We having been working as research assistants for Female Pelvic Medicine and Reproductive Surgery for about a month now. The main goal of this program is to encourage women to build the courage and be comfortable with health problems that they may have been too embarrassed to seek help for due to social stigmas. I have been going into the hospital Monday through Friday to either work on the database or shadow or a combination of both. The majority of the week I spend working on the Perineal Database which creates a log of all women at Massachusetts General Hospital who have had a perineal laceration as a result of vaginal child birth. Using a compiled excel sheet of all the patients that have endured some kind of perineal laceration, we search them through EPIC, a program containing all patient history, and read through and upload the details asked for by the database.
Dr. Hudson has been amazing to work with and learn from. She has been very helpful in that every Tuesday morning; we meet to discuss any problems or questions that we may have come across when working on the database. In these meetings, Dr. Hudson has also been wonderful in teaching us about the different cases of perineal lacerations we may come across so that we do not feel lost in the information we are working with.
This being my first research experience, working on the Perineal Database has been a fast learning experience. As explained above, the Perineal Database is a retrospective clinical database. Therefore, all the information that is compiled is information that had been logged as long as 10 years ago. I have learned that one of the benefits of a retrospective clinical research is that the information that you need is already available for you in the patients’ history. However, a major downside to a retrospective clinical research is that you only have the information that is available to you. We found that while reading and searching through the patients’ history, there are many cases where there are missing details or even missing documents as a whole. In these cases, the only option we have is to left those fields in the database blank. Nonetheless, working as a research assistant for perineal lacerations has been an amazing experience so far.
Once a week, we are shadowing in the clinic with whomever the attending of the week happens to be. The clinic mostly consists of consults with mostly older women who have already experienced menopause or are experiencing menopause, that have concerns about prolapse. So far, I have gotten to shadow multiple routine examinations and the taking of vaginal measurements to diagnose a prolapse. Other appointments include pre-operation and postoperation consults. Lastly, I have noticed that there are a lot of patients that are referred pelvic floor physical therapy, a far less invasive form of treatment, that is close to the patients’ home.
Shadowing in the operating room has also been a new experience. The main procedures that I have been shadowing have been sacrocolpopexies. In a sacrocolpopexy, a mesh sling is places to fix a prolapse or treat urinary incontinence. Furthermore, it has been interesting to see that they minimize invasion by proceeding with a laparoscopic approach. Furthermore, earlier this summer, I shadowed in the operating rooms in a public care hospital in Budapest. One huge difference that I noticed is that prepping the patient for surgery in Budapest would take a minimum of thirty minutes, especially because doctors in the public system were very understaffed. However, at Massachusetts General, by the time the surgeon shows up to the operating room, everything is prepped and in place. The hardworking nurses and the system that is in place makes everything go smoother and faster. I look forward to continuing my learning experiences at MassGeneral with Dr. Hudson for the weeks to come.