Oh my. Where do I even begin. Obstetrics & gynecology really is the best of ALL worlds. Surgery is awesome, but you don’t get a whole lot of medicine. Medicine is awesome but it’s missing a lot of hands on patient care. Emergency medicine is awesome because it’s exciting and there is a lot of variety… but you don’t know what happens to your patient afterwards. Obstetrics & gynecology really does combine them all. You do surgery in the OR, procedures outside of the OR, consults all throughout the hospital, have a clinic and get to build relationships with your patients, you are constantly on your feet and busy doing something, and you can even be an ob/gyn hospitalist now-a-days. And if all that wasn’t enough… you get to see little tiny humans enter the world for the very first time. Seriously, nothing is more amazing than that.
Continuing on with how awesome ob/gyn is: most of your patients are relatively young and have good outcomes. They also tend to care about their health more because they are carrying a little baby inside of them. Even the gyn side is awesome. There is a lot of surgery involved and the female reproductive system is just so cool.
The Medical School Ob/Gyn Rotation
I think that I probably had one of the best experiences that you can have as a medical student. For so many different reasons. My preceptor was AMAZING. He somehow fit in SO much teaching into our crazy days. In between patients while walking from room to room he would explain everything to me and why certain things are done the way they are done. I really coudn’t have asked for a better teacher. Beyond that, he is so patient and kind with every person he interacts with and always takes the extra time to help the nurses out. I also got to do so much as a medical student and got a lot of hands on experience with his guidance. I took call with my preceptor and got to come in to the hospital in the middle of the night for emergency surgeries and deliveries. This was absolutely the best rotation of medical school thus far.
Also, I will say that this rotation definitely has a lot of shocking and jaw dropping experiences. Technically I knew what was going to happen during a delivery, or c-section, or circumcision. But seeing it in real life and the exact step by step process and getting hands on experience made my jaw actually drop multiple times. Seeing a uterus OUTSIDE of a human body (to sew it up) really is shocking. And oh my goodness… circumcisions. I won’t even describe that one.
The call. Perhaps the one downside to ob/gyn. You are on call a lot, but you can definitely tailor that if you work in a practice with multiple physicians to share call with. But being on call as an ob/gyn is probably the best specialty for being on call. When you get called into the hospital in the middle of the night… it is because someone is about to be born instead of about to die. There definitely are obstetric and gynecological emergencies, but then you are there to perform the surgery and save their life (so also awesome). Another way around having call is to be an ob/gyn hospitalist. This is a relatively new idea, and not all hospitals have ob/gyn hospitalists. But essentially you would do shift work in the hospital delivering babies and doing gyn consults and surgeries.
The only other thing about ob/gyn is that your patients are 100% female. So essentially, you are cutting the diversity of patients you can treat in half. Before I had my ob/gyn rotation, that was one big thing that I wasn’t sure that I wanted. I really love knowing what to do in any situation (part of why I was initially drawn to emergency medicine). But after I had the ob/gyn rotation, I discovered that only treating females didn’t bother me at all. I never once felt like, ‘man.. I wish we had a male patient to switch things up.’ The way I see it is you have to specialize in something. If you do pediatrics, you never treat adults. If you do internal medicine, you never treat kids. Med/peds: no ob/gyn. Family medicine and emergency medicine have them all.. but they both have downsides as well (no surgery). For me personally, all of the amazing aspects of ob/gyn definitely outweigh the downside of never treating male patients.
These are the fellowships that you can do as an ob/gyn. They are all 2-3 years long. There are also a couple of other fellowship sub-specialties like adolescent medicine, but these are the main ones:
Maternal Fetal Medicine (high risk pregnancies)
Reproductive Endocrinology & Infertility
How to Prepare for Your OB/GYN Rotation
Like with any rotation, the most important thing is to be respectful and proactive. Don’t overstep your boundaries, especially when dealing with the female reproductive system. At the same time, show up early and be eager and ready to learn. Normally I would say keep UptoDate handy and look up things when you get home. To be honest, I did this maybe one time because my preceptor explained everything so well. He answered every question I had and then ones that I didn’t even know that I had until he answered them.
If you want to prepare ahead of time, it would probably be a good idea to refresh yourself on the labs and exams performed at the different trimesters of pregnancy. Also review the stages of labor and how to read a fetal monitoring strip. Definitely learn how to gown and glove yourself if you haven’t already. And brush up on your suturing… ob/gyn is a lot of surgery!
Some Helpful Resources:
Bio Digital – A 3D resource available for PC or as an app on your smartphone/ iPad. What I like about this resource is that it has normal anatomy as well as pathology. Ob/gyn requires a good 3D understanding of the body. Not only for surgery, but for pelvic exams and other procedures.
Sim Vivo Suture Kit – This is the suture kit that I use. Practice your sutures for any surgical specialty.
How to Prepare for the OB/GYN Shelf Exam
I studied for this one just how I have been doing for all of my other shelf exams. I start by watching videos and reading, and save doing questions for the last 2 weeks of the rotation.
OnlineMedEd – I still cannot praise this resource enough. They have a TON of videos for both obstetrics and gynecology. And its free!
Kaplan Step 2 CK Lecture Notes 2018 – Obstetrics and Gynecology – I am still happy with my Kaplan purchase. The books are easy to read, cover the majority of what will be on the shelf exam/board exam and it is organized very well. I have been taking notes in the book when I go through questions or watch OnlineMedEd videos.
COMBANK – I have been using COMBANK for the shelf exams. Closer to Level 2 of the boards I am going to purchase UWorld.
I am SO sad that this rotation is ending. However, I will definitely be doing more ob/gyn and gyn surgery rotations in the future. I think I may be narrowing down what specialty I am going to do ;)