OB/GYN was my very first clinical rotation, and I still remember feeling equal parts excited and nervous as I made the transition from the classroom to the wards. I wasn’t quite sure what to expect, but it didn’t take long for me to realize that OB/GYN is truly unique! It combines elements of medicine, surgery, pediatrics, and patient advocacy, while also providing countless opportunities to develop hands-on clinical skills.
As the rotation went on, I found myself enjoying it more and more. In fact, even after completing my other clerkships, OB/GYN remained one of my favorite rotations! The variety was a big part of what made it so memorable. One day you might be assisting in the OR, the next supporting patients through labor and delivery, and the next building rapport with patients in clinic. No two days are ever quite the same!
I share this experience because it’s completely normal to feel both excited and a little intimidated before starting your OB/GYN rotation. The unpredictability can be daunting at first, but it’s also what makes the clerkship such a rewarding learning experience. And because you’ll encounter so many different clinical environments, a little preparation can go a long way!
In this guide, I’ll share what I learned along the way so you can hit the ground running and make the most of your OB/GYN rotation. We’ll break down the key settings you’ll rotate through—the operating room, labor and delivery, and the outpatient clinic—so you know how to succeed in each one. We’ll also cover a few strategies to help you prepare for your shelf exam!
Whether you’re thrilled to start your OB/GYN rotation or feeling a little nervous about what’s ahead, you’ve got this. Let’s get started!
OB/GYN Rotation Tips: How to Succeed in the Operating Room
You’ll likely spend a portion of your rotation in the operating room. Your duties here will include (but aren’t limited to) observing and assisting with cesarean deliveries and rotating through gynecologic subspecialty services (i.e., benign gyn, gyn onc, urogynecology, and MIGS) .
The OR can feel like a high-pressure, unfamiliar environment at first, but it’s also one of the best places to get hands-on experience and show initiative.
Here are some tips that’ll help you thrive there:
1. Know OR etiquette.
First impressions matter in the OR and understanding the etiquette goes a long way.
Be sure to:
Introduce yourself to everyone in the OR.
This includes the resident, attending, circulator, and scrub tech. It’s important to be on their good side, as they often determine how involved you get to be.
🤝 Check out this guide on how to introduce yourself to physicians during your rotations!
Know your glove size.
And ask if they prefer you grab it or wait for them to get it. This small detail shows awareness and respect for workflow!
Be prepared!
Know how to scrub and maintain the sterile field. It’s helpful to watch a quick video beforehand to get comfortable with the steps. It’ll make your first day go much smoother.
Have situational awareness.
Surgery is a high-stakes environment. Understand when it’s a good time to speak up and ask questions, and when it’s better to stay quiet and observe.
2. Set yourself up for success.
Being proactive about your learning can significantly improve your OR experience.
Some ways to do this are:
Pick good cases.
Your resident can help with this. Choosing a case that has room for you to scrub or offers opportunities for hands-on skills will maximize your learning.
Learn the basic technical skills.
These include suturing (simple interrupted, continuous, subcutaneous, lap port site closure), and one and two-handed knot tying before starting the rotation. Even a little practice goes a long way!
Show interest and advocate for yourself.
If you want to be involved, communicate that respectfully and work to set up learning objectives with your team. Enthusiasm is often rewarded!
3. Be prepared.
Preparation is what truly sets you apart from other students. The goal isn’t to know everything—it’s to show that you’re thinking ahead, engaging with the case, and making an effort to understand both the “why” and the “how.”
Some good ways to be prepared include the following:
Know the anatomy.
You can use textbooks, YouTube videos, Zollinger’s illustrations, and more.
Ask yourself: What structures are being operated on? What are the key surrounding structures at risk? If the attending points to a structure, could I name it or at least narrow it down?
For example: In a C-section, can you identify the layers of the abdomen to the uterus? In a hysterectomy, what are the important nearby structures like the ureters or bladder?
Know the indications for the procedure.
Ask yourself: Why is this patient having this surgery? What do the guidelines suggest when this procedure should be done?
For example: Is this C-section due to arrest of labor, fetal distress, or prior uterine surgery? Is this hysterectomy for fibroids, malignancy, or abnormal bleeding?
Know the complications of the procedure.
Ask yourself: What could go wrong during or after this surgery? How would these complications present clinically, and how might they be managed?
For example: If there is bleeding when you put in the trocar for the diagnostic laparoscopy, which blood vessel was injured?
Know the steps of the procedure.
Videos, StatPearls, ACOG resources are all great starting points. Having a rough mental roadmap helps you stay engaged and answer intraoperative questions.
Ask yourself: What are the major steps from start to finish? Can you anticipate what comes next during the case?
Know patient-specific characteristics.
For example, their age, comorbidities, medications, prior surgical history, etc.
Ask yourself: How might their comorbidities impact the surgery or recovery? Are they on medications (anticoagulants, steroids) that could affect intraoperative management? Which medications were they taking pre-op that need to be resumed or held post-op?
💡 For more tips on how to stand out in the OR during your rotations, check out: 8 Hidden Skills to Make You Shine in the OR as a Med Student
General Tips for Procedures
The first time you see a procedure, focus on learning the steps really well so the second time you see it you can stand out by anticipating next steps, answering questions, and being more engaged.
First exposure: Focus on orientation. What’s happening, who’s doing what, and what does the flow look like?
Second exposure: Try to predict the next move. Follow the instruments, and be ready if someone asks “What’s next?” or “Do you want to give this a try?”
Also, if you don’t know the answer to a question, that’s okay, you’re still early in training. Go home, read about it, and come back the next day ready to explain what you have learned. This shows that you genuinely care about improving and is one of the most high-yield ways to stand out during your rotation.
OB/GYN Rotation: Tips for the Labor and Delivery Suite
The L&D floors are some of the most emotionally charged spaces in medicine. It’s an exciting opportunity to learn, but also a humbling reminder that you’re stepping into one of the most intimate moments of a patient’s life.
Here are some things to keep in mind when you’re doing L&D:
1. Be respectful.
Always introduce yourself and get to know the patient.
Don’t just show up when the delivery is happening. Spend time with the patient prior to the delivery and get to know their care plan and their support team.
🤝 Check out this guide on how to introduce yourself to patients during your rotations!
Respect patient preferences.
Patients are navigating deeply personal experiences and some may prefer to not have medical students present. These preferences should always be respected. Recognize that your education comes second to a patient’s comfort. Being a good med student isn’t just knowing when to step in, but also when to step back.
2. Know the nomenclature.
Familiarize yourself with these common abbreviations so that you can feel more confident on the floor:
- G#P# : Gravida/Para (G2P1 = 2 pregnancies, 1 delivery ≥20 weeks)
- T/P/A/L: Term /Preterm /Abortions /Living
- SROM: Spontaneous rupture of membranes
- AROM: Artificial rupture of membranes
- IOL: Induction of labor
- AUG: Augmentation of labor
- NSVD: Normal spontaneous vaginal delivery
- C/S: Cesarean section
- Pit: Pitocin (oxytocin)
- Epi: Epidural
- GBS: Group B streptococcus (status matters for antibiotics)
3. Master the physical exam.
Understanding the labor progress starts with mastering the cervical exam. When you hear the attending say “5, 80, -1,” that shorthand is conveying a real-time snapshot of how labor is progressing. As a medical student, getting comfortable with dilation, effacement, and station will help you follow along on rounds and actively participate in care.
Here are some physical exam terms you should know:
Dilation: Refers to how spread the cervix is. It ranges from 0 to 10 cm.
Effacement: Describes how thinned out the cervix is. Expressed from 0% (thick) to 100% (fully thinned).
Station: Indicates the position of the fetal head relative to the maternal ischial spines. Ranges from -5 to +5 with positive numbers indicate descent toward delivery.
4. Understand the stages of labor.
Understanding the stages of labor helps you anticipate what’s happening clinically and what to expect next.
The stages of labor are:
Stage 1: Cervical dilation (0 → 10 cm) This is further broken down into latent phase (0–6 cm) and active phase (6–10 cm).
Stage 2: Delivery of the baby (10 cm → delivery)
Stage 3: Delivery of the placenta
5. Know how to interpret fetal heart rate monitoring (FHR).
FHR is used to monitor the health of the fetus and track uterine contractions. At first glance it can be overwhelming because it’s a lot of information, but breaking it down systematically into components makes it much more manageable.
Here are some key terms and important information you need to be familiar with:
Heartrate: A normal fetal heart rate is 110–160 bpm.
Contractions: Frequency changes throughout labor.
Variability: Grades of variability are based on amplitude range from peak to trough.
- Absent variability = amplitude range undetectable.
- Minimal = < 5 BPM.
- Moderate = 6 to 25 BPM, reassuring.
- Marked = > 25 BPM.
Accelerations: A brief increase in FHT which is often benign. They are the hallmark of a reactive (reassuring) non-stress test, a common antenatal test used to assess fetal well-being by monitoring the fetal heart rate in response to its own movements without applying any stress- like contractions.
- ≥ 32 weeks: ≥15 BPM above baseline, lasting ≥15 seconds to < 2 minutes.
- < 32 weeks: ≥10 BPM above baseline, lasting ≥ 10 seconds to < 2 minutes.
- A reactive NST is defined by the presence of at least two of the aforementioned accelerations within a 20-minute period.
Decelerations: A decrease in the FHR of ≥15 bpm, lasting at least 15 seconds.
- Early decels:
- The lowest point of the deceleration (nadir) occurs at the same time of peak of contraction.
- This indicates compression of the head of the fetus.
- Does not require treatment.
- Variable decels:
- V-shaped
- The time from the start of the deceleration to the nadir is less than 30 seconds.
- This indicates compression of the umbilical cord.
- Late decels
- The nadir of FHT occurs after the time of peak of contraction.
- This indicates uteroplacental insufficiency.
- Helpful mnemonic: VEAL CHOP
- V = variable decel → C = cord compression
- E = early decel → H = head compression
- A = acceleration → O = okay
- L = late decel → P = placental insufficiency
Make sure to always FHT interpret with context: stage of labor, meds like Pitocin, maternal status, etc. Also, be ready to suggest interventions such as repositioning mom, fluids, or stopping Pitocin, and more.
6. Review the patient’s antenatal care.
Familiarize yourself with the patient’s past medical history and what the PCP has been monitoring throughout the pregnancy and how that may affect the delivery.
OB/GYN Rotation: Tips for the Outpatient Clinic
The outpatient clinic is where you’ll refine your clinical reasoning and build meaningful patient relationships. Unlike the fast pace of the OR or labor floor, the clinic offers the opportunity to slow down and think through differential diagnoses across a wide range of visits from routine screenings to complex gynecologic concerns.
Here’s a few tips that will help you excel during this part of the rotation:
1. Pre-chart your patients.
Just like in the OR, preparation matters. Review their past medical history, prior OB/GYN visits, labs, imaging, and current concerns.
2. Be intentional about your history-taking.
Reflect on how the questions you ask will change based on the type of visit it is.
For a well-visit, think about menstrual history, sexual history, intimate partner violence screening, STI screening, cervical cancer screening, breast health, and general health maintenance such as mental health screening, substance use, diet, and lifestyle factors.
For a third-trimester visit, consider fetal movement, contractions, signs of preeclampsia, fetal positioning, etc.
For a gynecologic complaint, visit review onset, duration, associated symptoms, risk factors, and prior treatments.
3. Know the basics of ambulatory women’s health.
Topics include but are not limited to contraception options, menopause management, abnormal uterine bleeding, routine screening, prenatal care, and abortion care. The best way to learn this would be to review the American College of Obstetricians and Gynecologists guidelines.
How to Prepare for the OB/GYN Shelf Exam
Finally, a few tips on how to study for the shelf exam.
Here are some exam preparation best practices:
1. Tie your studying to real patients.
When you connect concepts to cases you’ve seen, the material sticks and becomes clinically meaningful.
2. Give yourself permission to take days off.
Rest is part of the process and burnout will hurt your retention more than it helps.
3. Pick a Qbank you like and stick with it.
Consistency matters more than jumping between resources. If you’re looking for a place to start, consider Blueprint’s OB/GYN Shelf Qbank or the combined Step 2 & Shelf Exams Qbank for all of your rotations + Step 2!
4. Space out your practice tests.
Use them strategically to track progress and identify weak areas over time rather than cramming them in the last few days prior to shelf.
5. Focus on understanding patterns, not just memorizing facts.
Recognizing classic presentations and the “next best step” will help you excel on exam day and in clinical practice.
Approaching the end of your rotation and wondering if you’re on track with shelf exam prep? Take this FREE quiz from our Blueprint experts to find out!
Final Thoughts
The pathway to success on your OB/GYN rotation comes mainly down to being prepared, staying engaged, and focusing on patient-centered care. If you take the time to advocate for your patients and connect your studying to real cases, not only will you stand out, you’ll build a strong clinical foundation you can use moving forward.
Good luck, and be sure to reach out if you have any questions!
