OB/GYN Clerkship Review

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As a third-year medical student, you’re clinically and intimately exposed to all of the main specialties in medicine: general surgery, internal medicine, family medicine, pediatrics, psychiatry, and obstetrics/gynecology. The goal of your third year is to become proficient at taking medical histories and conducting physical exams, as well as learning how to manage patients and their illnesses. By the end of your rotations, you’ll have a little bit of experience in all of the fields, and you’ll (hopefully) have enough knowledge to know which specialty you are interested in pursuing!

I had the pleasure of completing my obstetrics and gynecology rotation first. This was my impression of the rotation, and my top tips for when you begin yours!

 

Obstetrics and Gynecology

Obstetrics and gynecology (OB/GYN) is a branch of medicine that specializes in the care of women during pregnancy and childbirth and focuses on the overall treatment of pathology of the female reproductive system. To become a board-certified OB/GYN, you must complete 4 years of medical school followed by a 4 year OB/GYN residency. As an OB/GYN resident, you get to continue your training in gynecologic surgeries, labor and delivery, and women’s health. You can even choose to sub-specialize in one of the following areas by completing a fellowship post-residency: maternal-fetal medicine, gynecologic oncology, reproductive endocrinology, family planning, or female pelvic medicine or reconstructive surgery.

 

OB/GYN Rotation

The OB/GYN rotation consists of a large variety of pathologies and requires a large range of clinical and surgical skills. Most of my days on rotation were spent in the Women’s Health Clinic affiliated with my hospital. I would work from 8 am – 5 pm seeing women of all ages that presented annual wellness exams, obstetrics check-ups, vaccinations, minor procedures, or acute complaints such as pelvic pain or dysmenorrhea (painful periods). On this rotation, you get a lot of experience doing annual exams which consist of pelvic exams and breast exams, along with pap smears and STD screens. Women also come to the outpatient clinic to get IUDs removed/inserted or birth control implants removed/inserted. I also spent 3 days of the month working “call” shift, which entails 24-hour shifts in the labor and delivery unit where I was responsible for monitoring the soon-to-be moms as they began the labor and delivery process! This is when I had the opportunity to deliver babies. The month-long rotation also included 3 days of scheduled surgeries. These days were spent in the OR where we’d perform elective cesarean sections, ovarian cyst removals, and other procedures and surgeries relating to the female reproductive system.

 

Pros of OB/GYN

As a student who never considered OB/GYN as a career, I must say that my experience was magical. The privilege of assisting in bringing new life into the world is second to none. Getting to be a part of such an incredible process also gives you a new respect and appreciation for the human body. Of course, there are losses, but it is such an incredible experience to deliver these babies and learn acute interventions for managing pregnancy and labor.

Another aspect of the specialty that I particularly love is the variety in the field. Having the opportunity to do surgeries and manage patients in the outpatient clinic is unique to a minority of medical specialties. I enjoyed doing the gynecologic surgeries and appreciated that these were mostly routine procedures that come with low risk that result in instant patient improvement. If you are somebody who enjoys surgical fields, OB/GYN could be an option for you.

Additionally, having the opportunity to build relationships with patients in the clinic was rewarding. Getting to follow your patient from conception to delivery and seeing them on a regular basis allows you to learn about who they are and allows you to learn about their life. This intimacy and familiarity help you to deliver more personalized and compassionate care.

Working in the clinic for the majority of the month was also beneficial as I had a reliable schedule where I knew what time I would be home at the end of the day. It allowed for a good work-life balance, giving me a lot of time to study. It is comforting to have a scheduled workweek so that you can schedule your personal life outside of your work schedule. My schedule was consistent, with a minority of the days being hectic OR or call shifts. The emotional and psychological strain of the work was minimal with the patient population being healthy and rarely presenting with acute life-threatening illnesses.

There is much to enjoy in this rotation including excitement, variety, and a lot of new material to learn!

 

Cons of OB/GYN

The only aspect of the specialty that I personally did not enjoy was that the field has a very specific patient population. You are only treating women in the reproductive and post-menopausal age group. This keeps you from having the opportunity to treat men, pediatric, and geriatric populations. Additionally, this field is very specialized. It was hard for me to accept that I would not be using the wide base of knowledge I have on other body systems including the gastrointestinal, cardiovascular, renal, and central nervous systems. Personally, I’m interested in a broader spectrum of patients and illnesses. But if you are looking to specialize in one area, and hyperfocus in that area, OB/GYN may be perfect for you!

 

Helpful Resources for the Rotation

At the end of every clinical rotation during your third year of medical school, you have to pass a comprehensive exam for that specialty. For this rotation, I used a variety of resources to review for my exam. I found APGO (Associate Professors of Gynecology and Obstetrics) UWise practice questions to be very helpful in preparing me for the style of the exam questions. I also completed the OB/GYN section of the UWorld Question Bank. I took the total number of questions in the question bank and divided them by the number of days I had in the rotation. This allowed me to only have to complete approximately 20 questions each day, which is very reasonable. I would take extensive notes on the correct and incorrect answers to the practice questions and would create flashcards on important associations and treatments. To fill in gaps in knowledge, I used OnlineMedEd videos and USMLE Master the Boards STEP 2 CK review book.

 

Overall, my obstetrics and gynecology rotation was very busy and very intense, but it was an amazing experience. In clinic, we would see about 35 patients, and overnight calls often kept me from getting any sleep, but the opportunity to be a part of the medical care of so many women was invaluable.

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