Guide for Daily and Call Schedule

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					Teacher – Learner Contract
Guide for WakeMed 3rd Year Obstetrics/Gynecology Rotation

Instructions: Please review this document which details daily activities
and expectations. All changes in this document will be noted and
agreed upon by all parties. You should sign document and return to
chief resident.

NIGHT CALL: Evening call begins at 5pm or once you have completed your daily
activities. You should check in with the Labor and Delivery team if you have not been
covering L&D throughout the day. Your duties will include evaluating and managing
patients in triage, L&D, postpartum with the assistance of the residents. You will
participate in deliveries and cesarean sections. Call ends at the completion of board
signout the following morning.

POST CALL: Home after board signout

GYN: You will work closely with a 2nd or 3rd year residents in the operating room. The
residents will review the list of GYN cases prior to the day of surgery. Based on this
information you should prepare to be an active member of the surgical team by reading
about the surgical procedure, learning surrounding anatomy and pre-operative
information prior to going to OR. You will be expected to write orders, preop notes,
operative reports as well as postoperative notes with the supervision of residents.

L&D: You will work closely with the intern managing the labor floor. In this manner
you will assist in evaluating patients admitted in labor by writing progress notes,
communicating with the managing team and performing deliveries. Ideally, you should
discuss with the intern and/or senior residenct one normal laboring patient and one high
risk obstetrics patient to assist in managing. This will provide you with at least one
opportunity for a vaginal delivery and exposure to complicated obstetric issues. If no
Float student is assigned, your duties will extend to evaluation of patients in triage as well
as cesarean section assistance.

CLINIC: You will attend the OB/GYN clinics in the Andrews Center. Most mornings
our clinics are comprised of High Risk OB/GYN patients. This is a great opportunity to
learn about routine prenatal care and antepartum management of women with
complicated pregnancies. Once comfortable you will be allowed to see patients
independently with discussion and management decision made with residents and

The afternoon is comprised of GYN patients. These patients present as follow-up from
the Emergency Department, referrals for potential surgery and routine annual GYN care.
You will be encouraged to first evaluate and examine the patient independently (except

WakeMed Faculty Physicians OBGYN                 919-350-8535                            7/2011-6/2012
for invasive components of the physical exam such as pelvic and breast), present to a
resident who will complete the evaluation and formulate a management plan with you.

FLOAT: This day is intended to be flexible. You are primarily responsible for
learning the L&D triage system and assisting in cesarean sections. You will work with
residents as well as our triage nurse practitioners to determine how to prioritize pregnant
patients that require hospitalization and those that can be safely discharged home. When
there are not any scheduled cesarean deliveries or triage patients, see if there are extra
GYN cases not covered by other students that you can attend. Otherwise, if nothing is
happening, you are encouraged to find a quiet place to read or prepare for your journal
presentations. Make sure you are available by pager.

WEDNESDAYS: Oncology is a subject not covered formally at WakeMed. In light
of that Dr. Daniel Clarke-Pearson has offered to include our students in his Wednesday
morning Chair Rounds at UNC. Based on lectures and activities occurring at WakeMed,
the most beneficial lectures for our students will be the 1st, 2nd,and 3rd Wednesdays of the
rotation. Thus, you should plan to report to The Old Clinic Building Room 3032 at
7:30am. On those Wednesday’s you will not have to round at WakeMed or return to
WakeMed between lectures. We DO expect you to use this time for study. All other
Wednesdays you will be expected to round and participate in morning activities prior to
returning to UNC for afternoon lectures. Aim to leave for UNC at noon so that you
arrive in time.

COLPOSCOPY: Each student will be able to observe the management of abnormal
pap smears in our colposcopy clinic one Tuesday morning during the rotation. After
board sign out, the assigned student will report to colposcopy clinic and work one-on-one
with an attending performing/ observing pap smears, colposcopy and LEEPS. Once the
morning session is completed, and afternoon conference, the student has the afternoon
free to read and prepare for presentation unless otherwise assigned.

ULTRASOUND: There is one day in the rotation that is designated for you observe
our ultrasound unit. You will follow the director of the unit Tony Schwartz for the
majority of ultrasounds as well as listen to genetic counseling with Dr. Steve Wells,
perinatologist. In addition, several other activities happen in ultrasound such as
biophysical profiles, non-stress tests and fetal anomaly discussions. You are encouraged
to see as much as possible and to practice reading non-stress tests. On the day you are
scheduled to go to ultrasound, you should introduce yourself to Dr. Wells at board
signout. Then once, morning rounds and duties are complete you may present your self
to his clinic. Please DO NOT WEAR SCRUBS.

BOOKS: Books are given to you for use during your OB rotation at WakeMed. They
need to be returned to the OB office before you take the OB Shelf Exam.
You will be charge $40.00 for each lost book.

WakeMed Faculty Physicians OBGYN                 919-350-8535                          7/2011-6/2012
Teacher – Learner Contract Signature Page
Please write both Name and Signature and give to Chief Resident

Student: _____________________________________ Date: __________________

PGY-3 Resident ______________________________ Date: __________________

Attending: ____________________________________ Date: __________________

WakeMed Faculty Physicians OBGYN             919-350-8535           7/2011-6/2012

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