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 residents or the midwife.

OB Clerkship Student Roles and Responsibilities

Student Roles

Physician (MD) Service:

It is expected that you meet all the laboring patients on this service with the team and check in on them every 2h.  Please check in with the OB Chief resident or 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.

  • You are expected to scrub into all surgeries including cesarean sections and tubal ligations.  You should introduce yourself to the patient and review their chart prior to the procedure.
  • You are also expected to observe circumcisions.  There are several interns during the day covering L&D (OB, ER, and FM).  Ask your interns in the morning if circumcisions are planned for the day and when they will take place.
  • Touch base with the interns/chief frequently throughout the day so that you know what’s happening with your laboring patient and to update them on your patient’s progress.
  • “Board Rounds” are at 8:30 AM and around 8 PM, and you should be present.  You should be involved in the history, physical exam and admission of any OB/FP patients admitted for induction, c/s or through triage.
Midwife (MW) service:

It is expected that you meet and follow all of the laboring MW patients with the residents and MW and check in on them every 2h.  Please check with the MW 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 MW 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 expected at morning and evening Board Rounds.

** Touch base with the MW frequently throughout the day so that you know what’s happening with your laboring patient and to update them on your patient’s progress.

Triage service:

The triage is the Labor and Delivery ED; all pregnant women >20 weeks present here for evaluation.  You will evaluate triage patients under the supervision of the triage MW and a Family Medicine Intern. Patients will present with a variety of labor and non-labor complaints. You will be responsible for helping the MW and Family Medicine intern to write triage notes in Epic.  You will be responsible for presenting medically complicated patients to the resident or attending as indicated by the MW.

Night Shift Student (MD & MW):
  • On night shift, you will leave after the following AM formal sit-down rounds.

RN Shift:

You will report to the charge nurse at 7am to find out which nurse you will be working with for the shift.

Clerkship Student Responsibilities on Ob service:

Morning L&D shifts starts with signout rounds at 7:00 AM in the L&D conference room.  You do not need to pre-round. On night shift, you will leave after the AM formal sit-down rounds (by 8:30AM).  If there are two students on the floor, all laboring patients (MD/FP/MW) 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 the floor during this time.

Postpartum Rounding

 Every weekday, one student will be assigned to Postpartum Rounding (PP rounding on your schedule).  You will round with the midwife who is rounding on the postpartum patients.  Instead of going to morning OB rounds, you will meet the midwife at 7:00 am. Page her at 0070 to find out where to meet her. The expectation is that you will have printed out the Team B signout and have picked no more than 5 patients to see.  You will round on patients with the midwife.  You will also attend interdisciplinary rounds with the midwife and the postpartum team from 10-11am.  The expectation is that you will finish up in time to attend your afternoon clinical responsibility.  You will write notes and evaluate patients as well as participate in patient education.

Schedule of Daily Events on L&D

Sitdown rounds 7:00am: L&D Conference Room

These are sit-down rounds at which all the laboring, MFM, and complicated postpartum patients are presented.

Board Rounds: L&D- 8:30a every day: (MD, MW & Triage Students) These are multidisciplinary rounds with OB, Family Medicine, Midwifery, and Nursing.  The nurses 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 5:30p M-F: (MD, MW, Triage Students) Like morning rounds, these are sit-down rounds in the L&D conference room at which all the laboring, MFM, and complicated postpartum patients are presented.