MCG Obstetrics - Antepartum, L&D, Postpartum

[Betsy]

If you stay at MCG, you will do 3 weeks on obstetrics, and 3 weeks GYN (benign, onc, endo/repro, fort gordon). There is also this new night float thing that some people will get assigned to (2 weeks surgery, 2 weeks ambulatory, 2 weeks night float). Thats all I know about that rotation, so someone else that did that will have to fill in the blanks.

As far as the 3 weeks OB at MCG, its pretty awesome. You do a week of ante, post, and L&D.

Basic schedules, and tons if info are here:
www.mcg.edu/som/clerkships/obgyn/MCGStds.htm

Antepartum - pretty much like Maternal Fetal Medicine. These women on this service are hospitalized for different reasons prior to delivery (placenta previa, uncontrolled diabetes, lupus flairs, pre-eclampsia, appendicitis....you name it, if they are pregnant and need to be hospitalized, they are here.......oh yeah, and even the crazy ones.......i had a munchausen's patient). Get there at 6am, leave by 5:30 after lecture. 3 days morning clinic. Pretty unexciting.

Postpartum - even less exciting. These are ladies that just pushed out their babies. Your job is to maintain the list of patients (lots of turnover). You will see the day 1 patients, and present to the attending. And if Dr Manting is the attending, breast and perineal checks for all. This week is mostly paper pushing, making sure all the discharge paperwork is done for the people going home. Taking staples out, etc. If the OBs are on for circumcisions that week, you will get to see that too. Clinic is the same as antepartum. Again, the website has all the details. Same hours as ante, lots of downtime to read.

L&D. Here's a quick summary:

Student at AMC on left, Student at MCG on right.


Of course I am exaggerating a bit, but some people didnt get to deliever a baby. I got to deliver one on my own, put my hands on 2 other babies as they were coming out. Off campus people will definately have one up on ya. You will get to see c-sections too. I didnt get to help suture, you may get to put some staples down. Hard work, I know.

Get there at 6:30am for board check out from night team, leave at 5:30pm for check out to night team. If you have someone that is about to deliver, you can always stay for that. Your job is to pick patients to follow, and hopefully they will deliver before you leave. All the triages that come in (L&D is kind of like an ER for pregnant women over 20wks), you have to interview them before the resident and let them know whats up. You have to stay on your toes, because the nurses wont necessarily let you know that there is a new patient there.

Downtime varies, I was on call on a Saturday with one patient there all day. Somedays, the whole board will be full. If there are Eisenhower patients there or midwife patients (MCG residents dont follow them), make sure to ask if they dont mind you following a patient. The eisenhower docs and MW are great to work with.

On L&D you should get to do a handful of speculum exams, cervical checks, and wet preps. I have found that most of the residents are extremely nice, and you will have a good time. I was worried about staying at MCG for this rotation, but honestly it was fine. Of course there is the hoops that you jump through with Dr. Manting with all the little things you have to do, but I learned alot and had a good time. Any other questions, email me.

Betsy =)

[jeana]

Dr. Manting has changed the way Ob/Gyn works at MCG. Now you do 2 weeks of either L&D during the day or 2 weeks on night float (which is L&D overnight), 1 week of REI, 1 week of GynOnc, 2 weeks off campus or a week in Urogyn/etc. Everyone's schedule is a little different. I had night float, REI, GynOnc and 2 weeks off campus with Dr. Natrajan (REI)

Disclaimer: this is just my opinion and others are welcome to post their own.

Here's my take on Ob/Gyn at MCG: If you are considering Ob/Gyn as a residency, no matter how badly you want to stay in Augusta for whatever reason, I would recommend getting an away rotation. People just don't come off Ob/Gyn at MCG dying to go into this field. I have various explanations for that, but I won't go into them here.

Night float: Despite what you may think and contrary to common belief, you do NOT see more deliveries or procedures. There is a TON of downtime, which ends up being torture because it is 5am and you have only slept 3-4 hours the day before. You basically arrive at 10pm, stay on L&D until 6am, round with antepartum or postpartum team until about 8:30am, then go to clinic until 12pm. You get out of clinic on time if you're lucky, go home and try to get some sleep, then return that night at 10pm to start over. Residents are just as sleep deprived as you, so you won't be taught as much as your daytime counterparts. If there were a ton of deliveries and lots of action going on in the ER with OB patients, then yeah maybe it would be worth the biorhythm disruption. But that just wasn't my experience or anyone else on night float during my rotation. My advice is to avoid it like the plague. Rank it lowest on your list and hope for the best. Of course, this was just my experience and hopefully others will post if they had a better one.

Day L&D: I wasn't on during the day, but those who were tell me the hours arelong and you may or may not get a break for lunch. Be prepared to work hard but have fun. It is busy but there is plenty of opportunity to deliver (depending on the resident, mood, etc) Don't expect to get there any later than 6am or leave anytime before 8 or 9pm. I would still choose this over night float because at least you get to see more patients.

REI: I only had a few days because it fell on July 4th week. I thought Dr. Layman was an excellent teacher. He will ask you questions and tell you when you should have gotten them right, but he's nice about it. Read up on endocrinology, pituitary feedback, infertility, PCOS, etc and you will be much better off.

GynOnc: Dr. Ghamandi is one of the busiest, hardest working docs in Ob/GYN. You will see a number of interesting surgeries. He is very nice but too busy to babysit you. Expect to just shadow him if you go to his clinic because he has too many patients to see to allow you to practice lengthy H&Ps. Make sure you read up on chemotherapy agents before clinic. I didn't get to work with Dr. Macfee as much as I would like, but he was very nice to me and also an excellent teacher. I enjoyed my week on GynOnc. Some sad moments with patients...be prepared for that, especially when you go on rounds.

Urogyn: I only had 2 clinic days with Dr. Francis, but he is loved by everyone. You have to be easy going around him, don't be uptight or anything. He likes people who are fun. That's my only advice because of the short time I spent on Urogyn. Read up on urinary incontinence meds before clinic. He does very interesting surgeries if you're interested, but residents get first dibs so don't get your hopes up.