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Rotations and Responsibilities

Available Rotations

OB (ROH)

Call

  1. Call is on the Day/Night float system. Students are assigned to one of 4 teams (A, B, C, or D). One team is on call (7:30 AM to 6:00 PM) Monday, Wednesday, Thursday, and Friday, and (6:30 AM to 6:00 PM on Tuesday). One team is on call Monday (6:00 PM to 6:30 AM) and (6:00 PM to 7:30 AM) on Tuesday, Wednesday, Thursday, and Friday. The third team is on call (7:30 AM Saturday to 7:30 AM Sunday). Students decide among themselves who will work the day shift and who will work the night shift. The fourth team is on call Sunday (7:30 A.M. Sunday to 7:30 AM Monday). Again, Students decide among themselves who will work the day shift and who will work the night shift.
    There is no sleeping on call. You must complete your pre-call and post-call duties. The on call night team does not have to stay for Turnover at 7:30 AM or 6:30 AM (Tuesday) unless requested to do so by their Resident.
  2. Introduce yourself to each of your Residents and Attendings. There will be Residents specifically assigned to each of the four call teams. The Attendings will change from day to day.
  3. On call, you will be stationed in the Labor & Delivery area which includes the triage area called Evaluations (EVAL). This is an Emergency Room for pregnant patients. Your Responsibilities here include:
    1. Assessing patients when they arrive and then checking out to the Resident in EVAL. Because you are the first “physician-type” person to assess a patient, let your Resident know immediately if you believe a patient is unstable or needs immediate attention. Be ready to present your patient to the Resident or Attending.
    2. Students will be assigned to follow patients who are in labor. All efforts should be made by the assigned Student(s) to be present for the delivery.
    3. Attend and assist on Ob surgery. This includes a wide variety of cases, including Cesarean sections and tubal ligations. This should be planned in advance with your team of Residents.
      • You must attend scheduled lectures and Grand Rounds unless you are post-call.
      • If you leave the L&D suite, let your Resident know.
      • During call, keep a list of your patients. Any patient who is delivered on your call belongs to your service.

Post Call

  1. After Turnover rounds, you should complete your floor rounds. During call, you can see floor patients if it is not busy in L&D in the early morning. This will ensure that your post-call work is completed sooner and that your departure time is earlier.
  2. You are expected to assist on circumcisions. Ask your Residents when to meet in the nursery.
  3. Check out with your Resident. Compare your rounding lists and make plans for the next morning.
  4. When all the AM work is complete, you may leave. Please drive safely.

Morning Duties

  1. No matter if you are on call or if it is a weekday or weekend, you must round on all your patients. You are expected to have your work completed and to be on time for formal and informal rounds. Check with your Resident as to the start time.
  2. Arrive early enough to see all your patients and to have your notes written prior to the arrival of the Resident. Refer to progress note templates for correct format.
  3. After Turnover rounds, check in with your Residents, report to call, clinic, lecture or home, depending on your assignment.
  4. You may rotate rounding duties among your immediate team, especially on weekends, if the census is low and if your Residents approve your plan. However, if patients are missed, or rounding is not completed in a timely fashion, this privilege will be removed.
  5. Prior to leaving, check out with your Resident or the cross-cover Resident and make sure that no additional help is needed.

Clinic

  1. You should be in clinic each weekday morning and afternoon that you are not on call or post-call.
  2. You will be assigned to clinics at the MedPlex (880 Madison). These include: NST (non-stress test), USG (ultrasound), COCC (Continuity of Care), Ob, Gyn, or faculty private office. Again, be flexible with the assignments. If assigned to USG, but help is needed in NST, please go help. The goal is to get all the work done together and to get a wide range of educational opportunities. You may also e assigned to the Center for High Risk Pregnancies (6215 Humphreys Blvd, Suite 201).
  3. You should see patients when they arrive, take a history, perform a basic and relevant physical exam. Do not perform a breast or pelvic exam without a physician present. Check your patients out with the Resident or the Attending.
GYN B (MED)

GYN B at the Med is an inpatient service, a consult service, a surgical service and a clinic service. Needless to say, there is a lot of work to be done, but a lot of learning happens in the process. You will be assigned certain clinics, please attend accordingly. The rest of the team who is not in clinic needs to cover the remaining Responsibilities.

Call

  1. At the end of the workday, the student on call should report to the L&D senior resident and introduce him/herself. Discover if there is anything happening or anything pending. Write your name and phone number on the turnover board in the back hall. Leave your pager on. It is up to the discretion of the L&D senior resident whether you can go home or not.
  2. You are responsible for doing any late post-op notes. When these are complete, call the Gyn pager and check out your patient to the resident, reporting any relevant findings.
  3. In the morning, you should call the Gyn pager to find out if there were any new admissions. Only one student needs to call the pager in the morning!
  4. You may be paged to help with a consult or a surgery. Please make yourself available in a timely fashion.

Clinic

  1. Each weekday students will be assigned clinics at 880 Madison, third floor. These include your Gyn residents’ COCC’s (continuity of care clinic), faculty Private Office, Colposcopy clinics or Urogynecology clinic. Again, be flexible with the assignments. If you are assigned to a COCC, but they need extra help in Private Office at a given moment, please go help. The goal is to get all the work done together while getting chances to learn the clinical medium.
  2. You should see patients when they arrive, take a history, perform a basic and relevant physical exam. Again, do not perform a breast or pelvic exam without a physician present. Check your patients out with the resident or the attending.

Morning Duties

This is the busiest time of the day so be sure to have all the work completed early. In the morning, you will be responsible for rounding and for assessing the surgical patients.

Floor rounding Responsibilities include:

  1. Arrive early enough to complete notes. Refer to progress note templates for progress note format.
  2. Alert your resident if the patient is in distress of if you are concerned about the patient’s status.
  3. Stay updated on the floor patients including late night admissions and new consults. Help the residents organize and maintain a list of the patients.
  4. Surgical duties include:
    • Assess patient;
    • Be sure chart is complete and labs are resulted;
    • Write pre-op note;
    • If there is no H&P, call the resident with the Gyn records or compose one by interviewing and examining the patient.
    • Help get patients to surgery on time and avoid paperwork mishaps, lab error or other types of delays.
    • Scrub and assist for every case (at least one student). Other students can observe, stand by, and help with prepping, draping, filling in paperwork and other OR tasks. All aspects of the OR can be educational. Rotate these duties.
    • Write a post-op note for each patient who stays through the night. The student on call can be responsible for notes written in the late evening. Patients with surgery early in the day can be post-op’d prior to 5:00 PM.

Consults

  1. Accompany your resident to assist on consults. If the residents are really busy, you may be sent ahead to assess a patient and then to report your findings. Take a complete history and do a complete physical minus the pelvic/breast/rectal exam.
  2. Try to assess what instruments will be needed to complete the pelvic exam (endometrial biopsy, formalin, speculum, ring forceps, specimen cup, Pap supplies, etc.). Assemble these for your residents.
GYN (Baptist)

GYN at Baptist are surgical and inpatient services. You will have additional clinic duties, and there is an occasional consult. Your primary Responsibilities include rounding, assisting on surgeries and attending clinic.

General Guidelines

In general, keep in mind the following:

  1. The patients are private patients, and some of them may not be expecting a medical student. You should introduce yourself as one.
  2. Introduce yourself to the attendings. They want to know who you are.
  3. Get to know your residents. It is very easy to go the whole month and never work with a particular resident because of scheduling.
  4. If you are scheduled for clinic, but there is a case that needs covering as well, your priority is to attend surgery and then proceed immediately to clinic. Call ahead to the clinic to let them know because they will be expecting you.
  5. The student on call should accompany the resident who is holding the pager and take direction from that resident. The resident might be performing surgery, seeing a consult or managing the labor hall.
  6. You must attend lecture. Please check out with your resident when you leave for lecture and check back in after lecture is over.
  7. Organization is important in these two rotations because there are multiple sites (Baptist East and Women’s Hospital) and multiple Responsibilities. Designate one student, preferably the on-call student, to obtain the surgery schedule and list of in-house patients each night from the on-call resident and distribute that information to the other students.
  8. At Baptist, surgery and the inpatient service are assigned at either the Women’s Hospital or the original Baptist East site.

Morning Duties

This is the busiest time of the day so be sure to have all the work completed early. In the morning, you will be responsible for rounding and for assessing the surgical patients.

Floor rounds Responsibilities include:

  1. Arrive early enough to complete notes. Refer to progress note templates for progress note format.
  2. Alert your resident if the patient is in distress of if you are concerned about the patient’s status.
  3. Stay updated on the floor patients including late night admissions and new consults. Help the residents organize and maintain a list of the patients.
  4. Surgical duties include:
    • Assess patient;
    • Be sure chart is complete and labs are resulted;
    • Write pre-op note;
    • If there is no H&P, call the resident with the Gyn records or compose one by interviewing and examining the patient.
    • Help get patients to surgery on time and avoid paperwork mishaps, lab error or other types of delays.
    • Scrub and assist for every case (at least one student). Other students can observe, stand by, and help with prepping, draping, filling in paperwork and other OR tasks. All aspects of the OR can be educational. Rotate these duties.
    • Write a post-op note for each patient who stays through the night. The student on call can be responsible for notes written in the late evening. Patients with surgery early in the day can be post-op’d prior to 5:00 PM.

Clinic

Clinic assignments are as follows:

  1. Students are assigned to clinics at the MedPlex or UTMG Wolf River.
  2. At some of these clinics, you will be working with a faculty member; there may be no resident.
  3. Check with each faculty member about the extent of your duties. In each clinic, you may have a different level of responsibility. Sometimes you will only observe and sometimes the full extent of patient care is your responsibility. You should see patients when they arrive, take a history, and perform a basic and relevant physical exam. Again, do not perform a breast or pelvic exam without a physician present.

Call

  1. Be available to assist the on-call resident. It is up to his/her discretion whether you may leave early or not.
  2. Be sure all surgical patients received a post-op assessment.
  3. Collect the surgery schedule and inpatient list from the resident prior to departure and inform the other students regarding the activities of the next day.

Last Published: Oct 16, 2018