Starting with OB any tips?

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tatabox80

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  1. Attending Physician
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Hi there,
I just found out today that my first rotation is OB/Gyn. Just wanted to see if anyone had any pointers since I can't search right now. Thanks.
 
be ready for long hours. have a good attitude, smile, try to be helpful. put your time in doing admits, 2 hour checks, etc. be aggressive but not pushy about doing deliveries. be nice to the nurses, and they can be a huge help in getting you the deliveries you want. practice cervical exams as often as possible, and compare your findings with the resident. these are not easy to get right, so repeat prn. there are lots of procedures to do (amniotomy, fetal scalps, iup monitors, episiotomy repairs, get good with the us machine, etc...)

most importantly, get ready to have fun! ob is a great specialty, you are going to be an active participant in a huge moment in these families lives. be supportive, helpful in any way you can, and participate in the joy as well.

things you should know (& things i was pimped on):
obstetric h&p
c-section indications
normal labor
failure to progress
understand fetal tracings
how to deal with dystocia
pain control in labor
induction of labor (ie bishop score)
biophysical profile
placentia previa
abruption
dates and the accuracy of how they were determined


that is all i can think of right now. it has been a while since i was on ob, sorry!
 
neilc said:
be ready for long hours. have a good attitude, smile, try to be helpful. put your time in doing admits, 2 hour checks, etc. be aggressive but not pushy about doing deliveries. be nice to the nurses, and they can be a huge help in getting you the deliveries you want. practice cervical exams as often as possible, and compare your findings with the resident. these are not easy to get right, so repeat prn. there are lots of procedures to do (amniotomy, fetal scalps, iup monitors, episiotomy repairs, get good with the us machine, etc...)

most importantly, get ready to have fun! ob is a great specialty, you are going to be an active participant in a huge moment in these families lives. be supportive, helpful in any way you can, and participate in the joy as well.

thanks for the reply! I have no idea what you just said....how long does it take for you to get used to everything you will be doing on OB? This is my first rotation and I'm a little nervous.
 
the learning curve is pretty steep. you will be an expert in no time! (ps...i added some stuff to my previous post...sorry!)
 
neilc said:
the learning curve is pretty steep. you will be an expert in no time! (ps...i added some stuff to my previous post...sorry!)

Thanks for the help!
 
OB is classically one of the hardest rotations, the others being medicine and surgery.

I'd recommend getting a good review book, maybe blueprints, and reading it during the first week of your rotation. Talk to your junior residents and chief residents about what is expected and how to make improvements. Ask if your notes can be improved and if you could be involved in procedures. OB residents want students to be interested in doing pelvics, 2 and 4 hour checks all night long. Ask if you can be involved in measuring cervixes and possibly breaking a BOW.

http://www.freeiPods.com/?r=20049323
 
I've heard that the hours are pretty rough in OB, how long did it take you guys to get used to working that much?
 
Bring gloves and lube everywhere you go and remember to forget your pager bateries. 😉
 
I just finished OB as my first rotation... I really enjoyed it. I was at a hospital with a lot of private attendings so I didn't get quite as much hands on as I would have liked, but I learned a lot. Smile, help out your intern & go with them when they run, ask what you can do to help. Be nice to the nurses. Remember, this is your first rotation, EVERYONE has been there and as long as you're not lazy, you'll be absolutely fine. I started out on L&D and found reading the OB section (pretty short) of blueprints to be very helpful, along with a fetal heart tracing tutorial. Know the causes and relative significance of early, variable, and late heart decels. This will keep you from asking "what's the big deal?" when everyone goes running.
 
If you are interested in doing procedures, then don't do OB/GYN with a private slurper. Especially if you are a male, because you won't be able to do anything. I never did a pelvic, checked a cervix and I wasn't even allowed in the room on any of his office gyn pts. The only thing I got to do was clamp the cord, suction the kid and cut knots (either to short or to long). The only good thing about doing it with a private slurper is the hours are easy. Otherwise, I would have had died of boredem.
 
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whatever you do, don't leave a patient on the exam table with legs spread apart and walk out leaving door open.

That's what I did on my first day...got reamed a new hole.

Then things got worse from there. Attendings in OB are bitter folks. Wouldn't you be if you were 55 years old, still taking in-house call?

OB residents HATE men. Absolutely hate them. If you want to ace this rotation, put on a skirt, paint your nails and answer the name "biatch" and you'll do fine.
 
StudKnight said:
whatever you do, don't leave a patient on the exam table with legs spread apart and walk out leaving door open.

That's what I did on my first day...got reamed a new hole.

Then things got worse from there. Attendings in OB are bitter folks. Wouldn't you be if you were 55 years old, still taking in-house call?

OB residents HATE men. Absolutely hate them. If you want to ace this rotation, put on a skirt, paint your nails and answer the name "biatch" and you'll do fine.
the OB residents liked the men rotating with me just fine. sounds like a lot of your bad experience is directly related to your poor performance. I'd likely hate you as a med student too, if you were insensitive and just plain stupid enough to leave someone in stirrups and walk out of the room, let alone leaving the door open. it ain't OB, cowboy, it's you.
 
StudKnight said:
OB residents HATE men. Absolutely hate them. If you want to ace this rotation, put on a skirt, paint your nails and answer the name "biatch" and you'll do fine.

That's funny, because as an OB resident, the two best MS 3 students right now on this rotation are men. I never had a woman kick them out of the room and they had the opportunity to do cervical checks, speculum exams and deliver babies. I did, however, have a woman kick my female med student out of the room. I think it's got less to do with gender and more to do with how comfortable you make them feel.
 
If you want to be a little more confident with your cevical exams before you start performing them. Get a Pocket Dilation Guide (pocketdilationguide.com). You can practice with it before your rotation and keep it in your pocket to refer to while doing your rotation. Helps alot. At least you'll have some idea of what your supposed to be feeling before you get there.
 
tatabox80 said:
Hi there,
I just found out today that my first rotation is OB/Gyn. Just wanted to see if anyone had any pointers since I can't search right now. Thanks.


Start taking prophylactic antidepressants or benzos.

I didn't have a problem with the women residents hating me. Matter-of-fact, I found most of them to be pretty cool. The problems with each other and other staff was the goocher.
 
i started OB monday and i hate it. not because its OB, but because my rotation sucks. as far as the advice that everyone else has given, none of that applies to my rotation. i am in a private practice- no residents, no interns. they dont let me do pelvics (im a girl), in fact, they dont let me do anything. well thats not true. i weigh the patients, check their BP, and stick them on the monitor, and i fetch birth control samples out of the closet. during deliveries i fetch ice chips. the only good thing is that im first assist for surgery. bad thing- i havent had surgery yet, and was expected to know how to scrub, gown, tie and suture (all things i had been shown, all things i had never really done). thankfully i didn't get yelled at- just spoken to sternly once or twice . . . i do recommend a book like blueprints. i read a chapter a night, and review the chapter i read the night before. its the only way im learning anything. my biggest advice for OB- befriend the nurses. OB nurses are actually nice. as far as all the other stuff, i'd say keep and open mind the first two days, figure out what sort of rotation yours is going to be, and then you'll have a better idea of how to prepare yourself for each day 🙂
 
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