Medical Student OB/GYN Clerkship Guidelines

Welcome to WakeMed. Here are some guidelines to help you have a better understanding of your clinical duties and our expectations during your rotation. We enjoy teaching and getting to know our medical students and hope you have a rich learning experience.

Morning Rounds1. Begin at 6:30am on the B side2. Please place your initials next to at least 2 postpartum patients on the master list.

After examining those patients, present them to a supervisor (resident or PA); they will cosign your note and cross the patient’s name off the master list. Resident physicians must write the notes on all anterpartum, patients. You may follow these patients to learn how they are managed, but only write notes on the postpartum and postoperative patients.

3. Once all A & B side patients have been seen, you may get breakfast before 8:15 attending rounds in the resident lounge. You must be in the resident lounge by 8:15am.

4. Morning conferences: Each month we have scheduled conferences. You will receive a conference schedule at the beginning of your rotation. On those days meet at 6:15 am on the B side for morning rounds. Breakfast is served at each of these morning conferences.

5. If there are any questions about what time to report to work, you may ask the chief resident in charge of the service. If you are going to be late or absent for any reason, you must call the chief resident and me.

Daytime Responsibilities1. L&D Medical Student (to be on call that night)

a. Check TO DO list with residents after roundsb. See triage patients, write triage notes, H&Ps, and orders to be cosigned by

residents; (do cervical examinations, interpret FHT, etc under direct resident supervision)

c. Follow at least 2 patients on labor and delivery; write 2-hour notes to be cosigned by the residents.

d. Perform supervised, uncomplicated vaginal deliveries; write delivery notes, postpartum orders, and delivery summaries.

e. Attend teaching service cesarean sections; write operative notes and postoperative orders with resident’s supervision and to be cosigned by the residents.

2. Post Call Medical Student a. Round on postpartum patients, and attend morning roundsb. Once all clinical duties are finished, you may sleep.c. Once all lectures are done for the day you may go home; you may not

leave before the lectures and conferences are concluded for the day.

3. GYN Medical Student a. The day prior to being on GYN, get the next days OR schedule. (You may

get this from the chief resident)b. Discuss the cases with the GYN resident to see which cases you should

attend. Read about the case the night prior to surgery.c. The morning of surgery, preop the patient with the GYN resident and

write a preop note. d. Participate in OR cases as directed by the resident and attending

physicianse. Write postoperative note and orders; to be cosigned by the residentf. If there are no OR cases, you may read or participate in clinical duties as

directed by the chief resident.

4. Clinic Medical Student a. Our clinic can only accommodate 2 students. There are usually no

residents in morning OB clinic (Monday, Tuesday, Thursday, and Friday). Please see the clinic-attending physician for your assignment when there are no residents in the clinic.

b. When residents are available, you should see at least 3 patients in the clinic

c. Present the patients to the residents (or attending as instructed). Present complete history; develop a differential diagnosis, and a plan for treatment. You may not perform breast or pelvic examinations without supervision. Discuss the differential and treatment plan with the resident or attending prior to discussion with the patient.

5. On Call Responsibilities a. Dinner with the team when clinical duties permitb. Admit and follow at least 2 laboring patients, (write admission H&P,

orders, 2 hour notes, delivery notes and delivery summary, postpartum orders); all to be supervised and cosigned by the resident.

c. Perform supervised, uncomplicated deliveriesd. Attend cesarean sections and other obstetrical procedures as directed by

the residentse. See triage patients, help with histories and admissions as appropriatef. Always let the intern and/or upper level know where you are; ask where

you may be most useful.g. If we have a slow OB night (extremely rare) or the intern does not need

help, ask the upper level to include you in all floor and ED consults so you can gain more GYN experience. You may also scrub on GYN cases at night as directed by the residents.

h. You have very few clinical duties the day after call, (you do need to stay through your lectures and conferences) so please try to stay up with the residents while on call. OB is a fast-paced specialty and you will miss valuable learning experiences if you sleep on call. We will not look for you or page you to come do deliveries if you are sleeping. The residents and interns are too busy to try to find you. Remember, you are adult learners and are responsible for your own learning experiences

6. Honor Performance a. Arrive on timeb. Have a pleasant and positive attitudec. Accept guidance and suggestions to improve your learning experience and

your clinical performanced. See more than the required number of patientse. Give focused, knowledgeable presentations on rounds and in clinic and

triagef. Anticipate resident duties and help without being askedg. Read and ask thoughtful questions

Remember your final grade is determined by the entire group of attending and resident physicians, we also consider feedback from the providers and the nursing staff.

There will be no call on Tuesday or Wednesday nights, as all students will return to Chapel Hill for lectures Wednesday afternoon. You will report to WakeMed Wednesday am as scheduled then go to Chapel Hill each Wendesday afternoon.

We will meet with you periodically through the rotation to follow your progress. We will spend time discussing clinical cases and any concerns you have with the rotation.

*** Please come directly to us, or the chief resident with any concerns or problems so that we can address them immediately.

You may call us anytime at 350-8535 (office) or by pager, 393-0136 Dr. Gantt and 393-6137 Dr. Sandhu. If any urgent issues arise after hours, you may contact Dr. Gantt on her Cell phone 919-619-4334 or Dr. Sandhu Cell phone 919-740-9994.

We are very excited to have you join us for your Ob/Gyn rotation!

Angela Gantt, MD Ritu Sandhu, MDClinical Assistant Professor Clinical Associate ProfessorUNC School of Medicine UNC School of MedicineDepartment OB/GYN, Wake AHEC Department OB/GYN, Wake AHEC

*********************************************************************APGO’s uWISE

uWISE was developed by the Association of Professors of Gynecology and Obstetrics (APGO) to help students prepare for the shelf exam.WEBSITE:http://www.apgo.org/elearn/uwise/index.cfm?doc=uWISE%20Introalso linked from the clerkship website: http://syllabus.med.unc.edu/yr3/obgclerk/resources_lectures.htmYour department user name is: uncYour department password is: uwise