OB Resident Duties & Expectations

Obstetrics

This document is meant to supplement the rotation goals and objectives document found in the resident handbook.

It is the intent of the Obstetrics faculty (Renown Women's Health) responsible for the supervision and education of the first year Family Medicine resident, to insure maximum exposure to all aspects of prenatal, intrapartum and postpartum care of both normal and high risk obstetrical patients. For this to occur, it is imperative that the first year resident prepare themselves for their OB rotation and throughout the rotation participate in both the didactic and bedside educational experiences.

Before the Rotation

  1. All residents should have completed basic reading assignments to be familiar with principles of normal labor. This should be a review from medical school, but that may not be the case for all residents.
    Recommended reading prior to the rotation includes:
    1. Williams Obstetrics Chapter 17- Normal Labor and Delivery
    2. Interpretation of the electronic Fetal Heart Monitor During Labor

Overview of Rotation

  1. Residents are expected to actively participate in the care of patients of the Pregnancy Center. This includes postpartum rounds, bedside evaluation of patients in L&D triage, active labor management, and the outpatient obstetrical clinic (The Pregnancy Center)
  2. As our goal is a quality educational experience along with excellent patient care, it is the discretion and responsibility of the OB faculty member to decide the level of participation of each resident in the intrapartum and delivery services that are the responsibility of the supervising OB faculty. The resident may or may not be involved in each patient's care, all depending on the volume and complexity of patients, the competence & skill of the resident, and the comfort level of the supervising faculty.
  3. Morning rounds (postpartum rounds) begin promptly at 06:00 on the postpartum unit. (Sierra Tower, 3rd floor)
  4. Pass on rounds (Board sign out) starts at 08:15 M-F and 08:00 S-S on Labor & Delivery (Sierra tower, 2nd floor)
  5. The resident is expected to be present on Labor & Delivery from 08:15 - 12:00. Breakfast and other personal duties should be completed before this time.
  6. The resident is expected to be at the Pregnancy Center from 13:00 - 17:00, exclusive of any requests for their assistance on L&D during this time.
  7. On Wednesdays, the resident will be excused at 10:45 to attend the FMC didactics and clinic.
  8. Overnight call will begin on L&D promptly at 17:00 and end at the conclusion of postpartum rounds the next morning.
  9. In the event that overnight call is on a Wednesday, call will begin at 1800 or sooner depending on the residents ability to complete the afternoon FMC clinic and travel to L&D.
  10. Weekend/Holiday call will begin on L&D for postpartum rounds and end after completion of postpartum rounds the following morning.

Schedule Template

Schedule for OB rotation by day of week and time of day
 SunMonTuesWedThursFriSat
AM O/C L&D L&D L&D L&D L&D O/C
PM O/C PC PC FMC PC PC O/C
Night O/C O/C O/C O/C O/C O/C O/C

L&D = LABOR AND DELIVERY PC = PREGNANCY CENTER

FMC = FMC Clinic/Didactics

O/C = OFF OR L&D CALL

If you are on call overnight, then you are off the entire following day. If you are not on call on the weekend, then you are off.

Labor And Delivery

  1. You are expected to arrive at 6:00 am to perform post partum rounds. The rest of the morning is spent with the attending seeing patients in labor and delivery and triage.
  2. While on labor and delivery, you are expected to see all patients that come to triage and perform a history and physical examination as well as a review of the prenatal record. You are then expected to formally present this H&P to the OB faculty member supervising for the day.
  3. The OB faculty will determine the level of participation of
  4. You are expected to write an admission note (H&P) if admission is determined. Please see the sample admission note in the resident handbook to use as a template for new admits. You should present all triage and new admissions to your attending physician after the completion of your H & P.
  5. The OB faculty will determine the level of participation of each resident for each patient. This is done to ensure a quality educational experience while allowing for excellent patient care. The OB faculty will communicate the level of participation expected of the resident in the care of each patient. This level of participation may be
    1. Monitor labor and observe the OB faculty or CNM in the delivery process
    2. Monitor labor and perform the delivery with the OB faculty as the direct supervisor.
    3. Observe repair of lacerations performed by the OB faculty or CNM
    4. Repair of lacerations with the OB faculty as the direct supervisor
  6. The resident is expected to write notes on each laboring patient assigned to them every 2 hours if possible.
  7. The resident is expected to assist on cesarean sections.
  8. The resident should be very available at all times on labor and delivery for all duties including new triage patients, new admissions, managing laboring patients, assisting on cesarean sections, managing ante/post partum patients.
  9. The resident should ask questions about their patients and their reading.
  10. You are expected to take active participation in the management of laboring patients. You should not go to the call room and wait for somebody to call you.

Pregnancy Center

  1. The resident should report to the pregnancy center promptly at 13:00. You are expected to stay in the pregnancy center until all the patients have been seen. Usually the afternoon will end around 5 to 5:30pm. You are off at this time unless you are on call that night in which case you should report to labor and delivery at 1700 ready for your shift.
  2. Resident duties in the pregnancy center include seeing patients by yourself and checking out the patients to the attending physician. Some residents may be allowed to check out to the midwives. Please ask the attending about check out preferences each shift.
  3. You must document in the prenatal record for each patient seen.

FMC Duties

  1. Residents are expected to report to didactic sessions and continuity clinic on Wednesdays at 11:00 AM. You may leave labor and delivery about 15 minutes before to allow travel time to the FMC/didactic sessions. If on call on Wednesday night, you are expected to arrive promptly back to L&D by 18:00 ready to start your shift.

Call

  1. Residents will be scheduled to be on call about every 3rd night. This call will include some weekend days and holidays.
  2. Call shifts for weekdays start at 17:00 (or at 1800 on Wednesdays).
  3. Call shifts for weekends and holidays begin at 06:00 with postpartum rounds
  4. The rest of the day (or night) is spent in labor and delivery until the following morning after postpartum rounds are completed.
  5. Residents are expected to be as active at night as during the day on labor and delivery. The amount of time for resting in the call room will depend on the number and complexity of patients and the preferences of the attending.
  6. In the morning after call, you are expected to perform postpartum rounds prior to leaving at about 08:00.
  7. You will always be off the entire day following a call shift.
  8. Call should never be scheduled on a Tuesday night as FMC clinic will always be Wednesday afternoon.

Reading

  1. Getting a review book and reading about the basics of obstetric care is very important. You already know this so please do it. You should have the book available in your call room on L & D so that you can read when there is down time.
  2. Please review the reading list in the handbook and read each article during the rotation.

Contacts

  • Myron Bethel (775) 982-3900 (mbethel@renown.org)
  • L & D (775) 982-5759
  • Pregnancy Center (775) 982-5646

Rev 12/2009