you like this field, don't let this discourage you from it. L&D is a very overwhelming place for a new intern, and sometimes this translates into little time for med student interaction. Things can go down hill very fast and we have to keep our eyes on the patients.

My other advice would be to do a 4th year elective next year in Oct or later, once the interns have settled in a bit.

Good luck.

This is exactly right. As a new intern who recently had my first day/night of OB call I can tell you that I would not be giving up any deliveries to med students. Luckily we don't have any right now. I want my 2nd year resident in the room with me. I barely know anything or what I am doing right now. I would not feel comfortable supervising somebody else.

 

[nightowl]

To clarify,

I am competing for deliveries with one family med resident, but my team is a new 2nd year and a 4th year. There are no interns on L and D right now. Which is an additional reason why I'm so frustrated with my lack of hands on experience in L and D. On the upside though, I got to do quite a few things in gynecology, and have scrubbed in enough to not complain... I've just been disappointed with L and D. I was hoping that my experience on it would make or break if I'm interested in doing OB/gyn, because I have liked all of the gynecology and the surgery more than I expected, but L and D hasn't made up my mind one way or the other. I'm trying to figure out if it's because of my lack of experience + not enthusiastic to teach (probably because they're SO busy themselves....?). I do have one more week of L and D on days, so hopefully the rotation will look up for me =)

 

[Pegsie]

At my program, our medical student clerkship coordinator has chosen to stress things other than a vaginal delivery for our third year students to focus on. While she understands that all students want to do a delivery, she thinks that it's more important for those not going into the field to know how to take a good obstetric H&P.

Now I don't necessarily agree with this - I do think that delivering a baby should be a basic physician skill like CPR (who knows what emergency situation you might be involved in?) - getting med students vag deliveries just may not be a priority for the rotation.

Whether that official line actually translates into what happens on the wards is a different thing. I do agree with the suggestion that you need to look out for deliveries that are not attended to by the new residents. You can't expect new med school grads to be able to supervise you when they are being supervised closely themselves. Does your OB service have midwives? They do a lot of normal SVDs that residents generally stay away from - when I did my 4th year rotation, most of my deliveries were with midwives.

Best of luck!

 

[nykka3]

I also got most of my deliveries on my clerkship with the midwives. If your prgm. has them try to work with the midwives. You will learn a lot about non complicated vag. deliveries.

 

[Sharkfan]

I agree with the July theory. It's a terrible time to rotate through OB if you're interested in it. Interns are busy/frantic trying to feel comfortable doing procedures, and upper levels are busy monitoring interns. Even worse if there's an AI around, which will begin soon- they'll expect dibs over you in just about anything. 3rd year students are at the bottom of the food chain. Although it won't help you, it gets much better second semester when interns are tired of NSVDs, AIs are gone, and upper levels are getting senioritis. 🙁

 

[tiredmom]

An additional opportunity is to arrange to come into L&D on the weekend between rotations (i.e. after the shelf exam). That's usually a student free weekend where you can be the only one there. If you are putting in the effort you say you are, then the residents would likely be able to get you deliveries.
I can tell you, as a new 2nd year resident, I'm not searching out the students to come to deliveries. I expect them to have already met the patient and be following them. Everyone can tell who's complete with our computerized charting system, so they just need to make it to the room before we are up in stirrups and they'll get to catch if: it's not a primip/preterm/my intern's already scrubbed in. If my intern is already scrubbed, they can still scrub and do placenta, etc.