Michigan, Ascension Providence Hospital
OBGYN CORE
.jpeg)
Hello everyone!
My name is Lana Hariri and I am a current 3rd year medical student at AUC. I was so graciously asked by Tayler to talk about my different experiences at Providence Hospital in Michigan.
OBGYN in Michigan is 6 weeks is broken up in the following:
-
1 week L&D at Southfield
-
1 week GYN surgery in Southfield
-
1 week L&D at Novi
-
1 week GYN surgery at Novi
-
1 week night-shift on Labor and Delivery in Novi
-
1 week outpatient in Southfield
OB - Southfield
-
I usually arrived at 6am to be on the safe side, sign-outs/shift change is at 6:30am
-
They use a white-board system and write all the info on the patients there. So make sure to pay attention to who is close to delivering so that you can see a delivery
-
-
After that, you have a 1-hour 7a-8a “Morning Report” where residents go over topics in the conference room
-
DUTIES IN OB:
-
When patients walk in, they are placed in 1 of the 4 Triage Rooms. The nurses will see them first, then come into the conference room and let residents/students know they are ready to be seen
-
Students usually go and see the patient and do the H&P on CPN (see below for info on CPN)
-
CPN is a system that we only have access to in the patient’s room
-
It is unique to OB, won’t find it anywhere else
-
-
Type in the H&P and then present to your resident
-
I only did heart, lungs, and extremities
-
In the last week of my rotation, one of the residents let me ultrasound to confirm that the baby was head-down. That was super cool and I highly recommend you ask your resident to let you do that because it will help them out a lot :)
-
-
If you want to see a delivery, check the board to see who is close to delivering
-
You MUST introduce yourself to the patient before delivery and/or C-section, or else you will not be allowed to watch/scrub in.
-
Just say, “HI my name is X, I’m with the OB team today. Just wanted to introduce myself in case you find me here in the delivery. Is there anything I can do for you right now?”
-
-
There can be lots of downtime in OB, so bring study material
-
The residents don’t really tell you what they’re doing/going, so just be “alert”
-
C-Sections:
-
You will probably scrub in for most C-sections
-
Usually, the residents/interns close and do stuff, so just be prepared to watch and observe
-
C-section ORs are on the L&D floor
General Things to Ask in OB:
-
When you start a note make sure it’s in this format:
-
39 G2P1001 at 36 6/7 presents with sudden onset contractions… continue HPI....
+FM
+CTX
+LOF
-VB
-
-
IMPORTANT NOTE INFO!
-
For an OB patient, you must, must, must ask the big 4:
-
Are you feeling baby move? (+/- FM) fetal movement
-
Are you having contractions? (+/- CTX) Contractions
-
Are you bleeding vaginally? (+/- VB)
-
Any loss of fluid? (+/- LOF)
-
-
Ask when last Ultrasound was
-
GTPAL
-
I messed this up a few times in the beginning so here is a quick breakdown
-
Gravida - how many pregnancies total (full-term, miscarriages)
-
Term - how many babies born full-term (37 weeks plus)
-
Preterm - how many babies born PREterm (Less than 37 weeks)
-
Aborta - how many babies aborted/miscarried
-
Living - how many living children
-
We had one lady who has been pregnant 7x, 2 kids, 4 abortions, and pregnant sooo
-
G7P2042
-
If 1 was full term and the other not full term - G7P1142
-
-
-
-
GYN History:
-
Ask about STDs, abnormal pap smears
-
Hx of fibroids, cysts, polyps
-
-
Pregnancy
-
Ask the patient very detailed questions about past pregnancies
-
Year baby was born (or miscarriage), how many weeks, vaginal, C-section, any complications?
-
For every pregnancy!!
-
-
Hx of PreE
-
-
Fetal Heart Tracing (FHR)
-
This will be on your OB shelf!
-
Know the acronym VEAL CHOP! Will help for Shelf
-
-
All the residents have the FHR on the computers. I was super lazy and did not really pay attention to it at all
-
-
Quick Facts to know
-
VBAC = Vaginal birth after C-section
-
TOLAC = Trial of Labor after C-Section
-
Normal FHR: 110 - 160 bpm
-
“D-Cell”: Deceleration in the baby’s heart rate
-
“A-Cell” Acceleration in the baby’s heart rate
-
**I feel like OBGYN was a whole new language, so if there isn’t anything you understand/know/acronym, look it up :) **
OB - Novi:
-
I arrived at 6:45am because signouts/shift change is at 7am
-
Duties are the same but in Novi, patients don’t have specific triage rooms, they are just assigned a room.
OB Night Shift at Novi:
-
I arrived at 6:45pm because signouts/shift change is at 7pm
-
Nights aren’t bad as long as you schedule your sleep kind of well haa so this is my recommendation
-
Taking a nap Sunday before your shift will help WONDERS
-
After Sunday night (aka Monday morning), I would sleep from like 730-12 (unfortunately not too long because of the sun entering the window) so if you have an eye mask or shades that would be really good :)
-
I wouldn’t get out of bed until I absolutely had to start getting ready to give my body some rest.
-
GYN Novi + SF:
-
Duties are pretty much the same at each hospital. I would look at the cases in the AM but the residents would pick and choose which ones
-
Sometimes I would be asked to round on patients post-op in the AM and write a note, but only a few times. By the time I got to the room to round, the intern was already there so it was kinda pointless.
-
Laparoscopic procedures are really cool. I really liked seeing the GYN procedures because when doing OBGYN questions, it helped knowing what they were talking about.
-
Beware
-
Vaginal Hysterectomies - they’re not really fun for students bc we just stand there and can’t see anything. There would be 3 people by the vagina operating and you can’t see anything :/
-
-
Duties in OR:
-
Help residents break down the bed for D&Cs are stuff. (just take out the last 2 parts of the bed)
-
Put legs up on the sling thingy
-
-
Take the bed out of the OR
-
Pull gloves, gown for you + resident
-
Write name on the board
-
Wednesday Didactics:
-
7a-1pm:
-
Each didactic day is different. Sometimes the residents present a topic, the attendings do, reps from tech companies come, etc.
-
Outpatient:
-
See patients in the clinic: wellness checks, pap smears, ultrasounds, etc.
-
Paired up with a resident
Hope you guys found this helpful! Feel free to reach out to me/Tayler for any questions regarding the rotation or anything else!
- Lana Hariri
