Department of Obstetrics and Gynecology
Department of Obstetrics and Gynecology
Residency Curriculum Goals and Education Objectives
Revised: June 2011
PGY-1
I. Obstetrics- Labor Floor Day Team
GOALS AND OBJECTIVES: General exposure to all aspects of inpatient obstetrics including intrapartum and postpartum management
CORE COMPETENCIES:
|Patient Care |-Manage patients on Postpartum Service including all order |
| |writing, test ordering, discharges |
| |-Participate in management of patients on Labor Floor including |
| |admission, assessment of labor progress and fetal heart tracings |
| |-Perform vaginal deliveries, cesarean deliveries |
| |-Triage second and third trimester patients presenting to the |
| |Perinatal Evaluation Center |
| |-Triage beeper calls from patients; recognize common issues of |
| |pregnancy vs. emergency issues requiring further evaluation |
| |-Evaluate patients in High-risk Postpartum Clinic and provide |
| |contraceptive counseling and management |
| |-Insert IUDs and Implanon during postpartum period |
| |-Respond to emergencies arising on L+D, Postpartum, Antepartum |
| |services |
|Medical Knowledge |-Understand maternal physiology and changes that occur in the |
| |antenatal, labor, and postpartum periods |
| |-Understand prenatal care and routine screening |
| |-Understand common antepartum complications and appropriate |
| |evaluation and management as outlined by PEC guidelines |
| |-Know indications for admission to Labor and Delivery unit for |
| |observation vs. delivery |
| |-Know stages of labor and be able to recognize normal and |
| |abnormal labor |
| |-Understand indications for operative and cesarean delivery |
| |-Understand intrapartum fetal heart tracing guidelines and |
| |interpret |
| |-Perform OB ultrasound for dating, biophysical profiles |
| |-Become adept at vaginal delivery and operative skills needed for|
| |cesarean delivery and laceration repair |
| |-Understand possible postpartum complications of normal vaginal |
| |delivery and cesarean delivery |
| |-Become familiar with post-operative care as relates to cesarean |
| |delivery |
| |-Understand physiology of breastfeeding and be able to |
| |troubleshoot common related issues |
| |-Learn principles of midwifery |
|Interpersonal and Communication Skills |-Be able to counsel patients regarding contraceptive options |
| |-Work with Social Work team to optimize conditions for mother and|
| |child upon discharge |
| |-Work with nurse practitioners to provide streamlined care for |
| |Postpartum service |
| |-Communicate with patients and families in an urgent care setting|
| |-Optimize care provided by healthcare team by communicating with |
| |nursing staff, anesthesia, pediatrics |
| |-Master a standardized effective signout process for optimal |
| |transitions of care |
|Professionalism |-Demonstrate respect, compassion, integrity, and responsiveness |
| |to needs of patients in labor and postpartum |
| |-Work with nursing towards common patient-centered care approach |
| |-Participate in Team Admissions |
| |-Participate in Risk Reduction initiatives |
| |-Participate in Quality Improvement and Patient Safety |
| |initiatives |
|Practice-Based Learning and Improvement |-Prepare to discuss management of patients on service using |
| |evidence-based medicine |
| |-Participate in work and teaching rounds on Labor Floor and |
| |Postpartum Service |
| |-Attend Morning and Noon Conferences |
|Systems-Based Practice |-Attend monthly M+M conferences to improve patient safety, learn |
| |from errors, become informed about complex medical issues |
| |-Use Baby Tracker system for data monitoring |
| |-Use Sunrise to generate concise and relevant discharge documents|
| |-Use EPIC to document phone triage calls and PEC encounters to |
| |facilitate follow up |
II. Night Float- Obstetrics
GOALS AND OBJECTIVES: General exposure to all aspects of inpatient obstetrics including intrapartum and postpartum management
|Patient Care |-Manage patients on Postpartum Service including all order |
| |writing, test ordering, discharges |
| |-Participate in management of patients on Labor Floor including |
| |admission, assessment of labor progress and fetal heart tracings |
| |-Perform vaginal deliveries, cesarean deliveries |
| |-Triage second and third trimester patients presenting to the |
| |Perinatal Evaluation Center |
| |-Triage beeper calls from patients; recognize common issues of |
| |pregnancy vs. emergency issues requiring further evaluation |
| |-Evaluate patients in High-risk Postpartum Clinic and provide |
| |contraceptive counseling and management |
| |-Insert IUDs and Implanon during postpartum period |
| |-Respond to emergencies arising on L+D, Postpartum, Antepartum |
| |services |
|Medical Knowledge |-Understand maternal physiology and changes that occur in the |
| |antenatal, labor, and postpartum periods |
| |-Understand prenatal care and routine screening |
| |-Understand common antepartum complications and appropriate |
| |evaluation and management as outlined by PEC guidelines |
| |-Know indications for admission to Labor and Delivery unit for |
| |observation vs. delivery |
| |-Know stages of labor and be able to recognize normal and |
| |abnormal labor |
| |-Understand indications for operative and cesarean delivery |
| |-Understand intrapartum fetal heart tracing guidelines and |
| |interpret |
| |-Perform OB ultrasound for dating, biophysical profiles |
| |-Become adept at vaginal delivery and operative skills needed for|
| |cesarean delivery and laceration repair |
| |-Understand possible postpartum complications of normal vaginal |
| |delivery and cesarean delivery |
| |-Become familiar with post-operative care as relates to cesarean |
| |delivery |
| |-Understand physiology of breastfeeding and be able to |
| |troubleshoot common related issues |
| |-Learn principles of midwifery |
|Interpersonal and Communication Skills |-Be able to counsel patients regarding contraceptive options |
| |-Work with Social Work team to optimize conditions for mother and|
| |child upon discharge |
| |-Work with nurse practitioners to provide streamlined care for |
| |Postpartum service |
| |-Communicate with patients and families in an urgent care setting|
| |-Optimize care provided by healthcare team by communicating with |
| |nursing staff, anesthesia, pediatrics |
| |-Master a standardized effective signout process for optimal |
| |transitions of care |
|Professionalism |-Demonstrate respect, compassion, integrity, and responsiveness |
| |to needs of patients in labor and postpartum |
| |-Work with nursing towards common patient-centered care approach |
| |-Participate in Team Admissions |
| |-Participate in Risk Reduction initiatives |
| |-Participate in Quality Improvement and Patient Safety |
| |initiatives |
|Practice-Based Learning and Improvement |-Prepare to discuss management of patients on service using |
| |evidence-based medicine |
| |-Participate in work and teaching rounds on Labor Floor and |
| |Postpartum Service |
| |-Attend Morning and Noon Conferences |
|Systems-Based Practice |-Attend monthly M+M conferences to improve patient safety, learn |
| |from errors, become informed about complex medical issues |
| |-Use Baby Tracker system for data monitoring |
| |-Use Sunrise to generate concise and relevant discharge documents|
| |-Use EPIC to document phone triage calls and PEC encounters to |
| |facilitate follow up |
III. Obstetrics- Antepartum
GOALS AND OBJECTIVES: Exposure to inpatient and outpatient management of complicated pregnancies
CORE COMPETENCIES:
|Patient Care |-Manage patients on Antepartum service including all order |
| |writing, test ordering, discharges, fetal monitoring |
| |interpretation |
| |-Triage second and third trimester patients presenting to the |
| |Perinatal Evaluation Center |
| |-Participate in outpatient prenatal care for high-risk |
| |pregnancies |
| |-Assist with consultation requested by other services and |
| |emergency department |
|Medical Knowledge |-Manage high-risk pregnancies in inpatient and outpatient setting|
| |and understand criteria for inpatient admission and discharge |
| |-Understand and perform fetal testing and surveillance (NST, BPP)|
| |-Perform OB ultrasound for dating |
| |-Understand common antepartum complications and appropriate |
| |evaluation and management as outlined by PEC guidelines |
| |-Understand risks and management of common medical complications |
| |in pregnancy i.e. diabetes, hypertension |
| |-Understand risks and management of surgical complications in |
| |pregnancy |
| |-Understand risks and management of obstetric complications of |
| |pregnancy i.e. PPROM, abruption, abnormal placentation, IUGR |
| |-Understand risks and management of multiple gestations |
| |-Understand fetal/ maternal indications for preterm delivery |
| |-Understand complications associated with extreme prematurity/ |
| |preterm delivery |
|Interpersonal and Communication Skills |-Use consultants appropriately in inpatient and outpatient |
| |settings |
| |-Communicate with patients and families regarding plan of care on|
| |inpatient service |
| |-Optimize care provided by healthcare team by communicating with |
| |nursing staff, anesthesia, pediatrics/ NICU, social work, |
| |consultants |
| |-Assist with meaningful consultation to requesting services and |
| |coordination of care |
|Professionalism |-Demonstrate respect, compassion, integrity, and responsiveness |
| |to needs of patients with complicated pregnancies |
| |-Offer a team-based approach to patient-centered care with |
| |attending, fellow, resident, nurse practitioner |
|Practice-Based Learning and Improvement |-Participate in work and teaching rounds on Labor Floor and |
| |Antepartum Service |
| |-Attend weekly MFM Division meeting |
| |-Attend weekly MFM Journal Club |
| |-Review all triage cases from PEC with senior resident/ attending|
| |and solicit feedback |
|Systems-Based Practice |-Attend monthly M+M conferences to improve patient safety, learn |
| |from errors, become informed about complex medical issues |
| |-Use Baby Tracker system for data monitoring |
| |-Use Sunrise to generate concise/ comprehensive discharge |
| |documentation |
| |-Use EPIC to facilitate outpatient follow-up |
IV. Gynecologic Oncology
GOALS AND OBJECTIVES: Exposure to all aspects of inpatient Gyn Oncology
CORE COMPETENCIES:
|Patient Care |-Manage patients on the Gyn Oncology inpatient service |
| |-Become adept at performing minor outpatient procedures, Benign |
| |and Oncologic including: laparoscopic BTL, LEEP, cold knife cone,|
| |hysteroscopy, D+E |
| |-Care for OBGYN patients in the outpatient Dickens Center setting|
| |-Wound care |
|Medical Knowledge |-Become familiar with post-op management of patients with |
| |concurrent medical illness and particularly with cancer diagnosis|
| |-Understand parameters for hemodynamic stability |
| |-Understand wound healing |
| |-Diagnose and treat common post-op complications |
| |-Recognize criteria for inpatient admission for women with |
| |gynecologic malignancies |
| |-Learn principles of chemotherapy |
| |-Know risk factors, diagnosis, treatment, and prognosis for |
| |gynecologic malignancies |
| |-Know staging for endometrial, ovarian, cervical cancer |
| |-Be familiar with common tumor markers for various ovarian |
| |pathology |
| |-Learn surgical technique and principles of laparoscopy, |
| |hysteroscopy |
|Interpersonal and Communication Skills |-Perform as an integral team member and patient advocate |
| |-Provide compassionate care to patients who are critically ill, |
| |coping with cancer diagnosis and associated treatments |
| |-Provide compassionate support to family members of patients |
| |-Master a standardized effective signout process for optimal |
| |transitions of care |
|Professionalism |-Demonstrate respect, compassion, integrity, and responsiveness |
| |to needs of patients with complicated medical illness, cancer |
| |diagnoses |
| |-Offer a team-based approach to patient-centered care with |
| |attending, fellow, resident, nurse practitioner |
| |-Model attending physicians |
|Practice-Based Learning and Improvement |-Prepare cases for Gyn Oncology Conference |
| |-Attend monthly M+M conferences to improve patient safety, learn |
| |from errors, become informed about complex medical issues |
|Systems-Based Practice |-Master the organizational skills necessary to provide care for |
| |an inpatient service |
| |-Introduction to hospice |
| |-Introduction to end-of-life issues |
| |-Learn use of ACGME database for case collection |
V. Benign Gynecology
GOALS AND OBJECTIVES: Exposure to all aspects of gynecology
CORE COMPETENCIES:
|Patient Care |-Scrub on operating room cases, primarily outpatient cases, |
| |hysteroscopy, basic laparoscopy, D+E |
| |-Perform office LEEP in Dickens |
| |-Perform endometrial biopsy, IUD placement |
| |-Participate in postoperative care for Benign Gynecologic surgery|
| |patients as well as inpatient admissions |
| |-Participate in postoperative care for Urogynecology and REI |
| |patients as well as inpatient admissions |
| |-Attend to emergency room and inpatient consults and become |
| |familiar with gynecologic surgical emergencies and admissions |
| |under supervision of senior resident |
| |- Care for OBGYN patients in the outpatient Dickens Center |
| |setting |
| |-Participate in preop clinic: counsel patients regarding medical |
| |vs. surgical management of benign gynecologic conditions |
| |-Become familiar with Quant Book and review daily |
|Medical Knowledge |-Become familiar with abdominal wall opening and closure |
| |-Be familiar with suture selection |
| |-Know principles of electrosurgery |
| |-Understand and execute surgical procedures including: basic |
| |laparoscopy/ hysteroscopy, D+E, CKC |
| |-Know management of PUL, medical and surgical management of |
| |abnormal intrauterine pregnancy, ectopic pregnancy |
| |-Know diagnosis, medical and surgical management of lower tract |
| |infections vs. upper tract infections/ PID |
| |-Understand the menstrual cycle and differential diagnosis for |
| |alterations of |
| |-Know options for treatment of acute vaginal bleeding |
| |-Postoperative management and treatment of complications |
|Interpersonal and Communication Skills |-Work with other services to provide emergency and/or consult |
| |care appropriately under supervision of senior resident |
| |-Preop counseling and informed consent for hysteroscopy, |
| |laparoscopy, D+E, BTL |
| |-Offer a team-based approach to patient-centered care with |
| |attending, fellow, resident, nurse practitioner |
| |-Address advanced directives for gynecologic admissions |
|Professionalism |-Review procedures and patient history prior to participation in |
| |surgical procedure |
| |-Respond to consult requests in a timely manner |
| |-Participate in medical student education |
|Practice-Based Learning and Improvement |-Participate in work and teaching rounds |
| |-Attend bi-monthly gyn preop conference |
|Systems-Based Practice |-Attend monthly M+M conferences to improve patient safety, learn |
| |from errors, become informed about complex medical issues |
| |-Be familiar with criteria for inpatient hospitalization and |
| |review daily to ensure proper utilization of resources |
| |-Continue use of ACGME database for case collection |
VI. Internal Medicine- Inpatient Wards
GOALS AND OBJECTIVES: General exposure to inpatient medicine therapy and patient management
CORE COMPETENCIES:
|Patient Care |-Caring for male and female patients with chronic illness in an |
| |inpatient setting |
|Medical Knowledge |-Pathophysiology of common chronic diseases: hypertension, |
| |diabetes, cardiac, renal, gastrointestinal |
| |-Medical treatments for the above and pharmacology |
| |-Geriatric medicine |
|Interpersonal and Communication Skills |-Taking a comprehensive history from patients with illness |
| |-Recording thorough H+Ps and progress notes |
|Professionalism |-Appropriate utilization of ancillary resources |
|Practice-Based Learning and Improvement |-Attending daily rounds and conferences as scheduled by |
| |Department of Internal Medicine |
|Systems-Based Practice |-Attend M+M conferences to improve patient safety, learn from |
| |errors, become informed about complex medical issues |
VII. Surgical Intensive Care Unit
GOALS AND OBJECTIVES: General exposure to all aspects of intensive care of postoperative patients
CORE COMPETENCIES:
|Patient Care |-Recognition of the critically ill patient that needs intensive |
| |care |
| |-Insertion of lines for invasive monitoring |
|Medical Knowledge |-Understand principles of mechanical ventilation, equipment, and |
| |settings |
| |-Understand invasive monitoring, hemodynamics |
| |-Fluid management and principles of transfusion |
| |-ACLS |
|Interpersonal and Communication Skills |-Perform as an integral team member and patient advocate |
| |-Provide compassionate care to patients who are critically ill |
| |and communicating with families |
|Professionalism |-Acting as effective member of team comprised of physicians of |
| |varying specialties |
| |-Participating in call schedule |
|Practice-Based Learning and Improvement |-Attending daily rounds as conducted by Unit Surgery or |
| |Anesthesia Chief/ Attending |
|Systems-Based Practice |-Charting as per SICU department |
VIII. Emergency Medicine
GOALS AND OBJECTIVES: General exposure to all aspects of emergency and acute care, including but not limited to:
1. Perform an appropriate focused history and physical exam
2. Demonstrate an appropriate differential diagnosis
3. Develop and carry out basic treatment plans through admission or discharge
CORE COMPETENCIES:
|Patient Care |-Learn evaluation and management of patients presenting with |
| |common types of illness and injury |
| |-Careful and thorough assessment of individual patients |
| |-Generate an appropriate and complete differential diagnosis for |
| |an undifferentiated patient |
| |-Develop and carry out a basic treatment plan |
| |-Suturing, lumbar puncture, splinting, I/D abcess |
| |-Keep medical record that is accurate, complete, timely, and |
| |appropriate |
|Medical Knowledge |-Generate an appropriate and complete differential diagnosis for |
| |an undifferentiated patient |
| |-Acquire the skills necessary to identify life-threatening |
| |conditions and presentations |
| |-Develop rational test-ordering strategies |
| |-Appropriate interpretation of ECGs, laboratory and radiologic |
| |testing |
|Interpersonal and Communication Skills |-Data gathering: perform an appropriate focused history and |
| |physical exam |
| |-Demonstrate effective information exchange with patients, their |
| |families, and the emergency health care team |
| |-Develop vital interpersonal skills and strategies to work in a |
| |team environment |
|Professionalism |-Being a reliable member of the Emergency Department team |
| |-Establishing good relationships in the ED |
| |-Strive for efficiency: effectively manage 1.5 patients/ hour |
| |-Introduce self to patient and/or family |
| |-Be respectful of patient’s privacy and confidentiality |
| |-Demonstrate good grooming, keeping rested and physically active |
| |to maintain health |
| |-Demonstrate respect, compassion, and integrity in all aspects of|
| |care |
|Practice-Based Learning and Improvement |-Attending daily rounds as conducted by ED attending |
| |-Use appropriate information resources (ie texts, online |
| |websites, etc.) for care of patient |
|Systems-Based Practice |-Ordering appropriate tests keeping in mind cost-effective care |
| |-Understand basic resources available for care of the emergency |
| |department patient |
| |-Understanding the role of the ED within the scope of inpatient |
| |admission/ continuity of outpatient care, including arranging |
| |appropriate ongoing care of patients once consulted upon, |
| |admitted to an inpatient service, or referred for further |
| |outpatient care |
IX. Ambulatory Women’s Health
GOALS AND OBJECTIVES: General exposure to common women’s health issues in the outpatient setting, including but not limited to:
1. Radnor gynecology
2. Radnor urogynecology
3. Breast clinic
4. MFM Ultrasound
5. Genetics
6. 3701 Market Street—Division of General OBGYN
7. Dickens
CORE COMPETENCIES:
|Patient Care |-Perform routine well-woman examinations with familiarization of |
| |periodic health assessment based on age |
| |-Perform routine and high-risk OB care in the outpatient setting |
| |with attention to periodic screening |
| |-Exposure to women’s health care in comprehensive setting at |
| |Radnor |
| |-Exposure to non OBGYN specialties related to women’s health |
| |(Dermatology, Gastroenterology, Breast) |
| |-Exposure to specialized OBGYN evaluation in urogynecology, OB |
| |Ultrasound, Genetics |
|Medical Knowledge |-Periodic health assessment, age-based |
| |-Know screening tests and when appropriate |
| |-Common medical problems (diabetes, hypertension, |
| |hypercholesterolemia) and how they affect the reproductive system|
| |-Routine OB screening tests and timing |
| |-Become familiar with OB ultrasound—First trimester screening and|
| |Level 2 |
| |-Know screening options for genetic disorders in pregnancy |
| |-Know FTS, SS, integrated screening options in pregnancy |
| |-Understand mammogram screening guidelines and interpretation |
| |-Become familiar with benign breast disorders |
| |-Understand diagnosis and treatment of breast cancer |
|Interpersonal and Communication Skills |-Eliciting accurate, focused, appropriate history and performing |
| |thorough physical exam |
| |-Understanding the needs of the well-woman presenting for an |
| |outpatient visit and incorporating education, preventive medicine|
| |into a meaningful encounter |
|Professionalism |-Maintaining a professional appearance |
| |-Introducing self to patient and/or family |
| |-Develop and maintain habits of punctuality and efficiency |
| |-Work with attending physicians to shadow, model encounters |
|Practice-Based Learning and Improvement |-Demonstrate responsiveness to instruction and feedback |
| |-Use knowledge from textbooks, websites, and up-to-date studies |
| |to guide patient care |
| |-Use of Blackboard curriculum |
|Systems-Based Practice |-Understand the basics of insurance, documentation, and coding |
| |principles |
| |-Understand patient referrals and interaction between ambulatory |
| |centers/ subspecialty clinics |
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