Robert C. Tatelbaum, MD
Site Coordinator, Third Year Clinical Clerkship

Guidelines for Students at Rochester General Hospital

Welcome to the third year clinical clerkship in obstetrics and gynecology at Rochester General Hospital. In addition to the general information you have been given, the following information is specific to Rochester General Hospital.

The clerkship is organized in the following way. The rotation is divided into two weeks of obstetrics, two weeks of gynecology, and one week of ambulatory ob/gyn. When you begin a particular service, report to the chief resident of that service for appropriate orientation.

Obstetrics – Sign-in rounds are held in the Residents’ Conference Room at 7:00 AM on Monday, Tuesday, Thursday, and Friday and at 7:30 AM on Wednesday. You should have your patient rounds completed and progress notes written prior to sign-in rounds. While on the ob team, students should be available on the Birthing Center Unit to evaluate and follow patients in labor. Availability and interest as well as establishing a good relationship with the house staff will ensure a good experience and a maximum number of deliveries. After you participate in a delivery, you will be expected to round on that patient daily. Sign-out rounds are at 5:00 PM in the Residents’ Conference Room.

Gynecology – You should attend sign-in rounds, as per obstetrics. Patient rounds, including progress notes, should be completed before sign-in rounds. The gyn chief resident will assign residents to cases in the gyn OR and make suggestions regarding which cases will be educationally beneficial for you to attend. This will include Urogynecology and Gyn Oncology cases. Cases should be distributed in such a way that each student has an opportunity to see a variety of procedures. Always introduce yourself to the attending doing the case. Also, be sure to review the patient’s hospital chart before going to the operating room. After surgery, you should round on the patient daily and record progress notes.

Ambulatory – One of the weeks will be an Ambulatory Ob/Gyn week. During that week you should attend sessions in The Women’s Center with the residents on Monday, Thursday, and Friday afternoon starting with a Primary Care Conference at 12:30 PM. You should also attend High Risk OB Clinic on Tuesday afternoon and Colposcopy Clinic on Wednesday afternoon, both of which start at 1:00 PM. During the mornings of this week you will alternate time in either obstetrics or gynecology depending on the activity of the service.

Night Float – Night float is from 5:00 PM to 7:00 AM Monday – Friday and Sunday 7:00 AM - 8:00 AM (24 hours). You are post call Friday and off on Saturday.

During call time, make sure that all call team members know you are the student on call. Ask the senior resident who you should work with to start the evening. Your learning will be maximized if you make yourself visible and available to see as much as possible (OB and GYN) during your call time.

Students should not write orders in the chart or do pelvic examinations unless they are directly supervised by a resident or attending. All notes and orders written in the chart must be countersigned. It is your responsibility to make sure a resident has countersigned your notes. The best way to make sure that this happens is to have your notes on the chart prior to the resident writing his/her note. It is also a good idea to always check with the residents before leaving the floor so they know where you are.

During the first day of the rotation you should contact your faculty preceptor and make arrangements to meet with him/her at least once a week. The preceptor’s function is to discuss and evaluate your write-ups, provide in-depth discussion of topics of mutual interest to you both, and to supplement formal teaching done during other conferences. Go through your list of objectives and make sure that you understand each point listed. Use your sessions with your preceptor to fill in knowledge gaps that you have not addressed via other learning opportunities and to review your patient logs.

Each week all students will meet with their faculty site coordinator. Week one will be an orientation session. A clinically oriented case conference will be conducted during the remaining weeks. Each student (see section 7 for schedule) will present a case, which will then be discussed by the group. The case should be derived from patients the student has seen during his/her clinical activities. The presenter is responsible for informing the faculty member what the general topic will be one day before the conference.

If you cannot attend a scheduled meeting with your preceptor or your coordinator’s meeting, please make sure that you call your preceptor or coordinator prior to the meeting time.

There are only two conferences that take precedence over anything else you do. You must not miss them no matter what rotation you are on, and you must be on time. The first is the SMH Thursday morning conferences. The second is the weekly case conference with your Site Coordinator. Formal resident conferences are from 8:00 AM - 12 Noon each Wednesday. You should plan on attending these conferences.

To maintain consistency across hospitals, students will be required to submit the same number of evaluations: 1) your preceptor, 2) one additional faculty member, and 3) a total of at least four resident evaluations with at least two of the four from upper level (R3 or R4) residents. It is to your benefit to obtain as many evaluations as possible. If you feel you have spent a significant amount of time with a resident or attending and they can evaluate your abilities, ask them to fill out an evaluation. You must add their name to your list, hand them an evaluation form, and ask them to sign your record sheet. The education office will contact them to make sure the forms are turned in.

This is a demanding clerkship. You will be expected to work hard and do a considerable amount of self-directed study. We also hope that it will be a fun and rewarding experience.

If you have any questions or concerns with any aspect of the clerkship, please bring it to the RGH Site Coordinator’s attention as soon as possible.

Good Luck!