OB Schedule and Objectives

Sample Schedule

OBschedule

Educational Objectives

The UWMC Obstetrics L&D team is comprised of R1, R2, and R4 OB Gyn residents and a R1 Family Medicine who rotates between the day team and night float team. An additional antepartum team is comprised of R2 and R3 OB Gyn residents. Clinical and educational responsibilities by level of training are summarized below. (insert link to ob daily schedule document)

Objectives for R1s

  • Continuity Clinics: Provide normal antepartum obstetrical care through the residents' continuity clinics at HMC and WHCC, and supervised by generalist OB Gyn faculty.
  • Triage and Admissions: Evaluation of term labor and low risk antepartum/postpartum patients with oversight by the second and fourth year residents.
  • Postpartum Rounds: Rounds by R1 on days and night are conducted with oversight by the second year residents and will include medically complicated, diabetic and hypertensive patients by the end of the first year.
  • Labor and Delivery: R1s are expected to evaluate and manage normal labor and recognize abnormalities that can occur during the course of labor and perform neonatal resuscitation when needed. R1s perform all term (and some preterm as the year progresses) vaginal deliveries in the presence of the R4 and faculty.
  • Circumcisions: OB Gyn R1s will rotate with Pediatrics and Family Medicine residents to perform circumcisions in MICC.

Objectives for R2s

  • Continuity Clinic: Continue to provide normal antepartum obstetrical care through the residents' continuity clinics at HMC and WHCC, supervised by the generalist OB Gyn faculty.
  • Intrapartum Care: With R4 supervision, the R2 manages all preterm or complicated labor. The R2 will perform the majority of the cesarean deliveries with the faculty and the R4.
  • Sign out/Board Rounds: The R2 is responsible for conducting concise and formal board rounds.
  • Postpartum Rounds: The R2 provides postpartum care for complicated patients and supervises R1s and medical students on postpartum rounds including delegation of clinical duties, timing of rounds, and review of management plans.
  • Antepartum inpatient service: R2s will be supervised by an R3 who serves as chief of the Antepartum inpatient service to manage a range of inpatient maternal medical and obstetric complications. This is a high acuity services with a high number of patients with preterm labor, preterm rupture of membranes, severe complications of diabetes, hypertensive disorders, multiple gestations and placental implantation abnormalities. The Antepartum team is directly supervised by the MFM faculty and fellows in evaluation and management of these complex patients. Informal case-specific teaching is performed frequently on this service.
  • MICC Specialty Clinics: Provide antepartum care in the Diabetes, Prematurity, HIV, Hypertensive, and Prenatal Diagnosis Clinics. This clinical and educational experience is supervised by the MFM faculty.
    • Diabetes Clinic: Diabetes Patient Care conference provides a formal Diabetes curriculum and opportunity to discuss complex management strategies. The exposure of residents to patient with a range of gestational and complications related to pre-gestational diabetes is extensive.
    • Prenatal Diagnosis/Pregnancy Termination: This clinic provides an opportunity to counsel patients on pregnancy options for undesired pregnancies, many of whom have complex fetal anomalies and perform cervical preparation for uterine evacuation by dilation and evacuation or induction of labor.

Objectives for R3s

  • Continuity Clinic: Continue to provide normal antepartum obstetrical care through the residents' continuity clinics at HMC and WHCC, supervised by the generalist OB Gyn faculty.
  • MICC Specialty Clinics: Build on clinical expertise in the antepartum care and management of high risk prenatal care in the Diabetes, Prematurity, HIV, Hypertensive, and Prenatal Diagnosis Clinics. This clinical and educational experience is supervised by the MFM faculty. See above R2 description of MICC Specialty Clinic expectations.
  • Antepartum inpatient service: Serve as the chief of the antepartum service providing supervision of the antepartum R2 to provide care for this busy inpatient service. See description for R2 above. In addition, the R3 will serve as the OB Chief during the R4's absence (vacations, meetings) and effectively hand-off management plans with the covering night and weekend residents.

Objectives for R4s

  • Inpatient obstetrics service:Provide leadership to all junior residents on the obstetrics service and oversight for L&D, postpartum, and antepartum services.
  • Appropriately delegate clinical duties and coverage of the obstetric services.
  • Recognize and manage obstetrical complications and acute care of the high risk pregnant patient.
  • Oversee the evaluation of women in labor, manage labor in both term and premature patients and initiate neonatal resuscitation, perform or oversee operative vaginal deliveries, breech extraction of second twin and complicated.
  • Coordinate care with faculty, resident team, nursing staff and Anesthesia services. Conduct daily TeamSTEPPs rounds.