Obstetrics & Gynecology Clerkship: MTER 7318

Overview

Welcome to the Third Year Medical School Ob/Gyn Clerkship. This rotation exposes students to a unique, complex and challenging field of women’s medicine.  It emphasizes those aspects of general Ob/Gyn important for all medical students and will provide a foundation for those students who elect to further study the health care of infants, children and adolescents.  Students have the opportunity to participate in clinical activities in general Ob/Gyn as well as subspecialties within the field.  The general ob-gyn ambulatory exposure, acute and chronic care of hospitalized patients and comprehensive patient care experiences, are varied and relevant to the most common Puerto Rican Women’s Health Problems.

As one of the core clerkships during the third year of medical school, Ob/Gyn shares with family medicine, internal medicine, psychiatry, pediatrics and surgery the common responsibility to teach the knowledge, skills and attitudes basic to the development of a competent general physician.  This curriculum is designed for 6-week core clerkship in the third year of medical school.  The content of the core curriculum has been revised and approved by the UPR, Course Committee, based on the School of Medicine Educational Objectives and the Association of Professors in Obstetrics & Gynecology (APGO).

Objectives

At the end of the rotation the student should be able to

  1. Develop competence in the medical interview and physical examination of women, incorporate ethical, social and diversity perspectives to provide culturally competent health care
  2. Apply recommended prevention strategies to women throughout the lifespan
  3. Recognize his/her role as a leader and advocate for women
  4. Demonstrate knowledge of preconception care including the impact of genetics, medical conditions and environmental factors on maternal health and fetal development
  5. Explain the normal physiologic changes of pregnancy including interpretation of common diagnostic studies
  6. Describe common problems in obstetrics
  7. Demonstrate knowledge of intrapartum care of the mother and newborn
  8. Demonstrate knowledge of postpartum care
  9. Describe menstrual cycle physiology, discuss puberty and menopause and explain normal and abnormal bleeding
  10. Describe the etiology and evaluation of infertility
  11. Develop a thorough understanding od contraception, including sterilization and abortion
  12. Demonstrate knowledge of common benign gynecological conditions
  13. Formulate a differential diagnosis of the acute abdomen and chronic pelvic pain
  14. Describe common breast conditions and outline the evaluation of breast complaints
  15. Demonstrate knowledge of perioperative care and familiarity with gynecological procedures
  16. Describe gynecological malignancies including risk factors, signs and symptoms and initial evaluation
  17. Provide a preliminary assessment of patients with sexual concerns

Educational activities

Academic Conferences

Small and large group discussions

Hands-on

Independent Learning

One-to-one faculty discussions

Directly supervised clinical evaluations

Rotations

Clerkship is 6 weeks long, divided in 2 academics and 4 clinical. The 6 sections of the year run from throughout the year and have a maximum of 20 students per section.

Clinical exposure is a mix of inpatient and ambulatory experiences. Areas included are prenatal clinics and high-risk obstetrical clinics, maternofetal sonography unit, labor room and antenatal ward. For gynecology, general gynecology clinics, subspecialty clinics, operating room, family planning clinics, and gyn/postoperative ward. Lastly, will be exposed to Ob/Gyn emergency room.

Institutions affiliated to the rotation are University District Hospital, University Hospital Carolina, Doctors Medical Center Manati, and San Antonio Hospital Mayaguez. Students participating in the off-site institutions are selected during their 2nd year of medical school.

Student Information

Clinical exposure will be divided by weeks, one in Gynecology service, one in Antepartum service, One at Labor Room and One in Primary Ob/Gyn service. All experiences include inpatient and ambulatory exposure with subspecialty exposure with the different weeks. All services are coordinated by a team of residents, from different levels with direct supervision of core faculty. You will be expected to evaluate patients independently with direct supervision.

Textbook recommended for this rotation in the Beckmann and Ling’s Obstetrics & Gynecology, 8th edition, 2018. Other suggested books are the Blueprint Obstetrics & Gynecology 7th Edition, John Hopkins Manual of Obstetrics & Gynecology, 5th Edition, 2015, and Case Files Obstetrics & Gynecology 5th edition, 2016.

Grading is comprehensive. Multiple choice exams represent a 30%, Clinical Standardized Exam represent a 20%, clinical experience a 30%, 10 % from clinical case discussions with a final 10% from an evidence-based project. Formative evaluations are present for clinical skills as well as medical knowledge.

4th year electives are available for all students who wish to broaden their experience. Active courses are General Ob/Gyn, Outpatient Ob/Gyn, Maternofetal Elective, and Clinical Research. It all depends on availability and approval by the 4th year academic coordinator. Students are incorporated into the clinical team and are expected to work to the level of the intern.