2024-2025 M3/M4 Course Syllabi
Obstetrics & Gynecology
COURSE NUMBER:
11 01 16
TITLE:
REPROD ENDOCRIN & INFERT -ICE
This primarily outpatient elective provides a broad exposure to reproductive endocrinology and infertility. Students will participate in the evaluation and treatment of patients with infertility, menopausal disorders, hormonal abnormalities, reproductive tract anomalies, and disorders in sexual differentiation. They will participate in or observe various procedures and rotate through the embryology & andrology laboratory.
PREREQUISITES:
26931373 (INTERNAL MEDICINE CORE CLKSP), 26931373 (INTERNAL MEDICINE CORE CLKSP), 26946374 (OBSTETRICS/GYN CORE CLKSP), 26946374 (OBSTETRICS/GYN CORE CLKSP), 26980373 (SURGERY CORE CLKSP), 26980373 (SURGERY CORE CLKSP)
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
STATUS:
Full-Time   
OFFERED AS FULL-TIME AND PART-TIME: NO
ALLOWS OVERLAP: NO
COURSE LENGTH:
4 Weeks
DIRECTOR:
Joseph Karnitis
karnitvj@ucmail.uc.edu

ADMINISTRATIVE SUPPORT PERSON:
Natalie Cassady
cassadnc@ucmail.uc.edu
558-7653
MSB, 4461
SITE(S):
Christ Hosp Medical Assoc-M
West Chester Ctr Reprod Hlth
MAX ENROLL:
1 
ROTATIONS:
Rotation Dates Max
1 05/06/2024 - 05/31/2024 0
2 06/03/2024 - 06/28/2024 1
3 07/01/2024 - 07/26/2024 0
4 07/29/2024 - 08/23/2024 1
5 08/26/2024 - 09/20/2024 1
6 09/23/2024 - 10/18/2024 1
7 10/21/2024 - 11/15/2024 0
8 11/18/2024 - 12/13/2024 0
9 12/16/2024 - 01/10/2025 0
10 01/13/2025 - 02/07/2025 1
11 02/10/2025 - 03/07/2025 1
12 03/10/2025 - 04/04/2025 1
13 04/07/2025 - 05/02/2025 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:
7:45 a.m. - 5:00 p.m.; Monday - Friday, no call, no weekend
REPORT 1ST DAY:
Report to Mandy Winkler 475-7657 (amanda.pack@uc.edu) please cc Natalie (cassadnc@ucmail.uc.edu) on any emails.

INSTRUCTION

LEARNING ACTIVITIES:
  • Case-Based Instruction/Learning
  • Clinical Experience - Inpatient
  • Conference
  • Journal Club
  • Patient Presentation--Faculty
  • 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.
TEACHING:
50% Attending Physician
50% Fellow Physician
FEEDBACK:
ASSESSMENT:

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

OBJECTIVES

Curricular Resources :
1. Syllabus will be provided. (Located in a binder with all pertinent REI reading material - available at rotation site as well as digitally.)

2.Clinical Gynecologic Endocrinology and Infertility, Fritz, M. and Speroff, L., Lippencott, Williams & Wilkins, (2005.)

3. Practice Bulletins and Committee opinions from ASRM and ACOG


OR

Recommended Articles to Review for Resident and Medical Student Rotators on the REI Rotation

E-Learns/AirLearing Material from ASRM



INFERTILITY

  • ASRM PRACTICE COMMITTEE DOCUMENT:  Optimizing natural fertility:  a committee opinion
  • ASRM PRACTICE COMMITTEE DOCUMENT:  Diagnostic evaluation of the infertile female:  a committee opinion
  • ASRM PRACTICE COMMITTEE DOCUMENT:  Diagnostic evaluation of the infertile male:  a committee opinion
  • ASRM PRACTICE COMMITTEE DOCUMENT:  Smoking and Infertility
  • ASRM PRACTICE COMMITTEE DOCUMENT:  Obesity and Reproduction
  • ASRM PRACTICE COMMITTEE DOCUMENT:  Female age related fertility decline 
  • ASRM PRACTICE COMMITTEE DOCUMENT:  Effectiveness and treatment for unexplained infertility
PCOS

  • ASRM PRACTICE COMMITTEE DOCUMENT:  Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome (2018) members-only
  • ACOG PRACTICE BULLETIN: Polycystic ovarian syndrome
  • ACOG COMMITTEE OPINION: Aromatase inhibitors in GYN practice
  • ASRM PRACTICE COMMITTEE DOCUMENT: Role of metformin for ovulation induction in infertile patients with PCOS
ENDOMETRIOSIS

  • ASRM PRACTICE COMMITTEE DOCUMENT:  Treatment of pelvic pain associated with endometriosis:  a committee opinion
  • ASRM PRACTICE COMMITTEE DOCUMENT:  Endometriosis and infertility:  a committee opinion
RECURRENT PREGNANCY LOSS

  • ASRM PRACTICE COMMITTEE DOCUMENT:  Definitions of infertility and recurrent pregnancy loss
  • ASRM PRACTICE COMMITTEE DOCUMENT:  Evaluation and treatment of recurrent pregnancy loss:  a committee opinion
ABNORMAL UTERINE BLEEDING

  • ASRM PRACTICE COMMITTEE DOCUMENT:  Current evaluation of amenorrhea
  • ACOG PRACTICE BULLETIN:  Management of Abnormal Uterine Bleeding Associated with Ovulatory Dysfunction
THYROID DISEASE

  • ASRM PRACTICE COMMITTEE DOCUMENT:  Subclinical hypothyroidism in the infertile female population:  a guideline
PUBERTY

  • Palmert MR, Dunkel L. Delayed puberty. N Engl J Med. 2012; 366: 443-53.
  • Herbison, Allan E. "Control of puberty onset and fertility by gonadotropin-releasing hormone neurons." Nature Reviews Endocrinology 12.8 (2016): 452.
SURGERY

  • ASRM PRACTICE COMMITTEE DOCUMENT:  Uterine septum:  a guideline
  • ASRM PRACTICE COMMITTEE DOCUMENT:  Removal of myomas in asymptomatic patients
  • ASRM PRACTICE COMMITTEE DOCUMENT:  Role of tubal surgery in the era of ART
ONCOFERTILITY

  • ACOG COMMITTEE OPINION: Child and Adolescent Cancer Survivors
  • ASRM PRACTICE COMMITTEE DOCUMENT:  Fertility preservation in patients undergoing gonadotoxic therapy
IVF

  • ASRM PRACTICE COMMITTEE DOCUMENT:  Use of preimplantation genetic testing (PGT-A):  a committee opinion members-only
  • ASRM PRACTICE COMMITTEE DOCUMENT:  Prevention of treatment of moderate and severe ovarian hyperstimulation syndrome:  a guideline
  • ASRM PRACTICE COMMITTEE DOCUMENT:  Guidance on the limit to the number of embryos to transfer
  • Gonadotropin preparations (2008)
MENOPAUSE

  • Manson JE. Current recommendations:  What should clinicians do? Fertility and Sterility. 2014. 
Instructional Methods:
  • Clinical Experience
  • Presentations
  • QI ProjectsJournal Club
Knowledge/Skills:
1. Understand the evaluation and management of gynecological endocrine and infertility problems such as menopause, polycystic ovarian syndrome, female infertility, endometriosis, tubal obstruction, uterine anomalies, male factor, ovulation induction, in vitro fertilization, oncofertility, and third party reproduction.
2. Be familiar with and experience surgical and procedural treatments performed for patients faced with endocrine and fertility disorders.
3. Be familiar with use of consents in assisted reproduction procedures and how ethical issues are addressed, i.e., sperm donor, embryo donation, oocyte and embryo freezing.
4. Gain appreciation of the performance and interpretation of semen analysis and immunoassay for hormones.
5. Gain experience in preparation and presentation of topics for infertility and endocrine seminars.
6. Be facile in OhioLink search through Department of Obstetrics/Gynecology intranet work.
7. Learn to take a focused female infertility and endocrine histories.
Main Course Topics :
  • Clinical Experience
  • Presentations
  • QI ProjectsJournal Club
  • IVF (In Vitro Fertilization)
  • Infertility
  • Menstrual cycle
  • Reproduction
  • Assisted reproductive technology
  • Endometriosis
  • Operative laparoscopy, Hysteroscopy
  • Reproductive endocrinology
  • Polycystic Ovarian Diseases
  • Oncofertility/Fertility Preservation
  • Menopause
Procedures:
1. Participate in pelvic ultrasounds
2. Observe/Scrub in on all REI operative cases
3. Observe IVF procedures
4. Practice female physical exam when indicated
Remediation Plan:
 Self Directed Assignment.

SAMPLE WEEK

Monday:
8:00AM 12:00PM Ultrasounds/IVF at West Chester South, Suite 315
1:00PM 5:00PM New & Established Patients at West Chester South, Suite 315 (Depending on faculty schedule, may attend surgery)
Tuesday:
8:00AM 12:00PM Ultrasounds/IVF at West Chester South, Suite 315
1:00PM 5:00PM Surgery with Dr. Thomas or New & Established Patients at West Chester South, Suite 315
Wednesday:
7:00AM 9:00AM Grand Rounds - in person or via GoToMeeting with Fellows, WCS Conference Room
9:00AM 12:00PM Ultrasounds/IVF at West Chester South, Suite 315
12:00PM 1:00PM Infertility Conference - WCS, Large Conf
1:00PM 5:00PM New & Established Patients at West Chester South, Suite 315
Thursday:
8:00AM 12:00PM Ultrasounds/IVF at West Chester South, Suite 315
Friday:
8:00AM 12:00PM Ultrasounds/IVF at West Chester South, Suite 315
1:00PM 2:30PM Fellow Education Conference is in West Chester South, Suite 315
3:00PM 5:00PM Charts/ patient call backs- WCS
SCHEDULE NOTE:

Weekly schedule and location is subject to change.

Alternate Location

Christ Medical Office Building

2123 Auburn Avenue, Suite A43

Cincinnati, OH 45219

1.   The student will participate in pelvic ultrasounds on ovulation induction service at 8 am daily. (Wednesday start time 9 am.)

2.   The student will scrub in on REI operative cases and observe some IVF procedures.

3.   The student will spend 1 - 2 days becoming familiar with Andrology Lab.

4.   On any given day, depending on the patient case load, a student may go to Christ.

5.   On the last week of the rotation, during the Tuesday or Friday Education Meeting, the student is required to give a 45-minute presentation.

6.   The student is expected to attend all related conferences, Grand Rounds, etc.

**Please contact Mandy Winkler with any questions - 475-7657 -  amanda.pack@uc.edu


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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