M3/M4 Course Offerings
2019-2020 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 OB Specialist (low-risk OB) or Maternal Fetal Medicine (high-risk OB) services at UCMC or Good Samaritan Hospital. A gradual increase in responsibilities and complexity of postpartum, antepartum, and triage patients occurs over the 4 weeks. Students assist with preparing for planned procedures, which may include circumcisions. Students may also assist on vaginal deliveries and C-sections. The weeks may be divided between days and nights depending on the service and enrollment. Night or weekend rounding will be required.
PREREQUISITES:
26931373 (INTERNAL MEDICINE CORE CLKSP), 26946374 (OBSTETRICS/GYN CORE CLKSP), 26980373 (SURGERY CORE CLKSP)

1. Successful completion of 3rd 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:
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:
DIRECTOR:
Andrea Hamel
hamelam@ucmail.uc.edu
513-558-6919
MSB, 4460
ADMINISTRATIVE SUPPORT PERSON:
Natalie Cassady
cassadnc@ucmail.uc.edu
558-7653
MSB, 4461
INSTRUCTOR:
Women's Generalist/Community
SITE(S):
CCHMC - Cincinnati Children's Hospital
Christ Hospital
Good Samaritan Hospital
Hoxworth Women’s Center
UC Health Medical Center
MAX ENROLL:
4 
ROTATIONS:
Rotation Dates Max
1 07/08/2019 - 08/02/2019 1
2 08/05/2019 - 08/30/2019 0
3 09/03/2019 - 09/27/2019 3
4 09/30/2019 - 10/25/2019 4
5 10/28/2019 - 11/22/2019 4
6 11/25/2019 - 12/20/2019 4
7 01/06/2020 - 01/31/2020 4
8 02/03/2020 - 02/28/2020 3
9 03/02/2020 - 03/27/2020 3
10 03/30/2020 - 04/24/2020 4
11 04/27/2020 - 05/22/2020 4
12 05/25/2020 - 06/30/2020 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 1ST 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 Low-Risk UCMC, Dr. David McKinney High-Risk UCMC or Dr. Sarah Hawkins Good Samaritan Hospital
TEACHING:
30% Attending Physician
35% Senior Resident
35% Junior Resident
FEEDBACK:
Faculty
ASSESSMENT:
FINAL GRADE:
GRADE ASSIGNED BY: Course 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 – 7th edition Dr. Arthur T Evans

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


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


Williams Obstetrics – 23rd 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. 199 Use of Prophylactic Antibiotics in Labor and Delivery (August 22, 2018) (Replaces Practice Bulletin Number 120, June 2011)
  2. 198 Prevention and Management of Obstetric Lacerations at Vaginal Delivery (August 22, 2018) (Replaces Practice Bulletin Number 165, June 2011) (Interim Update)
  3. 197 Inherited Thrombophilias in Pregnancy (June 25, 2018) (Replaces Practice Bulletin Number 138, September 2013) (Correction)
  4. 196 Thromboembolism in Pregnancy (June 25, 2018) (Replaces Practice Bulletin Number 123, August 2011) (Correction)
  5. 190 Gestational Diabetes Mellitus (February 2018) (Replaces Practice Bulletin Number 180, July 2017) (Interim Update)
  6. 189 Nausea and Vomiting of Pregnancy (January 2018) (Replaces Practice Bulletin 153, September 2015)
  7. 188 Prelabor Rupture of Membranes (January 2018) (Replaces Practice Bulletin Number 172, October 2016) (Interim Update)
  8. 186 Long-Acting Reversible Contraception: Implants and Intrauterine Devices (November 2017) (Replaces Practice Bulletin Number 121, July 2011) 
  9. 184 Vaginal Birth After Cesarean Delivery (November 2017) (Replaces Practice Bulletin Number 115, August 2010) 
  10. 183 Postpartum Hemorrhage (October 2017) (Replaces Practice Bulletin Number 76, October 2006) 
  11. 178 Shoulder Dystocia (May 2017) (Replaces Practice Bulletin Number 40, November 2002)
  12. 177 Obstetric Analgesia and Anesthesia (April 2017) (Replaces Practice Bulletin Number 36, July 2002; Committee Opinion Number 295, July 2004; Committee Opinion Number 339, June 2006; and Committee Opinion Number 376, August 2007)
  13. 175 Ultrasound in Pregnancy (December 2016, Reaffirmed 2018) (Replaces Practice Bulletin 101, February 2009, and Committee Opinion 297, August 2004) 
  14. 173 Fetal Macrosomia (November 2016, Reaffirmed 2018) (Replaces Practice Bulletin Number 22, November 2000) 
  15. 171 Management of Preterm Labor (October 2016, Reaffirmed 2018) (Replaces Practice Bulletin Number 159, January 2016) (Interim Update)
  16. 170 Critical Care in Pregnancy (October 2016, Reaffirmed 2017) (Replaces Practice Bulletin Number 158, January 2016) (Interim Update)
  17. 169 Multifetal Gestations: Twin, Triplet, and Higher-Order Multifetal Pregnancies (October 2016, Reaffirmed 2016) (Replaces Practice Bulletin Number 144, May 2014) (Interim Update)
  18. 163 Screening for Fetal Aneuploidy (May 2016, Reaffirmed 2018) (Replaces Practice Bulletin Number 77, January 2007) (See also Practice Bulletin Number 162)
  19. 162 Prenatal Diagnostic Testing for Genetic Disorders (May 2016, Reaffirmed 2018) (Replaces Practice Bulletin Number 88, December 2007) (See also Practice Bulletin Number 163)
  20. 161 External Cephalic Version (February 2016, Reaffirmed 2018) (Replaces Practice Bulletin Number 13, February 2000)
  21. 156 Obesity in Pregnancy (December 2015, Reaffirmed 2018) (Replaces Committee Opinion Number 549, January 2013)  (Correction)
  22. 155 Urinary Incontinence in Women (November 2015, Reaffirmed 2018)
  23. 116 Management of Intrapartum Fetal Heart Rate Tracings (November 2010, Reaffirmed 2017)
  24. 146 Management of Late-Term And Postterm Pregnancies (August 2014, Reaffirmed 2016)
  25. 145 Antepartum Fetal Surveillance (July 2014, Reaffirmed 2016) (Replaces Practice Bulletin Number 9, October 1999)
  26. 134 Fetal Growth Restriction (May 2013, Reaffirmed 2018) (Replaces Practice Bulletin Number 12, January 2000)
  27. 132 Antiphospholipid Syndrome (December 2012, Reaffirmed 2017) (Replaces Practice Bulletin Number 118, January 2011)
  28. 130 Prediction and Prevention of Preterm Birth (October 2012, Reaffirmed 2018) (Replaces Practice Bulletin Number 31, October 2001 and Committee Opinion No. 419, October 2008)
  29. 107 Induction of Labor (August 2009, Reaffirmed 2016) (Replaces Practice Bulletin Number 10, November 1999; Committee Opinion Number 228, November 1999; Committee Opinion Number 248, December 2000; Committee Opinion Number 283, May 2003)
  30. 106 Intrapartum Fetal Heart Rate Monitoring: Nomenclature, Interpretation, and General Management Principles (July 2009, Reaffirmed 2017) (Replaces Practice Bulletin Number 70, December 2005)
  31. 102 Management of Stillbirth (March 2009, Reaffirmed 2016) (Replaces Committee Opinion Number 383, October 2007)
  32. 86 Viral Hepatitis in Pregnancy (October 2007, Reaffirmed 2018) (Replaces Educational Bulletin Number 248, July 1998)
  33. 82 Management of Herpes in Pregnancy (June 2007, Reaffirmed 2018) (Replaces Practice Bulletin Number 8, October 1999)
  34. 72 Vaginitis (May 2006, Reaffirmed 2017)
  35. 60 Pregestational Diabetes Mellitus (March 2005, Reaffirmed 2016)

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
 

  1. Induction of labor protocol
  2. OB triage
  3. Ultrasound pregnancy dating
  4. Tocolysis protocol – Procardia
  5. Preterm labor
  6. PPROM
  7. Pre-eclamsia protocol
  8. 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.

SAMPLE WEEK

Monday:
6:00AM 6:00PM Labor & Delivery/Postpartum (6a - 7p)
Tuesday:
6:00AM 6:00PM Labor & Delivery/Postpartum (6a - 7p)
Wednesday:
7:00AM 9:00AM Wednesday Department Conferences
9:00AM 6:00PM Labor & Delivery/Postpartum (6a - 7p)
Thursday:
6:00AM 6:00PM Labor & Delivery/Postpartum (6a - 7p)
Friday:
6:00AM 6:00PM Labor & Delivery/Postpartum (6a - 7p)
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.




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