My very first clerkship rotation was in OBGYN outpatient clinics which I posted about here including some tips for surviving clerkship in general. This past month was a continuation of my OBGYN experience. The first 3 weeks were based in the birthing center where I had the opportunity to take part in a variety of interesting tasks:
Interview and examine pregnant patients in triage
Assist with vaginal deliveries and C-sections
Round on post-partum patients
Conduct consults in the ER
My last week was Gynecology-based where I got to assist with some gynecology surgical procedures in the OR, round on post-op patients, see patients in Gynecology/Early Pregnancy clinics and conduct consults in the ER.
What I enjoyed most:
I very much enjoyed interacting with pregnant patients and helping them through the beautiful, life-changing experience of welcoming their child into the world. I was also grateful to come out of this rotation with tangible, practical skills like delivering babies and suturing.
What I struggled with most:
The environment was fast-paced and quite stressful. It was difficult seeing patients experience pregnancy loss, particulary having gone through the experience myself. The schedule was exhausting with evening/night shifts and 2 weekends back-to-back. I definitely struggled with balancing work and family life and missed the kids a lot.
My take home message:
OBGYN is a great speciality in many ways. There is plenty of variety in terms of the work, it is rewarding bringing babies into the world and being a part of patients lives during such critical moments. For me personally, the demanding lifestyle was not a good fit for my family life, but I am grateful for all that I learned during this rotation and that it helped to clarify my interests more definitively.
It has been 3 weeks since I started clerkship and it is going very well so far. I started off with Obstetrics/Gynecology outpatient clinic where I had to give two presentations on cases I encountered during the rotation. I was also exposed to various diverse clinics:
Obstetrics: following pregnant women at various stages of their pregnancies, interpreting prenatal screening tests, measuring fundal height, finding the baby’s heart beat with doppler ultrasound (one of my favorite parts of this rotation!) and taking GBS samples
Gynecology:managing endometriosis, menorrhagia, performing pap tests and colposcopy
Gynecology-Oncology: managing patients undergoing treatment for ovarian cancer
Diabetes: managing pregnant patients with Diabetes Type 1, Type 2 or Gestational diabetes
Fertility clinic: managing patients trying to conceive via IVF or IUI.
Ultrasound: observing the routine ultrasounds for pregnant patients performed at 12 and 20 weeks of pregnancy as well as measuring nuchal translucency.
Photo credit: parentmap.com
My reflections on this rotation: I found this to be a generally fast-paced,diverse environment with plenty of opportunities to do some procedures.
What I enjoyed most:I very much enjoyed the patient contact and sharing the joy of pregnant mothers awaiting the arrival of their little ones. I also enjoyed the clinics where I had the most autonomy to interact with patients on my own. My favorite clinic of the rotation was without a doubt Obstetrics!
What I struggled with most: There was a steep learning curve as I generally only spent one day in each clinic and every clinic runs differently. I had to learn to adapt quickly.
My take home message:I learned so much from this rotation and felt that I improved in my history-taking and charting skills. I will wait until my OBGYN inpatient rotation to make a final decision about choosing this specialty but on a scale of low-medium-high, I would put Obstetrics and Gynecology as a “low” because I have much less of an interest in Gynecology than Obstetrics and there are alternative routes to practising Obstetrics (more on that later!).
My coping strategies on rotation:
I have a 2.5 hour daily train-commute which can be exhausting but I am using this time to study, read my Bible, decompress after a long day and also to read other topics/books that are of interest to me.
I make use of technology to stay in touch with my family and keep connected. For example, since I have to leave very early in the morning before anyone is awake, I Face-Time my hubby and kids every morning once I arrive at the hospital so I can see their adorable faces before I start my day. This is so energizing for me!
I have some prayer time during my 10-minute drive from my home to the train station (and on the way back as I reflect on my day). This plus reading my Bible on the train daily has kept me in a very positive state of mind despite feeling physically exhausted.
I aim to complete my reading/studying on the train so that once I am home, my focus is fully on my family.
It is challenging to find time to exercise so I wake up 15 minutes earlier every 2 days to have a short workout and then have my longer 35 to 45 minute workouts on the weekend.
Stay well hydrated and fed throughout the day. I carry granola bars in my white coat pocket or scrubs and carry around a bottle of water when feasible. This does wonders for your energy levels!
I had one particularly bad day last week where I felt extremely tired and did not feel my performance on rotation that day had been good at all. We have to remember that despite the really difficult days, there are better days to look forward to and it is all part of the learning process as we hone our skills.
I am currently on rotation in the Neonatal Intensive Care Unit and it has been both challenging and fantastic! I can’t wait to share with you my experiences on this rotation over the coming weeks!