After what seems like a mere few days on my ob-gyn clerkship, I can’t believe that in less than a week I will be taking my first shelf exam. The past few weeks since I last wrote have been a blur of many, many new experiences. In fact, a common sentence that has been running through my head throughout this clerkship has been, “I have never felt this new at anything!” I quickly came to realize that no matter how much I had heard about third year, or how many standardized patients I had worked with during M1 and M2 years, nothing had quite prepared me for that first time I knocked on a real patient’s door and entered her room to hear about her entirely real, unscripted problem.
I think I floundered a bit through that first interview—and the next several following it—coming to the off-putting, yet in retrospect obvious conclusion that actual patients don’t know the standard format of a patient interview that we are taught (chief complaint, history of present illness, past medical history, family history, etc), and the actual parsing out of these details can take quite a bit of work. I know I’m still incredibly far away from being what one would called “skilled” at these interviews, and yet I am amazed at how much more comfortable I already feel. It seems as though with each new patient, I learn a new little trick or morsel of advice that helps me with future patient encounters, from little ways to make nervous patients feel more at ease (and I’ve found that many moms-to-be are understandably quite nervous) to making sure to include family members in the room in the conversation, especially if they happen to be the fathers-to-be (often even more nervous).
One unique aspect of the ob-gyn clerkship is that each week I am on a new service, bouncing between inpatient and outpatient. I started with a week of Labor & Delivery, where as hoped in my last blog entry, I did in fact get to help deliver several babies! I then had a week of Reproductive Endocrinology and Infertility, a surgical week of Benign Gynecology, and then just finished a week of Maternal Fetal Medicine, which deals with high-risk pregnancies, such as diabetics and women struggling with addiction. Although the nature of this schedule hasn’t allowed me to ever feel quite comfortable with a given service, I have really enjoyed getting to experience such a gamut of subdivisions within the field of obstetrics and gynecology, and the combination of medicine and surgery inherent to this clerkship has been a great way to start off the year.
I finish next week with three days of Gynecologic Oncology, another predominantly surgical week—and one that I’ve heard to be the most time demanding—before taking the shelf exam and then enjoying my first, study-free switch weekend. After that, I’m onto psychiatry at the VA hospital, which I anticipate being an entirely different experience than these first six weeks of third year. I have heard that a common theme of M3 year is that just when you start to feel comfortable with one service, it’s time to switch to a new one and feel lost all over again. It is with this prediction that I anticipate with both anxiety and excitement, feeling new all over again…