OB: Baby's head crowning, attending leaves me alone to deliver to go get lunch..

[evenflowcarter]

my second time assisting delivery, baby about to crown.
My attending looks at his watch and says "its lunch time, see ya, ill be back in an hour"

i almost **** myself before delivering the baby and proceeding with the perineal suturing.

Talk about raw.

Talk about a rush.

I hope no one else gets this owned on their OB rotation.

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[MeowMix]

I hope you're kidding. Rush or not, that's irresponsible of the attending and you. Perineal suturing isn't like sewing up an appy incision. An unskilled job without good anatomical knowledge has long-term consequences. I'm glad that's not my privates you sewed up.

 

[Arsenic]

my second time assisting delivery, baby about to crown.
My attending looks at his watch and says "its lunch time, see ya, ill be back in an hour"

i almost **** myself before delivering the baby and proceeding with the perineal suturing.

Talk about raw.

Talk about a rush.

I hope no one else gets this owned on their OB rotation.

WOW, thats freaking crazy. why didnt you say anything?

 

[evenflowcarter]

WOW, thats freaking crazy. why didnt you say anything?

i guess I wanted a good eval, plus I stupidly told him (the obligatory) "I want to do OB."

He came back about 50 minutes later and asked me If I thought I did a good job on the suturing. He bent down and looked at the job while munching on an apple over the poor lady's hoo-ha, and said looks good.

Then he went on to tell me I'll be doing all the rest of the Title 19/medicaid insurance deliveries when he is on call.

thx pal.

 

[surrender903]

would you like a rasp for that chip on your shoulder?

 

[evenflowcarter]

would you like a rasp for that chip on your shoulder?

oh come on surrender, you can be more witty and sarcastic than that.

 

[Ashers]

i guess I wanted a good eval, plus I stupidly told him (the obligatory) "I want to do OB."

I got good evals from attendings without telling them that.

I like the fact that I got through OB without delivering a baby. Though, I delivered a lot of placentas.

 

[climbingdocs]

I LOVE delivering babies 😀
I would do OB if it wasn't for the LONG hours.

 

[surrender903]

oh come on surrender, you can be more witty and sarcastic than that.

i could but that would require it to be a weekday and for Phil to not have seen his shadow.

 

[justwondering]

You should find some smart way to report this to your dept head ASAP.

its totally dangerous to let u deliver unsupervised. what if there was a shoulder dystocia while he's down in the cafeteria?

 

[evenflowcarter]

You should find some smart way to report this to your dept head ASAP.

its totally dangerous to let u deliver unsupervised. what if there was a shoulder dystocia while he's down in the cafeteria?

i asked another partner of the practice about this, and he said if anything went wrong my school's malpractice insurance is there to back them up.

lol

 

[smq123]

I don't know why everyone's getting so upset. It's not like people get sued in OB/gyn or anything. And what could go wrong when delivering a baby? The mother does all the work, right? 🙄

OP - where do you live? In PA and NY, there's NO way that an ob/gyn attending would just leave, because malpractice is such a big issue around here. We have to have our progress notes triple-checked, just to make sure that we're not leaving ourselves open to liability issues. I'm trying very hard to give you the benefit of the doubt, and not to just automatically call on this thread.

 

[Ypo.]

I'm trying very hard to give you the benefit of the doubt, and not to just automatically call on this thread.

You're giving more credit than I am.

 

[evenflowcarter]

I don't really have much to gain by lying on this board. I just wanted to throw my story out, to let other students know that certain things go on. Just like the sexual harassment that is rampid at many of your programs. In this case, I'm guessing he was more than willing b/c im at a busy practice in iowa, and the mexican and sudan refugees, on our government funded medicaid, aren't litigenous. He has since let me do a few more title 19's on my own, but don't believe me, I am not credible.

 

[smq123]

I don't really have much to gain by lying on this board. I just wanted to throw my story out, to let other students know that certain things go on. Just like the sexual harassment that is rampid at many of your programs. In this case, I'm guessing he was more than willing b/c im at a busy practice in iowa, and the mexican and sudan refugees, on our government funded medicaid, aren't litigenous. He has since let me do a few more title 19's on my own, but don't believe me, I am not credible.

Sorry if I offended you. It just sounds really crazy to me that a practicing ob/gyn would let a med student handle a delivery and a perineal tear on his own. Every single ob/gyn attending that I've talked to has said "If you're interested in this field, great, but realize that it means walking on eggshells whenever you're in a delivery room. And that you'll be paying an arm and a leg for malpractice insurance."

You SHOULD say something, though, to your rotation director.

In this case, I'm guessing he was more than willing b/c im at a busy practice in iowa, and the mexican and sudan refugees, on our government funded medicaid, aren't litigenous.

So your attending is less vigiliant with his patients because they're illegal/refugees, and therefore are less likely to sue? That's nice of him. 👎

Not having to worry about malpractice issues in ob/gyn just means that you don't need to be extra-careful with paperwork. It does NOT mean that you can ignore the standard of care (and "letting a med student do the delivery while I get lunch" is not the standard of care).

He couldn't wait half an hour to eat? Does he have diabetes or something? 😕

 

[Old_Mil]

I like the fact that I got through OB without delivering a baby.

I like the fact that I got through OB without dropping one.

 

[AwesomO]

I LOVE delivering babies 😀
I would do OB if it wasn't for the LONG hours.

I've heard attendings and residents kicking around the idea of OB hospatilists. ie someone does all the prenatal care and you do the delivery and management in the hospital. From what I understand it would be shift work and you would hardly be paged at home since you techinically don't carry any patients in clinic. Could be interesting if this kind of thing takes off.

 

[SPINE DOCTOR]

I like the fact that I got through OB without dropping one.

Have you seen any baby get dropped before? What happened? Or does the same 5 second-food rule apply?

 

[Ashers]

Have you seen any baby get dropped before? What happened? Or does the same 5 second-food rule apply?

They go into the catching bag that's put at the end of the bed. I believe one of my friends actually saw that happen when an attending was doing the delivery.

My dad still can't believe I didn't catch a baby, he keeps talking about "the good old days" at LA county as a med student where he was the only one available to deliver some woman's baby out in the middle of a hallway because all the attendings and residents were in other and more complicated deliveries. I guess that was a little bit different in the 70s.

 

[Arsenic]

They go into the catching bag that's put at the end of the bed. I believe one of my friends actually saw that happen when an attending was doing the delivery.

My dad still can't believe I didn't catch a baby, he keeps talking about "the good old days" at LA county as a med student where he was the only one available to deliver some woman's baby out in the middle of a hallway because all the attendings and residents were in other and more complicated deliveries. I guess that was a little bit different in the 70s.

yeah, i didnt get to catch one either on OB. i took the rotation in august and the attendings and residents were giving all the deliveries to the new interns so that they could get more experience. grrrrrrr.

 

[smsc2009]

I LOVE delivering babies 😀
I would do OB if it wasn't for the LONG hours.

What is the process for someone who would just like to practice OB without the GYN? Is it possible to get out of medical school and do a residency in internal medicine and than some sort of fellowship in just OB? (I know OB isn't a normal internal medicine fellowship) but is it possible to be a primary care physician while practicing a lot of OB?
Thanks

 

[Ashers]

yeah, i didnt get to catch one either on OB. i took the rotation in august and the attendings and residents were giving all the deliveries to the new interns so that they could get more experience. grrrrrrr.

Yep, I had it from mid-Aug through September. The OB/gyn interns and FP residents took a whole bunch of the deliveries I would've been in, or everyone delivered when I was in emergent C-sections in the middle of the night.

 

[fantasty]

What is the process for someone who would just like to practice OB without the GYN? Is it possible to get out of medical school and do a residency in internal medicine and than some sort of fellowship in just OB? (I know OB isn't a normal internal medicine fellowship) but is it possible to be a primary care physician while practicing a lot of OB?
Thanks

FP. You've got your primary care and OB, which only routine gyn (non-surgical).

 

[Trooth]

Arsenic

Don't worry - I caught some for you too. Really shocked how babies come out - like greased lightning. Its like fitting a watermelon through a rubber sleeve - it will give... just gotta know where to push a little and when to extend the opening.

By week 2 I was sick of it though, the residents were annoyed that I was "bored of babies". But really after about 2 normal ones it is all the same - now when the sucker gets stuck or decides to play NST games then it gets spicy. I have no clue how people do this for a lifetime.

 

[smq123]

What is the process for someone who would just like to practice OB without the GYN? Is it possible to get out of medical school and do a residency in internal medicine and than some sort of fellowship in just OB? (I know OB isn't a normal internal medicine fellowship) but is it possible to be a primary care physician while practicing a lot of OB?
Thanks

You can do family medicine, and then do an OB fellowship after that. No gyn surgery, no gyn onc, uro-gyn, etc., but you get to deliver babies and do a lot of prenatal care.

 

[smsc2009]

You can do family medicine, and then do an OB fellowship after that. No gyn surgery, no gyn onc, uro-gyn, etc., but you get to deliver babies and do a lot of prenatal care.

Exactly how compectitive is this route? Obviously, it can be obtained by all MD/DO, but what about FMG?
Thanks again

 

[justwondering]

Have you ever seen a shoulder dystocia being delivered? first youre there thinking all's well, she'll just push it out...then suddenly u realize you have a shoulder dystocia and everyone is working to make sure u get the kid out IMMEDIATELY. when i was at my first dystocia as an FM intern, i was pushed out of the way so the senior could deliver it. im not telling u to report it because of malpractice. im telling u to report it to avoid morbidity/mortality for someone's child.

 

[Grace34]

And just because patients are on Medicaid or are immigrants, they are less deserving of quality health care somehow? (Yes, I AM saying that having an MS3 deliver is sub-par healthcare - no offense)

 

[Arsenic]

And just because patients are on Medicaid or are immigrants, they are less deserving of quality health care somehow? (Yes, I AM saying that having an MS3 deliver is sub-par healthcare - no offense)

the problem i had with it was not that the ms3 delivered but that the ms3 delivered unsupervised. i dont think its sub-par healthcare if the attending or senior resident is standing next to the med student to jump in if there are any complications but totally agree with you that it is if the student is unsupervised and the attending went to lunch.

 

[chagall]

the problem i had with it was not that the ms3 delivered but that the ms3 delivered unsupervised. i dont think its sub-par healthcare if the attending or senior resident is standing next to the med student to jump in if there are any complications but totally agree with you that it is if the student is unsupervised and the attending went to lunch.

Exactly...I got to deliver quite a few babies on my OB rotation, but the second that someone called out for a vacuum or forceps or something looked sketchy, I got pushed way to the back of the line (which I think is as it should be...you never know what might happen during a delivery, and it definitely would not have been good medical practice to leave me alone to deliver).

 

[deleted92121]

Be glad you don't have to deliver by yourself in the back of a moving ambulance...

your friendly EMS professional,
dxu

 

[gregMD]

my second time assisting delivery, baby about to crown.
My attending looks at his watch and says "its lunch time, see ya, ill be back in an hour"

i almost **** myself before delivering the baby and proceeding with the perineal suturing.

Talk about raw.

Talk about a rush.

I hope no one else gets this owned on their OB rotation.

I call BS on this.... I dont believe this actually happened. This would constitute malpractice on the attending's part...

 

[Flopotomist]

I call BS on this.... I dont believe this actually happened. This would constitute malpractice on the attending's part...

It is also possible that from the OPs perspective, the story is true, but what ACTUALLY might have happened is the attending said, "see you in an hour," and then stepped outside of the curtain, watched the entire thing to make sure it was going OK, and then popped back in when it was over so that the poor M3 could feel like a stud.

 

[Sean2tall]

You can do family medicine, and then do an OB fellowship after that. No gyn surgery, no gyn onc, uro-gyn, etc., but you get to deliver babies and do a lot of prenatal care.

As I heard it, you can do C-sections as an FP with OB fellowship?

 

[Grace34]

Yes, FPs can do a fellowship that allows them to do C-sections. However, keep in mind where you want to practice after residency. Many places the political climate is such that an FP would never get C/S privileges.

 

[Wednesday]

There is no baby catching sac at the end of the bed, that sac is to catch the fluid and blood so it doesn't mess up the floor. You actually have to have your hands on the baby as you deliver.

 

[ArcherM2]

I'm an MS3 and I delivered my first baby last night, on my second-night of OB, on the first vaginal delivery I had ever seen! The attending basically put my hands in position and then talked me through the whole thing, next thing you know I'm holding the baby with a death grip, just thinking to myself "DON'T DROP HER, DON'T DROP HER, DON'T DROP HER!"

It is definitely a rush. We'll see how soon the novelty fades. But I must say, I really do like the operative aspects of OB/Gyn so far - but every time I see a piece of bowel I just cringe and hope they don't make an enterotomy!

 

[Myempire1]

I started OB this week too. I haven't gotten to do a delivery yet, but have watched a couple C-sections. I also had the privilege of getting yelled at by a midwife for (1) not "waiting until the IV-line was in" before doing a physical exam (wtf?), and (2) doing a routine breast exam without a chaperon (n.b. unless requested, only 3/4 of male medical residents choose to have a chaperon for a breast exam). Based on the last 5 days, this is going to be a long 6 weeks.

 

[boulux]

my second time assisting delivery, baby about to crown.
My attending looks at his watch and says "its lunch time, see ya, ill be back in an hour"

i almost **** myself before delivering the baby and proceeding with the perineal suturing.

Talk about raw.

Talk about a rush.

I hope no one else gets this owned on their OB rotation.

 

[MeowMix]

doing a routine breast exam without a chaperon

I always have a chaperone for breast exams, and I'm female. It's just common sense and good practice.

 

[MeowMix]

As I heard it, you can do C-sections as an FP with OB fellowship?

You do not need fellowship training in all hospitals. Some places will credential you based on your experience alone. Others require the fellowship.

 

[Top Gun]

I started OB this week too. I haven't gotten to do a delivery yet, but have watched a couple C-sections. I also had the privilege of getting yelled at by a midwife for (1) not "waiting until the IV-line was in" before doing a physical exam (wtf?), and (2) doing a routine breast exam without a chaperon (n.b. unless requested, only 3/4 of male medical residents choose to have a chaperon for a breast exam). Based on the last 5 days, this is going to be a long 6 weeks.

Doing a physical exam before an IV line is placed is no big deal. That was a pretty stupid reason for the midwife to yell at you. But when she yells at you for doing a breast exam without a chaperone, that's something you need to take seriously, especially considering the fact that you are a male medical student. There is a good reason for having a chaperone when doing an exam. You have a witness to protect you if the patient decides to falsely accuse you of sexual harassment. You should also know that hospitals take allegations of sexual harassment very seriously. At the very least, you could be forced to do clinical rotations at another hospital. Worst case scenario, it could mean the end of your medical career and possible criminal charges. When I started clinical rotations, from day one, we were warned to have a chaperone with us when examining patients, especially those of the opposite sex. This was true even if we were not examining more intimate areas, such as the breasts or genitalia. I know that you didn't have any intention of committing sexual harassment on that patient. I'm just saying that the midwife yelled at you so that next time you examine a patient, you will know that you need to protect yourself.

 

[nabeya]

my second time assisting delivery, baby about to crown.
My attending looks at his watch and says "its lunch time, see ya, ill be back in an hour"

i almost **** myself before delivering the baby and proceeding with the perineal suturing.

Talk about raw.

Talk about a rush.

I hope no one else gets this owned on their OB rotation.

I'm calling BS on this post.

 

[GoBuckeyes913]

I like the fact that I got through OB without dropping one.

LMAO..... I didn't realize how slippery babies were until I did my first delivery, crikey!!!! I mentally chanted "don't drop it, don't drop it" every delivery thereafter.

I also had the privilege of getting yelled at by a midwife for (1) not "waiting until the IV-line was in" before doing a physical exam (wtf?), and (2) doing a routine breast exam without a chaperon (n.b. unless requested, only 3/4 of male medical residents choose to have a chaperon for a breast exam). Based on the last 5 days, this is going to be a long 6 weeks.

Midwives or "doulas" (the OB's arch nemesis), brainwash patients into having like 5-page birth plans that make you want to vomit. I had one that "preferred the baby not to be monitored during labor"... and all these crazy requests...YEAH, like that was going to happen! (can we say lawsuit?) If you want to have the baby like the old days, go into the middle of a field with a heavy-duty blanket, a bowl of water, and some candles. Mortality rate used to be 40% for moms (gee, I wonder why)......