Ob-Gyn is ridiculous

[lumbering]

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I really don't like making patients feel uncomfortable. Is it really necessary for me to do a rectovaginal exam on a 24 year old while an attending instructs me on technique and pimps me on anatomy? And of course...I have have to be super-professional, confident, and paternalistic the whole time to fit in with the old school culture. I'm all for learning by doing, but can't we do it with some degree of tact and social normalcy? Sheesh!

 

[smq123]

I really don't like making patients feel uncomfortable. Is it really necessary for me to do a rectovaginal exam on a 24 year old while an attending instructs me on technique and pimps me on anatomy? And of course...I have have to be super-professional, confident, and paternalistic the whole time to fit in with the old school culture. I'm all for learning by doing, but can't we do it with some degree of tact and social normalcy? Sheesh!

That's horrible. I hate when attendings "teach and pimp" in FRONT of patients. I think that the better method is to have the attendings teach right before the patient interview (i.e. "This is what you're probably going to have to do"), and then pimp after the patient interview. Much better all around.

 

[haveaniceday]

I agree, this is a difficult aspect to medicine and ob/gyn in particular (urology for guys, I would hate to have someone doing their first rectal on me even moreso than one's first pelvic/pap)! Anyway, it is something that must be learned and I think as long as you keep the patient's comfort in mind the whole time and while you are getting pimped/taught, make sure you are not speaking as if they are an object to be learned on. Of course, each attending may have a different style...but you can always pay close attention to the patient's responses and modify *your* approach for them, even if there is nothing you can do about the attending!

 

[71263]

Man, you guys are allowed to do vaginals??? 😱

Over where Im doing OB, they tell us to do the rest of the physical and then the resident will come in and examine the vagina. Then again, Ive only been on L and D, and that was for 2 weeks. Perhaps when I do gyne, rei, or onc, things might be different.

 

[Gimlet]

Man, you guys are allowed to do vaginals??? 😱

Over where Im doing OB, they tell us to do the rest of the physical and then the resident will come in and examine the vagina. Then again, Ive only been on L and D, and that was for 2 weeks. Perhaps when I do gyne, rei, or onc, things might be different.

It was the same for us on L&D, but you will more than likely get to do it all on gyn.

 

[smq123]

Man, you guys are allowed to do vaginals??? 😱

Over where Im doing OB, they tell us to do the rest of the physical and then the resident will come in and examine the vagina. Then again, Ive only been on L and D, and that was for 2 weeks. Perhaps when I do gyne, rei, or onc, things might be different.

You didn't examine the cervix during labor? 😕 That's prime "resident pimping" territory - i.e. can you feel the difference between 5 cm dilation and 3 cm dilation? (I still suck at that.)

Do you have an outpatient component to your OB/gyn rotation? You'll do a lot of bimanuals and speculum exams then.

 

[LuckyBambooGirl]

During my 2 weeks on labor and delivery, I wasn't allowed to do vaginal exams. But during my 2 weeks on outpatient clinic, I got to do lots of them, including cervical checks. Apparently there is just too much liability involved to let med students do vaginal exams on certain laboring patients. For example premature rupture of membranes. You would hate to give the patient some kind of infection!

As for REI, when it was time for that clinic all the med students got sent home! 😉

Gimlet, you could ask if they will let you learn to do cervical checks! That's what I did, because I think it's important to know how to deliver a baby no matter what field of medicine you go into!

 

[Ashers]

It was the same for us on L&D, but you will more than likely get to do it all on gyn.

Yep, the vaginal exam right after the woman was asleep before surgery

You didn't examine the cervix during labor? 😕 That's prime "resident pimping" territory - i.e. can you feel the difference between 5 cm dilation and 3 cm dilation? (I still suck at that.)

Do you have an outpatient component to your OB/gyn rotation? You'll do a lot of bimanuals and speculum exams then.

I just did my first sterile vaginal exam to see how far dilated the cervix was on my FP rotation. I wasn't allowed to do them on L&D.

I've also done more pap smears on FP than OB/gyn, and I'm continuing to do prenatal and postpartum visits.

 

[71263]

You didn't examine the cervix during labor? 😕 That's prime "resident pimping" territory - i.e. can you feel the difference between 5 cm dilation and 3 cm dilation? (I still suck at that.)

Do you have an outpatient component to your OB/gyn rotation? You'll do a lot of bimanuals and speculum exams then.

Maybe a couple of times, but not on a regular basis, and certainly not enough to tell 3 cm vs 5 cm...

Im doing the gyne part of my rotation last... I did 2 weeks of L and D already, 1 week of REI, and Im about to finish my week of Onc. Hopefully, Ill get to do a little more these last 2 weeks, although studying for that shelf is gonna have to go somewhere in there too...

 

[smq123]

Maybe a couple of times, but not on a regular basis, and certainly not enough to tell 3 cm vs 5 cm...

It wasn't meant to knock you - I cannot tell the difference between a 3 cm and a 5 cm, and I was lucky enough to have a lot of patients get epidurals. I embarassed myself quite a few times because I would say "I think she's 4 cm and -2 station," and the resident would say (nicely) "No, she's actually 8 cm and +1 station. But good try - you were close!" I was only off by 4 cm - yeah, real close. 🙁

And then the resident would invariably bust out the plastic tray with the little circles of varying diameters on it, and give it to me to practice with. Not that it did any good.

 

[achybrachy]

I really don't like making patients feel uncomfortable. Is it really necessary for me to do a rectovaginal exam on a 24 year old while an attending instructs me on technique and pimps me on anatomy? And of course...I have have to be super-professional, confident, and paternalistic the whole time to fit in with the old school culture. I'm all for learning by doing, but can't we do it with some degree of tact and social normalcy? Sheesh!

I'm currently on M4 Gyn Onc. My attending has the annoying habit of starting starting random chitchat conversations with the patient right as I sit down in the crotch to do my speculum exam. So I sit there with a face full of 70 year-old vulva for a couple minutes while they finish yakking and I can talk to the patient and do my exam. It's really awkward.

 

[Hoo\/er]

Man, you guys are allowed to do vaginals??? 😱

Over where Im doing OB, they tell us to do the rest of the physical and then the resident will come in and examine the vagina. Then again, Ive only been on L and D, and that was for 2 weeks. Perhaps when I do gyne, rei, or onc, things might be different.

Consider yourself lucky.

 

[71263]

Hey guys, I have my shelf exam in 2 wks and was wondering if anyone had any suggestions. So far Im doing Case Files, Boards and Wards, and any practice questions I can find. Any other ideas? (This is worth 50%, I actually need to do well on this one...)

 

[Ashers]

Hey guys, I have my shelf exam in 2 wks and was wondering if anyone had any suggestions. So far Im doing Case Files, Boards and Wards, and any practice questions I can find. Any other ideas? (This is worth 50%, I actually need to do well on this one...)

I didn't have experience with Boards and Wards.

I read Blueprints once and went through Case Files twice, the first time I summarized it into 8 pages, then the day of the shelf, I reread it quickly, mainly using my summary notes, and the Clinical Pearls, and reviewing all the charts in it. It was worth 40% of my grade because the dept just added an OSCE this year which is 10%. No score back yet, but the casefiles strategy worked for psych.

 

[achybrachy]

Hey guys, I have my shelf exam in 2 wks and was wondering if anyone had any suggestions. So far Im doing Case Files, Boards and Wards, and any practice questions I can find. Any other ideas? (This is worth 50%, I actually need to do well on this one...)

Most people I talked to swear by Case Files. It's pretty good, I read through it once but didn't go to any great lengths or effort like Ashers, and I highpassed the rotation.

 

[71263]

Dude... so today was my day in the OR for the Gyne part of the rotation. These 2 weeks will easily be the worst part of this all (the last 2 wks before the shelf no less). Ive been waking up at 4:30 am (I remember when I used to sleep that late) to get to the hospital at 5:30 and have notes done by 6 am...

But today, we had 3 surgeries scheduled and only got to do 2. Why? The first case was a woman who had multiple fibroids that she wanted out. Pretty simple here: Full hysterectomy, done in an hr, hr and a half tops, right? WRONG! We ended up having to do myomectomies for all 56 fibroids of various shapes and sizes, taking us nearly 6 hours total... And all because this woman decided that she wanted to keep her uterus so that she might be able to conceive, in the off chance that she gets pregnant at the ripe age of 47...

F!CK OB/gyn 😡😡😡

On a side note, thanks for all the feedback on Casefiles, it seems this will be my mainstay of study. Only 1 and a half more weeks left...

 

[Thievery Corp.]

Dude... so today was my day in the OR for the Gyne part of the rotation. These 2 weeks will easily be the worst part of this all (the last 2 wks before the shelf no less). Ive been waking up at 4:30 am (I remember when I used to sleep that late) to get to the hospital at 5:30 and have notes done by 6 am...

But today, we had 3 surgeries scheduled and only got to do 2. Why? The first case was a woman who had multiple fibroids that she wanted out. Pretty simple here: Full hysterectomy, done in an hr, hr and a half tops, right? WRONG! We ended up having to do myomectomies for all 56 fibroids of various shapes and sizes, taking us nearly 6 hours total... And all because this woman decided that she wanted to keep her uterus so that she might be able to conceive, in the off chance that she gets pregnant at the ripe age of 47...

F!CK OB/gyn 😡😡😡

On a side note, thanks for all the feedback on Casefiles, it seems this will be my mainstay of study. Only 1 and a half more weeks left...

I'm assuming it was done laparoscopically too, huh?

P.S. I've been using the uWise questions and found them pretty challenging but pretty good. Although I cannot speak to if that is properly represented on the shelf..

 

[Ashers]

I'm assuming it was done laparoscopically too, huh?

P.S. I've been using the uWise questions and found them pretty challenging but pretty good. Although I cannot speak to if that is properly represented on the shelf..

From my shelf, I was surprised to see specific antibiotic mechanisms. I didn't have any ethics like questions like are on the uWise questions.

 

[deleted29780]

well this is a simple advice. if you don't wanna get pimped, then at least do some extra reading. Hit them when they ask about anatomy and stuff.
You just flow like no other...at least you will get your own back. 👍

 

[smq123]

well this is a simple advice. if you don't wanna get pimped, then at least do some extra reading. Hit them when they ask about anatomy and stuff.
You just flow like no other...at least you will get your own back. 👍

If you read the OP, what she was saying was that being prepared for pimping is one thing. But getting pimped while you're sitting between someone's legs, about to examine their vagina? 👎 Keep the pimping for OUTSIDE the patient's room, please!

P.S. I've been using the uWise questions and found them pretty challenging but pretty good. Although I cannot speak to if that is properly represented on the shelf..

None of the ethics stuff, as Ashers pointed out. Really read up on PRE-PARTUM issues. I felt like the questions on the shelf that dealt with pre-partum issues were poorly represented on uWISE. Things like uterine infections, pre-pregnancy bleeding, etc.

And all because this woman decided that she wanted to keep her uterus so that she might be able to conceive, in the off chance that she gets pregnant at the ripe age of 47...

Ugh. What is that woman's problem? Is she going for the Guiness Record for oldest mother? Eww...

 

[deleted29780]

aaah, ok

 

[PugnaciousF]

Sigh.

 

[UDbiochem]

Please add myself to the long list of people who hate OB/GYN ... specifically their experience with the residents and attendings - not the patients ... who of course people in OB/GYN are clearly not about serving.

These "docs" are clearly evil and frankly I will feel nothing but pity for any patient I have to send to an OB/GYN and I as a doctor I will do everything in my power to keep my patients away from the people in this practice. Thank God there are still family practioners out there to refer to.

I am getting smashed on my rotation for everything you could possibly imagine: handwriting, having my shirt untucked, leaning/moving too much, not being fluent in Spanish, having to use the bathroom during 8+ hour surgeries, asking procedural questions the FIRST time I do them.

Clearly I don't want to do this for a living, so seriously, leave me alone. After spending 15+ hours in the hospital is it really necessary to fail me on my evaluation b/c of the aforementioned shortcomings? And calling me "unprofessional" for shifting my weight in front of the patient <gasp>.

Do these people not realize the interconnectedness of their practice in the flow of medicine? We are all going to be doctors, commenting on people's mannerisms, confidence during 1st time procedures,etc that are completely unrelated to what we will do in the future is so insanely rude I can't begin to vent on it. I especially love the standards I am held to that these people clearly cannot manage to do themselves, like not speaking in jargon to the patients, creating rapport, doing thorough exams w/o BS'ing results, etc.

Let the lawyers have 'em.

Can I just say... AMEN. You are not alone, my friend. My rotation ends in 3 days and I am so happy. This post describes ob/gyn exactly. No wonder they keep getting sued. I wonder if it really is the people themselves and not the field that has the reputation of being feeding-ground of lawyers. Pugnacious, you read my mind.

 

[basupran]

horrible rotation, though I did love the gyn surgery. too much malignancy for my taste.

 

[Thievery Corp.]

My Ob/gyn rotation ends in less than 24 hours. I am excited. This rotation could not go by fast enough. I agree with most here, that the surgery is great but everything else is lousy. I really have a difficult time understanding the prespective of these Ob/gyn docs (all female too, here) that are malignant. I mean I try putting my self into their shoes, but I just cannot understand their position. Is there some natural self-selection process to that field?