Department of Obstetrics and Gynecology

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OB/GYN Personnel and Syllabus

OBGYN Clerkship Syllabus

Contact Information

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Mark Schnee, D.O.
Statewide Clerkship Director
Office Phone: 317-948-2617
Email: mschnee@iupui.edu

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Kris Powell

Statewide Clerkship Coordinator
Office Phone: 317-948-7438
Office Fax: 317-948-7454
Email: krmpowel@iupui.edu

Clerkship Goal
  • The primary goal of the Clerkship is to provide you with a foundation of both knowledge and skills in order to better appreciate the healthcare needs of women.
  • To provide medical students with an opportunity to evaluate Ob/Gyn as a possible career path.
Clerkship Objectives

OB/GYN Verified Procedures - When one of these skills is entered an email will be generated asking the preceptor to verify it in PxDx.

  • Pelvic Exam – the student will be able to perform an accurate examination of the pelvis in a sensitive manner.
  • Pap Smear – The will be able to interact properly to gain the patient’s confidence, cooperation and assure her comfort and dignity.
  • Observed History- The student will be able to conduct a complete women’s history from the patient including: menstrual history, obstetric history, pap history, STD history, mammogram history, contraceptive history, sexual history and domestic violence screening.
  • Cesarean Section – The student will assist in at least one cesarean delivery.
  • Vaginal Delivery – The student will actively participate “hand over hand” in at least 2 vaginal deliveries.

OB/GYN Non- Verified procedures/diagnoses - When the topics listed below are encountered by the student, he or she is to record them in PxDx, but no email is generated to the preceptor to verify. The list below contains topics that are potentially supervised patient care encounters.

The student has observed and/or assisted in at least two of the following minor procedures:

  • Contraceptive implants
  • Colposcopy +/_ cervical biopsy
  • Cervical conization/LEEP
  • Dilation and curettage
  • Endometrial biopsy
  • Hysteroscopy
  • IUD insertion
  • Saline infusion sonohysterography
  • Tubal ligation
  • Vulvar biopsy

The student has observed and/or assisted in at least two of the following major procedures:

  • Abdominal hysterectomy
  • Vaginal hysterectomy
  • Laparoscopic hysterectomy
  • Operative laparoscopy
  • Myomectomy
  • Urogynecological procedure
  • Gynecologic –oncologic staging

Gynecology - General 6 required

  • Abnormal uterine bleeding
  • Amenorrhea
  • Androgen excess
  • Breast disorders
  • Chronic pelvic pain
  • Contraceptive methods
  • Domestic violence screening
  • Dysmenorrhea
  • Endometriosis
  • Female sterilization
  • Induced abortion
  • Infertility
  • Menopause
  • Normal menstrual cycle
  • Pelvic organ prolapse and urinary incontinence
  • Premenstrual syndrome
  • Normal/abnormal puberty
  • Sexually transmitted infections
  • Vaginal infections

Gyn neoplasia 1 required

  • Cervical dysplasia
  • Cervical carcinoma
  • Endometrial hyperplasia
  • Endometrial carcinoma
  • Gestational trophoblastic neoplasia
  • Ovarian mass
  • Ovarian carcinoma
  • Uterine leiomyomas
  • Adnexal/ovarian mass
  • Vulvar neoplasia
  • Vulvar carcinoma

OBSTETRICS

Normal Obstetrics 2 required from each category

  • Antepartum Care
    • Describe diagnostic fetal studies
    • Determine gestational age
    • Observe fetal ultrasound
  • Intrapartum Care
    • Describe true labor
    • Describe 3 stages of labor
    • Interpret fetal monitoring
    • Understand and management of premature rupture of membranes
    • Understand and management of preterm labor
    • Understand etiologies for abnormal labor pattern
  • Postpartum Care
    • Understand pathophysiology of postpartum hemorrhage
    • Understand pathophysiology of postpartum infections
    • Understand physiology of lactation
    • Be able to recognize postpartum depression/anxiety
    • Physiologic changes in pregnancy postpartum
  • Abnormal Obstetrics 1 required from this list
    • Alloimmunization
    • Ectopic pregnancy
    • Endocrine disorders
    • Fetal demise
    • Fetal intrauterine growth restriction
    • Multifetal gestation
    • Postterm pregnancy
    • Preeclampsia
    • Spontaneous abortion
    • Third trimester bleeding
Conclusion of Clerkship

At the completion of the Obstetrics and Gynecology third-year clerkship, the student should achieve the following objectives:

  • The student will demonstrate knowledge of normal and abnormal obstetrics and gynecology.
  • The student will demonstrate knowledge of preventive women's health including contraceptive care, care of the post-menopausal woman, and care of the woman patient at an annual health maintenance examination.
  • The student will acquire the skills of history taking of both the obstetrical and gynecologic patients in the inpatient and outpatient setting.
  • The student will acquire skills for examination of the female patient including breast examination and pelvic examination.
  • The student will acquire and demonstrate the attitudes and approach to the female patient necessary to establish rapport and trust of the patient
Clinical Learning Activities

Clinical learning activities in the Ob/Gyn clerkship include experiences in multiple venues including Labor & Delivery, the operating room, and outpatient clinics. At each clinical site, students will have approximately equal exposure to both obstetrics and gynecology (either general or subspecialty practice).

Obstetrical clinical activities may include evaluating patients in an obstetric triage for labor or potential complications of pregnancy, following a labor patient throughout her course and participating in the delivery of the infant, and postpartum or antepartum rounding.

Gynecologic clinical activities include the participation in the evaluation of gynecologic consultations and minor and major surgical procedures.

All students will also participate in outpatient continuity clinics. Ob/Gyn continuity clinics include patients seeking routine prenatal care, routine annual health maintenance exams, and the evaluation of both acute and chronic gynecologic complaints.

Non-Clinical Learning Experiences
  • Medical students rotating in Ob/Gyn are provided with a reading syllabus to address specific learning objectives (see OnCourse).
  • Students are provided free access through an institutional license to the APGO uWise sample questions (see Resources section).
  • Online learning cases (iuCOGs) will be posted to Oncourse during the last clinical week of the rotation. Students will be required to complete all cases.
  • CAST Project is an optional learning opportunity in which students will identify a clinical question derived from their clinical experience, learn how to identify and evaluate the best evidence from the clinical research literature, and then present a short summary of their findings. This program is open to a maximum of 6 students per rotation.
Ethics During the Ob/Gyn Clerkship

Facilitators:
Sara Jo Grethlein, MD FACP
Professor of Clinical Medicine, Associate Dean for Undergraduate Medical Education

Liam Howley, MD
Assistant Professor of Clinical Medicine, Competency Director, Professionalism

Objectives:
  1. Students will be able to describe the four foundational principles of medical ethics
  2. Students will be able to analyze a clinical case scenario to identify significant ethical principles, key stake holders and core challenges
  3. Students will be able to articulate a solution or approach balances interests with ethical principles
Activities:

In-Class Day One

  • Didactic session on the history of medical ethics (selected high points)
  • Small group case analysis
  • Small group role play

Between Sessions

  • Online MCQ
  • Submission of two case analyses
  • Completion of grading of peers cases analyses

In-Class Day Two (Indianapolis students)

  • Report out on case analyses
  • Didactic session with interactive case discussion

End of Session (Regional Campus Students)

  • Students will review on-line module (in parallel to the didactic session given to Indianapolis students)
  • Students will complete brief online assignment in lieu of interactive case discussion
Mid-Rotation Feedback
  • Each student will be scheduled for a 15 minute meeting with the Clerkship Director or the Vice Chair for Education. This meeting will include a review of the feedback form, discussion of goals and expectations, and any questions or concerns.
  • Mid-Rotation feedback forms will include a self-assessment (completed by the student) and a preceptor feedback form (completed by one faculty or resident).
  • Mid-Rotation Feedback forms must be submitted to Kris Powell in the Clerkship office by the stated deadline.
  • An email will be sent to all students during the 2nd week of the rotation with a copy of the form, the Mid-Rotation meeting schedule, and the deadline for submission.
Evaluation of Student Clerkship Performance
  • Clerkship Performance will be determined as follows:
    • Clinical Evaluations (50% of total score)
      • Students will be evaluated using the standardized Indiana University School of Medicine evaluation form.
      • End of the rotation evaluation forms will be solicited from both residents and faculty by the clerkship and will be given equal weight. Evaluation forms are weighted by “amount of time spent” with the student as stated by the preceptor.
    • NBME Ob/Gyn Subject Exam (50% of total score)
      • Score of 60 required to pass
Student's Evaluation of the Clerkship
  • There will be a mandatory evaluation session scheduled on the last day of the clerkship. Students will be asked to evaluate both the OBGYN Clerkship program, and the faculty and resident preceptors. All evaluations will be done online.

Clinical Venues

  • Indianapolis area sites include: IU Health University Hospital, Eskenazi Hospital, IU Health Methodist, and St. Vincent’s
  • Regional sites include: Bloomington, Evansville, Ft. Wayne, Lafayette, Muncie, Northwest, South Bend, and Terre Haute
Resources
    • Recommended Text:
      • Hacker, N. F., Gambone, J. C., Hobel, C. J. (2010) Hacker & Moore’s Essentials of Obstetrics and Gynecology (5th ed.). Philadelphia, PA: Elsevier.
      • Beckman, C. R. B., Ling, F. W., Herbert, W. N. P., Laube, D.W., Smith, R. P., Casanova, R., Chuang, A., Goepfert, N. A., Weiss, P.W., (2014). Obstetrics and Gynecology(7th ed.). Philadelphia, PA: American College of Obstetricians and Gynecologists, Wolters, Kluwert/Lippencott, Williams & Wilkinson

or

  • uWise - Practice exam questions:

Student resources from the Indiana University School of Medicine can be found from on theUME or MSAwebsites.

Additional Resources for the Ob/Gyn Clerkship can be found on theOb/Gyn Clerkship OnCoursesite.

Any student at any IUSM campus requesting accommodations for a disability must apply to the Indiana University School of Medicine Disabilities Accommodations Committee and must register with the adaptive educational services office at the host campus. Guidelines for applying along with a list of the adaptive services offices on each campus are available in the Student Handbook at
http://msa.medicine.iu.edu/files/3113/3252/6774/DisabilitiesAccommodationsPolicy.pdf

Indiana University School of Medicine
Department of Obstetrics and Gynecology
550 University Blvd
Indianapolis, IN 46202


obgyniu@iupui.edu

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