Guidelines

1. Length: minimum six weeks.
2. Site: Labor and delivery suite, operating room, outpatient facilities, the emergency room, gynecology inpatient wards and the ante-partum, post-partum and post-operative wards.
3. At the start of the clerkship, an orientation is given. This includes a discussion of the expectations and responsibilities of the students and their schedules and assignments to residency teams and preceptors. The SGU clerkship director for obstetrics and gynecology and the student coordinator participate in this orientation.
4. Students take night call no more than every third night and weekend or one week night float schedule, not to exceed residents’ hours on call.
5. Students participate in attending rounds for house staff and students at least once a week and work rounds with house staff at least twice a week.
6. A schedule of teaching conferences including staff conferences, residents’ conferences, grand rounds, subspecialty conferences and didactic sessions pertinent to the needs of the students is presented at the orientation.
7. Each student is required to complete a minimum of two clinical write-ups, including one obstetrical and one gynecological case. Each write-up must include the admission history and physical examination, impression, assessment and diagnostic/therapeutic plan. The history must include any cultural issues that may affect the patient’s treatment and compliance. Students must include a discussion of the patient’s social supports and any recognizable limits of the doctor-patient relationship, e.g. beliefs. The write-up should also mention any limitation of the patient; mental, physical, financial or emotional. When pertinent, the labor and delivery record, operative findings, post-operative progress notes, and pathology should be included. A written essay by the student on any aspect of the clinical case study is required. This requires a literature search to respond to the clinical question posed by the student. Critiques of the write-ups are provided to the student by the preceptor.
8. Direct preceptor supervision of the students of at least 3-4 hours per week should include case presentations by the students, bedside rounds, physical examinations and interactive sessions.
9. A formal one-on-one mid core evaluation is required. This is required to be reported to the DME with a signature acknowledgement by the student.
10. Each student will maintain an electronic log of all patients, with diagnosis, admitted, evaluated or followed after admission by the student.
11. The students are responsible for completing the introductory modules of the Communication Skills course (Drexel University College of Medicine Doc.com: an interactive learning resource for healthcare communication) prior to the start of the 3rd year core rotations. This self-directed learning computerized course can be accessed through the SGU website at My SGU (click Communication Skills course, upper left corner). In addition, required for the obstetrics rotation are modules:
               #18.  Exploring sexual issues
               #28.  Domestic violence
12. The oral examination given at the completion of the clerkship is based on the clinical cases the student has been exposed to during the clerkship as listed in the electronic patient log. The exam will be 20-30 minutes in length concerning 3-5 cases. It will include at least one obstetrical and one gynecological case along with one from a sub-specialty area (reproductive endocrinology/infertility, oncology, maternal fetal medicine.)
13. A final written examination is given at the end of the clerkship based on the recommended text readings. The University will send these exams to the participating hospitals where they will be administered and returned to the University for grading. The grades are then sent back to the hospital for inclusion in the final evaluation. Clerkship site faculty contributed questions to the University where they are screened and added to the pool from which the exams are constructed. The medical board format is preferred in which there is a case scenario followed by 3-5 multiple choice questions.
14. Special emphasis is placed on the development of certain skills. By the completion of the clerkship, the student should be able to competently perform a complete history relevant to the obstetric/gynecologic patient and a physical examination of the breast and pelvis. (These examinations must always be performed only when a “chaperone” is present.)

Core Topics

 General

1. History
2. Physical exam
3. Patient write up
4. Differential Diagnosis and management plan
5. Preventive care
6. Professional behavior and communication skills
7. Domestic violence and sexual assault

Obstetrics

1. Maternal-fetal physiology
2. Preconception care
3. Antepartum care
4. Intrapartum care
5. Care of Newborn in labor and delivery
6. Postpartum care
7. Breastfeeding
8. Abortion (spontaneous, threatened, incomplete, missed)
9. Hypertensive disorders of pregnancy
10. Isoimmunization
11. Multifetal gestation
12. Normal and abnormal labor

1. Preterm labor

14. Preterm rupture of membranes
15. Third trimester bleeding
16. Postpartum hemorrhage
17. Postdates pregnancy
18. Fetal growth restriction
19. Antepartum and intrapartum fetal surveillance
20. Infection

Gynecology

1. Ectopic pregnancy
2. Contraception
3. Sterilization
4. Abortion
5. Sexually transmitted diseases
6. Endometriosis
7. Chronic pelvic pain
8. Urinary incontinence
9. Breast disease
10. Vulvar disease and neoplasm
11. Cervical disease and neoplasm
12. Uterine disease and neoplasm
13. Ovarian disease and neoplasm

Endocrinology and Infertility

1. Menarche
2. Menopause
3. Amenorrhea
4. Normal and abnormal uterine bleeding
5. Infertility
6. Hirsutism and Virilization

Educational Objectives

 PATIENT CARE:

1. To learn the art of a complete and relevant reproductive history, in particular the ability to synthesize information into an informative, concise and completely written and oral narrative. The student must begin to appreciate that symptoms unrelated to each other may represent varying clinical manifestations of a single or related disease process.
2. To learn the indications for and interpretation of the common laboratory tests used in the specialty of obstetrics and gynecology.
3. To  observe   and  learn  basic  procedures,  common  to   the specialty  of obstetrics and

 gynecology.  Fundamental  to  this  learning  is the  active participation  in the  care of at  
 least one woman throughout the course of labor and delivery.

MEDICAL KNOWLEDGE:

1. To   understand  mechanisms   of  diseases  related   to  women’s  health  including normal
2. reproductive physiology and pathology.
3. To  understand   the   mechanisms   of   actions,   toxicities   and   proper   use   of     major
4. pharmacologic agents as they affect women and,  in pregnancy, the fetus.

INTERPERSONAL SKILLS AND COMMUNICATION

1.      To learn the importance and techniques of educating and counseling   patients  and their
         families regarding reproductive health.  
2.      Establish rapport with patients.
3.      Work   cooperatively   with   patients,   their   social   supports and other members of the  
         healthcare team.
4.      Assess his/her own strengths and weaknesses with regard to personal interactions.

General Educational Objectives:

There are educational objectives which are not specific to obstetrics and gynecology but are an integral part of this and other core clerkships. These are covered in the introductory portion of the manual.

Reading

 Students should use the most recent edition of the following textbooks:

Required

Obstetrics/Gynecology for the Medical Student
Beckman, et al  Lippincott Williams & Wilkins

Supplementary

Williams Obstetrics
Cunningham et al, Appleton

Danforth’s Obstetrics and Gynecology
Scott et al Lippincott, Williams and Wilkins

Clinical Gynecologic Oncology
DiSaia & Creasman, Mosby

Gynaecology by Ten Teachers and Obstetrics by Ten Teachers
Monga & Baker, Arnold

Problem Based Obstetrics and Gynecology
Groom and Cameron, Blackwell

Reproductive Endocrinology
Speroff et al, Lippincott Williams and Wilkins

Other Helpful Review Texts:

OB/GYN Mentor: Your Clerkship and Shelf Exam Companion
M. Benson, F. A. Davis Company

First Aid for the Wards: Insider Advice for the Clinical Years
Le et al, Appleton & Lange

First Aid for the USLME Step 2 CK and CS
Le et al, McGraw-Hill

Kaplan Lecture Book Series (OB/GYN) Available only through Kaplan

On Line References

APGO Website: APGO.edu

OBGYN 101: Introductory Obstetrics and Gynecology” : obgyn-101.org

MDConsult: mdconsult.net

Up To Date: UpToDateOnline.com

These two are particularly good at indicating how the patient presents:
WebMD.com 
Eneducube.com