During this rotation, I spent two weeks working in the clinic, one week on GYN service and two weeks in labor & delivery (with 1 week being night shifts). I was able to see a variety of different things. I was also able to attend lectures for the medical students that were taught during the day by the attendings on call. I was able to learn about important topics such as preeclampsia, gestational diabetes, third trimester bleeding, etc. A lot of these topics came up on my EOR and I was able to answer the questions with help from things I learned during these lectures. I also attended grand rounds every wednesday where the cases from the previous week were discussed. I enjoyed learning about the interesting cases along with complications that came up and how they could’ve been avoided or how to improve for next time.

For the clinic weeks, I would work select a PA to work with for the day and we would see their patient list together. Many of the visits we would see were OB revisits so I grew to be very comfortable measuring fundal heights and listening for heart sounds with the doppler. I was also able to learn how to do ultrasounds and measure crown to rump lengths on the new OB visits who were earlier in their pregnancy. During this week I was able to learn about which tests and labs are ordered for pregnancy and when they were ordered. In some cases, before we would call the patient back, my preceptor would tell me how many weeks the patient was and ask me what I would order for her. This helped me to learn what is ordered and when. I also learned a lot about contraceptive choices which was discussed at many visits. I was able to assist in placing nexplanon and was able to remove an IUD. I grew very comfortable performing pap smears and other procedures during my clinic weeks.

During my GYN week it was a bit slower, however I was able to scrub into some GYN surgeries such as TOP, hysterectomy, cystectomy, etc. I also spent much of this week doing GYN consults. The resident I was following would have me go down to the ED and interview the patient to collect a history. Then I would present to the resident and we would go see the patient together. This experience was helpful in teaching my how to collect a GYN history and what is important to ask. The resident also brought me back to the clinic with her on some days that were slower and I was able to see different types of visits such as postpartum visits and fertility related visits.

For my final two weeks I was in labor delivery. For my first NSVD I was able to scrub in and deliver the placenta. After seeing this first NSVD I became more comfortable with them and was able to get involved in other ways because I knew the flow of it. I was also able to do mag checks on the patients who were on magnesium for preeclampsia. I was able to see triage patients which helped me to become more comfortable collecting a OB history. I was also able to scrub into a c section for a female who was first trying for trial of labor. It was a complicated case so I enjoyed being able to see how it was managed. During this week I also had my overnight shift where things were a bit slower so the resident had me present a topic to her that I felt weak on. I selected molar pregnancies and I was able to learn a lot about molar pregnancies though my research.

Overall, I enjoyed this rotation as I was able to get a variety of experiences and procedures. I grew more comfortable presenting patients and doing more focused physical exams. Also, my history taking skills were broadened because you collect more information for OB and GYN focused histories.

My next rotation is in long term care and I hope to learn more about managing chronic conditions. I think one of my weaknesses when taking EORs is drug related questions. I hope to learn more about drugs and their adverse effects.