department of obstetrics, gynecology and reproductive sciences
MD Program
Junior Level OB/GYN Clerkship
Introduction
Time Distribution
Lectures
Clinical Rotation
Grading and Evaluation
Preceptor Contact Numbers
Goals of the OB/GYN Clerkship
Recommended Textbooks and References
All third year medical students are required to do a six-week clerkship in Obstetrics and Gynecology. This can be done at Temple University Hospital, West Penn Hospital, Abington Memorial Hospital, Crozer-Chester Medical Center, Geisinger Medical Center, or St. Luke’s Hospital. Electives in outpatient or inpatient OB/GYN are available to fourth-year medical students. The third year clerkship in OB/GYN is essentially clinically-oriented with a solid background of didactic material for the student to integrate and correlate. During the six-week block, the student will spend at least two weeks on the obstetrical service, two weeks on the general gynecological service, and two weeks on the gynecologic oncology service or outpatient general OB/GYN service or an additional two weeks on the obstetrical and/or gynecology services. Lectures are given the 2nd, 3rd and 4th Friday of the block from 12:00 noon to 4:00 pm. All students (except those at West Penn and Geisinger) attend these lectures. Additional lectures, group discussions and Grand Rounds during the week round out the student’s OB/GYN experience.
During this brief clerkship, the student is introduced not only to the general field of OB/GYN, but also to the subspecialities of gynecological oncology, maternal fetal medicine, urogynecology, and reproductive endocrinology. The student is expected to do supplemental reading in preparation for the lectures as well as for the clinical situations encountered during the inpatient and outpatient experiences.
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- Most sites divide the rotation into three weeks of OB and three weeks of GYN.
- Students may do two weeks OB, two weeks GYN, 2 weeks Ambulatory, or 2 weeks GYN oncology.
- The specific schedules are distributed at the sites.
- Students are expected to work through 12 noon on the last Thursday of the rotation.
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Friday Afternoon Lecture Series
- All students meet on Fridays at Temple from 12 noon to 4 pm for a series of core lectures presented by Temple faculty.
- Attendance is MANDATORY.
- These lectures will provide uniformity in the content of material taught during the rotation. All sites also have their own lecture series presented by their own faculty and resident physicians. Students may find that certain topics are covered at both sites. Although we attempt to avoid this, it is not always possible.
All of the sites require a Topic Presentation by students.
On Wednesday mornings students are invited to attend Temple OB/GYN Grand Rounds, GYN Tumor Board and the OB/GYN attending Wednesday's noon session.
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Night call is generally every 5th night with at least one Saturday and one Sunday 24-hour call. This equals 7 to 8 calls per rotation. Students work this out at the site orientation. Generally, during the OB portion of a rotation the student will cover OB during night call, and vice versa when on the GYN arm of the rotation. The site hospital will provide meals for those days when students are on call. No one is expected to take call on the last Wednesday or Thursday night of the block. The day after being on-call, students can go home after all scheduled didactic activities.
Students should read while in the OR and not scrubbed in, particularly about the patient and relevant details regarding the patient’s diagnosis and/or procedure. Attending physicians are aware and approve. If approved by the attending, student can go to the clinic or to a quiet place for reading.
One beeper for each service will be provided at the Temple site. Students are responsible for them and they must be returned to the Department Education Coordinator, Ann Gallagher, before leaving the hospital on the last Thursday of the rotation. If the beeper is lost, all students on the last rotation will not be allowed to take the final exam unless $80.00 is paid to the Department. Batteries for the beepers are available from the Education Coordinator.
The hospital site will also provide scrub suits. However, it is advisable to own a couple of sets of scrubs. Hospital scrubs are not always available.
Parking is provided by most of the sites. Temple does not provide free parking.
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50% Clinical
- All sites use the same evaluation form (copy)
- Both resident and faculty input
- Topic presentation is a clinical element
10% for completed procedure log submission. The data recorded needs to be accurate as spot checks will be conducted ad hoc.
30% Final Exam
- Written board shelf examination (100 questions)
- Given on the last Friday of the rotation
- Questions are based upon the APGO objectives which are included in the information packet
- Beckman lists the pertinent objectives at the beginning of each chapter
- The board questions are mostly in the form of case presentations. Beckman also has many case vignettes and board-type questions to help with studying.
10% Mid-Rotation Examination
- Given during the 4th Friday lecture period
- 50 to 60 questions, single best multiple choice type
Mid-rotation evaluations are not done routinely at all of the sites. Hopefully, in the future this will change. For now, however, it is suggested that performance be discussed midway through the rotation with both the chief resident and preceptor. Any questions or problems should be discussed with the preceptor.
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| Preceptor Contact Numbers |
Temple: Dr. Bruce Mabine, 215-707-3187 (Ann Gallagher)
Abington: Dr. Stephen Smith, 215-572-6222 (Denise Dongworth)
Crozer-Chester: Dr. Anne Raunio, 610-872-8802 (Marie Klecko)
Geisinger: Dr. Mitesh Parekh, 570-271-6364 (Kelly Beers, 570-214-5235)
St. Luke’s: Dr. James Anasti, 610-954-4670 (Connie Merrick)
West Penn: Dr. Suzanne Kavic, 412-578-5432 (Lori Slade)
If your preceptor is not addressing perceived problems during your rotation, please contact Dr. Mabine at:
Telephone: 215-707-3187
E-mail: gallagaf@tuhs.temple.edu
Your preceptors are very accessible and you are encouraged to contact them if you encounter any major problems during your rotation. You are expected to work everyday. If ill or otherwise unable to attend work, please contact your preceptor and your chief resident.
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| Goals of the Temple University School of Medicine OB/GYN Clerkship |
- Practice and perfect your interviewing and physical examination skills with special attention to the OB/GYN aspects of these skills.
- Continue to develop your interpersonal skills with colleagues, nursing staff, ancillary staff and patients.
- Learn the basics of OB/GYN/Reproductive Medicine
A. Obstetrics
1. Be able to diagnose and date a pregnancy
2. Be able to recognize abnormal pregnancy:
a. abortion
b. ectopic pregnancy
c. molar pregnancy
3. Be able to provide basic antenatal care
4. Be able to provide basic antenatal testing
5. Be able to diagnose ruptured membranes
6. Be able to manage normal labor
7. Be able to perform a normal vaginal delivery
8. Be able to manage the third stage of labor
9. Be able to manage the puerperium
10. Be able to recognize abnormal labor
11. Be able to describe the indications and technique of forceps delivery and vacuum extraction
12. Be able to describe the technique of cesarean section operation and indications for its performance
13. Be familiar with common medical complications of pregnancy, especially:
a. Diabetes
b. Chronic Hypertension
c. Pregnancy-Induced Hypertension
(Preeclampsia)
d. Pyelonephritis / UTI
e. HIV Infection
f. Hyperemesis Gravidarum
g. Thyroid disease
14. Be able to recognize and evaluate abnormal bleeding in pregnancy
B. Gynecology
1. Be able to perform bimanual and speculum examinations
2. Be able to obtain accurate cervical cytology and cultures
3. Be able to diagnose and treat common STD’s/PID
4. Be able to diagnose and treat common forms of vaginitis
5. Be able to provide basic contraceptive counseling
6. Be able to diagnose and treat menopause
7. Be able to diagnose and treat abnormal uterine bleeding
8. Be able to diagnose and manage uterine fibroids
9. Be able to diagnose, evaluate and manage adnexal mass
10. Be able to perform a clinical breast examination
11. Be able to teach self breast examination
12. Be able to manage benign breast disease/breast mass
13. Be able to perform basic infertility evaluation
14. Be able to manage abnormal cervical cytology
C. Gynecologic Oncology
1. Be able to diagnose, describe the staging of, and manage the major gynecologic malignancies:
a. Uterine cervix
b. Uterine corpus
c. Ovary
d. Vulva
e. Vagina
f. Gestational trophoblastic neoplasia
2. Be able to diagnose and describe the management of breast cancer
D. Common Gynecologic Operations and Procedures
1. Be able to describe the "D & C"
2. Be able to describe laparoscopy and its indications
3. Be able to describe Loop Electrosurgical Excision Procedure, Cold Knife Conization, Laser Vaporization and Cryotherapy of the cervix
4. Be able to describe "Incision and Drainage" of abscess
5. Be able to describe the types of laparotomy and the basics of wound healing and closure
6. Be able to evaluate, diagnose and manage common post- operative complications
E. Preventive Medicine and Primary Care
1. Be able to perform cancer screening:
a. Breast
b. Colon
c. Lung
d. Cervix
2. Screen for and treat hyperlipidemias
3. Screen for and treat tuberculosis
4. Screen for and treat HIV infection
5. Be able to provide appropriate adult immunizations
6. Be able to evaluate a palpable thyroid nodule
7. Be able to diagnose and manage thyroid disease
8. Be able to diagnose and manage chronic hypertension
9. Be able to diagnose and manage adult onset diabetes
10. Be able to diagnose and manage UTI and pyelonephritis
11. Be able to diagnose and manage URI and sinusitis
12. Be able to evaluate and manage common migraines
13. Be able to diagnose and treat osteoporosis
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Prior to graduation, students are expected to acquire the following skills:
Ability to:
1. Perform a complete history and physical examination of the female (both pregnant and nonpregnant) and generate a problem list and a differential diagnosis.
2. Synthesize the data obtained from the history and physical to arrive at a diagnosis and management plan for patients presenting in the typical manner with the following obstetrical/gynecologic conditions: menstrual irregularity, menopause, osteoporosis, vaginitis, common sexually transmitted diseases, pelvic or abdominal pain, pelvic mass, common GYN malignancies (cervix, endometrial, ovarian, breast), normal pregnancy, abnormal pregnancy including ectopic pregnancy and abortion, bleeding in pregnancy, preeclampsia, and diabetes in pregnancy.
3. Communicate about a new patient in both an oral presentation and a written note that presents subjective and objective data in a succinct and organized manner and is followed by a realistic assessment and plan.
4. Perform an uncomplicated vaginal delivery.
5. Perform the pap smear and interpret the resulting report.
6. Describe the components of basic prenatal care.
7. Describe the physiologic changes associated with pregnancy.
8. Prescribe various forms of contraception.
9. Practice evidence based medicine, utilizing biomedical information from electronic databases and other resources.
10. Evaluate a female patient for domestic violence.
Exposure to:
1. Operative gynecology, including abdominal and vaginal hysterectomy, D&C, hysteroscopy, laparoscopy, LEEP.
2. Commonly used diagnostic and therapeutic modalities, including ultrasound, colposcopy, cystoscopy, and endometrial biopsy.
3. Common postoperative and intra operative complications.
4. Common antepartum and intrapartum complications.
5. Common postpartum problems.
6. Operative obstetrics, including forceps delivery, cesarean section, cervical cerclage, and post partum tubal ligation.
Introduction to the subspecialty areas of obstetrics and gynecology including perinatology, reproductive endocrinology and infertility, gynecologic oncology and urogynecology and pelvic reconstructive surgery.
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| Recommended Textbooks and References |
1. Obstetrics and Gynecology for Medical Students (2002), Charles R.B. Beckman et al.
2. Essentials in Obstetrics and Gynecology (1998), Hacker and Moore.
3. Medicine of the Fetus and Mother , 3rd Edition (2006), E. Albert Reece et al.
4. Compendium of Selected Publications. The American College of Obstetricians and Gynecologists. Yearly Publication.
5. Comprehensive Gynecology, 4th Edition (2001), Stenchever et al.
6. Obstetrics, Normal and Problem Pregnancies, 4th Edition (2002), Gabbe et al.
7. Williams Obstetrics, 21st Edition (2001), Cunningham et al.
8. Clinical Gynecologic Endocrinology and Infertility, 6th Edition (1999), Speroff et al.
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