OB/GYN

Inpatient Obstetrics

Two months of obstetrical training is required in Family Practice during the three-year period. Training areas on obstetrics include the Birth Center, St. Elizabeth's Women's Care and the Family Practice Center. Supervision of resident training on the obstetric rotation is carried out by staff obstetrical attending physicians and nurse-midwives (CNM), if available.

The chain of responsibility in the obstetrical training of the residents is as follows:

• The resident on obstetrics is directly supervised by an OB/GYN attending on any of the St. Elizabeth’s group of patients.
• The resident on obstetrics is responsible for attending all scheduled obstetrical clinics announced at the beginning of the rotation. If OB clinic hours should extend beyond 4:30 p.m., the OB resident must remain until the session is complete.
• The resident(s) on obstetrics will be expected to acquire core knowledge. (See the Obstetrics and Gynecology Synopsis/Goal/Objectives in the Basic Standards for Residency Training In Osteopathic Family Practice and Manipulative Treatment). Residents who are assigned an OB patient have the responsibility of maintaining continuity of care with that patient which includes the delivery of the infant. The only reason someone else should deliver your patient is illness or vacation. Weekends are not a reason to miss the delivery of your patient. Residents are expected to wear their beeper 24 hours per day for one month prior to EDC and until delivery.
• It is imperative that these OB patients are signed out to the hospital service and the weekend call teams after delivery. The primary care resident is responsible for following these patients post-partum and after discharge, including the newborn.

The Longitudinal Obstetrics Curriculum is a requirement for graduation.

Goal/Objectives:

To teach and familiarize the family practice residents how to provide preconception, prenatal, labor and delivery and postpartum care to mother and child from their own patient panel.

Implementation:

• Two residents will pair up to follow 2-3 patients throughout their residency from the diagnosis of pregnancy to delivery.
• Residents will participate after they have completed at least one month of OB. During the OB month they will also, together with the nurse, do a complete prenatal 1st visit (intake).
• One resident from the pair will always be available for the prenatal visit.
• One resident from the pair will also be on call from when the patient reaches 36 weeks to delivery. The delivery will be supervised by the midwife/doctor on call.
• The resident team will also follow the patient and the baby until discharge.
• When our patients arrive on the OB labor floor before 36 weeks, the on call midwife/doctor for St. Elizabeth will be called, and an attempt will be made to contact one of the residents on the team.
• If the patients are after 36 weeks gestation, their own physician will be contacted; the two residents will develop their own coverage schedule and include it in the prenatal chart.

• A list of all prenatal patients will be kept at the front office and on Mox The list will contain patient's name, EDC and the doctors responsible for that patient.

Each resident will participate in two months of a gynecology rotation during his/her second and third year. Residents are encouraged to participate in gynecological cases of all attendings. The resident will follow any gynecological in-patients and participate in any gynecological surgical procedures being performed by the obstetric's attending staff if possible.

Family Practice Resident on Gynecology Responsibilities:

• Initial assessment and admission work-up for GYN Patient under the guidance of the GYN Attending.
• Assist in OR on GYN cases (1) half day per week.
• Follow patients post-op on floor and assist in discharge process.
• Attend office hours (GYN) under supervision of GYN attending (3) half days per week.
• Participate in weekly colposcopy clinic. It is expected that you will have reviewed the CD-ROM on colposcopy and the patient's chart.