Third Year Medical Student Obstetrics and Gynecology Clerkship
Clerkship Director: Sally Nalesnik MD
Clerkship Coordinator: Leticia Martinez
Contact: Sally Nalesnik MD
Goals and Objectives
Welcome to the Third-Year Medical Student Pediatric Clerkship at Kern Medical.
Welcome to Obstetrics and Gynecology at Kern Medical. Our faculty, residents and staff hope that the next six weeks will be an enjoyable and productive time for you.
Our goal is to provide a solid base and set of clinical skills relating to women’s health care and to introduce the field of obstetrics and gynecology and the subspecialties you will encounter:
- High-risk obstetrics (perinatology/maternal fetal medicine)
- Gynecologic oncology
- Reproductive endocrinology and infertility
This guide will help you navigate through your OB-GYN Clerkship for the next six weeks. It is your responsibility to read and understand all components. Orientation is on the first Monday of each rotation start date in OB Conference Room 4025 after morning conference.
We expect that professionalism in the field of medicine will guide your attitudes and behaviors and provide a basis for conduct in your encounters with the patients, residents, faculty and others you will work with during your rotation.
We encourage you to fully experience the challenge, complexity and excitement that can be so rewarding when engaged in obstetrics and gynecology.
OB-GYN can mean hard work and long hours, but it can also be a lot of fun. We expect you to work hard. Period. Proactive students tend to have the most opportunities for hands-on learning.
Your residents are your main educators and are often willing to teach. We appreciate the interested and assertive student.
Please be on time, and be a team player. (After all, no one likes to be on the job that early.) Don’t wait for someone to ask you to do something – Find something to do. And try to anticipate what needs to be done. Ask for opportunities to participate in or observe procedures.
Ask a LOT of questions – at the appropriate times! READ!
And please be courteous, respectful and professional in all your dealings with our wonderful nurses, staff, and auxiliary personnel.
Goals and Objectives
The primary learning goals and objectives for the rotation will help prepare students for Step 2 of the National Medical Licensing Exam and the Objective Structured Clinical Examination (OSCE) through the following Must-Know Topics:
Must-Know Topics in Obstetrics
- Obstetric History and Physical
- OB prenatal visit, prenatal care, postpartum care
- First trimester complications of pregnancy, including spontaneous abortion and ectopic pregnancy
- Diabetes in pregnancy
- Domestic violence
- Hypertension in pregnancy
- Preterm Premature Rupture of Membranes (PPROM)
- Intrauterine Growth Restriction (IUGR)
- Normal and abnormal labor
- Fetal monitoring
- Third trimester bleeding
- Obstetric hemorrhage
- Gestational Trophoblastic Disease (GTD)
Must-Know Topics in Gynecology
- Age-specific gynecology History and Physical
- Annual pelvic examination
- Age-specific preventive care and cancer screening
- Pap smear screening and management
- Endometrial hyperplasia
- Abnormal uterine bleeding and amenorrhea
- Menopause and hormone replacement therapy
- Contraceptive options and counseling
- Breast masses and diseases
- Pelvic masses and gynecological malignancies
- Pelvic pain
- Sexually transmitted diseases/Pelvic Inflammatory Disease
- Vaginal discharge
Check your school’s objectives.
Core Clerkship Duration: Six weeks
Medical Student Typical Duty Hours:
- Daily: Weekdays, 5 a.m.-5 p.m.
- Weekends – Off unless on you are on call (see below)
- Pre-rounds: Daily starting at 5:30 a.m. while on a team
Have the list ready by 6 a.m., then round on the patients. Be ready to present patients by 6:30 a.m.
Rounds (Morning Conference): Daily at 7:30 a.m. (except Accreditation Council for Graduate Medical Education (ACGME) Conference days*). All faculty, residents and students must attend.
- Monday-Thursday: OB Conference Room 4025
- Fridays (Didactics): Main Conference Room 1058
Labor and Delivery/Operating Room: 8 a.m.-sign-out
OB-GYN and Faculty Clinic: 9 a.m.-5 p.m., unless otherwise posted
Rotations: See posted schedule for your assignments.
- Teams: A, B, C resident teams designated to different fields within OB-GYN. You will see the spectrum of Clinic, L&D, and OR on this service.
- Sagebrush Faculty: See posted schedule. You will work directly with an attending in the Kern Medical faculty clinics.
- Community Faculty: You will rotate with various community OB-GYN providers in their private offices. See posted schedule for address/contact information.
- Night Shift: 7 p.m.-8 a.m. Monday, Tuesday, Thursday-Sunday. Meet in Labor and Delivery or find residents on call.
- Weekend Call: 7:30 a.m.-7 p.m. Meet in OB Conference Room (4025).
*ACGME Conference: First and second Wednesdays of each calendar month. Morning conference starts at 7 a.m. on these days.
OB-GYN Didactics and Grand Rounds: Fridays 7:30 a.m. – 1 p.m.
Student Didactics: Thursdays at 1 p.m. in 4025
Students are expected to be present all day unless excused.
Students are excused for shelf exams and school-specific meetings or duties.
Notify your team for sick calls or planned absences. All absences must be cleared by Dr. Nalesnik.
Clinic: Professional attire
Labor and Delivery/Operating Room/Call: Kern Medical scrubs (See Medical Education for scrub card)
Policy for Medical Student Notes in EMR:
All inpatient and clinic notes are to be written by residents, co-signed by an attending. If a student sees the patient with an attending, the attending writes the note.
Didactic time is protected for all medical students for two-three hours per week, Thursday beginning at 1 p.m. in the OB-GYN Conference Room in 4025, unless otherwise specified.
Students are excused from other responsibilities so they can participate in didactics.
All students are required to do a 30-minute presentation during the course of their rotation and prepare questions.
- Should be approximately 30 minutes
- Should be a case-based presentation
- You can choose from many topics; sometimes they are assigned, but try to choose something interesting to you.
Reading is essential on any rotation. The new Ob/Gyn assigned reading will be the 7th edition of Beckman
Helpful Practice Bulletins: These are publications by the American Congress of Obstetricians and Gynecologists (ACOG) on common topics you will see on this rotation. Many more are available – ask your residents.
No. 30: “Gestational Diabetes”
No. 46: “Benefits and Risks of Sterilization”
No. 97: “Fetal Lung Maturity”
No. 106: “Intrapartum Fetal Heart Rate Monitoring”
No. 131: “Screening for Cervical Cancer”
No. 114: “Management of Endometriosis”
Students will be evaluated by their assigned team chief resident and faculty. Written evaluations, with the student’s participation in the weekly didactics, will account for 70 percent of the student’s grade. Students will be evaluated based on their knowledge base, clinical and analytic skills, enthusiasm, and professional demeanor.
The remaining 25 percent of the grade will be derived from the student’s performance on the national shelf exam. This computerized 40-question exam is given over one hour at the Sagebrush Technology Learning Center on the last Thursday of each rotation. A passing grade is a minimum of 70 percent correct on the exam.