Obstetrics

General Information

The student responsibilities include admitting history and physical examination, laboratory evaluation, review of prenatal record and hospital chart; following the patient through her labor while acting as a support person; and delivering babies under the supervision of either a resident, certified nurse midwife or attending. Completion of necessary paperwork associated with the previously described process is also the responsibility of all students. This will be fully explained in the orientation session regarding the labor and delivery area.

Students should be familiar with assigned patients and be able to discuss various complications of labor as well as appropriate interventions. We suggest that you follow patients with a variety of problems and augment your reading to focus on those problems. This will help maximize what you learn during this rotation. Remember, your immediate supervisors are the fourth-year residents or their designates.

OB Clerkship Student Roles and Responsibilities

Student Roles

Physician Service:
  • It is expected that you meet all the laboring patients on this service with the residents, Ob attending and FP attending and check in on them every 2h. Please check with the OB Chief resident of intern before meeting each patient. If there is time, the entire team will meet all the patients on the floor as a group. If appropriate, the residents will have you introduce yourself to the patients you will be following on your own. You will be with your patient for delivery regardless of outcome, vaginal delivery or c/s.
  • In addition you, you are expected to scrub into all scheduled repeat cesarean sections and on all tubal ligations.
  • You are also expected to observe circumcisions. There are 2 interns during the day covering L&D (OB & FM). The interns alternate daily who is in charge of organizing and performing the circumcisions.
  • Touch base with the interns/chief frequently throughout the day, so you know what’s happening with your laboring patient and to update them on your patient’s progress. You should be involved in the history, physical exam and admission of any OB/FP patients admitted for induction, c/s or through triage.
CNM service:
  • It is expected that you meet and follow all of the laboring CNM patients with the residents and CNM and check in on them every 2h. Please check with the CNM before meeting each patient. If there is time, the entire team will meet all the patients on the floor as a group. If appropriate, the CNM will have you introduce yourself to the patients you will be following on your own. In addition, if your patient should have an unexpected c/s, you are expected to participate. You should scrub into all cesarean sections on the patients you are following.
  • You are also expected to observe circumcisions. There are 2 interns during the day covering L&D (OB & FM). The interns alternate daily who is in charge of organizing and performing the circumcisions.
  • Touch base with the CNM frequently throughout the day, so you know what’s happening with your laboring patient and to update them on your patient’s progress. You will be with your patient for delivery regardless of outcome, vaginal delivery or c/s.
Triage service:
  • The triage is the Labor and Delivery ED. You will evaluate triage patients at the discretion of the triage CNM. Patients will present with a variety of labor and non-labor complaints
On Call Student (MD & CNM):
  • Weeknight call is overnight except for Tuesday when call ends at 10p. On weeknight overnight calls, you will leave after the following AM formal sit-down rounds. Weekend call (Friday, Saturday, & Sunday) is 24 hours.

Clerkship Student Responsibilities on Ob service:

Floor rounds 6:30a M-F: (All Students)
  • Students are expected to pre-round on postpartum patients on the intern service. You should, follow at least 1 vaginal delivery and 1 cesarean section. It is preferable that you follow patients in whose deliveries you were involved. If you have greater than 4 patients ask a chief to help you decide who to continue to follow and who to pass to other students. An example of an Ob note can be found under Course Documents – Useful Information.  All your notes need to be co-signed by a resident.  If one of the residents has already written a note, please do not write another one after him/her. You can print the postpartum list from SCM when you come in the morning. It is expected that you will complete all your notes by 6:30a, and be prepared to round with the Chief at 6:30a. At this time you will be expected to present your patients in a clear concise manner. An example of an Ob presentation can be found on course info under Course Documents –Useful Information. On the weekends there are no floor rounds. The off-going team rounds on all the patients.
Sitdown rounds 7:30a M,T,TH,F; 7:00a W; 7:00a w/e or holidays: (All Students)
  • These are sit-down rounds at which all the laboring, MFM, and complicated postpartum patients are presented. Students who were on call the night before should come prepared to present a laboring patient on L&D. Students who are following complicated postpartum patients should be prepared to present those patients. You can always practice your presentations with the intern and chief before you present formally. Thereafter, you go to your respective services (or go home if you’re post-call).
Board Rounds on L&D 8:30a and 8:30p: (MD, CNM & Triage Students)
  • These are multidisciplinary rounds with OB , Family Medicine, Midwifery, and Social Work services. The chief resident will briefly present the patients on L&D to ensure that all parties involved in the patient’s care are aware of the plan.
Sitdown rounds 5:00p M-F: (MD, CNM, MFM & Triage Students)
  • These are sit-down rounds at which all the laboring, MFM, and complicated postpartum patients are presented.
Call:
  • On weeknights the students stay in house overnight with exception of Tuesdays when call ends at 10p. Weekend call (Friday, Saturday, & Sunday) is 24 hours. If there are two students on call all laboring patients, MD/FP/CNM, should be divided between the students. Students should participate in complications that arise on the postpartum and MFM services. There is no specific person assigned to triage at night and on the weekend so there are many opportunities for students to participate in triage while on call. There is only one student on Labor and Delivery for weekend calls.

Conferences:

  • MFM Conference is held at 12:15p on Thursdays in the Labor and Delivery Conference room.  Bring lunch!