So I have been done with my OBGYN rotation for a week and a half now and I am just now getting around to writing about it! Somehow my week off disappeared before my eyes and now I am in the middle of a brutal on-campus week full of long days in the classroom. Makes me miss didactic ….. NOT! Any-who, I reached out to many of you on Instagram about what topics you’d like to see covered in regards to PA School and more on rotations was a big one! So I am planning on incorporating some tips and tricks on here for each rotation as I complete them. Today is all about OB/GYN!
Depending on your program you may have a Women’s Health focus where you’re dealing mainly with gynecologic issues or you may have a combination of obstetrics and gynecology in a more traditional clinical setting. My rotation was OB/GYN and I got experience with routine and complicated OB appointments, gyn issues, labor and delivery with both vaginal and cesarean births, as well as opportunities to first-assist in the OR for gyn surgeries. I had a diverse and well-rounded rotation and I truly enjoyed it!
Topics to Review
Before starting your OB/GYN rotation you may want to review some topics. These are some of the ones I saw most frequently:
- Routine OB care – know what is normal through gestation and when you do different screening tests
- Hypertension in pregnancy
- Gestational diabetes
- Dysfunctional uterine bleeding
- Antenatal fetal monitoring
I actually didn’t really use too many resources on this rotation, unlike my Internal Medicine one. Many of the books I already had helped me out. Some that I would recommend are:
Tips for Survival
- Always eat before going into a vaginal delivery. If not you might find yourself having a vasovagal event. I might know this from personal experience. In the event that you do start to feel faint just take yourself out of the situation for a minute. Mine happened after I had been in a number of deliveries but my blood sugar was low. No one made me feel like a doofus.
- Think about how you’re going to handle tough situaitons. There are some really emotionally challenging events in OB/GYN. Think about how you would want them to be handled if YOU were the patient.
- When trying to find fetal heart tones with the Doppler always give the patient a heads up that you’re a student and it might take you a minute. As a mother I always started getting anxious when it took awhile to find the baby. As a student you are still learning where they like the hide. Word of advice – before about 16 weeks just go low in the abdomen and in the middle.
- Brush up on the “normal” side effects of pregnancy. Women will commonly ask about back pain, round ligament pain, pelvic pressure, and Braxton Hicks. Know what’s alarming and what’s not.
- Really get a good OB history if they have prior children. How was the delivery? Were there any complications? Did they tear/have episiotomies? How big was the baby? Did they need assistance (i.e.: vacuum) etc. A good OB history is super important.
- Get good at your speculum exam. Ask for help from your preceptor if necessary. For many women if you apply good downward pressure and go pretty posterior the cervix will pop into view. Pay attention to your anatomy! Worse case scenario? Pull out the speculum and feel where the cervix is on bimanual exam and try again.
- Thing about your word choices when it comes to well-women exams. I have heard other students say some wildly inappropriate things without meaning to! This is a very personal exam and you want to try to make your patient as comfortable as possible.
End of Rotation Exam
I prepped for the EOR by studying the PAEA OB/GYN Blueprint. Pay attending to some things that aren’t on there. PCOS and Sheehan’s Syndrome aren’t listed but I have had many practice questions on both! If you’re doing practice questions and something bizarre comes up add it to the EOR list
That’s about all I have for now! If you have specific questions I would LOVE to answer them below
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