UC COM :: M3/M4 Course Syllabi

M3/M4 Course Offerings

2018-2019 M3/M4 Course Syllabi

Obstetrics & Gynecology

COURSE NUMBER:

11 01 03

TITLE:

ELECTIVE AI - OBSTETRICS SERVICE -ICE
The Obstetrics AI is a member of the postpartum & triage service. A gradual increase in responsibilities & complexity of postpartum & triage patients occurs over the 4 weeks. Students assist with preparing for Planned Procedures & Newborn Circumcisions. Students can also assist on C-sections. The rotation is split between day and night service.

PREREQUISITES:

26931373 (INTERNAL MEDICINE CORE CLKSP), 26946374 (OBSTETRICS/GYN CORE CLKSP), 26980373 (SURGERY CORE CLKSP)

1. Successful completion of 3^rd year clerkships.

2. 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

3. UC Health or TriHealth required EPIC training completed and working log-in by first day of elective.

4. Cell phone.

expand all

GENERAL INFORMATION

COURSE YEAR:

CREDIT HOURS:

CREDIT WEEKS:

DOMESTIC VISITING:

YES

INTERNATIONAL VISITING:

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:

DIRECTOR:

Amy Thompson, MD
thompay@ucmail.uc.edu
513-558-7651
MSB, 4410

ADMINISTRATIVE SUPPORT PERSON:

Deana Brown
deana.brown@uchealth.com
513-585-9456
MSB, 4408

INSTRUCTOR:

Women's Generalist/Community

SITE(S):

Good Samaritan Hospital
UC Health Medical Center

MAX ENROLL:

ROTATIONS:

Rotation	Dates	Max
1	07/02/2018 - 07/27/2018	0
2	07/30/2018 - 08/24/2018	0
3	08/27/2018 - 09/21/2018	1
4	09/24/2018 - 10/19/2018	2
5	10/22/2018 - 11/16/2018	3
6	11/26/2018 - 12/21/2018	3
7	01/02/2019 - 01/25/2019	3
8	01/28/2019 - 02/22/2019	1
9	02/25/2019 - 03/22/2019	3
10	03/25/2019 - 04/19/2019	2
11	04/22/2019 - 05/17/2019	3
12	05/20/2019 - 06/30/2019	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 - 7 pm when assigned to OB Day Team; 6 pm - 8 am when assigned to Night Float

REPORT 1^ST DAY:

UCMC or Good Sam TBA

INSTRUCTION

LEARNING ACTIVITIES:

Case-Based Instruction/Learning
Clinical Experience - Inpatient
Demonstration (description, performance, or explanation of a process, illustrated by examples, observable action, specimens, etc)
No call scheduled, but may be assigned night float week(s)
Patient Presentation--Faculty
Patient Presentation--Learner

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:

Dr. Amy Thompson - Director - UCMC or Dr. Sarah Hawkins - Director - Good Samaritan Hospital

TEACHING:

30%	Attending Physician
35%	Senior Resident
35%	Junior Resident

FEEDBACK:

Faculty

ASSESSMENT:

FINAL GRADE:

70%	Clinical work performance evaluations
20%	Attitude, e.g., professionalism, motivation etc
10%	Topic presentation

GRADE ASSIGNED BY: Elective director

OBJECTIVES

Attitudes :

Provide patient care that is compassionate, appropriate, and culturally sensitive.
Be a reliable team member who can take directions and complete assigned tasks in a reasonable time period.
Demonstrate effective communication skills to all team members (residents, attending, and nursing staff) and patients/families.

Curricular Resources :

Manual of Obstetrics – 7^th edition Dr. Arthur T Evans

(entire text is a good quick reference for any OB rotation)

Manual of Obstetrics – 8^th edition Chapter 4 "Post-Partum Care" Nolan and Thompson

Williams Obstetrics – 23^rd edition – Section VI – Chapters 30-33 "The puerperium"

Available in HSL E-books collection

http://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/Newborn-Male-Circumcision.aspx

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, reaffirmed2015

3. "Antepartum fetal surveillance" #145, July 2014

4. "Fetal Macrosomia" #22,November 2000, reaffirmed 2015

5. "Fetal Growth Restriction" #134, May 2013

6. "Management oflate-term and post-term pregnancies" #146, August 2014

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

8. "Postpartum Hemorrhage" #76 October 2006, reaffirmed 2013

9. "Induction of labor" #107 August 2009, reaffirmed 2015

10. "Nausea and vomiting of pregnancy" #153 September 2015,

11. "Ultrasonography in pregnancy" #101 February 2009, reaffirmed 2014

12. "Vaginal Birth after Previous Cesarean Delivery" #115 August 2015

13."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

18. "Benefits and Risks of Sterilization" #133, February 2013

ACOG Committee Opinions

1. "Emergent therapy for acute onset of severe hypertension during pregnancy and the postpartum period" #623, February2015

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

UC Maternal Fetal Medicine Practice Protocol

https://www.uc.edu/obgyn

· Divisions

· Maternal-Fetal Medicine

· Practice Protocols

User log in - UC 6 + 2 and network password

Induction of labor protocol
OB triage
Ultrasound pregnancy dating
Tocolysis protocol – Procardia
Preterm labor
PPROM
Pre-eclamsia protocol
Oxytocin Induction/augmentation protocol

Knowledge/Skills:

Recognize the normal maternal physiologic changes of the postpartum period
Provide the important components of normal postpartum care to your assigned patients
Provide appropriate postpartum patient counseling. Including discharge precautions, follow up requirements, circumcision counseling, and family planning.
Recognize risk factors for postpartum infection and know the differential diagnosis for postpartum fever
Develop an evaluation and management plan for a patient with a postpartum infection
In triage, provide direct patient care in the work up for vaginal bleeding in pregnancy, abdominal pain in pregnancy (including term and preterm contractions), hypertension and nausea/vomiting. The experience should include these topics, but not be limited to them.
Review charts and prepare inpatient documents for patients who are on the Planned Procedures list. (scheduled inductions of labor and cesarean sections). Review pregnancy dating criteria for each patient and know the indications for their timed delivery. Anticipate any possible issues that may arise during their delivery or postpartum care and formulate recommendations for the oncoming team. Present these patients to the L&D team at morning rounds. (EVIDENCE OF INTERFACE BETWEEN OUTPATIENT/INPATIENT CARE)

Main Course Topics :

Obstetrics

Postpartum care

Circumcision

Family planning

Postpartum infections

Patient Consent

Triage

Communication

Objectives:

Other Resources - Audiovisuals:

1. Video on circumcision

2. Chalk talks – FHR, vaginitis

3. https://www.youtube.com/watch?v=uwgtcpqT3Fc (Dr. Christopher Morosky)

Other Resources - Computer resources:

Posted on LCMS+

Other Resources - Other :

N/A

Procedures:

Write complete history/physicals – including assessments and plans on patients admitted by the student.
Enter and pend admission orders.
Update the inpatient list with patients admitted from triage and the planned procedures
Write triage notes.
Coordinate the circumcision schedule with RN, resident, and attending staff as well as families.
Assist with a circumcision and cesarean delivery.
Participate in the patient consent process for patients (circumcision, cesarean section, transfusion) (RISK BENEFIT ISSUES)
Perform limited ultrasounds for fetal position, number, and AFI/BPP with supervision in triage.
Present a 10 - 15 minute formal talk to residents on a topic relevant to a patient you cared for on the rotation. The talk should outline the clinical/management dilemma that occurred and provide a review of literature to answer the question and resolve the dilemma. (CRITICAL REVIEW OF LITERATURE, COMPUTER BASED LITERATURE SEARCH)

SAMPLE WEEK

Monday:

6:00AM

6:00PM

Labor & Delivery/Post-partum (6 am - 7 pm)

Tuesday:

6:00AM

5:30PM

Labor & Delivery/Post-artum (6 am - 7 pm)

Wednesday:

6:00AM

6:00PM

Labor & Delivery/Post-partum (6 am - 7 pm)

Thursday:

8:00AM	1:00PM	General OB Clinic
1:00PM	6:00PM	Labor & Delivery (1 pm - 7pm)

Friday:

6:00AM

6:00PM

Labor & Delivery/Post-partum (6 am-7pm)

SCHEDULE NOTE:

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.