OB-GYN High Risk OB Elective

Course Name: High-Risk Obstetrics Acting Internship

Course Offered: All periods

Elective Duration: 4 weeks

Enrollment Limit: 1

Facilities: Greenville Memorial Hospital

Visiting Students: Accepts visiting students

Course Director: Francis S. Nuthalapaty, M.D.

Contact: UME Clerkship Coordinator


Department of Obstetrics and Gynecology
Greenville Health System
890 W. Faris Road, Ste 470
Greenville, SC 29605

Phone: 864-455-5524

Fax: 864-455-3095

Email: obgyncoordinator@ghs.org

Format for the Course: Clinical Participation

Description: This Acting Internship is offered to students who have satisfactorily completed their third year clinical rotations. The purpose of this course is to provide the learner with an intensive exposure to high-risk obstetrical care in an inpatient setting. Students will be exposed to a breadth of medical and obstetrical complications and fetal conditions. The student will be expected to function at the level of a PGY-1 resident, participating in clinical experiences in the Antepartum Ward and Labor and Delivery under the direct supervision of resident and attending MFM physicians.

Course Objectives:

  1. To gain competency in the evaluation and management of medical complications during pregnancy

    1. Diabetes
    2. Chronic hypertension
    3. Asthma
    4. Renal disease
    5. Thyroid disorders

  2. To gain competency in the evaluation and management of obstetrical complications during pregnancy

    1. Preeclampsia-eclampsia syndrome
    2. Preterm labor
    3. Preterm premature rupture of membranes
    4. Third trimester bleeding

  3. To gain competency in the evaluation and management of fetal complications during pregnancy

    1. Fetal growth abnormalities
    2. Isoimmunization
    3. Congenital infections

Instructional Methodology:

Clinical Settings: All clinical activities for this course are performed with the Inpatient Obstetrical Teaching Service (OBTS) and are conducted in the Greenville Memorial Hospital (GMH) campus. There are 3 main venues for clinical activities during this course: Inpatient High-Risk Ward, Labor & Delivery, and the Obstetrics Ambulatory Care Clinic.

Duty Hours: Patient care responsibilities typically commence at 6:00 AM and conclude at 6:30 PM (Monday - Friday). The time to commence work rounds on these days will be determined by the PGY-3 High-Risk resident on a daily basis and will be based on patient volume. The student will have overnight on-call responsibilities on Monday and Friday nights, and will conclude duties by 10:00 am the following day.

Patient Care Responsibilities (Antepartum Inpatient Ward): Students will perform daily work rounds on antepartum patients as a member of the High-Risk resident team. The PGY-3 High-Risk resident will assign patients to the student to manage. The student will be assigned a minimum of 2 and no more than 4 patients to manage. Students should contribute to the care of their assigned patients by performing daily rounds, writing progress notes in the medical record, writing orders, interpreting laboratory and imaging studies, and under the supervision residents and faculty.

Patient Care Responsibilities (Labor & Delivery): Students are expected to continue to provide care for assigned patients in Labor & Delivery should the patient be transferred to that setting. Students should contribute to the care of their assigned patients by performing intrapartum assessments, writing progress notes in the medical record, writing orders, and participating in the delivery under the direct supervision of residents and faculty. Once an assigned patient has delivered, the student should continue following this patient through the duration of her postpartum course.

Patient Care Responsibilities (OB Ambulatory Care Clinic): Students participate in 1 half day of ambulatory obstetrics each week of this course (Thursday afternoons). This time is focused exclusively on high-risk patient clinic assignments. The High-Risk clinic is staffed by an MFM attending and 2-3 residents. Students will participate in the provision of prenatal care under the direct supervision of the residents and attending. The student should be prepared to evaluate and then present and discuss each patients for whom he/she provided care.

Teaching Rounds: Morning Report with the L&D and MFM attendings of the week is conducted daily (Monday - Friday) at 7:30 am. The student should be prepared to present all patients for whom he/she provided care. The student will also perform walk-rounds with the MFM Attending each Saturday morning.

Conference Responsibilities: There are no additional conference responsibilities for this elective.