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India Corrin is a 5th year medical student at Cardiff University.
Out of all the speciality placements, it is probably Obs & Gynae that invokes the most shock, horror and wonder in medical students. It is a vast specialty containing elements of just about every aspect of medicine – surgical procedures, outpatient clinics, real life-or-death emergencies and of course, many hours spent waiting alongside anxious, expectant mums as they progress through labour and delivery.
It is a speciality which personally filled me with fear leading up to my first day of placement as it is an area of medicine quite unlike any other. This particularly was evident in Obstetrics, as the number of patients you manage suddenly doubles (triple if you include panic-stricken fathers as well as mother and baby).
As I soon discovered, there is little to fear about Obs & Gynae but certainly much to gain if approached sensibly, so in what will hopefully be the start of many mini-guides to surviving different placement blocks, here are my Dos and Don’ts: Obs & Gynae Edition.
Do your reading!
It’s advice which seems obvious and is bound to invoke a beleaguered eye roll in many, but approaching Obs & Gynae with just a little bit of pre-reading under your belt will work wonders. Key things to get up to speed on:
A lot of the time, teaching sessions will be organised to go over these topics with a consultant but being up to scratch beforehand means you will get far more from the sessions and be able to receive more specialist teaching as opposed to labouring over the basics.
Make friends with the whole multidisciplinary team
Obstetrics is a speciality which, on the whole, is run more by the midwives and nurses than the doctors. They are the people who know exactly which stage of labour mothers are in, which births are bound to happen imminently and the most interesting cases for you to go and see. Make a point of taking some time to introduce yourself to these members of the team; they have vast amounts of knowledge to give and will often point you in the right direction if you’re feeling a bit lost (usually towards the tea and toast station….). Giving people a smile, your name and a thank you will get you further than you think!
Be prepared to stay late
Giving birth is certainly not a 9-5 business, which means that your usual placement day is thrown out of sync. A lot of my most interesting cases occurred outside of these hours, meaning you might have to be prepared to stay in the hospital a bit later than usual. It’s often worth having a chat to the team to see if you can arrange placement timings that fall more in with a shift pattern, arriving early or staying late, to maximise your chances of seeing the really exciting cases.
Practice your communication skills
If there was ever a time to practice talking to patients, Obstetrics is it. If you’re seeing a birth through from the start of labour to delivery, it’s not uncommon to spend hours with the same patient in one room. Take these opportunities not only to practice your history taking skills but also to develop your interpersonal skills. It might feel a bit artificial at first but by the end of the placement, I can guarantee your small talk skills will never have been better.
Gynae patients can often feel very vulnerable due to the sensitive nature of their problems, so the ability to make scared patients feel at ease can work wonders.
Be afraid to get involved
Obs & Gynae can seem horribly daunting but do not let this put you off getting stuck in. All of the staff I worked with were extremely enthusiastic about letting the medical students get involved. However, opportunities will not just fall into your lap – finding the confidence to ask if you can help out is paramount to success. Staff will not know that you want to get involved if you don’t ask, so don’t just expect them to offer you opportunities. This approach led to me having the chance to assist in C-sections, help deliver a natural birth and practice my suturing after a laparoscopic procedure!
Act outside of your competency
Obstetrics deals with an extremely fragile phase of life, so knowing where your capability limits lie is crucial. By all means take opportunities if you feel comfortable, but if a doctor or nurse asks you to do something you feel incapable of doing it is important to vocalise this. No one will criticise you for acting within your limits but all sorts of trouble can result from someone taking on a job they are not capable of doing.
The same applies for gynae, both in surgery and in outpatient clinics. Good cosmesis is an important end goal in a lot of gynae surgeries, so this may not be the time to volunteer practicing your suturing skills. Equally in clinics, many patients will undergo a bimanual and speculum examination, both of which can be incredibly uncomfortable and painful if done incorrectly so make sure you’re confident in these skills before taking the chance to practice on real patients.
Forget to bring snacks
Anyone who knows me will know that I always have a pack of oatcakes or a banana somewhere on my person to keep me going throughout the day. I found this really came into its own in Obs & Gynae as often the days are long and full on, sometimes with little opportunity to run to the nearest canteen or coffee shop to get some sustenance. Having a big bottle of water and a few snacks in your backpack can really make the difference between making it through a surgical procedure or ending up on the floor having passed out midway through.
Forget to say thank you…
….to everyone! This especially includes the patients, as often they are letting you in to extremely intimate moments of their life. Having the privilege to witness all that goes on in Obs & Gynae is an honour that is foolish to overlook, so make sure that you thank both the patients and the medical team for the opportunities you have.
For some people, this may be the first and last time they experience Obs & Gynae – it really isn’t to everyone’s taste but if anything, it makes it even more imperative that you make an effort to see all that the specialty has to offer. For more information, visit the Royal College of Obstetricians and Gynaecologists website (RCOG, https://www.rcog.org.uk/). Good luck and I look forward to writing about my experiences from my next placement.