Medical studies prove it. Interns are more error prone during the first month of their first year in training. July 1 is the “changing of the guard,” so doctors and patients alike – be careful out there.
In honor of the graduating students and the residents graduating to their new PGY year, below is my version of a MasterCard commercial for the best story I heard about a new resident on an OB service. First a bit of an explanation.
When a woman is in labor, doctors will periodically do a gyne exam to determine how dilated the cervix has become. When the cervix is only 1 or 2 cm dilated (sometimes called “fingertip” dilated because all you can get in there is a fingertip), delivery usually isn’t imminent. As the cervix dilates, you can begin to feel the baby’s head (unless there is a breech presentation and you feel a foot or the baby’s buttocks). When the patient hits 8 or 9 cm, the patient usually starts feeling a need to push the baby out. Grab your catcher’s mitt, because the baby is coming. A little more information about cervical dilation in pregnancy is here.
Getting back to the story … mind you that this story is hearsay, but it comes from a friend of mine who worked as a secretary on an OB floor, so I consider her a pretty reliable source. I also did an internet search to make sure that I’m not perpetuating some urban legend and I couldn’t find anything. So here goes:
Medical school education: $240,000
Brand new white lab jacket with embroidered name: $37.50
Four pack of Red Bull to keep you up all night during your first call: $9.00
Obstetrical textbook to learn about the stages of labor: $219
Three one-minute cell phone calls to the chief resident to update him on the patient who is pushing but whose cervix remains “fingertip” dilated: $1.20
Spanish-English dictionary to find out why the patient keeps saying something sounding like “debo empujar” (”I have to push”) and keeps calling you “pendejo“: $16.95
Watching the OB nurse double check the patient’s cervix, flip out, and call for a STAT c-section because the patient’s cervix is fully dilated, the newborn is in a breech presentation, and you’ve been sticking your finger in the kid’s anus instead of the mom’s cervix for the past 30 minutes: priceless