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Student Expectations

All Teams/Services

• Dress: you are required at all times to have an identifier (your official name badge)
• Introduce yourself to patients and team members (nurses, residents, attendings, etc.)
• Come in to the hospital in the morning before the residents to have rounding notes on your patients completed before sign-out rounds
• Review your findings (with informal oral presentation) and notes with the resident(s), and if possible with the attending, involved with your patients’ care
• Attend morning and afternoon sign-out rounds
• Take initiative to not be meek about presenting on your patients at rounds

Obstetrics

• Dress: scrubs, white coat (when not in the OR’s), appropriate shoes for the OR

Evaluation of obstetrical patients in triage:

• Completion of a triage note
• Assess laboring patients, admit them (i.e., complete at least one admission H&P), follow them through their labor, and participate in their deliveries

Intrapartum rounding:

• Notes every two hours on (awake) laboring patients whom you are following

Postpartum rounding on the patients in whose deliveries you have participated:

For patients who have had a vaginal delivery:

• Once daily (morning) rounding starting the day following the delivery

For patients who have had a cesarean delivery:

• Postoperative check 3-6 hours after their surgery has finished
• Once daily (morning) rounding starting the day following the delivery

Daily activities of the team:

• Lab follow-up (based upon what was discussed in sign-out rounds):
• Look up labs, review them with the team, discuss any potential interventions with the team, document them in the patient’s chart
• Participate in “intercare” or other interdisciplinary rounds on the unit throughout the day
• Follow-up on any consult service of attending notes on patients with pending plans
• Prepare at least one educational topic per week to present to your team

Of note: it is not expected that you perform cervical exams on triage or laboring patients; however, if a resident or attending offers you this learning experience, you have the option to participate. Please be sensitive to patients and seek guidance prior to entering the exam room, and feedback after leaving the exam room.

Gynecology

• Dress: scrubs, white coat (when not in the OR’s), appropriate shoes for the OR

Postoperative rounding on the patients in whose surgeries you have participated:

• Postoperative check 3-6 hours after their surgery has finished
• Once daily (morning) rounding starting the day following the surgery

ED and floor consultations: see and assess the patient, perform examination with a team member, write a consultation note (complete H&P), work on formulating differential diagnoses, assessments, and plans

• Notes

Prepare for your cases:

• Ask the chief resident in advance what cases you may be scrubbing (in order to know what topics you should review)
• Read the patient’s H&P – to review the HPI. Indications for procedure, etc.
• Review steps of the intended procedure – this can be found online, in texts, by reading operative notes/sample dictations in the red book
• Review relevant anatomy
• Practice knot tying/suturing at home
• Come prepared with at least TWO questions per case regarding the diagnosis, or the indication for procedure, or the anatomy, etc.
• Introduce yourself to the patient, the attending, and the OR staff
• Be polite to all the staff in the OR
• Pull your own gloves and gown unless you are told not to do so
• Scrub unless you are told not to do so
• During the case, at appropriate times, ask your questions, ask if you can review anatomy
• Let the team know that you would like to participate in any way that they feel is appropriate
• Prepare at least one educational topic per week to present to your team in sign-out rounds

Daily activities of the team:

• Lab follow-up (based upon what was discussed in sign-out rounds):
• Look up labs, review them with the team, discuss any potential interventions with the team, document them in the patient’s chart
• Follow-up on any consult service of attending notes on patients with pending plans

Oncology

• Dress: scrubs, white coat (when not in the OR’s), appropriate shoes for the OR
• If you go to the office for office hours, you should follow the dress code for ambulatory (below)
• Page chief resident before starting on the service to review his/her expectations for and plans for rounding
• Recommended patients to follow:
• At least one patient admitted for medical concerns
• At least one postoperative patient, ideally one in whose surgery you participated
• Prepare at least one educational topic per week to present to your team, possibly on:
• One particular type of cancer
• Chemotherapy medications any of the chemotherapy admissions are receiving
• Prepare for your surgical cases (see above and additions below):
• Review cancer staging prior to cases, and appropriate treatments for various stages of cancer
• Ideally, prepare for the service in the weekend beforehand by reviewing Blueprints, texts, or the red review book some basics on endometrial, cervical, and ovarian cancer (the most common gynecologic cancers)
• Spend time addressing palliative care/hospice topics (if at HH, with Dr. Mendelsson)
• Participate in a family meeting

Night Float

• Dress: same as OB (above)
• Similar expectations to the OB rotation (see above)
• Night float typically starts at 5 PM sign-out rounds
• The exception to this is that on Thursdays, you will come in at 7 PM (as you are required to attend Thursday morning didactics)
• If you are attending weekly teaching sessions that are required for the clerkship, you will perhaps be late to sign-outs
• Prepare at least one educational topic per week to present to your team and possibly also the day team at sign-outs
• Help prepare charts for induction or cesarean section admissions as directed by your teams
• Participate with ED consults

Ambulatory

• Wear dress/professional clothing, appropriate shoes (closed-toe), and ideally your white coat to the clinics
• Review the ASCCP guidelines (www.asccp.org) regarding management of abnormal cervical cytology and histology prior to colposcopy clinic
• Perform physical examinations on patients presenting for annual examinations (obvious exceptions are patients with mental limitations, teen or pediatric patients undergoing their first examination, etc.)
• Become comfortable with saline microscopy, obtaining cultures, obtaining pap smears
• Ask chief residents about how to prepare for the specialty clinics – they may assign you several patients’ charts to prepare