Written by: McMaster Medical School c2023 Student, Hamilton Campus Where was your placement and what specialty was it in?
I did my OBGYN core at Brampton Civic Hospital. How did you get there? My parents were able to drive me from Hamilton to Brampton, where I lived in a basement apartment in a family home in Brampton. It was a roughly 30 minute bus to Brampton Civic Hospital, but the drive would've only been 10-15 minutes. The busses in Brampton are highly reliable and the bus stops are very nice and well-protected from the cold weather. A huge snowstorm hit Brampton half-way through my core, and all the streets were plowed later that morning. There were traffic disruptions due to the storm and the snow in the morning, but there were fleets of snowplows sent out and the roads were cleared relatively quickly. Since I bussed the whole month I did not have to pay for parking, but the bus pass for the month was roughly $100. I applied and was approved for $800 from MacCare for funding for housing. Describe a typical day at your core. The admin will send out your schedule a few days before the core begins, and you will be given 12-13 12-hour shifts. The shifts run from 8am-8pm (days) or 8pm-8am (nights). You will usually be given a week or two of days, then a week or two of nights. You get a post-call day after every shift as well, so a week might look like Monday 8am-8pm, Tuesday off, Wednesday 8am-8pm, etc. When you start your shift in L&D write your name on the whiteboards at the nurses' station, introduce yourself to everyone (including in triage), and be present for handover at 8. Depending on the patients in L&D you might spend your time seeing new patients in triage, helping out during deliveries (you can ask to take the cord gases or help the moms push), or scrubbing in during C-sections. Some doctors will take you with them to the Early Pregnancy Clinic during weekdays, or you may be asked to do an emerg consult. We didn't get much/any exposure to gyne clinics as we were told they weren't running due to Covid. If you want to get the most out of the core, try to be present as much as possible. What level of responsibility/exposure did you have as a medical student? Different doctors had different expectations for medical students, and the great task at the beginning of every shift was trying to figure out the vibe of each doctor. Try to ask your fellow students for tips/preferences of each doctor, but most of it will just come with experience. Some doctors will let you do perineal repairs, do cervical checks, and take more of a leading role during the delivery, others will only let you take cord gases and watch. Don't be afraid to ask to do something, as they are more likely to let you do something than offer you an opportunity unprompted. What are some things to review about for this core? - Gestational diabetes - Pregnancy-induced hypertension (and preeclampsia, eclampsia, HELLP) - Cholestasis of pregnancy - Different types of inductions (Foley, prostin gel, cervidil) - Postpartum hemorrhage, risk factors, treatment (ie. hemabate, misoprostol, etc.) - Review the steps and anatomy of a C-section - For the NBME exam review breast cancer/breast masses as there's little exposure to that, as well as gyne complaints like STIs, abnormal vaginal bleeding, uterine leiomyomata, etc. What is your most memorable experience from this? The first vaginal delivery I saw, which was a completely unmedicated and precipitous delivery because the mother had come in 10cm dilated and the baby was crowning. What was one thing you didn’t like about the core? Not enough exposure to gyne clinics and patients with breast complaints. What’s one piece of advice you have for students doing an elective here in the future? Introduce yourself to all the nurses and always be respectful to them, they have 20+ years of experience and nearly always know better. They can be an invaluable resource to you, and try to help them out whenever possible. Would you recommend this placement to current students? Yes absolutely! The only caveat is if you are a male medical student you may not have as many opportunities here as the patient population often prefers to have female physicians and nurses working with them. I saw a number of patients request that only female healthcare workers be present, and one patient nearly refuse treatment from the male Obstetrician on call. Anything else you would like to add about the experience? There's a physician's lounge on the 3rd floor with lots of snacks and tea/coffee and juice, definitely don't be afraid to check it out.
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Brampton Civic Hospital, image credit: plenarygroup.com
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