Preceptor: Moiuri Siddique, MD, MPH
Contact: Angela Sarkisyan, Angela.Sarkisyan@NYULangone
Telephone: 646-501-0025

Prerequisites: Obstetrics and Gynecology core clerkship

Who should enroll in this elective?

Students who are considering obstetrics and gynecology as a career

Clinical sites

NYU Langone Hospital Brooklyn
150 55th St, Brooklyn, NY 11220

Description

This is an advanced 4-week elective that seeks to build on obstetrics and gynecology knowledge and experiences gained in the pre-clerkship and clerkship years. As an advanced elective, students will be expected to serve at the level of a sub-intern as an integral member of the care team. The rotation offers students hands-on experience and a deeper understanding of obstetrics and gynecology, exposing them to a wide range of clinical cases in both inpatient and outpatient settings. Students will also participate in departmental didactics within the OBGYN department. This rotation offers a comprehensive educational and leadership development experience, equipping students with essential foundational knowledge and practical skills. Additionally, it provides opportunities to assume teaching responsibilities, all of which will effectively prepare them for residency.

Objectives of the Elective

The objectives of this rotation are to acquire both theoretical knowledge and practical skills in preparation for residency. The specific goals of this elective include:

1. Clinical Skills Development in Obstetrics and Gynecology
   • Labor Management: Gaining familiarity with the basic management of labor, including assessing progress and making management decisions
   • Cesarean Section: Understanding the indications and the steps involved in performing a cesarean section
   • Obstetric Complications: Developing a high level of understanding of major obstetric complications like hemorrhage, shoulder dystocia, chorioamnionitis, and abnormal fetal heart tracings
   • Labor & Delivery (L&D) Triage: Becoming comfortable working in an L&D triage setting, which involves assessing and managing patients in early labor or those with potential complications
   • Operative cases: Participating in and contributing to the management of patients undergoing operative management for gynecologic conditions as well as participating in the preoperative and postoperative care of patients who have planned and unplanned surgery
   • Clinical Documentation: Gaining proficiency in writing comprehensive and accurate notes for obstetric and gynecologic patients
   • Clinical Decision-Making: Developing the skills needed to create assessments and plans for basic obstetric and gynecologic patients
2. Practical Skills: Familiarizing oneself with navigating the EMR system to document patient information effectively. Learning and practicing key technical skills such as suturing, knot tying, and urinary catheter insertion
3. Leadership Development: Developing leadership skills by mentoring and guiding clerkship students during the rotation, helping them acclimate and succeed

Key Responsibilities of the student while on Elective

By enrolling in this advanced elective, you have agreed to:

1. Participate in at least 35 contact hours of education each week 
2. Provide communication of any excused absences to the Office of Student Affairs (excused absence form) and to the elective coordinator in a timely fashion 
3. Arrive to all locations to which you are assigned on time
4. In addition to the responsibilities outline in the Weekly Schedule below, the student is expected to complete a 24-hour call shift at Tisch one weekend during this rotation
5. Serve as an acting intern on the inpatient obstetrics (2 weeks) and gynecology (2 weeks) services during your elective, thus mirroring the resident schedules during this time frame. 
6. Participate in daily morning rounds and patient care with residents and attendings. Preround on patients on the obstetrics and gynecology service as directed
7. Be an active participant in the care of patients being followed by the team, as dictated by the resident/attending
8. Participate in weekly didactics and on Friday mornings along with the resident team

Key Responsibilities of the preceptor/residents/faculty while you are on Elective

By accepting your enrollment in this introductory elective, the department has agreed to:

1. Clearly communicate their expectations of you
2. Maintain a supportive clinical learning environment
3. Ensure that you have access to a broad case mix and clinical experience
4. Provide the education necessary for you to gain an understanding of the patients and pathology reflective of this specialty
5. Provide feedback on your clinical skills
6. Provide guidance on how to pursue a career in Obstetrics and Gynecology

Didactic program

Students will participate in regularly scheduled didactics for the residents in Obstetrics and Gynecology on Friday mornings from 8:30-12PM. There are also weekly case conferences and other morning didactic sessions that the student will be in attendance for.

Weekly schedule

Weeks 1 and 2 – Obstetrics: Labor and Delivery

Students will be working primarily with a PGY3 resident who will serve as their primary mentor and guide them in clinical tasks. Additionally, they will receive supervision and mentorship from the staffing attending physician. 

Triage Patients & Admissions:

• Assist with evaluating and managing triage patients, including performing initial history and physical exams (H/P) for admissions
• Write progress notes for intrapartum patients (patients in labor), documenting their status and any changes
• Support active labor management, which may include monitoring contractions, assessing cervical dilation, and supporting patient care in the delivery process
• Assist patients with pushing during labor as part of the clinical team

Patient Presentations:

• New Admissions: Present new admissions to the team, starting with presenting to the PGY3 resident
• Progress of Intrapartum Patients: Present updates on the status of intrapartum patients 
• Progression toward independence: Over time, as students demonstrate proficiency and confidence in their clinical reasoning and communication, they may transition from presenting to the PGY3 to presenting directly to the staffing attending

Scrubbing for Cesarean Sections:

• Gain hands-on experience by assisting with scrubbing in for both scheduled and emergency C-sections

Postpartum Care:

• Follow up with postpartum patients after delivery to ensure their care is coordinated and complete
• Address any additional social work needs (e.g., discharge support, etc.)
• Ensure appropriate outpatient follow-ups are scheduled for postpartum care, including contraception counseling, and any necessary referrals

	Monday	Tuesday	Wednesday	Thursday	Friday
Morning	L&D	L&D	L&D	L&D	Didactics
Afternoon	L&D	L&D	L&D	L&D	L&D

Important times:

• L/D signout and board huddle: 7:00AM
• Subsequent board huddles: 9:00AM, 1:00PM, 5:00PM

Specific Goals: 

• Presenting Progress of Laboring Patients at Board Huddles: Present at least 1-2 patients each day
• Presenting New Patients & Management Plans: At least 1-2 presentations to the staffing attending: Each day, the student should present new cases or updates to the staffing attending, demonstrating their clinical reasoning and ability to synthesize information

Weeks 3 and 4 Gynecology: Inpatient Service

Students will primarily work with the day GYN team in the care of patients admitted, ED consults, dispo plans for patients, covering OR cases (scheduled and unscheduled), engage in preoperative and postoperative care management, receive and provide signout to night team. 
 
Clinical Duties:

• OR Cases: Assist in scheduled and unscheduled (emergency) surgeries. This will usually involve scrubbing in or assisting with surgery
• Postop Care – follow patient’s progress postop and provide timely updates to the team
• Care of Admitted Patients: Monitor and manage the care of patients who are admitted with daily progress notes 
• Emergency Department Consults: Evaluate patients referred from the ED, write consult notes, communicate with team 
• Discharge Planning: Participate in discharge planning discussions to ensure patients are ready to leave the hospital safely. This might include coordinating follow-up appointments or arranging home care services as needed

Note: 

• Preop conference is held 7:30 AM on Wednesdays, students can prepare 1-2 patients to present each week 
• One Friday afternoon during the rotation, students will be able to work with Dr. Siddique in the office seeing patients with postpartum pelvic floor disorders

	Monday	Tuesday	Wednesday	Thursday	Friday
Morning	OR, Floor, ED consults	OR, Floor, ED consults	Preop conference at 7:30AM  OR, Floor, ED consults	OR, Floor, ED consults	Didactics
Afternoon	OR, Floor, ED consults	OR, Floor, ED consults	OR, Floor, ED consults	OR, Floor, ED consults	OR, Floor, ED consults

Specific Goals:

• Patient load of 1-2 per day with documentation on progress throughout the day
• Communicate initially with PGY4 regarding plan of care and as student gains autonomy, they can present directly to attending – aim for at least 1 presentation to attending per day

Method of evaluation

Biweekly meetings either in person or virtual will take place between the student and the faculty preceptor to allow the student the opportunity to discuss their progress during the rotation and elicit any feedback.

Scheduling information

Duration: 4 Weeks

Months Offered: All year

Student point of contact before start of elective: Dr. Moiuri Siddique

On day one, students report to: Student will meet with Dr. Siddique at 6:30AM on Labor and Delivery (or mutually agreed upon location), shortly before first huddle, to discuss goals and expectations of the rotation.

Students per elective block: 1-2