Specialty Search: OB/GYN

My 3rd clerkship of the year: OB/GYN.

This is one that I could not WAIT for! Between my first and second year, I did an externship at St. John's Hospital in Grosse Pointe, MI (See here) where we rotated through various sub-specialties and I got my first glimpse of the beauty of OB/GYN, so I couldn't wait to start! On the flip side, Ob/gyn at our hospital doesn't have the best reputation -- its known for being quite catty and for having many residents/doctors who pick favorites. Part of our grading includes evaluations from residents/doctors and this clerkship was known for people getting low evaluations that excluded them from honors (which I know isn't the most important thing, but it was still worrisome). Lastly, I was nervous because of the horrible hours associated with this clerkship. More so than any other clerkship, the amount of night shifts/24 hour shifts during OB/GYN would pretty much take up all of my weekends available in the clerkship to study/stay sane.

On the first day of the clerkship, we were handed our schedules and walked through what would be expected of us. My schedule was as followed: 1 week of orientation/lectures, 2 weeks of Gyn Surgery, 2 weeks of Labor and Delivery, 2 weeks of out-patient clinic,  1 week of oral exam/written exam/random wrap-up things and (of course) the dreaded 24 hour weekend shifts sprinkled in between. Overall, I was very happy with this since it meant I was ending on out-patient clinic (which had super relaxed hours) and I would have plenty of time to study! Also, just talking about the clerkship made me excited - finally something that I was truly interested in!

GYN SURGERY - My two weeks on gyn surg were great! Having just come off of an 8-week surgery clerkship, I was kind of ready for a break from the OR, but it turns out gyn surg and gen surg are totally different! Yes, there are some long procedures (ex: hysterectomies) in gyn surg, but I just loved that a large proportion of the surgeries were 45 minutes long. Get in, get out - get the patient home! I also loved that Gyn Surg is specialized surgery from the start. Learning specialized surgical areas to select body parts is way more interesting to me than learning general surgery. At the end of the two weeks, I was not ready to leave Gyn Surg... I wanted more! That has to be a good sign, right?

LABOR AND DELIVERY - This was definitely a roller coaster of emotions! It was high stress and you really had to put a lot of effort in to know what was going on when. Unlike surgery, live births aren't scheduled...obviously. So, if you weren't waiting outside your patients rooms at the right time, no one would call you and you would miss the delivery. Also, I had several moments where I really thought I screwed up bad, which is such a horrible feeling. Ex: my very first cesarian section (ever) was right when I was coming on at sign-out of my first L&D shift. The resident told me to run and introduce myself to the patient so that I could go in on a Cesarian section secondary to severe pre-eclampsia. So, I did as I was told. I walked into the patient's room and proceeded to say "Hello! My name is Kailyne and I am a medical student. I would like to observe your c-section today." At that moment, the nurse gave me a death stare and stated "She hasn't been told she was having a c-section yet." Worst. Feeling. Ever. In the end, it turned out fine, but still I felt like a piece of bleep. On the other hand, the L&D can be the happiest place in the hospital. What is more beautiful than watching somebody come into this world? I think the highlight of my whole medical school career thus far is doing my first solo delivery, knowing that I just helped a baby successful gain life. So overall, I really really enjoyed these two weeks. Even though its extremely high stress, you adjust. Once I got my footing and felt comfortable in L&D, it was my absolute favorite place to be!

OUT-PATIENT CLINIC - This semester, I have had VERY little time in the outpatient setting. Going from IM to Surgery to OB/GYN, I had maybe 10 clinic days total up until now. So, I really didn't know if I would like this or not. Well, I loved it! I love that ob/gyn clinic is also semi procedural. I love that there is some continuity of care. I love that this element is also so predominant in the field, because of how diverse the field of OB/GYN is. I had a really great experience and got to perfect my ability to do a pap smear, while also being able to rotate through subspecialties. I also wasn't ready for this to end.

FINALS WEEK - After my 7 weeks of the clerkship, it was finally time to face the music and test out what I had learned. This week, we would have both our oral and written exam. Up until now, I had screwed up the written by a few points to not allow me to honor the rotations, so I was ready to finally get that H. Also, I knew if I was really serious about maybe going into OB/GYN, getting that mark would be important....and sure enough...I honored!!! Finally!

What a great rotation. I loved every (well, at least almost every) minute of it! But, like every field, there are definite pros and cons:
1) PROS: Women's health is an interesting and important field, continuity of care potential, procedural field, diversity of patients and diversity of settings to work in, and the incredible rewards of obstetrics. I was never EVER bored and went home every single day with a smile. I looked forward to going to work every day and was very sad when the clerkship ended.
2) CONS: The two most obvious are 1) the unpredictable hours and 2) malpractice insurance. The only other real con is that you really do just have to give the babies away immediately. I will never ever see a pediatric patient, which I don't know if I can handle.

So thats it! It was a great rotation and definitely a possibility for my specialty of choice! :)