RCOG Curriculum Consultation 2009



Core Module 13: Gynaecological ProblemsLearning outcomes: To understand and demonstrate appropriate knowledge, skills and attitudes in relation to common gynaecological disordersTo understand paediatric and adolescent gynaecological disorders.Knowledge criteriaGMPClinical competencyGMPProfessional skills and attitudesGMPTraining supportEvidence/assessmentTo understand the epidemiology, aetiology, biological behaviour, patho-physiology, clinical characteristics, prognostic features and management of:Menstrual disordersBenign conditions of the genital tractEndocrine disordersProblems of the climacteric Pelvic painVaginal dischargeEmergency gynaecologyCongenital abnormalities of the genital tract Paediatric gynaecologyPubertyAble to describe the natural history of diseases and illnesses that run a chronic courseHave knowledge of long term management plans for chronic conditions (see Module 2)Able to describe the anatomy and physiology of the vulva, and its variation between prepubertal, reproductive and post-menopausal state1,2Diagnose, investigate and manage common gynaecological disordersEndometrial assessment**Diagnostic hysteroscopy**Diagnostic laparoscopy: staging of endometriosis See Module 7 for other surgical competenciesRecognise the need for appropriate referral for more complex or detailed evaluation with ultrasound or other imagine techniquesSee ultrasound modules for other ultrasound competenciesTake a vulval historyCounsel patient on the use of topical steroids/emollients on the vulvaInterpret histopathological reports and ask a histopathologist if needed1,2Demonstrate the ability to communicate prognosis and counsel patients sensitively about the options availableHave the necessary skills to explain the nature, complications and adverse effects of medical and surgical treatmentsDemonstrate the ability to formulate and implement a plan of management and have the ability to modify this as necessary Recognise the need for appropriate referral for more complex or detailed evaluation with ultrasound or other imaging techniquesHave the skills to liaise with colleagues in other disciplines where requiredDemonstrate and understanding of the use of appropriate referral pathways and local protocols if abnormal findings : Gynaecological Problems and Early Pregnancy Loss e-tutorials**Use of low fidelity (box) trainers or virtual reality (VR) simulation to enhance psychomotor skillsSupervised clinical sessionsSpecific courses and academic meetingsLocal and regional courses in paediatric gynaecological problems and problems of puberty National Institute for Clinical Excellence. Scottish Intercollegiate Guidelines Network websiteScottish Health on the Web websiteThe Obstetrician and Gynaecologist journalLocal and regional courses in assessment and management of vulval disordersBritish Society for the Study of Vulval Disease website Greentop Guideline No 58 – Management of vulval skin disorders (2011)LogbookReflective diaryLog of experiencesMRCOG Part OneMRCOG Part TwoAudit projectMSF (TO1 and TO2)OSATS: Diagnostic LaparoscopyAppendix to Module 13: details of knowledge criteriaMenstrual Disorders:Menstrual irregularityExcessive menstrual lossInvestigation of menstrual disordersMedical and surgical management of menstrual disordersFibroids Non menstrual bleeding (intermenstrual, postcoital)Premenstrual syndrome Problems of the climacteric:Abnormal bleedingPostmenopausal bleedingHormone replacement therapyNon hormonal therapy Osteopenia and osteoporosisBreast cancer in relation to the climactericAmenorrhoea and endocrine disorders:Investigation and interpretation Hypothalamic/pituitary disordersHyperprolactinaemiaPremature ovarian failurePolycystic ovaries and polycystic ovarian syndromeOther causes of hyperandrogenismThyroid / adrenal disordersAutoimmune endocrine diseaseCongenital abnormalities of genital tract:Ambiguous genitaliaImperforate hymenVaginal septaeUterine anomaliesMullerian duct developmentGonadal dysgenesisPuberty:Physiology and chronologyPrecocious pubertyDelayed pubertyExcessive menstrual lossBenign conditions of the lower genital tract:VulvaPruritus vulvaeNon-neoplastic cystsVulvodyniaVulval painLichens (sclerosus, simplex, chronicus and planus)Contact dermatitisPsoriasisVaginaVaginal discharge (non sexually transmitted causes)Pelvic pain:DysmenorrhoeaDyspareuniaEndometriosis (staging, treatment)Pelvic inflammatory diseaseNon-gynaecological disorders Ovary:Benign ovarian neoplasmsFunctional ovarian cystsEmergency gynaecology:Pelvic inflammatory diseaseBartholin's and vulval abscessOvarian cyst accidentsAcute vaginal bleeding outwith pregnancyMiscarriage and ectopic pregnancyCore Module 13 LogbookCompetence level Basic level Intermediate level Advanced level Not requiredLevel 1Level 2Level 3DateSignatureDateSignatureDateSignatureDiagnose, investigate and manage the following clinical problems:Menstrual disorders:Menstrual irregularityExcessive menstrual lossPremenstrual syndromeAmenorrhoea/oligomenorrhoeaDysmenorrhoeaPelvic pain:DyspareuniaEndometriosis (medical management)Endometriosis (surgical management)Pelvic inflammatory diseaseNon-gynaecological disordersProblems of the climacteric:Postmenopausal bleedingHormone replacement therapyOthers:Benign ovarian cystsVaginal dischargeFibroidsHirsutismPruritus vulvaeVulval painTraining Courses or sessionsTitleSignature of educational supervisorDateProblems of pubertyRape/ forensic gynaecologyPaediatric gynaecological problemsAuthorisation of signatures (to be completed by the clinical trainers)Name of clinical trainer (please print)Signature of clinical trainerOSATSEach OSATS should be successfully completed for Independent Practice on 3 occasions before the module can be signed offDiagnostic laparoscopyDateDateDateSignatureSignatureSignatureCOMPLETION OF MODULE 13I confirm that all components of the module have been successfully completed:DateName of educational supervisorSignature of educational supervisor ................
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