Tag Archives: rotations

4th Year Electives for Ob/Gyn

12 Jan

I think this topic is really specific to what one’s individuals strengths and weaknesses are, however there are a few staples that I encourage students to consider as electives in 4th year, some that I did and some that I wish I did.

Infectious Disease

I found this rotation to be one of the most helpful rotations in medical school.  It forced me to think about a very wide differential with many “zebras” that are not often considered in general internal medicine.  You also often end up thinking about dermatology, global/travel medicine, toxicology and rheumatology as well.  The general diagnoses have already been considered and ruled out by the patient’s PCP by the time ID is consulted.  It also  helps you think about antibiotics better including side affects and how to trouble shoot recommended antibiotics vs. patient’s allergies, something that ob/gyn’s encounter on a daily basis.

Colorectal Surgery or Gastroenterology

I realize many ob/gyn’s would have went into general surgery if they found operating and talking about the colon all day was exciting, however, even though it is not our specialty we often do end up talking about bowel movements and changes in bowel habits quite often.  I personally did a rotation in colorectal surgery and it was one of my favorite rotations by far.  I became much more comfortable discussing bowel habits and questioning people about it.  I also was blown away by the amount of women either not getting colonoscopies, having bloody stools for >1year, anal fissures/fistulas that no one (the patient or the physician) was addressing.  Many of these women ended up having colon resections for cancer, cancer so advanced only salvage therapy could be done, and radiation for anal cancers that could have been detected on routine gyn exams.  So in the end I found that there is a great need for women to have these discussions with their PCPs and ob/gyns.

Hematology/Oncology

I recommend this rotation mostly because of the vast amount of breast cancer that you will see and also some of the blood dyscrasias and bleeding/clotting disorders.  I wish I had spent more time on my heme/onc rotation than 2 weeks.  There was just so much to learn.  I thought it was interesting going to do tumor board meetings in both heme/onc and colorectal and learning about initial patient presentations and how one would possibly detect these cancers earlier.  I also found it interesting and helpful to see what the women have to go through from their initial visit to making the decision for chemo/radiation/surgery and even stopping treatment.

NICU

I think this rotation is especially important if your future residency does not have a rotation in NICU.  If you have one booked as an intern I’d maybe skip this one.  I found it extremely helpful to have a solid understanding of the “bread and butter” problems of prematurity and other reasons babies end up in the NICU and what happens to them there.  I also felt more at ease dealing with premature and sick babies when I completed this rotation also.  It’s helpful just to see the reactions of the providers than take care of these babies every day and be able to get an idea of just how sick they are versus the babies that are very resilient.

Medical or Surgical ICU

I think this one speaks for itself.  In OB/GYN we get some pretty sick patients sometimes and it’s nice to at least be comfortable and familiar with the ICU and general principles of vent settings, weaning protocols, ARDS management, electrolyte imbalance corrections, etc.

Urology or Uro/Gyn

Specifically urology/gynecology or urology that does mostly gyn/pelvic reconstruction work.  I found this to be one of my most useful rotations since general ob/gyn and even more so in resident clinics you don’t see as much gyn.  The gyn you do see are people that are so anemic from their heavy menses that they have to come in.  So recognizing and being familiar with bladder and prolapse questions is important.

Cardiology

Perhaps a 2 week rotation isn’t the worst idea.  I did a month and it was too much.   The cardiology that is important for ob/gyn is recognizing problems and when they’re too much for you to handle and need to consult, and some EKG interpretation. So depending on what you did in your general IM rotations you may or may not be adequate in this already.

MFM

I realize this one is less important since you will be getting a few MFM rotations as a resident, I enjoyed it for the ultrasound experience.  I learned to ultrasound well and be able to recognize many of the landmarks and characteristics of fetal anomalies.  I think if you have a dedicated ultrasound month or some sort of rigid curriculum on ultrasound in your residency this isn’t as important.  For me, it was really helpful.

Endocrinology

I did not do a rotation in endocrine because all of the endocrinologists mostly only did diabetes where I was looking.  I do think it would be useful though.  Perhaps with an REI may be the answer for this.

Something easy

If you’ve heard of an easy rotation from friends/classmates I recommend doing this for at least two weeks of spring term.  I made sure January was really busy right before the match and then right after the match I tried to schedule less stressful rotations.   You really should try to enjoy the time between the match and residency!

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