Dr. Katherine Semrau, PhD, MPH, is an Associate Epidemiologist at the Division of Global Health Equity at Brigham and Women’s Hospital, Assistant Professor at Harvard Medical School, and the Director of the BetterBirth Program at Ariadne Labs, a joint health innovation center between Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health. The BetterBirth Program is focused on improving quality of care in facility-based childbirth using the WHO Safe Childbirth Checklist. This quality improvement program recently completed a large-scale study of the peer-mentoring implementation of the WHO Safe Childbirth Checklist in facility-based deliveries conducted in Uttar Pradesh, India.
Central to the skillset of every physician is the differential diagnosis; this is the process by which new patients are evaluated to establish the most likely diagnosis. Similarly, the first clinical year of medical school is like a differential for each student, except instead of a medical diagnosis, students are seeking to determine which specialty they will choose. This column explores this differential: experiences from each rotation by a current third year student.
Having finished my first rotation, Women’s Health Clerkship, I’d like to offer a short look into the specialty, sharing some of my observations the last few weeks. As I have said often over the past two months, I believe this was the perfect rotation to kick off third year. OB/GYNs have a wide scope of practice, and their field contains elements of many other specialties. During this rotation I was exposed to clinical medicine, by which I mean the art of seeing patients in a clinical setting, spending a few minutes with each, and using history and physical exam skills to offer a diagnosis and treatment plan. I was also exposed to surgery. I hadn’t realized just how surgical of a specialty it is, or at least can be, depending on how a doctor chooses to practice. (More on that later.) I also saw some inpatient medicine, managing patients in a hospital setting and consulting with other specialties as needed. And of course, OB/GYNs have a very unique aspect of medicine that is theirs alone: the labor & delivery floor. This breadth of practice settings was an excellent introduction to many aspects of medicine that I’m only beginning to understand.