Learning Outcomes

Obstetrics and Gynecology M2 Clerkship Intended Learning Outcomes 

 Instructions:
1.  You should plan to complete all of the ILOs. Even if you do not participate in every subspecialties listed, you are still responsible for completing the associated ILOs.
2.  If you do not encounter a patient, participate in a didactic session or a simulation corresponding to a particular ILO, please go to APGO.org, click on “Objectives.” read the associated outline/sample case and answer the questions.
4.  This is not a substitute for completing your Required Clinical Experiences (RCEs). You must also complete your RCEs as you go.
 
 Gynecology (Outpatient Clinic)

1.  Develop competence in the medical interview and physical examination of women and will incorporate ethical, social and diversity perspectives to provide culturally competent health care.

□  Perform pelvic exam (including speculum and bimanual examination)
□  Perform clinical breast exam
□  Conduct, record and present GYN patient H & P

2.  Apply recommended prevention strategies to women throughout the lifespan.

□  Annual well-woman exam

3.  Recognize your role as a leader and advocate for women. (one of following)

□  Domestic violence screening, teen pregnancy

4.  Describe menstrual cycle physiology, discuss puberty and menopause, and explain normal and abnormal bleeding.

□  Menopause/perimenopause
□  Abnormal uterine bleeding

5.  Develop a thorough understanding of contraception, including abortion and sterilization.

□  Contraceptive counseling

6.  Provide a preliminary assessment of patients with sexual concerns.

□  Take a sexual history

7.  Demonstrate knowledge of common benign gynecological conditions.

□  Vulvar/vaginal benign disease
□  Fibroids
□  Endometriosis

8.  Formulate a differential diagnosis of the acute abdomen and chronic pelvic pain.

□  Pelvic pain
□  Ectopic pregnancy

9.  Describe the etiology and evaluation of infertility
10.  Describe common breast conditions and outline the evaluation of breast complaints.

□  Perform clinical breast examination
□  Breast mass
□  Nipple discharge
□  Mastitis

11.   Pelvic Organ Prolapse-

□  Discuss the levels of pelvic organ support
□  Identify symptoms
□  Identify risk factors
□  Identify surgical and non-surgical treatment options for prolapse

12.  Lower Urinary Tract Symptoms

□  Take a history regarding voiding and storage disorders to identify symptoms of irritation, obstruction, and incontinence
□  Define types of urinary incontinence: stress, urge, mixed, overflow, functional, continuous
□  Explain primary evaluation for urinary incontinence: urinalysis, post void residual, voiding diary, stress test
□  Identify treatments for Incontinence: physical therapy, behavioral, medications, pessary, surgery
□  UTI management- antibiotic choice, prophylaxis

13.   Describe gynecologic malignancies including risk factors, signs and symptoms and initial evaluation.

□  Abnormal Pap smear
□  Postmenopausal bleeding
□  Adnexal mass/cyst
 

Gynecology Surgery

1.  Gynecology Perioperative Care-

□  Perform pelvic exam and digital rectal exam. (may be under anesthesia)
□  Insert Foley catheter
□  Demonstrate ability to write the following notes-
     
 i.      GYN preoperative note, including appropriate studies and prophylaxis   
 ii.     GYN operative note
     
 iii.    GYN postoperative note   
iv.    GYN postoperative progress note

2.  Demonstrate familiarity with gynecologic procedures.

□  Observe hysterectomy
□  Observe laparoscopy
□  Observe other gynecology procedure (enter below)
     
 i.      ____________________
   
 ii.     ____________________
   
 iii.    ____________________
     
iv.    ____________________
     
v.     ____________________

Obstetrics

1.  Demonstrate knowledge of preconception care including the impact of genetics, medical conditions and environmental factors on maternal health and fetal development.

□  Preconception care
□  1st trimester care
□  Prenatal diagnosis

2.  Explain the normal physiologic changes of pregnancy including interpretation of common diagnostic studies.

□  New OB prenatal visit
□  Routine prenatal care follow-up visit
□  Conduct, record and present OB patient history

3.  Describe common problems in obstetrics.

□  Diabetes in pregnancy
□  Preeclampsia/eclampsia
□  3rd trimester bleeding
□  Peripartum infection
□  1st trimester bleeding

4.  Demonstrate knowledge of intrapartum care.

□  Present patient for labor admission
□  Clinical course of labor
□  Premature rupture of membranes (PROM)
□  Preterm labor (PTL)
□  Normal Spontaneous Vaginal Birth (NSVD), participate/observe
□  Observe perineal laceration repair
□  Write delivery note

5.  Demonstrate knowledge of postpartum care of the mother and newborn.

□  Postpartum discharge instructions
□  Current breastfeeding recommendations regarding indications/contraindications
□  Postpartum hemorrhage
□  Write postpartum note
□  Present postpartum patient