1. OB/Gyn do’s, don’ts and pearls: a guide for students on the rotation
Resident of the day

2. Objectives General knowledge What you can expect from the residents
What we expect from you
How to shine on each service
Transitions between services
Miscellaneous pearls and helpful hints
Alphabet soup

3. General Issues Get the most out of the rotation
You may have no interest in OB/GYN, but learning as much as you can will make you a better doctor

4. Code of Ethics Know why we’re doing what we’re doing
Meet the patient, learn her history, read about the disease process before surgery
In the OR
Get involved – learn how to position the patient, help move the patient, help clean up the patient, etc.
Be the first in the OR to help with setup and the last to gown
Take ownership of your patients
Watch for lab results, vitals, new information

5. MD Interaction Room Reserved for those on L&D
Students on other services should refrain from using this room (please use other facilities to study…library, Sorrell Center, cafeteria, Durham)
It is ok to store your things in there, but keep in mind that OB rounds are from 7-8: DO NOT interrupt rounds

6. Labor and Delivery: UNMC
What to expect:
Rounds at 7am (8am on weekends)
Scheduled cesarean sections or IOL’s
Deliveries
Postpartum tubal ligations
Outpatients (>20weeks with OB complaints)
Circumcisions
In general, the more available and involved a student is, the more you get to do

7. Labor and Delivery: UNMC
What we expect from you:
Round on the postpartum patients
Add your initials in the student column by your patient
Divide the patients with your classmates
Write SOAP notes
Bring up any questions or concerns PRIOR to rounds
Present your patients at rounds
Pertinent pos and neg only, no routine vitals
Speak up if you saw the patient
Practice before you present
Divide the laboring patients
Meet her in between cervical exams, learn her history, discuss plan with resident
Fill out a blue card afterwards (no abbreviations)

8. Labor and Delivery: UNMC
What we expect from you:
C-section patients
Meet the patient
Ask the resident if you can scrub
Be ready to help
Be ready to tie suture
Fill out a blue card
See the patient 4 hrs after surgery and write a post op note

9. Labor and Delivery: NMC
Mag Notes
All patients on mag get notes at least three times per day: 0600, 1400, 2200
Students should write the 1400 and 2200 notes (the resident will include the mag note in the morning rounding note
See example on gray card

10. Labor and Delivery: NMC
How to be helpful:
Keep the board up to date (pts in labor get checked every 1- 2hrs
Get the babies rounded up for circumcisions (tylenol, lidocaine, baby hasn't eaten in last hour)
Keep a "to do" list on the white board (circ’s, post-op notes, etc)

11. Labor and Delivery: NMC
If you feel like you are stuck in the interaction room:
Watch the monitors
You can figure out when someone is pushing, a new patient arrives, a patient is having decels
Follow the intern on the floor
You can always ask one of us "Can I come with you?"
If you feel like you don't know what it going on with your patient, read through progress notes in the chart or ask a resident

12. Labor and Delivery: NMC
Don’t!
Stay in the interaction room all day
Do an exam on a patient without the resident present

13. Labor and Delivery: Methodist
Morning rounds at 8am.
SOAP notes on antepartum patients – done by 0730
Round with MFM resident and staff
After rounds, get the list of laboring patients from the charge nurse
Meet the patients and nurses
Meet the doctors
Stay involved and visible
Coordinate with the OB resident

14. Labor and Delivery: Methodist
Befriend the nurses
They will help you figure out when the deliveries are
Meet the generalists and explain who you are and why you are there
Ask the generalists if you can scrub for
c-sections
Be present for all MFM c-sections and deliveries

15. Labor and Delivery: Methodist
During the day:
Check on antepartum pts throughout the day (if labs, repeat bp’s, ctx status)
Labor pts: checked q2-3hrs by nurses, keep up to date on how the pts are progressing
Assist resident with any new admissions

16. Gyn/Onc What to expect OR cases for suspected or known cancer
Uterine, cervical, ovarian, vulvar, etc
Possible Da Vinci surgery
Sick, hospitalized patients
Clinic
Many patients will be receiving chemotherapy

17. Gyn/Onc
Friday before you start, talk with the students who were on that week
We check out when we change services, so should you
Have one student page the resident (usually the intern) on Friday to get the plan.
Friday before your week of Gyn/Onc, get the surgery schedule for the next week
Read about the patient before the case and understand why the type of surgery was scheduled.

18. Gyn/Onc Daily: rounds in am and pm Monday: Surgery with Remmenga
Throughout the day, read the nursing notes on your patient (VS, I/O tab)
Monday: Surgery with Remmenga
Tuesday: Surgery with Rodabaugh
Finalize your topic with chief resident
Wed, Thurs, Fri: clinic
See the return patients, check out with resident, then check out with attending
Go with the resident to see the new patients
Friday afternoon
Students present a 10 min gyn/onc topic
Make a one page handout (put your name on it)

19. Benign Gyn Surg What to expect OR cases for benign disease
Hysterectomies, ablations, D&C’s, TVT’s, etc
ER consults throughout the day
Gyn Chief Clinic (Wed afternoons)
Clinic Add ons

20. Gyn Surg Monday (wear scrubs) Tuesday (wear scrubs)
am hospital rounds, OR cases
Tuesday (wear scrubs)
am rounds, OR cases
Wednesday (dress up)
pre-op conference at 7am, am rounds, Grand Rounds, M3 education, pm Chief clinic
Thursday (wear scrubs)
am rounds, 7am teaching (topic to be chosen every Mon), OR cases
Friday (wear scrubs)
am rounds
Students present a min gyn topic (one page handout) Please have topics picked by Tues am of GYN week

21. Gyn Surg
Friday before you start, talk with the students who were on that week
We check out when we change services, so should you
Have ONE student page the resident (usually the intern) on Friday to get the plan, then pass plan to other student teammates.
Friday before your week of Gyn Surg, try to get the schedule for the next week
Read about the patient before the case and understand why the type of surgery was scheduled!!!!
Make sure you know how to get scrubs and access the OR schedule for the next week so you can prepare appropriately.
You may have to page intern on Sunday to see if there are any patients you need to round on Monday am.

22. OB/Gyn Clinic What to expect
Variety of patients with ob or gyn concerns
Go see the return ob’s
Ask before seeing a new ob, but plan to see them
See the gyn patients (focused history, wait on the exam until the physician gets there)

23. What to Expect From Your Residents
Teaching
We will pass on the basics of OB/GYN with a focus on likely shelf questions
Maximize your educational opportunities
We will get you involved with high-yield cases
No busywork
Things we ask you to do are important for patient care
Address your concerns
If you are having trouble, let us know

24. General Pearls Phrases for students: What can I do to help?
What should I read about for tomorrow?
Ask questions as they come up
It is easier to learn and remember a concept when you can associate it with a patient
Treat the rotation as a job interview
Put out your best effort and you will be rewarded with a better experience and a greater increase in knowledge

25. G’s & P’s G: gravida (number of pregnancies)
P: para (number of deliveries)
A: abortus (number of abortions/ectopics)
G_TPAL
Gravida, term, preterm, abortus, living children
Ex: G3 P1112
Ex: G3 P1012

26. Ob/Gyn = Alphabet soup CTX: contractions LOF: loss of fluid
VB: vaginal bleeding
TAH: total abdominal hysterectomy
TVH: total vaginal hysterectomy
BSO: bilateral salpingoophrectomy
LAVH: laparoscopic assisted vaginal hysterectomy
LVH: laparoscopic vaginal hysterectomy
PTL: preterm labor
SROM: spontaneous rupture of membranes
PROM: premature rupture of membranes
PPROM: prolonged premature rupture of membranes

27. Ob/Gyn = Alphabet soup
GDMA1: gestational diabetes mellitus, diet controlled
GDMA2: gestational diabetes mellitus, controlled with meds
ROB: return ob visit
NOB: new ob visit
s/p: status post
h/o: history of
IOL: induction of labor
PNV: prenatal vitamin
TVT: transvaginal tape

28. Ob/Gyn = Alphabet soup
SVD: spontaneous rupture of membranes (sometimes NSVD: normal spontaneous vaginal delivery)
PLTCS: primary low transverse c-section
RLTCS: repeat low transverse c-cestion
PPTL: post partum tubal ligation
BTL: bilateral tubal ligation
LVAVD: low vacuum assisted vaginal delivery
OVAVD: outlet vacuum assisted vaginal delivery
LFAVD: low forceps assisted vaginal delivery
OFVAD: outlet forceps assited vaginal delivery

29. Have fun! Key concepts: Get involved Read about the patients
Find ways to be helpful 
Approach the residents if you are having problems