Professional Documents
Culture Documents
Describe routine antenatal care, including booking, risk assessment, options in patterns of
Gynaecology
Describe different methods of contraception for men and women and discuss their
Menopause/perimenopause
Abnormal uterine bleeding
5. Develop a thorough understanding of contraception, including abortion and sterilization.
Contraceptive counseling
6. Provide a preliminary assessment of patients with sexual concerns.
Take a sexual history
7. Demonstrate knowledge of common benign gynecological conditions.
Vulvar/vaginal benign disease
Fibroids
Endometriosis
8. Formulate a differential diagnosis of the acute abdomen and chronic pelvic pain.
Pelvic pain
Ectopic pregnancy
9. Describe the etiology and evaluation of infertility
10. Describe common breast conditions and outline the evaluation of breast complaints.
13. Describe gynecologic malignancies including risk factors, signs and symptoms and initial
evaluation.
Abnormal Pap smear
Postmenopausal bleeding
Adnexal mass/cyst
Gynecology Surgery
1. Gynecology Perioperative Care Perform pelvic exam and digital rectal exam. (may be under anesthesia)
Insert Foley catheter
Demonstrate ability to write the following notesi.
GYN preoperative note, including appropriate studies and prophylaxis
ii. GYN operative note
iii. GYN postoperative note
iv. GYN postoperative progress note
2. Demonstrate familiarity with gynecologic procedures.
Observe hysterectomy
Observe laparoscopy
Observe other gynecology procedure (enter below)
i.
____________________
ii. ____________________
iii. ____________________
iv. ____________________
v. ____________________
Obstetrics
1. Demonstrate knowledge of preconception care including the impact of genetics, medical
conditions and environmental factors on maternal health and fetal development.
Preconception care
1st trimester care
Prenatal diagnosis
2. Explain the normal physiologic changes of pregnancy including interpretation of common
diagnostic studies.
New OB prenatal visit
Routine prenatal care follow-up visit
Conduct, record and present OB patient history
Diabetes in pregnancy
Preeclampsia/eclampsia
3rd trimester bleeding
Peripartum infection
1st trimester bleeding
Elicit a comprehensive history (menstrual, obstetric, gynecologic, contraceptive, sexual, family and social),
perform a well woman exam (with pelvic and breast exam), and recommend screening adhering to the
primary preventative care standards established by ACOG.
2.
List and describe age-appropriate screening procedures and appropriate time intervals for these tests:
3.
Mammogram
Bone density
Pap tests
Demonstrate the ability to counsel patients in a non-directive manner on the following methods of
contraception, their mechanism of action, and the risk associated with each:
o
Barrier methods
Oral contraceptives
Emergency contraception
LARC methods
Permanent contraception
4.
Demonstrate how to perform a comprehensive breast exam and discuss the diagnostic approach to a
woman with the chief complaint of breast mass, nipple discharge or breast pain.
5.
Explain the identification and appropriate management of menopausal and peri-menopausal symptoms.
6.
Assess patients' risk for the following after reviewing their history:
o
Unintended pregnancy
STIs
Cervical pathology
Breast malignancy
Gynecologic malignancies
Domestic violence
Obstetrics
1.
Participate in a first prenatal visit observing the taking of a history, physical exam, pelvic exam,
determination of due date and lifestyle counseling
2.
3.
4.
Demonstrate appropriate counseling for pregnant patients or those considering pregnancy regarding the
effects of the following on pregnancy:
5.
Substance abuse
Medications
Environmental hazards
Describe common symptoms, clinical manifestations and management of the following obstetric
complications:
o
Second-trimester loss
Preterm labor
Third-trimester bleeding
Hypertension
GDM
Multiple gestation
IUGR
Post-term pregnancy
Fetal death
6.
Participate in the care of high-risk obstetric patients and be able to discuss the use of integrated care
resources in the high-risk obstetrics setting.
7.
8.
List the normal anatomic and physiologic changes to the breast during pregnancy and postpartum periods
and the benefits of breastfeeding to mother and newborn.
9.
Intermittent auscultation
Electronic monitoring
Vibroacoustic stimulation
Biophysical profile
10. Explain the management for the following medical and surgical conditions in pregnancy:
o
Anemia
Diabetes mellitus
Chronic hypertension
TORCH infections
Group B streptococcus
HIV
Asthma
DVT
Appendicitis
Pneumonia
Gynecology Outpatient
1.
Participate/observe in a pertinent history, a focused physical examination, select and interpret diagnostic
tests and establish an initial treatment plan for some/all of the following conditions:
o
Vaginitis
Amenorrhea
Pelvic pain
Breast mass
Uterine fibroids
Galactorrhea
2.
Explain the etiologies of abnormal menstrual bleeding as well as its diagnosis and management.
3.
Identify the risk factors for cervical neoplasia and discuss the management of an abnormal Pap smear and
appropriate follow-up for patients with that finding.
4.
Interpret abnormal Pap smear results and establish a treatment plan in accordance with the latest ASCCP
guidelines.
5.
Compare the characteristics of functional cysts, benign ovarian neoplasm and ovarian malignancies.
6.
7.
Differentiate stress, urge and mixed urinary incontinence using history, physical exam, and test results.
8.
Describe the most common dermatologic disorders of the vulva and their evaluation and treatment
including:
o
Vulvovaginitis
Lichen planus
Lichen sclerosis
Vulvar neoplasia
9.
10. Perform and interpret the results of tests to confirm the diagnosis of vaginal infections including:
o
Vaginal pH
Hydroxide microscopy
11. As part of the patient care team participate/observe in the history, physical exam, and management of
women with one of these gynecologic cancers:
o
Cervical
Endometrial
Vulvar
Ovarian
12. Demonstrate via patient discussions the different modalities of aneuploidy screening including:
o
Amniocentesis
Obstetrics Inpatient
1.
List the signs and symptoms of pre-labor contractions and labor contractions.
2.
Describe the cardinal movements of labor and the steps of performing a vaginal delivery.
3.
Arrest of dilation
Protracted descent
Arrest of descent
4.
Discuss indications for and potential risks associated with cesarean delivery.
5.
Elicit an accurate history, and assist in the performance of a focused exam and development of a
treatment plan for term patients presenting with:
Labor concerns
ROM
Vaginal bleeding
6.
Demonstrate respect for the patient by respecting her preferences in the care of the infant and mother
immediately after delivery.
7.
During delivery demonstrate proper self-positioning, delivery technique, and handling of baby after
delivery.
8.
Describe the causes and management of postpartum hemorrhage including delayed hemorrhage.
9.
Perform a focused postpartum exam, and participate in the counseling of patients regarding contraception,
future pregnancies and breast feeding.
10. Be able to identify and explain treatment for the most common maternal complications including:
o
Mastitis
Perineal discomfort
Wound infection
Postpartum depression
Gynecology Inpatient
1.
2.
Perform a pertinent history, assist in a focused physical examination, the selection and interpretation of
diagnostic tests and the initial treatment plan for common presenting patient complaints including:
o
Abdominal pain
Vaginal bleeding
Pelvic mass
Urologic/gynecologic infections
Vulvar/vaginal symptoms
Describe pre-operative indications for and explain the basic procedure and the potential intra and postoperative complications for:
o
Sterilization procedures
3.
Meet patients prior to surgery and review their history and physical, when advised by supervisors.
4.
Describe the anatomy of the anterior abdominal wall, pros and cons of surgical incisions, and use of pre
and post incision anesthesia.
5.
6.
7.
Neurologic innervation
Anatomic relationship between reproductive organs and the non-gynecologic abdominal viscera
Evaluate patients and develop treatment plans for post-operative complications including:
o
Fever
Bleeding
Pain control
Ileus/obstruction
Nausea
Wound complications
Infection
Cardiovascular symptoms
Respiratory symptoms
Thromboembolism
Rounding
1.
2.
3.
Present patients to healthcare team in a well-organized manner during morning board report, highlighting
pertinent positives and negatives.
4.
Present and appropriately prioritize differential diagnosis for patients and develop a postpartum or postsurgery management plan.
2.
Describe the basics of labor evaluation and how to complete a cervical assessment.
3.
4.
Introduction to Gynecology
1.
List the four age categories of women patients and explain the major health concerns for each category.
2.
3.
4.
Discuss the diagnosis and treatment of patients with the human papilloma virus.
2.
Discuss the normal parameters of the fetal heart strip and how the readings relate to labor.
3.
Identify accelerations and decelerations on the fetal heart strip and explain their significance relating to
fetal health and the labor process.
2.
Describe abnormal uterine bleeding and list the most common causes.
3.
Explain proper counseling of patients regarding STI treatment and public health consequences.
2.
3.
Prenatal Care
1.
Explain, using specific examples, the importance of prenatal care to the health of baby and mother.
2.
List and explain the purpose of laboratory tests completed during the first prenatal visit.
3.
Explain the assessment of fetal growth, well-being, maturity, and amniotic fluid volume.
List common causes of first trimester vaginal bleeding and proper treatment for each.
2.
List the symptoms, test to diagnose, and proper management of ectopic pregnancy.
3.
Ectopic Pregnancy
1.
2.
3.
Menopause
1.
2.
Discuss the benefits and risks of treatments, including hormone therapy, for menopausal symptoms.
3.
2.
3.
4.
List the maternal and fetal complications of placental previa and abruption placenta.
5.
Describe the initial evaluation and management plan for acute blood loss.
2.
3.
Describe the symptoms and physical examination findings in a patient with endometriosis.
4.
2.
Describe symptoms and physical examination finding of benign or malignant conditions of the breast.
3.
4.
Discuss the steps in the evaluation of common breast complaints: mastalgia, mass, nipple discharge.
5.
Discuss initial management options for benign and malignant conditions of the breast.
Define the normal menstrual cycle and describe its endocrinology and physiology.
2.
3.
4.
Describe the steps in the evaluation and initial management of abnormal uterine bleeding.
5.
Summarize medical and surgical management options for patients with abnormal uterine bleeding.
Fibroids
1.
2.
3.
4.
Sexual Assault
1.
2.
Domestic Violence
1.
Cite prevalence and incidence of violence against women, elder abuse, and child abuse.
2.
3.
Summarize the available resources for a victim of intimate partner violence including short-term safety.
Simulation Stations
Labor and Delivery Simulation
1.
Explain the medical students role in the labor and delivery room.
2.
3.
Demonstrate proper delivery technique, traction, and handling of infant after delivery.
4.
Discuss cultural sensitivity to family preferences regarding the post-delivery handling of the infant and
care for the mother.
2.
3.
Explain how to reposition the patient and handle the equipment after the exam.
4.
By the end of the Obstetrics and Gynaecology Clerkship rotation, the medical student should be able to
perform the skills/procedures listed below. Competency to complete these skills may be acquired
during clinical shifts, seminars, workshops, or simulations.
1.
9.
2.
3.
4.
Pap test
5.
screening
membranes)
abnormal tracings
6.
7.
Leopold manoeuvres
8.
By the end of the Obstetrics & Gynaecology Clerkship rotation, the student should be able to
demonstrate an approach (including differential diagnosis, investigation and initial treatment) to
women presenting for antenatal care, intrapartum care, gynaecological consultation (outpatient,
inpatient, emergency room), and gynaecologic surgery, based on real or simulated encounters listed
with the following issues:
Gynaecological:
1.
8.
Endometriosis
postmenopausal)
9.
Fibroids
2.
10.
3.
Amenorrhea/oligomenorrhea
11.
Incontinence
4.
Contraceptive methods
12.
Infertility
5.
13.
Irregular periods
complications:
a.
Spontaneous abortion
15.
b.
16.
abortion
17.
c.
Ectopic pregnancy
18.
Sexual disorders
d.
19.
Urogenital prolapse/disorder
6.
Dysmenorrhea
7.
Dyspareunia
21.
7.
delivery)
8.
3.
9.
Preterm labour
10.
diagnosis
11.
b.
12.
c.
a.
Postpartum hemorrhage
d.
Fetal demise
b.
Postpartum fever
c.
Obstetrical:
1.
Antepartum haemorrhage
2.
4.
Diabetes in pregnancy
5.
Hypertension in pregnancy
13.
6.
Induction of labour
Obstetrical emergencies
1.
A.
B.
C.
D.
AFP
AFP and HCG.
2.
A.
B.
C.
D.
3.
A.
B.
C.
D.
4.
A.
B.
C.
D.
2 cm
2.5 cm
3cm
5.
A.
B.
C.
D.
6.
A.
B.
C.
D.
Both
None
7.
A.
B.
C.
D.
8.
A.
B.
C.
D.
9.
Syphilis
Bacterial vaginosis
Trichomoniasis
Chlamydial infection
A.
B.
C.
D.
10.
A.
B.
C.
D.
11.
A.
B.
C.
D.
12.
A.
B.
C.
D.
I&D
Any of the above
13.
A.
B.
C.
D.
Aortic stenosis
Mitral stenosis
Eisenmengers complex
14.
A.
B.
C.
D.
E
F
15.
Colon cancer
Ovarian cancer
Brain cancer
Breast cancer
A.
B.
C.
D.
16.
A.
B.
C.
D.
17.
A.
B.
C.
D.
intravascular volume
peripheral vascular resistance
cardiac output
18.
A.
B.
C.
D.
19.
A.
B.
C.
D.
20.
A.
B.
C.
D.
21.
X ray of a premature baby with bullous lesions showed periostitis, next diagnostic work up is
ELISA for HIV
PCR for Tuberculosis
HbSAg for mother
VDRL for mother & baby
A.
B.
C.
D.
22.
A.
B.
C.
D.
23.
4. Define Obstructed Labor. Discuss the place of destructive operations in modern obstetrics in developing
nations.
5. Partographic management of Labor.
6. What is the pathophysiology of Rh-Allo-Immunization? Discuss the management of Pregnancy in a RhImmunized Woman.
7. Antepartum assessment of fetal well-being.
8. Recent advances in the management of Atonic PPH (Post Partal Hemorrhage)
9. Prevention of mother to child transmission of HIV.
10. Septic Abortion: Pathophysiology and Complications
11. Management of Persistent Vaginal Discharge.
12. Evaluation and treatment of tubal factor in sub-fertility.
13. Management of post-menopausal bleeding in a 60 year old lady.
14. Current concepts in the management of Ovarian Carcinoma.
15. Management of Ectopic Pregnancy.
16. Avoiding post-operative adhesions.
17 Hysteroscopy in Gynaecology .
18. Management of Pruritis Vulvae.
19. Clinical application of urodynamic investigations.
20 Investigations and treatment of Primary Amenorrhoea
21 Etiopathogenesis of Pre-Eclampsia
22 Perinatal complications of Preterm Baby.
23 Causes of Azoospermia and its evaluation.
24 Management of a woman with Cu-T 380A with Missing Thread
25. Estrogen Free Pills
26 Preconceptional counseling in a young woman with previous birth of a baby with Spina Bifida.
27. Management options for Polycystic Ovary Syndrome in woman desirous of fertility.
28. Mullerian Agenesis
29. Reconstructive Tubal Surgery.