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Department of Obstetrics, Gynecology and Reproductive Sciences Gynecologic Oncology Surgery Division of GYN Oncology

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

 

Introduction

 

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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Time Distribution

 

  • 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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Lectures

 

Friday Afternoon Lecture Series

  • All students meet on the 2nd, 3rd and 4th Friday 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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Clinical Rotation

 

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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Grading and Evaluation

 

60% 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.

 

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's textbook 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.


Performance should 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, 215-707-0697 (Ann Gallagher)
Abington: Dr. Stephen Smith, 215-572-6222 (Denise Dongworth)
Crozer-Chester: Dr. Anne Raunio, 610-872-8802 (Marie Klecko)

Geisinger:  Dr. Diane Zarconi, 570-214-81214 (Amanda Wingate)
St. Luke’s: Dr. James Anasti, 610-954-4670 (Connie Merrick)
West Penn: Dr. Ashi Daftary, 412-578-5432 (Lori Slade)

If your preceptor is not addressing perceived problems during your rotation, please contact Dr. Mabine at:

Telephone: 215-707--697
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

 

OB/GYN Clerkship Competencies (clerkship objectives)

 

The OB/GYN clinical clerkship competencies are based on the APGO Medical Student Educational Objectives and listed under the six categories of the ACGME core competencies.

 

During the clerkship, the student will be introduced not only to the general field of OB/GYN, but also to the subspecialties of gynecologic oncology, maternal fetal medicine, urogynecology, and reproductive endocrinology. Throughout the rotation, students will be exposed to a wide variety of clinical and surgical problems. Exposure to the clinical settings and independent reading, combined with didactic lectures will fully prepare students to meet and exceed required competencies.

 

The supervising attending and residents will evaluate the performance of each student throughout the rotation and through the online One 45 clinical evaluation form the final cumulative clinical performance will be determined.

 

Listed below are the competencies (clinical learning objectives) for the MS III OB/GYN rotation.

 

I. Knowledge Based Competencies


Each student should:

  1. Demonstrate a fund of knowledge of common obstetric, gynecologic and GYN oncology disorders (MK-3) (MK-4)
  2. Show basic knowledge of the female reproductive tracts anatomy and physiology (MK-01)
  3. Demonstrate the ability to do independent reading and research of scientific literature and complete a formal presentation to the supervising attending and residents (MK-11) (MK-15)
  4. Knowledge of the basic principles and ethics of clinical and translational research, and how such research is conducted, evaluated and applied to the care of the patient.(MK-16)


II. Patient Care Competencies


Each student should:

 

  1. Obtain a full and comprehensive OB/GYN focused history and physical examination (PC-3) (PC-5)
  2. Be actively involved in the team approach to make accurate assessments and implement appropriate treatment plans (PC-1) (PC-8) (PC-9)
  3. Communicate effectively with patients, patients’ families, residents and attending concerning patient care (PC-2) (PC-4) (PC-3)
  4. Demonstrate the ability to perform routine OB/GYN procedures (ie: speculum insertion, PAP smears, pelvic exam, vaginal deliveries….) and interpret commonly ordered laboratory tests (PC-6) (PC-7)
  5. Have a basic knowledge of pain control in OB/GYN patient care (PC-10)
  6. Incorporate the findings of clinical and translational research into clinical decision-making, and explain how the findings apply to patient care (PC-11)


III. Interpersonal and Communication Skills


Each student should:

 

  1. Demonstrate the ability to effectively communicate with patients to elicit vital information for an accurate history, then record the information in the chart and present it to the supervising resident/attending (ICS-1) (ICS-2) (ICS-3)
  2. Work effectively with his/her team and any consults involved in the care of the patient (ICS-4) (P-3) (SBP-2)
  3. Demonstrate the ability to provide clear and well organized case presentations (ICS-5)
  4. Show the ability to observe confidentiality and to be nonjudgemental in patient encounters (ICS-6) (P-7)


IV. Professionalism


Each student should:

 

  1. Treat all patients with respect, compassion and a sensitivity to cultural differences and independent patient issues (P-5) (P-8) (P-9)
  2. Demonstrate the desire to enhance their medical education through independent reading and professional development (P-4) (P-1) (PBL-1) (PBL-2)
  3. Work within the confines of their abilities and to recognize limitations (P-2)


V. Practice-Based Learning

 

Each student should:

 

  1. Utilize a variety of information sources, including journals, textbooks, simulation and web based information to enhance their ability to improve patient care (PBL 1-5)
  2. Work effectively in groups to increase the knowledge base of other students in the rotation, and to use this information to better inform patients and their families (PBL-6)


VI. Systems-Based Practice

 

Each student should:

 

  1. Be able to utilize consults, social services and other ancillary services to provide optimal care for patients and effective and cost conscious utilization of services (SBP-1)

 

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Clinical Skills

 

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), 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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