Department of Obstetrics and Gynecology



Department of Obstetrics and Gynecology

Residency Curriculum Goals and Education Objectives

Revised: February 2008

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 admitted to Labor Floor |

| |including vaginal deliveries, cesarean deliveries |

| |-Triage second and third trimester patients presenting to the |

| |Perinatal Evaluation Center |

|Medical Knowledge |-Understand possible postpartum complications of normal vaginal |

| |delivery and cesarean delivery |

| |-Become familiar with post-operative care as relates to cesarean |

| |delivery |

| |-Understand normal and abnormal labor as well as indications for |

| |operative and cesarean delivery |

| |-Understand fetal monitoring |

| |-Perform OB ultrasound for dating, biophysical profiles |

| |-Become adept at vaginal delivery and operative skills needed for|

| |cesarean delivery and laceration repair |

|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 |

| |-Communicate with patients and families in an urgent care setting|

| |-Optimize care provided by healthcare team by communicating with |

| |nursing staff, anesthesia, pediatrics |

|Professionalism |-Demonstrate respect, compassion, integrity, and responsiveness |

| |to needs of patients in labor and postpartum |

|Practice-Based Learning and Improvement |-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 |

II. Night Float- Obstetrics

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 |

| |-Participate in management of patients admitted to Labor Floor |

| |including vaginal deliveries, cesarean deliveries |

| |-Triage second and third trimester patients presenting to the |

| |Perinatal Evaluation Center |

|Medical Knowledge |-Understand possible postpartum complications of normal vaginal |

| |delivery and cesarean delivery |

| |-Become familiar with post-operative care as relates to cesarean |

| |delivery |

| |-Understand normal and abnormal labor as well as indications for |

| |operative and cesarean delivery |

| |-Understand fetal monitoring |

| |-Perform OB ultrasound for dating, biophysical profiles |

| |-Become adept at vaginal delivery and operative skills needed for|

| |cesarean delivery and laceration repair |

|Interpersonal and Communication Skills |-Communicate with patients and families in an urgent care setting|

| |-Optimize care provided by healthcare team by communicating with |

| |nursing staff, anesthesia, pediatrics |

|Professionalism |-Demonstrate respect, compassion, integrity, and responsiveness |

| |to needs of patients in labor and postpartum |

|Practice-Based Learning and Improvement |-Participate in work and teaching rounds on Labor Floor and |

| |Postpartum Service |

| |-Attend Morning 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 |

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 |

|Medical Knowledge |-Manage high-risk pregnancies in inpatient and outpatient setting|

| |and understand criteria for inpatient admission |

| |-Understand and perform fetal testing and surveillance (NST, BPP)|

| |-Perform OB ultrasound for dating |

|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, social work, consultants |

|Professionalism |-Demonstrate respect, compassion, integrity, and responsiveness |

| |to needs of patients with complicated pregnancies |

|Practice-Based Learning and Improvement |-Participate in work and teaching rounds on Labor Floor and |

| |Antepartum 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 |

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|

|Medical Knowledge |-Become familiar with post-op management of patients with |

| |concurrent medical illness |

| |-Recognizing criteria for inpatient admission for women with |

| |gynecologic malignancies |

| |-Learn principles of chemotherapy |

| |-Learn surgical technique and principles of laparoscopy, |

| |hysteroscopy |

|Interpersonal and Communication Skills |-Perform as an integral team member and patient advocate |

| |-Providing compassionate care to patients who are critically ill,|

| |coping with cancer diagnosis and associated treatments |

|Professionalism |-Demonstrate respect, compassion, integrity, and responsiveness |

| |to needs of patients with complicated medical illness, cancer |

| |diagnoses |

|Practice-Based Learning and Improvement |-Prepare cases for Gyn Oncology Conference |

| |-Master the organizational skills necessary to provide care for |

| |an inpatient service |

|Systems-Based Practice |-Attend monthly M+M conferences to improve patient safety, learn |

| |from errors, become informed about complex medical issues |

| |-Learn use of ACGME database for case collection |

V. 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 |

VI. 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 |

VII. Emergency Medicine

GOALS AND OBJECTIVES: General exposure to all aspects of emergency and acute care

CORE COMPETENCIES:

|Patient Care |-Triage patients presenting to Emergency Room and be able to make|

| |distinction between emergent/urgent/routine medical issues |

| |-Stabilize patients in need of further care |

| |-Order appropriate diagnostic tests |

| |-Understand criteria for inpatient admission |

| |-Assess need for operative intervention |

|Medical Knowledge |-Disease processes and complications |

| |-ACLS |

|Interpersonal and Communication Skills |-Calling for appropriate consultations and conveying patient |

| |history and physical in a clear and concise manner |

| |-Cooperating with physicians and ED staff to provide effective |

| |care |

|Professionalism |-Being a reliable member of the Emergency Department team |

| |-Establishing good relationships in the ED |

|Practice-Based Learning and Improvement |-Attending daily rounds as conducted by ED attending |

|Systems-Based Practice |-Ordering appropriate tests keeping in mind cost-effective care |

| |-Understanding the role of the ED within the scope of inpatient |

| |admission/ continuity of outpatient care |

VIII. Ambulatory Women’s Health

GOALS AND OBJECTIVES: General exposure to common women’s health issues

CORE COMPETENCIES:

|Patient Care |-Perform routine well-woman examinations with familiarization of |

| |periodic health assessment based on age |

| |-Exposure to non OBGYN specialties related to women’s health |

| |(Dermatology, Gastroenterology, Breast) |

|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|

|Interpersonal and Communication Skills |-Eliciting accurate 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 |

| |-Develop and maintain habits of punctuality and efficiency |

|Practice-Based Learning and Improvement |-Demonstrate responsiveness to instruction and feedback |

| |-Use knowledge from textbooks and up-to-date studies to guide |

| |patient care |

|Systems-Based Practice |-Understand the basics of insurance, documentation, and coding |

| |principles |

PGY-2

I. Obstetrics- Labor Floor Day Team

GOALS AND OBJECTIVES: Continued general exposure to all aspects of obstetrics with focus on operative vaginal deliveries and cesarean delivery, maternal and fetal assessment, and development of management skills

CORE COMPETENCIES:

|Patient Care |-Actively manage laboring patients admitted to Labor Floor |

| |-Participate in operative vaginal deliveries and cesarean |

| |deliveries |

| |-Participate in management of antepartum patients admitted to |

| |Labor Floor |

| |-Care for OBGYN patients in the outpatient Dickens Center setting|

|Medical Knowledge |-Understand normal and abnormal labor as well as indications for |

| |operative and cesarean delivery |

| |-Know management of term and preterm delivery with associated |

| |medical complications |

| |-Become familiar with principles of Obstetric anesthesia |

|Interpersonal and Communication Skills |-Be able to counsel patients regarding vaginal delivery, |

| |operative vaginal delivery, vaginal birth after cesarean, |

| |cesarean delivery |

| |-Communicate with patients and families in an urgent care setting|

| |-Optimize care provided by healthcare team by communicating with |

| |nursing staff, anesthesia, pediatrics, obstetrics |

| |-Provide thorough, concise signout to night team |

|Professionalism |-Demonstrate respect, compassion, integrity, and responsiveness |

| |to needs of patients in labor |

| |-Participate in team admissions |

|Practice-Based Learning and Improvement |-Participate in work and teaching rounds on Labor Floor |

| |-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 |

II. Night Float- Obstetrics

GOALS AND OBJECTIVES: Continued general exposure to all aspects of obstetrics with focus on operative vaginal deliveries and cesarean delivery, maternal and fetal assessment, and development of management skills.

CORE COMPETENCIES:

|Patient Care |-Actively manage laboring patients admitted to Labor Floor |

| |-Participate in operative vaginal deliveries and cesarean |

| |deliveries |

| |-Participate in management of antepartum patients admitted to |

| |Labor Floor |

| |-Care for OBGYN patients in the outpatient Dickens Center setting|

|Medical Knowledge |-Understand normal and abnormal labor as well as indications for |

| |operative and cesarean delivery |

| |-Know management of term and preterm delivery with associated |

| |medical complications |

| |-Become familiar with principles of Obstetric anesthesia |

|Interpersonal and Communication Skills |-Be able to counsel patients regarding vaginal delivery, |

| |operative vaginal delivery, vaginal birth after cesarean, |

| |cesarean delivery |

| |-Communicate with patients and families in an urgent care setting|

| |-Optimize care provided by healthcare team by communicating with |

| |nursing staff, anesthesia, pediatrics, obstetrics |

|Professionalism |-Demonstrate respect, compassion, integrity, and responsiveness |

| |to needs of patients in labor |

| |-Participate in team admissions |

|Practice-Based Learning and Improvement |-Participate in work and teaching rounds on Labor Floor |

|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 |

III. Gynecology- Benign

GOALS AND OBJECTIVES: Exposure to all aspects of gynecology

CORE COMPETENCIES:

|Patient Care |-Cover operating room cases, majors and minors at HUP, |

| |Presbyterian Hospital, VA |

| |-Participate in postoperative care for Benign Gynecologic surgery|

| |patients as well as inpatient admissions |

| |-Attend to emergency room and inpatient consults and become |

| |familiar with gynecologic surgical emergencies and admissions |

| |- Care for OBGYN patients in the outpatient Dickens Center |

| |setting |

| |-Counsel patients regarding medical vs. surgical management of |

| |benign gynecologic conditions |

|Medical Knowledge |-Understand and execute surgical procedures including: operative |

| |laparoscopy/ hysteroscopy, abdominal/vaginal/laparoscopic |

| |hysterectomy, myomectomy |

| |-Know medical and surgical management of ectopic pregnancy/ SAB |

| |-Understand the menstrual cycle and alterations, treatment of |

| |disturbances |

| |-Postoperative management and treatment of complications |

|Interpersonal and Communication Skills |-Work with other services to provide emergency and/or consult |

| |care appropriately |

| |-Pre and post-surgical counseling |

| |-Address advanced directives for gynecologic admissions |

| |-Provide informed consent |

|Professionalism |-Respond to consult requests in a timely manner |

|Practice-Based Learning and Improvement |-Participate in work and teaching rounds |

| |-Attend weekly GYN Case Conference |

|Systems-Based Practice |-Attend monthly M+M conferences to improve patient safety, learn |

| |from errors, become informed about complex medical issues |

| |-Continue use of ACGME database for case collection |

IV. Gynecologic Oncology

GOALS AND OBJECTIVES: General exposure to all aspects of inpatient Gynecologic Oncology

CORE COMPETENCIES:

|Patient Care |-Cover operating room cases, majors and minors with Gyn Onc |

| |fellows and attendings |

| |-Participate in postoperative care for surgery patients |

| |-See known Gyn Onc patients presenting through emergency room and|

| |determine need for admission |

| |- Care for OBGYN patients in the outpatient Dickens Center |

| |setting |

| | |

|Medical Knowledge |-Continue complicated management of post-operative patients with |

| |concurrent medical illness |

| |-Recognize criteria for inpatient admission for women with |

| |gynecologic malignancies |

| |-Learn principles of chemotherapy |

| |-Principles of fundamental and radical oncologic surgery and |

| |staging procedures |

|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 |

| |-Coordinate inpatient and outpatient care |

| |-Signout to gynecology night coverage |

|Professionalism |-Demonstrate respect, compassion, integrity, and responsiveness |

| |to needs of patients with complicated medical illness, cancer |

| |diagnoses |

|Practice-Based Learning and Improvement |-Prepare cases for Gyn Onc Conference |

| |-Participate in work and teaching rounds with fellows and |

| |attendings |

|Systems-Based Practice |-Attend monthly M+M conferences to improve patient safety, learn |

| |from errors, become informed about complex medical issues |

| |-Continue use of ACGME database for case collection |

V. Ambulatory

GOALS AND OBJECTIVES: Exposure to specialized and unique aspects of obstetric and gynecologic care

CORE COMPETENCIES:

|Patient Care |-Care for OBGYN patients in the outpatient Dickens Center setting|

| | |

| |-Evaluate for urogynecologic conditions under the supervision of |

| |Dr. Arya |

| |-Perform obstetric ultrasound in MFM department |

| |-Diagnose and manage breast disease with Dr. Tchou |

| |-Family planning: counsel and treat patients with complex |

| |contraceptive needs |

|Medical Knowledge |-High-risk obstetric conditions |

| |-Pelvic prolapse, urinary incontinence, and medical and surgical |

| |options |

| |-Principles of ultrasound |

| |-Understand benign and malignant breast disease, diagnosis and |

| |treatment options |

| |-Understand hormonal, non-hormonal, short-term, long term |

| |contraception, modes of action, contraindications |

|Interpersonal and Communication Skills |-Develop ability to counsel pregnant women regarding management |

| |of complex maternal and/or fetal conditions |

| |-Counsel patients with urogynecologic conditions regarding |

| |medical and surgical options for intervention |

| |-Assist women in choosing the most appropriate form of |

| |contraception |

|Professionalism |-Demonstrate respect, compassion, integrity, and responsiveness |

| |to needs of patients |

|Practice-Based Learning and Improvement |-Review of ultrasound images with MFM attendings with feedback |

| |-Learn by shadowing attending physicians |

| |-Formulate plans of care with fellows and attendings in clinic |

|Systems-Based Practice |-Compare different outpatient practice settings (resident clinic,|

| |private offices, ultrasound units, procedure units) and identify |

| |factors which contribute to effective quality care |

| |-Provide thorough and accurate documentation for various types of|

| |encounters (routine, problem visits, preoperative counseling, |

| |procedure notes) |

VI. Reproductive Endocrinology and Infertility

GOALS AND OBJECTIVES: Exposure to basic office infertility and endocrinology with outpatient evaluation

CORE COMPETENCIES:

|Patient Care |-Care for OBGYN patients in the outpatient Dickens Center setting|

| | |

| |-See patients in the REI faculty practice office in order to |

| |become familiar with basic office infertility and endocrinology |

| |-Perform ultrasounds and hysterosalpingograms |

|Medical Knowledge |-Assessment of the infertile couple |

| |-Understanding normal physiology and abnormalities of the |

| |menstrual cycle |

| |-Assessment of ovulation and management of ovulatory dysfunction |

| |-Principles of ultrasound; scanning for follicular development |

| |and early pregnancy |

| |-Principles of oocyte retrieval |

|Interpersonal and Communication Skills |-Communicate effectively with patients in language appropriate to|

| |age, educational, cultural, socioeconomic background |

| |-Convey information to colleagues in a concise, effective manner |

|Professionalism |-Demonstrate a commitment to excellence and interest in ongoing |

| |professional development |

|Practice-Based Learning and Improvement |-Attend REI conferences |

| |-Attend morning resident conferences |

|Systems-Based Practice |-Use Blackboard on-line curriculum to broaden knowledge base and |

| |improve patient care |

PGY-3

I. Obstetrics- Labor Floor Day Team

GOALS AND OBJECTIVES: Exposure to all aspects of normal and high-risk pregnancies, active management of labor, and supervision of the labor floor

CORE COMPETENCIES:

|Patient Care |-Actively manage laboring patients admitted to Labor Floor |

| |-Participate in operative vaginal deliveries and complicated |

| |cesarean deliveries |

| |-Participate in management of antepartum patients admitted to |

| |Labor Floor |

| |-Participate in postpartum care for women with complicated |

| |deliveries |

| |-Care for OBGYN patients in the outpatient Dickens Center setting|

|Medical Knowledge |-Prenatal diagnosis and treatment |

| |-Understand and teach fetal and maternal invasive and |

| |non-invasive monitoring |

| |-Repair of 3rd and 4th degree lacerations |

|Interpersonal and Communication Skills |-Be able to counsel patients regarding vaginal delivery, |

| |operative vaginal delivery, vaginal birth after cesarean, |

| |cesarean delivery |

| |-Communicate with patients and families in an urgent care setting|

| |-Optimize care provided by healthcare team by communicating with |

| |nursing staff, anesthesia, pediatrics, obstetrics |

| |-Provide thorough, concise signout to night team |

|Professionalism |-Provide effective mentoring and role modeling for junior |

| |residents and students |

|Practice-Based Learning and Improvement |-Run Fetal High-Risk Conference in conjunction with fellows |

| |-Attend Pediatric/OB Conference |

|Systems-Based Practice |-Present at monthly M+M conferences to improve patient safety, |

| |learn from errors, become informed about complex medical issues |

| |-Use Baby Tracker system for data monitoring |

II. Gynecology- Benign

GOALS AND OBJECTIVES: Exposure to all aspects of benign gyn surgery with further development of operative skills and techniques and expertise in postoperative management

CORE COMPETENCIES:

|Patient Care |-Cover operating room cases, majors and minors at HUP, |

| |Presbyterian Hospital, VA |

| |-Participate in postoperative care for Benign Gynecologic surgery|

| |patients as well as inpatient admissions |

| |-Attend to emergency room and inpatient consults and become |

| |familiar with gynecologic surgical emergencies and admissions |

| |- Care for OBGYN patients in the outpatient Dickens Center |

| |setting |

| |-Counsel patients regarding medical vs. surgical management of |

| |benign gynecologic conditions |

|Medical Knowledge |-Pelvic anatomy |

| |-Understand and execute surgical procedures including: operative |

| |laparoscopy/ hysteroscopy, abdominal/vaginal/laparoscopic |

| |hysterectomy, myomectomy |

| |-Perform more complex surgeries with greater independence |

| |including operative laparoscopy, vaginal surgery and |

| |reconstruction, lysis of adhesions |

| |-Postoperative management and treatment of complications |

|Interpersonal and Communication Skills |-Assist chief with delegation of responsibilities and with |

| |teaching of junior residents |

| |-Work with other services to provide emergency and/or consult |

| |care appropriately |

| |-Pre and post-surgical counseling |

| |-Address advanced directives for gynecologic admissions |

| |-Provide informed consent |

| |-Follow up for early pregnancy patients tracked in quant book |

|Professionalism |-Provide effective mentoring and role modeling for junior |

| |residents and students |

| |-Respond to consult requests in a timely manner |

|Practice-Based Learning and Improvement |-Provide educational experiences to Gyn team with presentations |

| |of consults |

| |-Participate in work and teaching rounds |

| |-Attend weekly GYN Case Conference |

|Systems-Based Practice |-Present at monthly M+M conferences to improve patient safety, |

| |learn from errors, become informed about complex medical issues |

| |-Continue use of ACGME database for case collection |

III. Gynecology- Chester County Hospital

GOALS AND OBJECTIVES: Exposure to all aspects of benign gyn surgery with further development of operative skills and techniques and expertise in postoperative management

CORE COMPETENCIES:

|Patient Care |-Achieve the level of first surgical assistant/ primary surgeon |

| |on gynecologic surgical cases |

| |-Provide post-operative follow up and inpatient care |

|Medical Knowledge |-Pelvic anatomy |

| |-Broaden experience with varying surgical techniques, |

| |laparoscopic and open |

|Interpersonal and Communication Skills |-Cooperate with residents from Pennsylvania Hospital to provide |

| |effective patient care |

|Professionalism |-Maintain a good work ethic, punctuality, and efficiency as |

| |representatives of HUP |

|Practice-Based Learning and Improvement |-Use personal clinical experience to improve knowledge and |

| |surgical skills in the operating room |

| |-Seek instruction and feedback from attendings with a commitment |

| |to practice improvement |

|Systems-Based Practice |-Attend monthly M+M conferences to improve patient safety, learn |

| |from errors, become informed about complex medical issues |

| |-Continue use of ACGME database for case collection |

IV. Gynecologic Oncology

GOALS AND OBJECTIVES: Exposure to all aspects of Gyn Oncology including operative technique, pre and post-operative management, chemotherapy. This rotation is designed to give the resident experience in managing a surgical service as the primary decision-maker working closely with the fellows.

CORE COMPETENCIES:

|Patient Care |-Management of service as the senior resident |

| |-Organize coverage of all gyn oncology operative cases and act as|

| |first assistant/surgeon on complex surgical cases |

| |-Assess the need for admission to inpatient service for patients |

| |presenting through office or emergency room |

| |-Cover Colposcopy clinic |

|Medical Knowledge |-Advanced management of the gyn oncology surgical and |

| |post-operative patient |

| |-Surgical approach to the treatment of gynecologic malignancies |

| |and staging procedures |

| |-Principles of chemotherapy and radiation |

| |-Familiarity with GOG protocols |

|Interpersonal and Communication Skills |-Perform as a team leader and patient advocate |

| |-Provide compassionate care to patients who are critically ill, |

| |coping with cancer diagnosis and associated treatments |

| |-Coordinate inpatient and outpatient care |

| |-Signout to gynecology night coverage |

|Professionalism |-Provide effective mentoring and role modeling for junior |

| |residents and students |

|Practice-Based Learning and Improvement |-Conduct morning work rounds |

| |-Participate in afternoon rounds with Oncology fellow/attending |

| |-Participate in Gyn Onc Conferences and case presentations |

|Systems-Based Practice |-Present at monthly M+M conferences to improve patient safety, |

| |learn from errors, become informed about complex medical issues |

| |-Continue use of ACGME database for case collection |

V. Night Float- Gynecology

GOALS AND OBJECTIVES: Postoperative management, emergency gyn consultation, and surgery

CORE COMPETENCIES:

|Patient Care |-Provide care/coverage for all gynecology inpatients |

| |-Act as primary consultant to the ED |

| |-Determine need for and cover OR cases for all gynecologic |

| |emergencies |

| |-Assist with the labor floor team as necessary |

|Medical Knowledge |-Management of routine and emergent postoperative issues |

| |-Evaluation and management of patients presenting to the |

| |Emergency Department |

| |-Understanding criteria for inpatient admission of gynecologic |

| |patients |

| |-Diagnosis and management of ectopic pregnancy |

| |-Emergency surgical skills |

|Interpersonal and Communication Skills |-Respond to ED consult requests in a timely and efficient manner |

| |-Provide whole and compassionate care to gyn patients in an |

| |urgent care setting |

| |-Triage surgical emergencies efficiently and work with OR staff |

| |to expedite cases appropriately |

|Professionalism |-Provide effective mentoring and role modeling for junior |

| |residents and students |

| |-Adhere to attending supervision guidelines and protocols |

|Practice-Based Learning and Improvement |-Follow quant book data to compare clinical impressions and |

| |outcomes |

| |-Attend weekly GYN Case Conference |

|Systems-Based Practice |-Practice cost-effective health care and resource allocation that|

| |does not compromise quality of care |

VI. Reproductive Endocrinology and Infertility

GOALS AND OBJECTIVES: Exposure to basic office infertility and endocrinology with the evaluation of outpatients

CORE COMPETENCIES:

|Patient Care |-Care for OBGYN patients in the outpatient Dickens Center setting|

| | |

| |-See patients in the REI faculty practice office in order to |

| |become familiar with basic office infertility and endocrinology |

| |-Perform ultrasounds and hysterosalpingograms |

| |-Cover major and minor cases with REI fellows and attendings |

|Medical Knowledge |-Assessment of the infertile couple |

| |-Understanding normal physiology and abnormalities of the |

| |menstrual cycle |

| |-Assessment of ovulation and management of ovulatory dysfunction |

| |-Principles of ultrasound; scanning for follicular development |

| |and early pregnancy |

| |-Principles of oocyte retrieval |

|Interpersonal and Communication Skills |-Communicate effectively with patients in language appropriate to|

| |age, educational, cultural, socioeconomic background |

| |-Convey information to colleagues in a concise, effective manner |

|Professionalism |-Demonstrate a commitment to excellence and interest in ongoing |

| |professional development |

|Practice-Based Learning and Improvement |-Attend REI conferences |

| |-Attend morning resident conferences |

|Systems-Based Practice |-Use Blackboard on-line curriculum to broaden knowledge base and |

| |improve patient care |

VII. Elective

GOALS AND OBJECTIVES: Focused project for career development

CORE COMPETENCIES:

|Patient Care |-Care for OBGYN patients in the outpatient Dickens Center setting|

| | |

| |-varies by elective |

|Medical Knowledge |-varies by elective |

|Interpersonal and Communication Skills |-varies by elective |

|Professionalism |-varies by elective |

|Practice-Based Learning and Improvement |-varies by elective |

|Systems-Based Practice |-varies by elective |

PGY-4

I. Obstetrics- Labor Floor Day Team

GOALS AND OBJECTIVES: Exposure to normal and high-risk obstetrics as the first-line decision-maker on patient management issues. This rotation is designed to promote leadership and administrative skills and promoting readiness for independent management of antepartum, laboring, and postpartum patients.

CORE COMPETENCIES:

|Patient Care |-Direct and manage care of antepartum and laboring patients |

| |admitted to the Labor Floor as the responsible decision-maker |

| |-Direct and manage care of patients admitted to the Postpartum |

| |Service |

| |-Perform cesarean sections with junior residents under attending |

| |supervision |

| |-Perform normal and operative vaginal deliveries with junior |

| |residents under attending supervision |

| |-Provide antepartum care for high-risk obstetric patients at |

| |Dickens |

|Medical Knowledge |-Understand management of normal and abnormal labor and delivery |

| |-Understand maternal and obstetric complications of pregnancy and|

| |management/ timing of delivery |

| |-Surgical skills to perform complicated repeat cesarean sections |

| |and laceration repair |

| |-Obstetric emergencies and interventions (postpartum hemorrhage, |

| |eclampsia, shoulder dystocia, malpresentation, cesarean |

| |hysterectomy) |

|Interpersonal and Communication Skills |-Be able to counsel patients regarding vaginal delivery, |

| |operative vaginal delivery, vaginal birth after cesarean, |

| |cesarean delivery |

| |-Communicate with patients and families in an urgent care setting|

| |-Optimize care provided by healthcare team by communicating with |

| |nursing staff, anesthesia, pediatrics, obstetrics |

|Professionalism |-Provide effective mentoring and role modeling for junior |

| |residents and students |

| |-Participate in team histories |

|Practice-Based Learning and Improvement |-Present cases at High Risk OB Conference |

| |-Lead teaching at am and pm signout |

| |-Tracing review |

|Systems-Based Practice |-Present at monthly M+M conferences to improve patient safety, |

| |learn from errors, become informed about complex medical issues |

| |-Use Baby Tracker system for data monitoring |

II. Obstetrics- Antepartum

GOALS AND OBJECTIVES: Exposure to high-risk, inpatient, and outpatient obstetrics as the first-line decision-maker on patient management issues

CORE COMPETENCIES:

|Patient Care |-Direct and manage the Antepartum service |

| |-Direct and manage the Perinatal Evaluation Center |

| |-Provide prenatal care for high-risk patients at Dickens |

|Medical Knowledge |-Complete management of high-risk obstetrical conditions |

| |(diabetes, hypertension/preeclampsia, cardiac disease, multiple |

| |gestation, IUGR, preterm labor/ PPROM) |

| |-Antepartum fetal surveillance- indications, frequency, |

| |interpretation |

|Interpersonal and Communication Skills |- Educate inpatients regarding disease and how pregnancy is |

| |affected, discuss indications for inpatient care |

|Professionalism |-Provide effective mentoring and role modeling for junior |

| |residents and students |

|Practice-Based Learning and Improvement |-Present cases at High Risk OB Conference |

| |-Lead teaching at am and pm signout |

| |-Tracing review |

|Systems-Based Practice |-Providing care in team setting with nursing, obstetrics, social |

| |work |

| |-Present at monthly M+M conferences to improve patient safety, |

| |learn from errors, become informed about complex medical issues |

| |-Use Baby Tracker system for data monitoring |

III. Night Float- Obstetrics and Gynecology

GOALS AND OBJECTIVES: Complete management of all inpatients, emergency and inpatient consults, and obstetric triage patients

CORE COMPETENCIES:

|Patient Care |-Complete management of all inpatient obstetric and gynecology |

| |admissions, triage, and consults |

|Medical Knowledge |-Understand management of normal and abnormal labor and delivery |

| |-Understand maternal and obstetric complications of pregnancy and|

| |management/ timing of delivery |

| |-Surgical skills to perform complicated repeat cesarean sections |

| |and laceration repair |

| |-Obstetric emergencies and interventions (postpartum hemorrhage, |

| |eclampsia, shoulder dystocia, malpresentation, cesarean |

| |hysterectomy) |

| |-Management of routine and emergent postoperative/ postpartum |

| |issues |

| |-Supervision of Emergency Department consults and recognition of |

| |surgical emergencies |

| |-Understanding criteria for inpatient admission of gynecologic |

| |patients |

| |-Diagnosis and management of ectopic pregnancy |

| |-Emergency surgical skills |

|Interpersonal and Communication Skills |-Supervise junior residents and delegate responsibilities among |

| |team members to provide appropriate patient care |

|Professionalism |-Provide effective mentoring and role modeling for junior |

| |residents and students |

|Practice-Based Learning and Improvement |-Teaching junior residents: postoperative evaluation, labor and |

| |delivery, triage of obstetric patients, emergency room |

| |consultation, examination skills, surgical skills |

| |-Lead teaching at am and pm signout |

|Systems-Based Practice |-Providing care in team setting with nursing, obstetrics, social |

| |work |

| |-Present at monthly M+M conferences to improve patient safety, |

| |learn from errors, become informed about complex medical issues |

| |-Use Baby Tracker system for data monitoring |

IV. Gynecology- Benign

GOALS AND OBJECTIVES: Exposure to the full range of preoperative, operative, and post-operative gynecologic conditions as the primary decision-maker. This rotation is designed to promote leadership, operative and administrative skill, along with the clinical management of outpatient and inpatient gyn patients.

CORE COMPETENCIES:

|Patient Care |-Direct and manage the Benign Gynecology service |

| |-Oversee all Emergency Room and floor consults and formulate plan|

| |of care |

| |- Care for OBGYN patients in the outpatient Dickens Center |

| |setting, with emphasis on preoperative counseling and |

| |postoperative follow up |

| |-Prepare patients for outpatient and inpatient benign gynecologic|

| |surgery |

| |-Coordinate coverage for all cases at HUP, VA, Presbyterian |

| |Hospital |

| |-Supervise patients followed in quant book and intervene with |

| |treatment as deemed necessary |

|Medical Knowledge |-Full range of gynecologic procedures as primary operating |

| |surgeon |

| |-Medical and surgical options/ indications for benign gynecologic|

| |disease |

| |-OR complications and management |

| |-Postoperative care and management of complications |

| |-Treatment options for early pregnancy failure and ectopic |

| |pregnancy |

| |-Treatment for acute vaginal bleeding |

|Interpersonal and Communication Skills |-Supervise junior residents and delegate responsibilities among |

| |team members to provide appropriate patient care |

| |-Communicate with Gyn attending regarding floor admissions and |

| |emergencies |

| |-Communicate with patients followed in quant book regarding |

| |diagnosis and plan of care |

|Professionalism |-Provide effective mentoring and role modeling for junior |

| |residents and students |

| |-Supervise ER and floor consults and provide coordinated, timely |

| |care |

| |-Discuss scheduled OR cases with attending prior to admission |

|Practice-Based Learning and Improvement |-Attend morning conferences |

| |-Present cases at Tuesday Gyn Case Conference |

|Systems-Based Practice |-Present at monthly M+M conferences to improve patient safety, |

| |learn from errors, become informed about complex medical issues |

| |-Continue use of ACGME database for case collection |

V. Ambulatory- Dickens Center

GOALS AND OBJECTIVES: Exposure to and management of outpatient obgyn primary care, allowing the establishment of continuity of care, office practice management, knowledge of ambulatory medicine, and assessment of patients requiring inpatient and surgical treatments

CORE COMPETENCIES:

|Patient Care |-Providing outpatient management of routine and complex |

| |gynecologic issues |

| |-Providing follow-up for patients seeking care through the |

| |emergency room setting and facilitating their entry into the |

| |system |

| |-Prepare patients for outpatient and inpatient benign gynecologic|

| |surgery |

| |-Assist Antepartum Chief with outpatient management of prenatal |

| |care for high-risk obstetric patients |

|Medical Knowledge |-Age-appropriate preventive medicine skills |

| |-Ambulatory procedures (colposcopy, endometrial biopsy, IUD |

| |insertion) |

| |-Appropriate follow-up treatment for abnormal screening imaging |

| |and/or lab abnormalities |

| | |

|Interpersonal and Communication Skills |-Identify patient needs and coordinate care in comprehensive |

| |fashion with awareness of clinic resources |

|Professionalism |-Provide effective mentoring and role modeling for junior |

| |residents and students |

| |-Ensure smooth and timely flow during resident clinic sessions. |

| |-Follow up lab results in a timely/ appropriate fashion |

|Practice-Based Learning and Improvement |-Attend morning resident conferences |

| |-Attend High-Risk OB conferences |

|Systems-Based Practice |-Know proper coding for preventive and evaluation/management |

| |visits |

| |-Advise junior residents regarding patient flow and proper |

| |documentation for office visits |

| |-Appropriately use knowledge of clinic resources (nursing, social|

| |work, nutrition, financial)to optimize patient care |

VI. Reproductive Endocrinology and Infertility

GOALS AND OBJECTIVES: Exposure to complex surgical procedures as evaluation and treatment of infertility

CORE COMPETENCIES:

|Patient Care |-Acting as primary or assistant operating surgeon for all complex|

| |REI operative procedures such as myomectomy, operative |

| |hysteroscopy, operative laparoscopy, tuboplasty/ reanastamosis, |

| |endometriosis, treatment of ectopic pregnancy |

|Medical Knowledge |-Full range of gynecologic REI procedures as primary or assistant|

| |operating surgeon |

| |-Medical and surgical options/ indications for evaluation and |

| |treatment of infertility |

| |-OR complications and management |

| |-Postoperative care and management of complications |

|Interpersonal and Communication Skills |-Communicate effectively with patients in language appropriate to|

| |age, educational, cultural, socioeconomic background |

| |-Convey information to colleagues in a concise, effective manner;|

| |especially with coordination of care with benign GYN service |

|Professionalism |-Demonstrate a commitment to excellence and interest in ongoing |

| |professional development |

|Practice-Based Learning and Improvement |-Attend REI conferences |

| |-Attend morning resident conferences |

|Systems-Based Practice |-Use Blackboard on-line curriculum to broaden knowledge base and |

| |improve patient care |

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download