Student Reflection by Annah Andavuki

Reflections on my OBGYN Electiveat the University of Toronto’s School of Medicine in April/May 2008

As the plane touched Canadian soil, I felt a surge of different emotions. I was so excited to be here but so nervous and apprehensive. I did not know what to expect and what was in store for us.

As I look back, I realize that I should not have been nervous at all. My stay here has been memorable and has acted as an eye opener to my future academic endeavors I had the pleasure of working at Mount Sinai hospital and St. Michael’s hospital. During that time I worked under different staff. Everyone I worked with was so enthusiastic and willing to teach me and help me out. Within a short time I was able to feel at home and perform my duties as a clerk with ease.

Labor and delivery was my best place to be. The current technology was overwhelming. I had not had a chance before to see the big screens located in the nursing station. The ones in front of the nursing station had the patients’ information and current status of the patient, the obstetrician, whether high risk or not. All this information is seen just at a glance. The ones at the back showed fetal tracing and if something was wrong it would show alerts. This I found to be very efficient and quick in identifying both fetal and maternal compromise.

Management of labor here is just remarkable. A CTG machine is used to assess the fetal heart and maternal contractility. This is then displayed on the monitor and can be seen by anyone that has access to the OBTV programme. If the fetal heart tracing is not reassuring, a fetal scalp electrode is used to get a clear picture of the baby’s heart rate. A fetal scalp pH can be done at MSH.

Each patient in labor and delivery has the luxury of having her own nurse. This I found to be so good as it allows for continuity of care and it is easier for the patient to get to see a familiar face throughout her labor and child birth. The patients are also allowed to go through the process with their partners. Patients are given epidurals and that is easier for the patient and also clerks to learn how to do vaginal exams.

The staff and residents allowed us to have a ‘hands on’ experience. This was the most exciting part as it allowed us to participate more and made the whole experience very interesting.

Because learning is a dynamic process, both hospitals have a CME programme. There are weekly rounds with different teaching sessions each day. I was so honored when I was given a chance to speak on FGM on one of these forums. Grand rounds are also done and this allows staff, residents and students to share their views and learn more about disease processes.

Every department is involved in research. I was privileged to attend the Annual Research Day. UofT has great minds at work and all the research topics discussed were very interesting. It was good to know that most of them are also well funded by different bodies.

My experience in the OR was memorable. For the very first time I was able to see procedures like hysteresccopy and laparascopy. It was interesting to know that the rate of laparatomy is low. Hysterescopy is a one-day procedure and it’s efficient and good as it reduces the duration of hospital stay.

To sum it all up: it’s all possible because of team work. Everyone works as part of a team. The relationship between everyone is warm yet very professional. This creates the best experience both for the patients and students.