Welcome to your clerkship in obstetrics and gynecology! You’ll find this rotation beneficial no matter your future specialty because you’ll very likely encounter pregnant patients, whether you’re a primary care physician or a surgical subspecialist. Probably the best part of your OB/GYN clerkship is that you’ll gain valuable skills that you’ll use throughout your career as a physician, whether working in a clinic or the operating room.
Kindness and compassion are essential.
One thing that will not only impress your attending but will help you build a trusting and supportive relationship with your patients is to show kindness and compassion in your encounters with them. Remember that when your patient presents for gynecologic care, they’ll likely be nervous or scared, especially if this is their first time in the OB/GYN clinic and they don’t know what to expect. If you take the time to listen to each patient’s concerns and remain compassionate and respectful in your interview, you’ll find that you’ll gain their trust.
Be a team player.
Whether in the clinic, in the operating room, or on Labor & Delivery, you’re part of an integrated care team. You’ll not only work with your medical team but also collaborate with others, including housekeeping, medical/surgical assistants, allied health professionals, nurses, administrators, and more. Practicing humility and mutual respect helps build strong relationships, which will be beneficial throughout your career. The most effective attending physicians have mastered this and will be happy to see you showing respect for your teammates.
Demonstrate confidence with your exams.
Performing a pelvic exam, especially for the first time on a “real” patient, can induce anxiety for both the patient and the student. A common problem most students have is an inability to locate the patient’s cervix on a speculum exam. A good way to overcome this anxiety is to practice the technique before you step into the room for the first time, especially if you have access to a manikin, and continue to refine your technique while learning from past mistakes. When your patients see you as calm and confident, they’ll be more relaxed and comfortable during the exam.
Build relationships with Labor and Delivery staff.
Keep in mind that you’re one part of a team, and your effectiveness as a team member depends on your ability to build relationships. Remember that the nursing staff likely have hundreds or maybe even thousands of deliveries under their belt. Building a relationship based on mutual respect can go a long way to successful rotation. It could be something as simple as helping to clean up a mess you’ve made, asking for something kindly while at the nursing station, or seeking the nurse’s opinion on a fetal heart rate interpretation.
Ask questions.
By now, you’ve discovered that as a student, you’ll be asked many questions by residents and attendings to assess your knowledge but take it as a compliment that they are investing time in you this way. An effective way to gain the respect and trust of your senior residents and attendings is learning how to ask questions in return. Begin by reading an article or an ACOG practice bulletin and ask for their opinion on the subject after demonstrating that you already have an understanding of and interest in it. If they take this opportunity to ask you some questions in return, you know you’ve gained their confidence!
Know your laboring patients.
Depending on the size of your facility and the number of students rotating, you may be responsible for knowing a few or even all of the patients “on the board.” Get to know your patients well enough that you can give a report from memory on your patients using a format like this: Name (not room number), age, GP, EGA, LMP, EDC, reason for admission, significant antepartum issues, and their labor progress since admission. Always know their cervical exam and how the baby is doing on monitors. If you’re unsure of how to approach some of their medical complications, do a quick search on our OB/GYN content to find the appropriate DMT, and watch the video when you have a few minutes. If you have a lot of patients, keep clear notes so you don’t confuse yourself; sometimes, a busy labor deck can get overwhelming.
Practice delivery procedures.
Perhaps your goal is to deliver just one baby, or you want to deliver as many as you can! Either way, you should practice, practice, and practice some more on delivery techniques, ideally with a 4th-year medical student or one of the residents. Most facilities will have a baby manikin, and some may even have a high-fidelity delivery simulator. Watch our video on intrapartum care to get to know the cardinal movements of labor, where to place your hands when the baby is delivering, and what to do once the baby is delivered. When your residents see that you know the steps, they’ll be more likely to invite you in rather than keep you as an observer.
Learn emergency labor and delivery procedures.
Once you know how to complete an uncomplicated delivery, get to know the steps for managing obstetric emergencies, and be prepared to recite the steps from memory without hesitation because you’ll have to act quickly! Watch some Osmosis videos on managing emergencies, such as the approach to postpartum hemorrhage, the approach to hypertensive disorders, and shoulder dystocia. If your patient develops these complications, your resident or attending will likely take over. However, make sure to know what’s going on and anticipate the needs of your team. You’ll go to bed with the satisfaction of knowing you saved a life!
Read about your surgical cases in advance.
When it comes to the operating room, be sure to look at the schedule the night before and know what cases are on for the next day. If you have an opportunity, read through their charts, learn their history, and read up on the surgical approach the night before. Be sure to introduce yourself to the patient in advance. If you haven’t already done your surgery rotation, take the opportunity to learn sterile techniques such as scrubbing, proper assisting, and, depending on the size of the operating team, assisting with closure. So be sure to learn the common suture materials and be ready to tie the knot when given the chance!
Your OB/GYB clerkship will help you learn valuable skills and get a range of important experiences that will benefit you in any future specialty. Embrace these opportunities to navigate the challenges and successes of your clerkship and future career as a physician.
About the Author
Andrew Allen, MD, FACOG, is an OB/GYN Clinical Content Editor for Osmosis. After retiring from the US Air Force, he attended the Uniformed Services University of the Health Sciences and graduated with a Doctor of Medicine degree in 2002. He began his OB/GYN Residency at Keesler Air Force Base, Mississippi. When the disastrous effects of Hurricane Katrina closed the residency program in 2005, he completed his Chief Residency at Travis Air Force Base in California in 2006. Andrew attained specialty board certification through the American Board of Obstetrics and Gynecology in 2008 and has delivered women’s health care at many Air Force facilities across the globe, including Antarctica! In 2020 he earned a Masters in International Relations from the University of Oklahoma and has extensive training and experience in global health. Andrew is also an Assistant Professor at McMurry University, where he teaches Public Health, Global Health, and Anatomy and Physiology. In his spare time, he enjoys wildlife photography and traveling across the US in an RV with his lovely wife and two magnificent dogs.
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