OB/GYN as an Emergency Medicine Doctor

I started a new rotation this week. I am on OB/Gyn. Many ask why do you have to do an OB/Gyn rotation / training as an EM resident? Well, we see a whole bunch of OB/Gyn in the ED. Nearly every shift in the ED I have several patients "OB/Gyn" chief complaints like (not an all inclusive list); vaginal bleeding during 1st trimester, STD complaints, yeast infections, UTI's, rape, abnormal vaginal bleeding, pre-eclampsia, preterm labor, full term labor, fetal demise, pregnancy related complaints, etc.

It is crucial to be proficient at pelvic exams (speculum and bi-manual). Although it is not as common as it once was there is still several deliveries done in the ED by the EM physician every year. As part of my training I have to show proficiency in OB/Gyn management common in the ED. I have to deliver a enough babies to graduate and become board certified. Obviously we are not required or expected to be on the same level as OB/Gyn physicians but we do need to handle the emergency type OB/Gyn complaints.

Many STD's are more commonly diagnosed in the ED than in an OB's office in certain areas. There are some OB/Gyn complaints that ED physicians will see more often than OB/Gyn physicians given the current use of the emergency department. When the complaints are beyond the ED physician's skill set OB/Gyn will be consulted. Every attempt will be made to have the delivering mother deliver in the Labor and Delivery department when possible but this does not always occur.

Finally EM doctors will see lots of emergency traumas, illnesses and disease states that happen to pregnant patients. If  a pregnant patient has a seizure they are brought to the ER. Anyways this is why we spend a good amount of time doing OB/gyn training during our residency. I want to be clear that EM doctors are not the experts when it comes to OB/Gyn. Certainly our skill set in this area is not near their level of expertise.

Today was a great day. I delivered 2 babies. One was fairly complicated and the other was fairly straight forward. Both were vaginal deliveries. It is always a great feeling to share that moment with a happy couple when they bring a healthy child into the world and when you deliver it their gratitude and thanks is always a great reminder of why I love my job.