2017-2018 M3/M4 Course Syllabi
Obstetrics & Gynecology
COURSE NUMBER:
11 01 01
TITLE:
MATERNAL FETAL MEDICINE -ICE
This elective allows students an opportunity to participate in the care of pregnant women with medical and surgical problems who require maternal-fetal medicine subspecialty care. It involves work with the faculty to perform invasive and noninvasive prenatal diagnostic procedures for fetal problems. Students spend time in both inpatient and outpatient settings.
PREREQUISITES:

Successful completion of OB/GYN Core Clerkship.

Student membership in ACOG (free) - may apply online and should be completed 4 weeks before rotation starts to ensure access to online publications.

http://www.acog.org/About-ACOG/ACOG-Departments/Medical-Students/Membership-Application

UC Health required EPIC training completed and working log-in by first day of rotation.

Cell phone.

expand all

GENERAL INFORMATION

COURSE YEAR:
M4
CREDIT HOURS:
8
CREDIT WEEKS:
4
DOMESTIC VISITING:
YES
INTERNATIONAL VISITING:
NO
GRADED:
Honors/High Pass/Pass/Fail
COURSE QUALIFICATIONS:
ICE
COURSE TYPE:
Clinical
STATUS:
Full-Time   
OFFERED AS FULL-TIME AND PART-TIME: NO
ALLOWS OVERLAP: YES
COURSE LENGTH:
4 wks
DIRECTOR:
David McKinney
mckinndi@ucmail.uc.edu
513-558-5723
Medical Science Bldg, MSB-4553C
ADMINISTRATIVE SUPPORT PERSON:
Deana Brown
deana.brown@uchealth.com
513-585-9456
MSB, 4408
INSTRUCTOR:
ArthurEvans, MD
SITE(S):
University Hospital
MAX ENROLL:
1 
ROTATIONS:
Rotation Dates Max
1 07/03/2017 - 07/28/2017 1
2 07/31/2017 - 08/25/2017 1
3 08/28/2017 - 09/22/2017 0
4 09/25/2017 - 10/20/2017 1
5 10/23/2017 - 11/17/2017 1
6 11/27/2017 - 12/22/2017 1
7 01/02/2018 - 01/26/2018 1
8 01/29/2018 - 02/23/2018 1
9 02/26/2018 - 03/23/2018 1
10 03/26/2018 - 04/20/2018 1
11 04/23/2018 - 05/18/2018 1
12 05/21/2018 - 06/22/2018 0

NOTE: If a rotation is offered in both 2 and 4 week slots, the max capacity is limited to the actual spots offered for the 4 weeks. (ie: the 2 week rotations listed share the max of the 4 week rotation)
WORKING HOURS:
6 am - 5 pm M-F; 6 am - 11 am Saturday
REPORT 1ST DAY:
UH - Labor & Delivery TBA TBA

INSTRUCTION

LEARNING ACTIVITIES:
  • Case-Based Instruction/Learning
  • Clinical Experience - Inpatient
  • Conference
  • Demonstration (description, performance, or explanation of a process, illustrated by examples, observable action, specimens, etc)
  • Presentations at morning report
  • Patient Presentation--Learner
  • Research
LEARNING ENVIRONMENT POLICIES:
UCCOM strives to provide medical students with a learning environment that is conducive to their professional growth. All UCCOM and visiting medical students are encouraged to review the Student Handbook.

The Office of Student Affairs and Admissions is available to all UCCOM and visiting medical students to discuss any concerns/questions related to the learning environment. Please call 558-6796 to access faculty/staff that can assist you.
ORIENTATION:
Emily DeFranco, DO, Elective Director or MFM Fellow
TEACHING:
30% Attending Physician
30% Senior Resident
30% Junior Resident
10% sonographers
FEEDBACK:
Faculty
ASSESSMENT:
FINAL GRADE:
50% Clinical work performance evaluations
50% Attitude, e.g., professionalism, motivation etc
GRADE ASSIGNED BY: Elective director

OBJECTIVES

Attitudes :

1. Demonstrate cultural sensitivity with a diverse patient population.

2. Improve abilities to communicate with patients, physicians and other health care providers.

3. Develop leadership skills and ability to perform as a member of a team.   

4. Improve teaching abilities to benefit patients, the community and medical colleagues.

5. Develop advocacy for women's health.

Curricular Resources :

1. Maternal-Fetal Medicine; Creasy and Resnik, ed.

2. Williams Obstetrics

3. Ultrasonography in Obstetrics and Gynecology; Callen, ed.

4. Selected readings for journal club and as assigned.

**Textbooks are available for reference in the Perinatal Clinic and the Labor and Delivery Unit.


UC Maternal-Fetal Medicine Practice Protocol

http://med.uc.edu/obgyn/divisions/maternal-fetal-medicine/protocols


ACOG Practice Bulletins

1.“Management of Intrapartum Fetal Heart Rate Tracings” #116 November 2012, reaffirmed 2015

2. ”Intrapartum Fetal Heart Rate Monitoring: Nomenclature, Interpretation, and General Management Principles” #106  July 2009, reaffirmed 2015

3. “Antepartum fetal surveillance” #145, July 2014

4. “Fetal Macrosomia” #22, November 2000, reaffirmed 2015

5. “Fetal Growth Restriction” #134, May 2013

6. "Management of late-term and post-term pregnancies” #146, August 2014

7. “Management of Stillbirth” #102, November 2009, reaffirmed 2014

8. â€śPostpartum Hemorrhage” #76 October 2006, reaffirmed 2013

 9. â€śBenefits and Risks of Sterilization” #133 February 2013, reaffirmed 2015

10. “Induction of labor” #107 August 2009, reaffirmed 2015

11. “Nausea and vomiting of pregnancy” #153 September 2015,

12. “Ultrasonography in pregnancy” #101 February 2009, reaffirmed 2014 

13. “Vaginal Birth after Previous Cesarean Delivery” #115 August 2015 9.“Premature rupture of membranes” #139 October 2013

14. “Management of Preterm Labor” #127 June 2012, reaffirmed 2014

15. “Prediction and prevention of preterm birth” #130 October 2012, reaffirmed 2014

16. “Use of prophylactic antibiotics in labor and delivery” #120 June 2011, reaffirmed 2014

17. “External Cephalic Version” #13 February 2000, reaffirmed 2014


ACOG Committee Opinions

1.     “Emergent therapy for acute onset of severe hypertension during pregnancy and the postpartum period” #623, February 2015

2.     “Non-medically indicated early term delivery” #561, April 2013, reaffirmed 2015


ACOG Task Force Publications

1. Hypertension in Pregnancy, 2013

http://www.acog.org/Resources_And_Publications/Task_Force_and_Work_Group_Reports/Hypertension_in_Pregnancy

Knowledge/Skills:
1. Manage high risk pregnancies with consultation from the residents and attending faculty both in inpatient and ambulatory settings.

2. Improve knowledge and skill in the ambulatory management of obstetrical problems.

3. Improve proficiency in the performance of pelvic and breast exam, including the taking of cytological, as well as biopsy, specimens.

4. Critically review the literature and use computer based Medline searches.

5. Evaluate the use of biostatistics in clinical trials and clinical medicine.

Main Course Topics :
 1. High-risk pregnancy 
 2. Congenital malformations
 3. Chromosomal abnormalities
 4. Prenatal diagnosis 
 5. Medical complications of pregnancy 
 6. Diagnostic ultrasound, obstetrics 
 7. Sickle cell disease
 8. Rh isoimmunization
 9. Preterm labor
10. Preeclampsia - eclampsia
11. Tests of fetal well-being
12. Clinical trials and biostatistics
 
Objectives:

The elective is designed primarily to improve the senior medical student's skills in providing ambulatory care to "high-risk" pregnant patients.  He/She will be expected to learn how to assign risk and formulate plans.  The senior medical student will also be given education regarding the interpretation and management of antenatal fetal surveillance testing using the Non-Stress Test and Biophysical Profile.  The senior medical student will also have exposure to advanced obstetrical ultrasound and ultrasound guided prenatal diagnosis procedures.

Expectations for this elective include:

Morning Inpatient High Risk Rounds - as directed by residents assigned to MFM rotation

1)  Antepartum Clinics: MCPC; Diabetes; Fetal Care Clinics

2)  Conferences:  NICU conferences (Mondays 12 noon - 1 pm (NICU conf. rm.)

       Grand Rounds/M&M Conf. etc. Wed. 7 - 9 am, (MSB 2351)

        Fetal Care Conference 7 - 8 am Thurs. (Location TBA)

3)  Resident lectures - Fridays 7:45 - 9:45 am, Rm. 2351 MSB & other locations when noted           

Grades will be determined by equally rated resident, fellows, and attending MFM staff evaluations.



Other Resources - Audiovisuals:
N/A
Other Resources - Computer resources:
1.  Internet access on labor & delivery unit and at the Perinatal Treatment Center
Other Resources - Other :
1. Perinatal treatment center ultrasound unit with digital images from fetal ultrasound.
Procedures:

1. Perform basic obstetrical ultrasound examination.

2. Perform basic pelvic examination including sterile speculum examination in obstetrical patients and collect specimens for bacterial/viral culture, Pap smear and evaluation for rupture of membranes.

 

SAMPLE WEEK

Monday:
6:00AM 7:00AM Pre-round on Antepartum Service
7:00AM 8:00AM L&D Board Rounds
8:00AM 12:00PM Fetal Care Clinic (Hoxworth)
12:00PM 1:00PM NICU Conference
1:00PM 5:00PM Independent Study - Ward Duties
Tuesday:
6:00AM 7:00AM Pre-round on Antepartum Service
7:00AM 8:00AM L&D Board Rounds
8:00AM 12:00PM Round w/ MFM Team; Ward Duties
1:00PM 5:00PM MCPC Clinic
Wednesday:
6:00AM 7:00AM 0600 Pre-round on Antepartum Service, 0615 L&D Board Rounds
7:00AM 9:00AM Grand Rounds/M&M Conference
9:00AM 12:00PM MCPC Consult - Fellow Clinic Hoxworth
1:00PM 5:00PM Independent study - Ward Duties
Thursday:
7:00AM 8:00AM Fetal Care Conference
8:00AM 12:00PM Round w/ MFM Team; Ward Duties
12:00PM 1:00PM DAPP Meeting
1:00PM 5:00PM DAPP Clinic
Friday:
6:00AM 7:00AM Pre-round on Antepartum Service
7:00AM 7:30AM 7 - 7:45 am L&D Board Rounds
7:30AM 9:30AM 7:45 - 9:45 am Resident Lectures
9:30AM 12:00PM Independent Study - Ward Duties
1:00PM 5:00PM Ward Duties (See note below for Saturday schedule)
SCHEDULE NOTE:

SATURDAY:

6 am - 7 am  Pre-round on Antepartum Service

7 am - 8 am  L&D Board Rounds

8 am - 11 am  Round w/ MFM Attendings; Ward Duties

1. Time spent on labor and delivery or independent study can be substituted with time on the ultrasound unit (targeted ultrasound exams and procedures).

2. Time spent on labor and delivery or independent study may also be substituted by time spent at the fetal care center observing procedures at the discretion of the Fetal Care Team.

3. Independent study time may also be spent shadowing a perinatologist at other MFM sites.

*Option to follow an MFM faculty physician for outpatient evaluations & consults at other MFM sites. (Will need to be pre-assigned.)

 

ATTENDANCE AND ABSENCE POLICY

 

Session Attendance for M4 Students

  • Students may miss no more than two days of planned excused absences on a four week rotation without being required to make-up the work, at the discretion of the clerkship/elective/course director or his/her designee.
  • Non-AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the clerkship director to best align with the site schedule. Students may request to schedule 1 or more of these 4 days for planned absences that fall under 1 of the categories listed below for excused absences during non-AI rotations, in consultation with the course/elective director, who may or may not approve such planned absences.
  • AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the course director to best align with the site schedule. Students may request to schedule 1 or 2 of these days for planned absences that fall under 1 of the categories listed below for excused absences during AI rotations, in consultation with the course director, who may or may not approve such planned absences. Students must avoid scheduling Step 2 examinations during an Acting Internship.
  • Excused Absences - The following will be considered excused absences:
    • Diagnostic, preventative, and therapeutic health services (e.g. doctor appointments, physical therapy, counselling, etc).
    • Personal illness, accident or a major catastrophic event
    • Death or serious illness of immediate family members. Immediate family members, as defined by UC, are Grandparents, Brother, Sister, Brother-in law, Sister-in-law, Daughter-in-law, Son-in-law, Father, Mother, Mother-in-law, Father-in-law, Step-sister, Step-brother, Step-mother, Step-father, Spouse or domestic partner, Child, Grandchild, legal Guardian or other person who stands in place of parent (in Loco Parentis)
  • Whenever possible, planned absences should be requested a minimum of six weeks in advance of the start of the clerkship/elective/course in which the absence will occur; this enables the clerkship/course/elective to help plan for educational event scheduling (e.g. a known appointment could be scheduled around with enough notice and the student might not have any required coursework to make up). Absences requested less than 1 week prior to the planned absence may not be considered for a possible excused absence unless extenuating circumstances prevented the student from providing timely notification per the policy. Students should first submit their request for a planned absence to the clerkship/elective/course director using the online MSSF. All planned/excused absences for any reason should be documented on the MSSF.
  • The COM abides by the UC Religious Observance Policy that respects the religious diversity of its students by providing opportunities, where possible, for accommodation in cases where conflicts exist between students’ religious beliefs/practices and educational activities. In clinical settings, such accommodations must honor the primacy of a commitment to patient care and avoid unduly burdening faculty, staff and the general student population involved in the affected educational and/or patient care activity.
  • The following items are explained in detail in the Medical Student Handbook:
    • Excused/unexcused/unplanned absence, religious holidays, jury duty, and make-up work

See Attendance and Absences Policy, Religious Observance Policy, Medical Student Handbook.




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