From the Residency Vault: L&D Sign Out Styles

The EMORY OBGYN Class of 2010 - Not shown because she is taking the picture (why?) is Martina Badell

As I gear up for the "Channeling Doctor Manners: L&D entry" I was reminded of my list of OBGYN signout styles and thought I would share.

As a 3rd year resident on L & D, you are in charge of "running" labor and delivery." Pretty much every patient is your responsibility and in the post-duty hours world of Graduate Medical Education (GME) communication is essential. But everyone has a unique style of communication.

I did my OBGYN residency at Grady Memorial Hospital - the GRADYs as the nurses like to call it. When you came on to start your shift, both day and night teams would sit (stands) and listen to the 3rd year resident present the board. 

The point is to provide "inventory," so-to-speak, on all the patients and their issues on Labor and Delivery. The goal is to be concise-yet thorough-logical, and coherent. Obviously, the more experienced one got, the smoother things were. 

Labor and delivery signout is where the true personalities of OBGYN residents shine. As a result I always tell medical students who are on away rotation sub-I's to spend time on labor delivery because the signout is one place where you can capture "the pulse" of the program.

While every obstetrician (and physician for that matter) has his/her own personality, it quickly became evident to me that there were certain signout styles that were common. Hit the jump for the most common L&D signout styles and let me know if I am missing one or need to qualify one further.

Channeling DOCTOR Manners in the OR: A Guide for Physicians and Medical Students

While medical student blogs are very common, few physicians have blogs dealing with advice for their trainees. Most physicians start blogs in an effort to educate patients and market. But this space could be used to educate medical students and residents. We feel that this is important and due to the recent popularity of the last "channeling Miss Manners," post we have decided to take this head on.

Miss Manners

Most medical student rotation textbooks deal with the path or phys about the rotation, but few address professionalism advice and decorum...Let's call this segment "Dr. Manners."Here, we have identified another area that deserves attention: The operating room. Between the revolving door of personalities and, in general, the stress of what happens there, manners can be easily tossed out the door, but they really shouldn't - right?

There should be a baseline set of guidelines that young physicians and medical students should incorporate during training. Medical education is no doubt changing but the goal of excellent patient care does not change. If you are ultimately swept up in ego, following OR specific mores can only enhance your ego because ancillary staff, your trainees and others will enjoy working with and talk about "how great you are in the OR." You can still have the mean streak in the OR though, just have some manners if you need to let it out!

What follows are my observations based on being in undergraduate, graduate medical education for the last 13 years. Please note that the goal is not to preach that a certain way is better, but to stress the importance of professionalism in the OR.

Channeling Miss Manners at your work related retreat

Professional Development conferences/retreats are a vital part of any professional's work commitment. In my field, our retreat is a rite of passage for incoming and outgoing reproductive endocrinology and infertility fellows. For first year fellows it is the first time since the interview season that we are reunited with our ”interview” buddies, and for third year fellows it is the “calm before the storm” as we pursue job options.

The retreat is 5 days long, during which we are given excellent career advice and a tremendous opportunity for networking between each other and faculty – probably one of the most important elements of any professional development retreat, regardless of the profession.  Needless to say retreats are exceedingly valuable and I am grateful that I have had the fortune of attending them.

On a lighter note, though, retreats always seem to have their share of social etiquette miscues, and I wonder if Miss Manners (my mom always invoked her when I was growing up) has a guide for how to navigate them. On one hand it is nice to be able to be blindsided by such blissful, “awkward” moments to learn from, yet it would be nice to be aware of situations so one can follow appropriate etiquette.

Hit the jump for some potential awkward moments that can happen at any professional development conference and tips on how to respond. Also your feedback would be quite valuable.