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Women's Health

Objectives Readings/Assignments Policies Clerkship Sites
Evaluations/Assessments Topics Lecture Material

Women's Health - Handbook (PDF)

Women’s Health Clerkship Orientation

 

Objectives:

Women’s Health Clerkship: Educational Objective


Knowledge and Lifelong Learning

At the conclusion of the Women’s Health Clerkship the students will:

  1. Demonstrate knowledge in the basic and clinical sciences appropriate for the level of training and be able to integrate this knowledge to patient care situations.

    1. Demonstrate knowledge of normal pelvic anatomy and the physiologic changes of pregnancy.

    2. Identify the processes of normal labor and delivery

    3. Participate as a principal and assistant in normal labor and delivery

      1. The student will act as the principal obstetrician for a laboring patient with supervision.

      2. The student will write a full admission H&P and progress notes on a laboring patient.

    4. Recognize antepartum, intrapartum, and postpartum complications.

      1. Participate in both postpartum and antepartum rounds.

      2. Attend all outpatient obstetrical patient clinics.

      3. Assist residents in triage and admission decisions.

    5. Obtain a complete history from an obstetrical and gynecological patient.

      1. Interview a patient in a variety of settings such as the OB/GYN clinic and Labor & Delivery

      2. Receive feedback on the physical examinations (see section objective 6).

    6. Recognize and manage common problems in ambulatory obstetrics and gynecology including breast care, contraception, and preventive health care for women.

      1. The student will learn to manage common medical complication in pregnancy such as hypertension, asthma, diabetes mellitus, and seizures.

      2. Perform a complete breast examination

      3. Specify appropriate preventive health care measures for different populations of women, e.g. mammogram, PAP smears and DEXA scans

      4. Student should be familiar with various forms of contraception including emergency contraception.

    7. Perform pelvic examinations on healthy and ill obstetric/gynecologic patients

      1. Have a basic understanding of the pelvic examination.

      2. Perform several PAP smears

      3. Participate in colposcopy clinic

      4. Make a wet prep of a patient with a vaginal discharge

      5. Microscopically recognize various forms of vaginitis.

    8. Recognize the clinical features of common gynecologic disorders and their prevention. These include: pelvic inflammatory disease, endometriosis, hydatidiform moles, uterine fibroids, chronic pelvic pain, breast disorders.

      1. Each student should be able to develop a differential diagnosis for these disorders

      2. Each student should be able to suggest the primary form of therapy for these disorders.

    9. Recognize the clinical features of gynecologic neoplasms including ovarian, endometrial, cervical and vulvar. Be able to discuss treatment modalities.

    10. Have a basic understanding of Reproductive Endocrinology and Infertility

      1. Be able to diagnose disorders of androgen excess including polycystic ovarian syndrome, congenial adrenal hyperplasia.

      2. Be able to discuss infertility, diagnostic evaluation and possible treatment options.

      3. Be able to diagnose menopause and discuss treatment modalities.

      4. Understand disorders of menstruation including amenorrhea, abnormal uterine bleeding and precocious puberty.

  2. Demonstrate knowledge of the ethical, social, economic and cultural influences upon the health and health care delivery of patients.

    1. Participate in resident continuity clinics and follow patients throughout their pregnancy.

    2. Demonstrate an understanding of the coding procedure.

    3. Attend to hospitalized patients with the attending and/or resident.

    4. Serve as an advocate for patients for quality patient care and assist patients in dealing with the system complexities when appropriate.

  3. Be able to identify socio-cultural, familial, psychological, economic, environmental, legal, political, and spiritual factors affecting health care, and demonstrate ability to respond to these factors.

    1. Demonstrate the ability to interact effectively and compassionately with patient of all cultures and economic classes.

    2. Demonstrate an understanding legal climate affecting the practice of obstetrics and gynecology in the United States by proper documentation.

    3. Demonstrate and understanding of the impact of escalating health care costs and suggest appropriate testing and procedures.

    4. Understand the political climate of reproductive rights and non-directive counseling.

Interpersonal and Communications

At the conclusion of the Women’s Health Clerkship the students will:

  1. Demonstrate the ability to establish professional relationships with patients, build a comprehensive medical, social and personal history, conduct either a focused or comprehensive physical examination as indicated, develop a suitable diagnosis and management plan for common obstetrical and gynecologic problems affecting patients.

    1. Demonstrate the ability to see patients independently and to elicit an accurate history.

    2. Demonstrate the ability to elicit key physical findings on a physical examination.

    3. Develop the ability to work with the health care team to develop a differential diagnosis and a suitable management plans for both obstetrical and gynecologic patients.

  2. Demonstrate clear, professional, and effective communication skills with patients and family member, as well as health care team members.

    1. Demonstrate the ability to write clear and concise histories and physicals in a timely manner.

    2. Be able to present the patient in an accurate and logical manner

    3. Give two comprehensive presentations to a faculty member on patients seen in the rotation.

    4. Demonstrate the ability to give “bad news” to patients and families.

    5. Demonstrate the ability to give short concise presentations on areas of interests in obstetrics and gynecology during morning report

  3. Demonstrate the capacity to both give and receive constructive feedback.

    1. Participate in the mid-term evaluation process

    2. Participate in the evaluation of the residents and faculty in a responsible manner

    3. Respond appropriately to feedback given by the residents and faculty throughout the rotation.

    4. Receive appropriate feedback following observations of clinic histories and physicals by staff and residents.

Professionalism, Advocacy, and Personal Growth

At the conclusion of the Women’s Health Clerkship the students will:

  1. Identify personal strengths and weaknesses in both patient care and within the healthcare team as well as make changes to facilitate collaborative relationships.

    1. Recognize the limits of both knowledge and surgical skills.

    2. Be willing to obtain help from others when limits of skills are reached.

    3. Respond appropriately to feedback.

  2. Demonstrate responsible behaviors consistent with the highest ethical standards of Women’s Health.

    1. Be punctual and attend all required conference, clinics, surgeries, etc.

    2. Write complete and accurate notes in a timely fashion.

    3. Document and present medical data accurately and truthfully

    4. Be courteous to patients, families, and other healthcare professionals

    5. Demonstrate respect for the confidentiality of information

    6. Avoid imposing personal values: use non-directive questions

    7. Demonstrate respect for patients with lifestyles different from your own.

  3. Demonstrate a commitment to leadership and the advancement of new knowledge in the field of Women’s Health.

    1. Demonstrate the ability to review the literature and present findings in a clear concise manner.

    2. Demonstrate the ability to synthesize information from various sources.

 

Readings/Assignments:

Readings

 

ASSIGNED TEXTBOOK: OBSTETRICS AND GYNECOLOGY
Charles R.B. Beckmann
6th Edition

 

ADDITIONAL READING (GYN)
Comprehensive Gynecology
Herbst et al.

 

TeLinde Operative Gynecology
Rock and Thompson

 

Required for 3rd year medical students;
THE FEMALE PELVIC EXAM
1st edition

 

Gary Ventolini, MD
Sheela Barhan, MD
Mark Bidwell, MD
Janice Duke, MD
Michael Galloway, DO


This book is in the Book store at Wright State University.

During the Ob/Gyn Clerkship there will be four quizzes posted in your schedule to compliment the lecture schedule. The questions on each quiz will encompass the material covered in the didactic lectures and the corresponding chapter in the assigned textbook, if there is one. Therefore, at times the quizzes will include two weeks’ worth of lectures and at other times, just one week.

To excel on the quizzes it is recommended that you read the chapter that covers the corresponding lecture topic in the assigned textbook prior to the lecture. By doing this you will absorb more from the lecture and you will not need to catch up on all of this reading the night before the quiz.

 

ATTENDANCE AT LECTURES AND GRAND ROUNDS IS MANDATORY!


 

Policies:

Policies

POLICY REGARDING ABSENCES FROM CLERKSHIP ACTIVITIES AND DUTIE

Rationale:

The purpose of the clerkship year is provide both education and supervised experiences in a variety of medical specialties. For this to occur, it is imperative that a student attend all scheduled activities during the period of each clerkship. Student absences do not allow the clerkships to meet their obligations to their students individually or as a group. Medical students are professionals in training and are expected to conduct themselves in a professional manner at all times.

Policy:

Student absences from a scheduled clerkship activity due to personal illness or a personal family crisis will be handled on an individual basis by the clerkship director or his/her designee. Once the illness or crisis occurs, the student is responsible for notifying her/his preceptor and the specific clerkship office immediately. If the absence exceeds two days, the student will be required to (a) submit a statement from his/her personal physician and (b) speak directly to the clerkship director (or designee) to arrange to make up the lost time.

Student absences for any other reason (e.g. a conference, or to attend a family function) will be considered unexcused unless written approval is received from the clerkship director at least 30 days prior to the event causing the absence. In any case, the student will be required to make up all time lost. An unexcused absence will be reflected unfavorably on the student’s written record and may adversely affect the grade received for the clerkship. Until the time missed is made up, the student’s grade will be recorded as an incomplete.

Student should follow the holiday schedule of the hospital, clinic, or practitioner’s office to which he/she is assigned unless specifically instructed otherwise by the clerkship director.

This policy will become effective during the 1995-96 academic year, will be provided to all clerkship students, and will be published in the Student Handbook.

NOTE: Statements underlined were added at the April 11, 1995, Biennium II Curriculum Subcommittee Meeting.

 

COMPILATION OF FINAL GRADE

The evaluation process disperses grading into as many elements o the clerkship as possible to alleviate the impact of any one grade. We keep a file on each student in the department that can be reviewed by the student at anytime during or after their clerkship rotation.

Clinical Evaluation: 40%
NBME Shelf Examination: 30%
Quizzes (4): 2.5% each 10%
Oral Presentations (2): 4.5% each 9%
Five Minute Talk: 6%
Clinical Work Cards: 5%

GRADING POLICY:

Grades are reported as Pass/Fail and a numerical grade. A grade of 70% and above (Pass) and a grade that is lower than 70% (Fail).

NBME: The NBME Shelf Exam is considered the final exam for the Obstetrics and Gynecology Clerkship. A score of less than 56% constitute a course failure, regardless of the composite grade described above. If student does not pass the NBME Shelf Exam, he/she will be allowed to retake the exam one additional time only. If exam is not passed the second time, the student will have to repeat the entire clerkship. If exam is passed the second time, no matter how high the score, the student will receive a 56 as their NBME score. That score will be averaged in with the other clerkship scores for a final clerkship grade.

COMPOSITE SCORE:

Seventy percent is a passing grade for the Obstetrics and Gynecology Clerkship. Less than 70% represents course failure and the entire clerkship will have to be repeated.

 

DRESS CODE POLICY

RESIDENTS AND STUDENTS

It is hoped that students and residents alike realize that how they look does not correlate wit how good a physician they are. However, it can certainly influence how a patient reacts to the physician and how willingly he/she accepts subsequent diagnosis and recommendations for treatment. With this in mind, the following guidelines for dress in the Wright State University Boonshoft School of Medicine affiliated programs are suggested.Dress in a socially acceptable manner. This should include neat clean clothes and clean hair. A clean white coat is expected. Attempt to limit the use of scrub suits to those times that seem appropriate. This is to mean when participating in surgery or between surgical cases, while on duty for Labor and Delivery or when taking night call. If scrub suits become soiled in surgery, they should be changed immediately. Otherwise, street clothes are encouraged particularly when meeting patients or family for the first time, in clinic or when “working-up” elective admissions.

 

EVALUATION POLICY

The clinical evaluation of medical students is something that the residents and faculty take quite seriously and for years have given insightful evaluations. This important evaluation comprises 40% of their grade.

  1. Students on OB at Miami Valley Hospital will be evaluated by Dr. Janice Duke and the fourth year resident on that service.
     
    Students on GYN at Miami Valley Hospital will be evaluated by Dr. Sheela Barhan and the fourth year resident on that service.
     
    Students on ONC at Miami Valley Hospital will be evaluated by Dr. Thomas Reid and the fourth year resident on that service.

  2. Student/s on OB at Good Samaritan Hospital will be evaluated by Dr. William Rush.

  3. Students on OB at WPAFB will be evaluated by Dr. Ajit Gubbi and the third year resident on that service.
     
    Students on GYN at WPAFB will be evaluated by Dr. Samantha Wiegand and the third year resident on that service.

The evaluation forms with student pictures will be disseminated to the appropriate physician at the beginning of that sub-rotation through RMS so that the physician will be reminded of the student/s that they will be evaluating.

The chief resident needs to pick a time at the end of the sub-rotation to meet with the entire resident team. All of the students’ performances on the sub-rotation need to be discussed and agreed upon. The chief resident fills out the evaluation form. On the service where evaluations are filled out by the third year resident the same steps should be followed in order to fill out an accurate evaluation on each student.

The students may choose to give not more than two blank evaluations to a resident or attending that they felt they worked a great deal with and who did not have the prior privilege of evaluating them on their sub-rotation. We will add these evaluations in their final clinical summary.


 

Clerkship Sites:

Clerkship Sites

SITE INFORMATION:

 


Miami Valley Hospital (MVH)
(937) 208-2850
Gary Ventolini, M.D., Chair
Mark Campbell, M.D., Program Director
Lawrence S. Amesse, M.D., Clerkship Director
Jackie A. Shells, BS, Clerkship Coordinator
(937) 208-2302

Wright-Patterson Air Force Base (WPAFB)
(937) 257-1941
Ajit Gubbi, M.D.

Good Samaritan Hospital (GSH)
(937) 274-5420
William Rush, M.D.

 

Students assigned to WPAFB or GSH will do one month at those hospitals and one month at MVH. There will be some students that will do their entire clerkship rotation at MVH.

Parking:
Parking badges are provided by the Clerkship Coordinator during orientation. MVH Security is provided with a list of names and dates of students. Students are to park in Parking Garages #4.

Meals:
Free Meals with a $5 limit (one per day) for medical students assigned to MVH for their Ob/Gyn clerkship rotation. Meal cards will be issued to students by MVH Medical Education Department, on the 7th floor of the main hospital during the hours of 7:30 AM – 4:00 PM. Meal passes cannot be used in Magnolia Place.


 

Evaluations/Assessments:


 

Topics:

PROCEDURES IN OB & GYN FOR 5 MINUTE STUDENT TALK

  1. Vacuum Assisted Delivery

  2. Forceps Delivery

  3. Low Segment Cesarean Section

  4. Amniocentesis

  5. Colposcopy

  6. Myomectomy

  7. Dilatation and Curettage/Evacuation

  8. Tubal Ligation

  9. Total Vaginal Hysterectomy and Bilateral Salpingo-oophorectomy

  10. Total Abdominal Hysterectomy & Bilateral Salpingo-oophorectomy

  11. Diagnostic and Operative Laparoscopy

  12. Diagnostic and Operative Hysteroscopy

  13. Cervical Cerclage

  14. Targeted Ultrasound

  15. Quad Screen (Estriol, AFP, HCG)

  16. Cordocentesis

  17. Amnioinfusion

  18. Fetal Echocardiography

  19. Chorionic Villus Sampling


 

Lecture Material:


Lecture Material

  1. The Female Breast and Pelvic Examination (PDF)

Ob/Gyn Medical Student Lectures

  1. Antepartum and Pre-natal Care - PPT

  2. Maternal-Fetal Physiology - PDF

  3. Prenatal Diagnosis - PDF

  4. Diabetes in Pregnancy - PPT

  5. Preterm Labor - PDF

  6. Preterm Rupture of Membranes - PPT | PDF

  7. Obstetric and Postpartum Hemorrhage - PDF

  8. Normal Labor and Delivery - PPT | PDF

  9. IUGR - PPT | PDF

  10. Intrapartum Fetal Monitoring - PDF

  11. Pelvic Organ Prolapse and Urinary Incontinence - PDF

  12. Osteoporosis - PPT | PDF

  13. Hirsutism and Virilization -

  14. Dysfunctional & Abnormal Uterine Bleeding - PPT

  15. Contraception/Sterilization - PDF

  1. Dysmenorrhea and Pelvic Pain - PPT

  2. Vulvar Disease and Neoplasia - PDF

  3. Endometriosis - PPT

  4. Abortion - PDF

  5. Infertility from A-Z - PDF

  6. Ovarian and Adnexal Disease

  7. Medical Ethics - PDF

  8. Domestic Violence - PDF

  9. Menopause - PDF

  10. Ectopic Pregnancy - PDF

  11. Postpartum Psychiatric Disorders - PPT

  12. PIH/Preeclampsia - PPT

  13. Gestational Trophoblastic Disease - PDF

  14. Disorders of the Breast - PPT | PDF

  15. Shoulder Dystocia - PDF