A rotation on the in-patient services, which combines daytime work and night on-call responsibilities (work rounds, teaching rounds, admissions, following laboring patients and participating in deliveries and postpartum care). All team members will attend daily morning Labor and Delivery rounds. The Chief Resident will release the post-call student to home after morning rounds. Each student will be scheduled on-call 3 weeknights and one weekend night. Two students will be expected to attend work/teaching rounds on Saturday and Sundays, and if not on-call that day, will be off for the rest of the day when rounds have been completed. A similar arrangement will be set-up at Methodist Hospital. Students at Methodist will report to the Methodist resident assigned to the "perinate" service and Methodist Maternal Fetal Medicine specialists. Methodist students will also be able to participate in the labor and delivery care of the generalist ob/gyn patients.
Learning Objectives for Obstetrics Block:
Cognitive: Students should become familiar with the following topics:
Students should become familiar with the following topics:
Normal Obstetrics
- Preconception Counseling
- Diagnosis of Pregnancy
- Physiology and Maternal Adaptation of Pregnancy
- Antepartum Care including Prenatal Diagnosis
- Labor and Delivery including induction of labor
- Obstetric Analgesia and Anesthesia
- The Puerperium
- Postpartum Care and Lactation
- Counseling on Male Circumcision
Abnormal Obstetrics
- Bleeding in Pregnancy- second and third trimester
- Fetal Death in Utero
- Dystocia
- Breech
- Cesarean section and VBAC
- Hypertensive Disorders in Pregnancy- Preeclampsia
- Isoimmunization
- Multiple Gestation
- Intrauterine Growth Restriction
- Premature Rupture of Membranes
- Preterm Labor
- Postpartum hemorrhage
- Puerperal Fever
- Medical and Surgical Complications of Pregnancy: Anemia, Cardiac Disease, Diabetes, Pyelonephritis,
other
M4 Ultrasound Elective:
Students will have exposure to ultrasound and prenatal diagnosis in pregnancy by spending time with the High Risk Obstetricians (MFM) and ultrasound technicians during ultrasound clinic. Students should focus on the following goals while spending time in ultrasound clinic:
- Understand the components of an anatomic obstetric survey
- Be familiar with 1st trimester screening
- Be familiar with the QUAD screen testing and how normal or abnormal results affect counseling and testing at time of ultrasound
- Understand the types of antenatal surveillance (such as NST (non-stress test), AFI (amniotic fluid index), BPP (biophysical profile) available; understand indications for these tests
Some students will get to see some unusual ultrasound findings and it would be expected that the student would perform extra research into that anomaly.
Knowledge and Skills Expectations:
By the end of the Obstetrics block students will be expected to competently:
- Obtain, present, and document a relevant history on patients being evaluated or admitted; examinations will be done with supervising resident/ faculty
- Interpret and document fetal heart rate monitoring strips
- Assess and document labor course in patients
- Understand the normal hospital course for the patient after a vaginal delivery and operative cesarean delivery
Directed studying recommendations:
- Web-based learning:
Students have only 6 weeks to cover a wide range of clinical problems seen by Ob/Gyns. It is important that students use "down-time" for directed studying. On the Obstetrics block, activities aimed at directed studying include:
- Ultrasound Images link
- FHT Tracing link
- Learning about Nurse Midwifery
- Breastfeeding Information
- Virtual Hospital (patient education on OB topics)
2. Reviewing Obstetric-related sample test questions and answers to prepare for NBME shelf examination. (Binder of sample questions available through Clerkship Coordinator)
3. Reading the assignments for that week's Wednesday faculty teaching sessions. References listed on student web site and copies available through Clerkship Coordinator.
4. Preparing for the topic of daily teaching rounds and problem-based learning sessions.