NEW!! - Link to the Online Video Clerkship Lectures for OBGYN

NEWER!! - Link to the Friday Lecture Schedule (please be aware that this changes almost daily. This is meant as a convienence for you, but always refer to the email sent on Wednesday for the most up to date schedule)

Link to Procedure Log Instructions and Procedure Log (the log link is imbedded withing the instructions)

Clerkship Guidebook

Section 1 - Orientation Information

Section 2 - Fall 2 08 Rotation Schedules - Weekly and Team

Section 3 - Preceptor Bios and Lecture Notes

Section 4 - ACOG Medical Student Application and Maps

Quiz - Please complete before Orientation begins

Schedules

The schedule is complicated. The goal of these seemingly uninterpretable schedules is to give each student 3 weeks on an ob team, 3 weeks on a gyn team and a half-day each week with a generalist preceptor in clinic.

Two thirds of the students rotate at OHSU. The OHSU rotation consists of three weeks of obstetrics and three weeks of gynecology, either benign or oncology. One-third (4) of the students will rotate at Legacy Emanuel Hospital (LEH), and Good Samaritan Hospital (GSH). All students take call on labor and delivery (L&D) every fourth or fifth night depending upon number of students enrolled in the rotation. The OHSU students take call at OHSU and the LEH/GSH students take L&D call at LEH. Students at each hospital are allowed to make call switches.

Preceptor clinic

Each student has half a day per week assigned with a generalist preceptor. The preceptor clinic remains the same throughout the six-week clerkship. Please e-mail or page your preceptor to confirm time and places for clinic. This clinic pre-empts any other team duties that you have. However, if you have a conflict it is fine to ask your preceptor to change the time or day of the clinic that you attend.

Ob teams

The students on OB at OHSU are divided so that two students spend their time on L & D, and two students go to high-risk clinic every morning. The students on L & D may spend AM time doing newborn exams with the pediatrics team. Those students on clinic do rounds in the afternoon. Halfway through the first three weeks, the two teams switch jobs.

OB at LEH is less structured, although each student spends a half-day with one of the perinatologists in clinic. You may do newborn exams, however you must request this.

OB runs more like an ED than a ward service. The labor unit is covered in shifts, both by attendings and by residents. You do not take call as a team, nor do the residents. This can be a difficult system at first, as there is no one resident to identify as being in charge. One way to deal with this is to identify first with the patients, then identify which resident will help you accomplish your goals in caring for your patients. The L&D nurses are very knowledgeable about how to get things done, and can be infinitely helpful to you as long as they perceive that you have the patients' best interests at heart.

L&D Orientation

At both OHSU and LEH there is a brief orientation to L&D held on the first day of the clerkship, after your orientation to prenatal and antepartum care. All students attend at the L&D where you will take call, even if you start on the GYN service.

Midwifery service

Students are welcome to approach the midwives, either at EH or OHSU, and ask to follow their patients. If they do not already have a midwife student, they will gladly have you. At OHSU, the midwifes expect you to function like a midwife student for the day or night that you are with them, seeing their exam patients and following and supporting their labor patients as your first duty and taking on patients with the resident service only if time permits.

Gyn teams

GYN teams are teams in the traditional sense, and your schedule reflects two days in the OR, a half-day in pre-op clinic, and a half-day in GYN clinic (or colpo clinic) with your team. Again, GSH has less structure but the same goals.

Team schedules are templates and have approximate times. The time that AM rounds begin depends on the census. Ask your team each night. PM rounds usually occur when the physicians have time.

Orientation to Call

On the first Wednesday of each clerkship, Dr. Emmons meets with students for 3 hours in the morning to go over a problem based learning exercise that is designed to get you ready for your first call night on L&D. The written materials for this session are in your packet, labeled “quiz 1”. Please read about normal intrapartum and work through this exercise before coming to orientation.

Texts

The Ob/gyn department has a number of copies of a small handbook that was written by a former resident, Melanie Harker, Ob/Gyn Intern Pocket Survival Guide. You may borrow these books. They have great practical information like how to write postpartum notes and c/sec notes, as well as a small amount of clinical information. I encourage you to look through it before starting the clerkship.

For the OHSU students, in your packet are guides to how the teams function on Ob and Gyn. These guides also were prepared by former residents and are valuable to look through.

There is no required text. Many students have liked Blueprints in Obstetrics and Gynecology, by Callahan, Caughey and Heffner. I’ve reviewed this and like it. Other similar books include those edited by Hacker & Moore or Beckman.

FRIDAY LECTURES AND PRESENTATIONS

Lectures are scheduled every Friday. You should do AM rounds, then come to OHSU for lectures, which begin between 8:30-9:30. OB/GYN Grand Rounds is every Friday, September through June, 7:30-8:30 a.m. in UHS 8B60 and you are welcome but not required to attend this.

Midway Evaluation

After three weeks, you have an opportunity to review your progress on the clerkship. Dr. Emmons speaks with the residents on your teams and gives you a written assessment based on their comments, which is distributed at the Friday lecture session. Office hours with Dr. Emmons are available during your lunch break that day for anyone who wants to discuss the evaluation. You also may schedule an appointment at any time, just email emmonss@ohsu.edu or page on 10204.

Attendance

Please page your team if you need to be absent for any reason. If you must miss more than three days of the clerkship, you need to make arrangements for make-up time.

Problems

If you feel you are having a personality conflict or other sort of problems with your team or preceptor, please bring this to Dr. Emmons as early as possible. Three weeks goes by very quickly!

Optional Clinics

Included in your packet is a list of clinic opportunities for which students are welcome but not routinely assigned. If such an opportunity appeals to you and fits your schedule, you are welcome to attend. I try to keep the list current, but because of changes in residents on service or vacations, it may sometimes be inaccurate.

Dress Code

Students are expected to wear a white coat and name tag. Men should wear ties to clinic and women wear equivalent attire. Scrubs are for L&D and the OR. Please do not wear scrubs to clinic and if you must, don't wear the ones you slept in!

OBGYN Policy: Exams under Anesthesia

Students do pelvic exams in anesthetized patients when they are scrubbed as part of the surgical team. If more that one student is involved in a case, only the student who is going to scrub should do the exam under anesthesia, unless there is special permission from the patient for another student to do an exam. Most patients are open to allowing this, but the surgical consent for exam only applies to the scrubbed team.

View the policy.

Grades

There is a multiple-choice final exam that reflects your course objectives and counts 15% towards your final grade. Student presentations count for 10% of the grade. Evaluations from residents and faculty make up the rest of the grade. The evaluation of your clinic preceptor is weighted at 15%, and each team evaluation is weighted 30%. The median grade is NH in this course.

Your final grade is submitted to the dean's office on a summary form (sample included in your packet). The summary comments represent a distillation of the various evaluators, and are meant to be transcribed directly onto your Dean's letter. Formative comments are transcribed straight off the evaluations and are not meant for the Dean's letter. If you want to review you grade packet, make an appointment with Terri Welsh, clerkship coordinator, 503-494-7897, or drop by her office.

If you feel your grade is unfair or does not contain complete material, you can contact me by e-mail or phone to discuss this.