Ahh Obstetrics. If there is a kind of bodily fluid that you haven't seen yet, you're in luck! Everything from urine to meconium. So. Much. Fun.
Apart from that, it's a great block. Unlike many curricula around the world, Obstetrics and Gynaecology will form two separate blocks in fifth and final year. The block is, like the other blocks, six weeks long and it will go pretty quickly.
You will be expected to do a few deliveries yourself, which is great (the first time). You will also hear that you must get all your deliveries in the first week and unless you're at Bara that simply isn't possible. The Gen is notoriously quiet, so make sure you use every opportunity. Rahima Moosa (the old Coronation) is where I was situated. It was loads of fun and the on call rooms are great. Only real issue is that there are very often student nurses who also have to deliver kiddies and, no matter who says what, they get preference and they are EVERYWHERE! If you're lucky enough and they're not there, getting your deliveries shouldn't be a problem.
Obs probably has the worst calls of fifth year. You are expected to call until one in the morning, after which you can go and sleep for a small number of hours before the ward round starts at seven. Calls are great, because you get to learn a lot. Labour is a long drawn-out process (just ask your mum) and you will have lots of time to get well acquainted with the different dilatory measures of the cervix. In addition, your call will provide the opportunity to assist in theater. What an experience.
Just be careful on your calls. After a long day of tutorials and then many hours of doing the intern's work you will be tired and wish that contraception was more widely utilised. I had my first post-exposure prophylaxis experience in Obs. Be careful guys! ARVs suck and give some people night terrors, and you wake up screaming for no apparent reason other than the toxins floating in your body. There's also a slight possibility that your liver could fail and you'll need a transplant... but that's neither here nor there.
What textbooks will you need? Clinical Obstetrics is amazing. It describes things very well. Obstetrics was probably the only block in which I found the objectives to be really useful. Use that in conjunction with this textbook and you will be very comfortable. The tutorials we had were also amazing. Make sure you ask a lot of questions and write down everything the consultants say. They will more often than not describe things way better than the textbook.
The most important book of the block is the Wits Obstetrics - Guidelines (little yellow book) that you must get from the department. You simply need to start reading it from day one and know everything verbatim. This is especially important for your OSPE in which it's possible to get 95%. You must know the drugs and their doses too. For example - you might get a case in the OSPE (which is a paper based theoretical patient) in which there is preterm labour. On page 86 are the exact guidelines as to what you need to do. I can't stress enough how well you need to know this. It may seem like a daunting task, but six weeks is enough time. I promise. Repetition is key.
This brings me to the assessment. Everything counts 20% to your final mark. Firstly there is the marks for jam - block assessment. This is seriously free marks. Half of the block mark is for your attendance, attitude, etc. Ask a lot of questions, be active in tuts and impress your ward consultant and you're set. The other half is for your case report. Make sure to clarify with the person marking it what they want. If in doubt, write your case report early and give it to another consultant for them to read it and give you some feedback.
The clinical case is fairly stressful. Here you are given 20 minutes to clerk a patient (history and examination) and to formulate and assessment. Then a consultant will grill you for like 20 minutes. Know your theory, but more importantly, know how to do the examination properly! They will often ask you to show them the maneuvers on the patient. Stay calm, and use the experience that the calls gave you.
The OSPE (which Dr Bera from Coro usually sets up, so listen to his hints!!) is a different kind of exam. You get 18 minutes to read the scenario and write down what you will do with this patient. Always start with history, exam, investigations. They will give you the values and ask you questions around it. KNOW THE YELLOW BOOK!!
The OSCE is basic. You go from one station to the next answering questions based on a picture, scenario, etc. It can be rather difficult and random. Make sure you know the names of the forceps and how to use them. Ask someone to show you during the block. Oh, and there will be a CTG to interpret.
There isn't much to say about the MCQ exam. It's random and it's difficult. Like every MCQ ever!
A few useful tips: stand clear from projectile fluids (that includes the ladies in lithotomy with membranes about to rupture); treat every patient with the utmost respect! It's not a nice thing they're going through and they really deserve respect; always get consent before you perform a per vaginal exam; for the guys - ask the patient if they would prefer if a female doctor does it or if a female doctor is in the room with you. Other than that, you'll be fine!
All the best!
