Medical Monday: OB/GYN Clerkship Review

I just finished up my second clerkship and I started my third one last week. I've been MIA for the past few weeks, but I wanted to get some blogging in before the hospital swallows me up again. I plan on doing a post about Family Medicine and Step 1 studying as well, but first I wanted to write about my experience in OB/GYN while it's still really fresh.

My OB/GYN clerkship was separated into a week and a half on OB and three weeks on GYN. The hospital I worked at is a level IV hospital which means it provides care for the highest risk mothers and babies. That being said, I saw a lot of pregnancies complicated by chronic diseases. Most of the women I worked with had either gestational diabetes or gestational hypertension. I seemed to get paired up with some of the sickest patients too - not by choice, but just by random selection. The first patient I ever followed ended up staying at the hospital for over a week because she had so many complications after delivery. Other patients had pre-eclampsia, HELLP syndrome, thrombotic thrombocytopenic purpura, and other rare genetic diseases. There were also a lot of patients whose care was complicated by drug and alcohol use during pregnancy which added a whole new level of complexity.

As a medical student, I was mainly responsible for triaging new patients, presenting patients to the residents, and assisting during the deliveries. Triaging patients consisted of going through a focused history and physical exam to assess the soon-to-be moms before presenting each patient to the resident doctors. We also signed up to help out with C-sections that were scheduled throughout the day. I scrubbed in on a lot of C-sections and was able to be involved in most of the surgeries. During one of my first C-sections I actually got to close up part of the abdominal fascia, which totally caught me off guard but was really exciting. Most of the time though, I did more mundane things during the surgeries. I've basically become an expert at retracting (opening up the surgical field by using instruments to pull the tissue out of the way) and if you need someone to cut suture, I'm your girl.

The GYN portion of the clerkship was by far my favorite part. I had this preconceived idea that GYN was all about Pap smears and pelvic exams, but I was shocked to find that a big part of GYN is surgery. Surgery was the biggest part my GYN rotation. The majority of the surgeries I scrubbed into were hysterectomies and treatments for incontinence, but I also observed minor procedures like LEEPs, colposcopies, and dilation and curettages. Going into OB/GYN, I didn't anticipate that I would like it, but I really enjoyed my experience in GYN and could actually see myself doing an OB/GYN residency and then going on to do a fellowship in something like Gynecologic Oncology or Urogynecology. I'm nowhere near making up my mind yet, but it's definitely something I'll be considering when it comes time to make the big decision!