2023-2024 M3/M4 Course Syllabi
Obstetrics & Gynecology
COURSE NUMBER:
11 01 09
TITLE:
ELECTIVE AI - GYNECOLOGY SERVICE -ICE
The gynecology AI is a member of the Gynecology or Gynecologic Oncology team at UCMC or at Good Samaritan Hospital. The student participates in surgeries and follows patients postoperatively. Inpatient and emergency department consults are also provided. They participate in GYN specialty clinics as well. Weekend rounding or shift(s) may be required.
PREREQUISITES:
26946374 (OBSTETRICS/GYN CORE CLKSP), 26980373 (SURGERY CORE CLKSP)

1. Successful completion of 3rd year Obstetrics & Gynecology and Surgery 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: NO
COURSE LENGTH:
4 Weeks
DIRECTOR:
Amanda Jackson, MD
jacks2a6@ucmail.uc.edu

Jane Morris, MD
Jane.Morris@uc.edu

ADMINISTRATIVE SUPPORT PERSON:
Natalie Cassady
cassadnc@ucmail.uc.edu
558-7653
MSB, 4461
SITE(S):
Barrett Cancer Center
Bethesda North Hospital
UC Health Medical Center
MAX ENROLL:
2 
ROTATIONS:
Rotation Dates Max
1 05/29/2023 - 06/23/2023 0
2 06/26/2023 - 07/21/2023 0
3 07/24/2023 - 08/18/2023 2
4 08/21/2023 - 09/15/2023 2
5 09/18/2023 - 10/13/2023 2
6 10/16/2023 - 11/10/2023 2
7 11/13/2023 - 12/08/2023 2
8 12/11/2023 - 01/05/2024 0
9 01/08/2024 - 02/02/2024 2
10 02/05/2024 - 03/01/2024 2
11 03/04/2024 - 03/29/2024 0
12 04/01/2024 - 04/26/2024 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 - 6 pm
REPORT 1ST DAY:
UC Health or Good Samaritan (TBA)

INSTRUCTION

LEARNING ACTIVITIES:
  • Case-Based Instruction/Learning
  • Clinical Experience - Inpatient
  • Clinical Experience - Inpatient (Nights)
  • Conference
  • Demonstration (description, performance, or explanation of a process, illustrated by examples, observable action, specimens, etc)
  • 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.
TEACHING:
30% Attending Physician
35% Senior Resident
35% Junior Resident
FEEDBACK:
ASSESSMENT:
 90% of grade will be from clinical performance rating by resident team and attendings.


10% of grade will be based on a required topic presentation based on an interesting patient case.

ASSESSMENT METHODS:
Clinical Performance Rating/Checklist
Oral Patient Presentation
FINAL GRADE:
GRADE ASSIGNED BY: Course director

OBJECTIVES

Curricular Resources :
Williams Gynecology (available in library eBooks)

Chapter 6 Video on First trimester abortion

Other videos are in this text as well that you may find useful based on your clinical encounters

TeLindes Operative Gynecology – available in library eBooks

Chapter 32   - "Hysterectomy"                   

Chapter 30   "PID"

Chapter 34 "Ectopic" – can use as supplement to Sperroff text

Chapter 8 "Pre-operative Care"

Chapter 9 "Post-anesthesia and post-op care"

Sperroff Reproductive Endocrinology – should have copy in resident lounge

             Chapter 15 "Dysfunctional Uterine bleeding"

Chapter 33 "Ectopic"

Lentz   Comprehensive Gynecology –available in library eBooks

               Chapter 16 "Spontaneous and Recurrent Abortion"  -   Chapter by Katz

Website Links

http://www.asccp.org/ConsensusGuidelines/tabid/7436/Default.aspx

http://www.cdc.gov/std/tg2015/default.htm

http://www.atlasofpelvicsurgery.com/home.html

 
Journal Articles

Barnhart "Ectopic Pregnancy"   NEJM, July 23, 2009.   361(4)   379-387

Zhang et al "A comparison of medical management with misoprostol and surgical management for early pregnancy failure"   NEJM, Dec 1, 2005   353(8)   761-769.

Bhatt et al "Sonographic evaluation of ectopic pregnancy"   Radiol clini North America ay 2007   45(3)   549 review

ACOG Practice Bulletins

  1. 200 Early Pregnancy Loss (August 29, 2018) (Replaces Practice Bulletin 150, May 2015) (Interim Update)
  2. 195 Prevention of Infection After Gynecologic Procedures (June 2018) (Replaces Practice Bulletin Number 104, May 2009, and Committee Opinion Number 571, September 2013) 
  3. 193 Tubal Ectopic Pregnancy (March 2018) (Replaces Practice Bulletin Number 191, February 2018) (Interim Update)
  4. 185 Pelvic Organ Prolapse (November 2017) (Replaces Practice Bulletin Number 176, April 2017) (Interim Update)
  5. 182 Hereditary Breast and Ovarian Cancer Syndrome (September 2017) (Replaces Practice Bulletin Number 103, April 2009)
  6. 175 Ultrasound in Pregnancy (December 2016, Reaffirmed 2018) (Replaces Practice Bulletin 101, February 2009, and Committee Opinion 297, August 2004) 
  7. 174 Evaluation and Management of Adnexal Masses (November 2016) (Replaces Practice Bulletin Number 83, July 2007) 
  8. 168 Cervical Cancer Screening and Prevention (October 2016, Reaffirmed 2018) (Replaces Practice Bulletin Number 157, January 2016) (Interim Update)
  9. 167 Gynecologic Care for Women and Adolescents With Human Immunodeficiency Virus (October 2016) (Replaces Practice Bulletin 117, December 2010, and Committee Opinion 572, September 2013)
  10. 152 Emergency Contraception (September 2015, Reaffirmed 2018) (Replaces Practice Bulletin Number 112, May 2010)
  11. 143 Medical Management of First-Trimester Abortion (March 2014, Reaffirmed 2016) (Replaces Practice Bulletin Number 67, October 2005)
  12. 140 Management of Abnormal Cervical Cancer Screening Test Results and Cervical Cancer Precursors (December 2013, Reaffirmed 2018) (Replaces Practice Bulletin Number 99, December 2008)
  13. 136 Management of Abnormal Uterine Bleeding Associated With Ovulatory Dysfunction (July 2015, Reaffirmed 2018) (Replaces Practice Bulletin Number 14, March 2000)
  14. 135 Second-Trimester Abortion (June 2013, Reaffirmed 2017)
  15. 133 Benefits and Risks of Sterilization (February 2013, Reaffirmed 2017) (Replaces Practice Bulletin Number 46, September 2003) 
  16. 128 Diagnosis of Abnormal Uterine Bleeding in Reproductive-Aged Women (July 2012, Reaffirmed 2016)
  17. 126 Management of Gynecologic Issues in Women With Breast Cancer (March 2012, Reaffirmed 2016)  
  18. 114 Management of Endometriosis (July 2010, Reaffirmed 2018) (Replaces Practice Bulletin Number 11, December 1999)
  19. 110 Noncontraceptive Uses of Hormonal Contraceptives (January 2010, Reaffirmed 2018) (Replaces Committee Opinion Number 337, June 2006)
  20. 96 Alternatives to Hysterectomy in the Management of Leiomyomas (August 2008, Reaffirmed 2016) (Replaces Practice Bulletin Number 16, May 2000 and Committee Opinion Number 293, February 2004)
  21. 91 Treatment of Urinary Tract Infections in Nonpregnant Women (March 2008, Reaffirmed 2016)
  22. 84 Prevention of Deep Vein Thrombosis and Pulmonary Embolism (August 2007, Reaffirmed 2018) (Replaces Practice Bulletin Number 21, October 2000) (Correction)
  23. 81 Endometrial Ablation (May 2007, Reaffirmed 2018)
  24. 53 Diagnosis and Treatment of Gestational Trophoblastic Disease (June 2004, Reaffirmed 2016)

ACOG Committee Opinions

  "Salpingectomy for ovarian cancer prevention" #620, June 2015



  Journal Articles


Barnhart, Kurt T., et al. "Differences in Serum Human Chorionic Gonadotrophin Rise in Early Pregnancy by Race and Value at Presentation." Obstetrics and gynecology 128.3 (2016): 504.
Instructional Methods:
  • Clinical Experience
  • Presentations
  • QI ProjectsJournal Club
Knowledge/Skills:
·    Understand key components of pre-operative evaluation and planning. Perform/assist chief resident in pre-op history, physical examination and informed consent. Participate in Anesthesia Pre-Admission Testing (PAT) clinic for 2 half day sessions. (RISK/BENEFIT ISSUES)
·    Provide essential components of postoperative care.  Recognize and treat common post-operative complications.
·    Observe the communication of operative findings and complications to families.
·    Manage the beta list (patients with pregnancy of unknown location and molar pregnancies) with the intern for first week. Gradually assume management of this list with upper level guidance. Present this to the attending on Monday of each week.
·    Collect histories on patients with incontinence and pelvic organ prolapse.  Participate/perform the POP-Q exam and document findings.  Observe pre-ops in UroGyn clinic to understand the importance of the correct surgical approach for different anatomical defects. (RISK/BENEFIT ISSUES)
·    Utilize guidelines for management of abnormal pap smears to see and evaluate patients in colposcopy clinic (PREVENTION)
Main Course Topics :
  •         Pre- & post-operative care
  •          Patient communication
  •          Pap smear
  •          Cancer prevention
  •          Contraception
  •          Ectopic pregnancy
  •          Urinary Incontinence
Procedures:
·        Colposcopy and cervical biopsies
·        Foley catheter insertion
·        Hysteroscopy
·        Cystoscopy
·        Dilitation & Currettage
·        Tubal ligation
·        Placement of uterine instruments for laparoscopic surgeries
·        POP-Q exam
·        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)
Remediation Plan:
There is no remediation plan.

SAMPLE WEEK

Monday:
6:00AM 7:00AM Rounds
7:00AM 6:00PM OR
Tuesday:
6:00AM 7:00AM Rounds
7:00AM 6:00PM OR
Wednesday:
6:00AM 7:00AM Rounds
7:00AM 9:00AM Wednesday Department Conferences
9:00AM 6:00PM OR
Thursday:
6:00AM 7:00AM Rounds
7:00AM 6:00PM OR
Friday:
6:00AM 7:00AM Rounds
7:00AM 6:00PM OR
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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