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GYNECOLOGYWilliamsport Family Medicine ResidencyGoal:1.Develop the knowledge and skills to appropriately diagnose and treat common gynecological problems.2.Become proficient in the gynecological exam and common office procedures, including endometrial aspiration and colposcopy.3. Become familiar with common operative procedures performed by OB/GYNs and recognize when these procedures are clinically appropriate.4.Utilize evidence-based guidelines for periodic health exams and cancer screening in women.Faculty ContactsGynecology Preceptors:Susquehanna Health OB/Gyn (SHOB)Faculty Coordinator: Janice Schifferli, DOFaculty Coordinator Colposcopy:Elizabeth Anderson, MDResident Expectations 1.Residents are expected to come to their gynecology experience with SHOB professionally dressed and ready to see patients. They may be responsible for seeing patients independently or with the OB/GYN and should be prepared for either experience. While ideally their clinical exposure will provide them with a well rounded experience, any topics that are not seen clinically should be addressed during independent reading time. See recommended readings below.2.During the Gynecology Clinic, residents are expected to see patients independently, develop their own management plans, and then present the case to a supervising OB/GYN. If a procedure is clinically appropriate, the OB/GYN will be in the room to provide appropriate supervision.3.During the STD clinic, patients are seen independently; residents develop and carry out their own management plans and their supervision comes from one of the Family Medicine faculty, Dr. Jeffrey Verzella. He is responsible for performing the chart reviews and making sure that resident are up-to-date on the most current treatment guidelines for STDs.4.For details of responsibilities during the Colposcopy Clinic, please see that specific area of the curriculum.Supervision Structure Resident will report directly to the assigned supervising gynecology provider.Recommended Readings / Areas of FocusWomen’s Health / Screening:Health Maintenance in Women Maintenance in Postmenopausal Women Osteoporosis Cardiovascular Disease in Women Urinary Incontinence Breast Health Screening:Common Breast Problems Breast Cancer Risk in Women Breast Cancer Risk in Women Cancer Screening Update Evaluation and Management of Galactorrhea Contraception and Infertility:Initiating Hormonal Contraception New Contraceptive Options IUD’s Emergency Contraception Contraception with Underlying Medical Conditions Abnormal Uterine Bleeding:Evaluation and Management Amenorrhea PMS Dysmenorrhea PCOS Uterine and Ovarian Disorders:Endometriosis Pelvic Masses / Ovarian Cysts Pelvic Organ Prolapse Fibroids Pelvic Pain Infertility Sexually Transmitted Diseases and Acute Pelvic Pain:STD’s and Treatment Pelvic Inflammatory Disease Acute Pelvic Pain External Genital Warts Vaginitis HPV and Cervical Disease: (refer to the colposcopy curriculum)ASCCP GuidelinesCervical CancerHPV vaccinationsLGTB Population:Lesbian and Bisexual Care Transgender AbuseSexual Abuse Domestic Abuse Based Gynecologic Procedures:Endometrial Biopsy IUD Insertion and Removal Intradermal Contraception Insertion and RemovalBartholin Cyst Drainage Breast Cyst Aspiration Colposcopy (refer to colposcopy curriculum)Objectives:Patient careResidents must be able to provide family-centered patient care that is developmentally and age appropriate, compassionate, and cost effective for the treatment of health problems and the promotion of health.municate effectively and demonstrate caring and respectful behaviors when interacting with patients and their familiesb.Gather essential and accurate information about their patientsc.Make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgmentd.Develop and carry out patient management planse.Counsel and educate patients and their familiesf.Use information technology to support patient care decisions and patient educationg.Collaborate with other health care professionals h.Demonstrate competence in gynecologic care and procedures, including:1.Normal gynecological exams2.Gynecological cancer screening3.Periodic health visits in mon STD’s and infections5.Contraception management6.Reproductive and hormonal physiology7.Menstrual physiology and disorders of menstruation8.Perimenopause and postmenopause9.Management of breast disorders10.Management of cervical disease11.Pelvic floor dysfunction12.Colposcopy and cervical biopsy13.Endometrial biopsy14.Breast examMedical KnowledgeResidents must demonstrate knowledge about established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences and the application of this knowledge to patient care.a.Develop gynecological fund of knowledge (See Learning Objectives for resources)b.Recognize limits of knowledge and seek help when neededPractice Based Learning and ImprovementResidents must be able to use scientific methods and evidence to investigate, evaluate, and improve their patient care practices.a.Demonstrate performance of self-directed learning, both for self improvement and improvement of patient care practicesb.Seek out feedback and use to improvec.Use information technology to access online medical information and enhance own educationInterpersonal and Communication SkillsResidents must be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, their families, and professional associates.a.Create and sustain therapeutic and ethically sound relationships with obstetrical municate clearly with patients, staff, and colleaguesc.Develop relationships with gynecological colleagues and an understanding of when consultation is appropriateProfessionalism Residents must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to diversitya.Demonstrate commitment to patient confidentiality and informed consentb.Gain an understanding of the desire of women to be treated as competent participants in their health care, in a caring and compassionate fashionc.Gain an awareness of the role that being female plays in bringing women into the health care system more frequently than mend.Gain an appreciation of the role that women play in the health of the family by choosing a health care provider, making meal selections and providing family care at homee.Demonstrate the understanding that a woman's health is affected not only by medical factors but also by family, life cycle, relationships and communityf.Show interest, self-motivation, and initiative in pursuing learning opportunitiesSystems- Based Practice Residents must practice quality health care and advocate for patients in the health care systema.Gain understanding of the role of family physicians in the provision of gynecological care, and when further consultation is appropriateb.Function as a patient advocate within the health care system, and assist patients in dealing with system complexitiesOsteopathic Philosophy and Manipulative MedicineUnderstand the integration between visceral and somatic components of the body, and how OMM can be utilized in the therapeutic management of disease.Understand the utility of OMM and its clinical contraindications.Demonstrate a clear understanding of osteopathic principles and upholds the osteopathic philosophy when approaching patient care. ................
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