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The “Crease”…..Your Gyn Rotation

in PA-S on 03/13/16

 

shocked

 

 

If you’ve made through the didactic year and started rotations, chances are this may be a dreaded clinical. Prior to starting clinicals, my program hired people to allow us to practice the GU exam. I have no idea what low spot these people were in to allow 42 pelvic exams in a row, but maybe they were just dedicated to higher education. Luckily, I had some idea of what I was doing on my Gyn rotation….spending a lot of time in “the crease” before I set foot in the door. My most memorable patient was an elderly demented woman brought in from a nursing home. The chief complaint was “She put something in down there”. I was sent into the room with a non-verbal patient to do a pelvic exam. One of the CNA from the home was there to “help”. The speculum was lubed and inserted and….Whaaaaaat? There was not just one thing, there were THINGS. Plural people. I removed bottle caps, tea bags, and an eraser. What kind of nursing home was this? The emitted smell sent me to another world and I felt horrible for this frail old woman. I discarded the objects into the garbage and finished up the exam. After completing this almost impossible task, I got chewed out for not double gloving the previously inserted objects prior to throwing them away. I banked that one for future use! The following are a few heads up that no one ever told me.

1) Many gynecologists are not practicing obstetricians. If you want any experience with pregnancy or deliveries, make sure you find the right clinic.
2) Get your game face on, you will be seeing and hearing about some of the most intimate issues women face. Do not show any signs of surprise or you just lost your patient. As far as they know, you have always known that people get irritation around their recent clitoris piercing.
3) Prior to starting rotation, go over birth control methods. A large portion of the rotation will be about starting/adjusting/discontinuing contraceptives.
4) Dysfunctional Uterine Bleeding….own it.
5) If there are any procedures done at the clinic, get involved! Colposcopies, IUD insertion, Bartholin’s abscess I&D, marsupialization, among others are all really cool things to see, and will cross over to primary care and the ED
6) There will be pro-life/pro-choice discussions…its uncomfortable.
7) Women come to the clinic with very scary situations and diagnosis. Cancer diagnosis and abuse are two examples that pop into my mind. Guide and care for these women carefully.
8) Don’t judge. Its not our place. Gentle discussions about lifestyles are within our scope. Making them feel horrible about themselves because they are in being treated with a second STI from the same partner is not our place.
9) Please…..please, from the bottom of my heart, use lube on that speculum, every time.
10) This may be the job for you if you enjoy seeing many patients a day with similar complaints, but you get to know them at deeper level. There is some variation and higher complexity, but you have to be dedicated to pelvic exams. Many PAs enjoy a high level of autonomy in this field!

FOOTNOTE- I was corrected by a veteran PA who is in the Gyn field. She states that too much lube can actually ruin the wet prep or cytology results. Use in moderation

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I would like to share some excited news with you. I recently was accepted to 2 PA schools and still have another interview coming.

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I don’t even know how to thank you for all your help!! I was accepted to my first choice program at the Yale School of Medicine Physician Associate Program Class of 2019! Not only that, but I was one of those they called right after the interview. I am absolutely excited (and scared)!

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My experience with PA Trek Coaching was great. The team really provided me with the guidance I was looking for, plus tons of extra information that really came in handy. Initially, I was struggling with my personal statement but my PA Trek coach encouraged me to look inside myself and dig deep. Without their help, I’m not sure if I would have been able to articulate my story in such a professional way. Additionally, the mock interview with my coach gave me a new perspective and insight on the entire process. I know the mock interview helped me gain confidence with my interviewing skills, which really paid off. Thank you, PA Trek Coaching! 

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I just wanted to share that after my ONLY interview this cycle (aaand my first cycle applying), I was just accepted to Carroll University’s PA Program and will be starting this coming May!!!!!
I will be forever glad that I took advantage of  PA Trek! My coach gave me great advice and suggestions which I definitely took to heart and worked on the week following our mock, and knowing what I needed to work on gave me the confidence that I needed. I felt I truly rocked that interview and clearly I did something right. 🙂

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We took an hour for a mock interview at the end of September and I just wanted to give you an update on my interviews! So far, I have gone to four. I was accepted at South University (Savannah, GA) and Western Michigan University! Your mock interview helped me so much. At WMU, I had an impromptu essay about the state of health care in America / pros and cons of the current health system and I felt completely prepared – I wouldn’t have had too much to say if you hadn’t recommended I look into it further! Just wanted to let you know! Thanks so much for your time. It was well worth it.

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