Department of Obstetrics and Gynecology



Department of Obstetrics and Gynecology

Residency Curriculum Goals and Education Objectives

Revised: June 2011

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 labor management skills especially in patients with high-risk pregnancies

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 |

| |-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 |

| |-Be familiar with obstetric emergencies and team-based management|

| |i.e. shoulder dystocia, stat c/s, breech |

|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 |

| |-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 |

| |-Communicate with senior residents, fellows and attendings with |

| |regards to changes in patient status |

| |-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 monthly M+M conferences to improve patient safety, learn |

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

| |-Attend Morning and Noon Conferences |

| |-Adopt and encourage debriefing as critical component of |

| |team-based care and practice-based learning |

|Systems-Based Practice |-Use Baby Tracker system for data monitoring |

| |-Adopt Pitocin protocol, Second stage protocol |

II. Obstetrics—Night Float

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 labor management skills

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 |

| |-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 |

| |-Be familiar with obstetric emergencies and team-based management|

| |i.e. shoulder dystocia, stat c/s, breech |

|Interpersonal and Communication Skills |-Communicate with senior residents, fellows and attendings with |

| |regards to changes in patient status |

| |-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 with complicated pregnancies, 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 monthly M+M conferences to improve patient safety, learn |

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

| |-Attend Morning Conferences |

| |-Adopt and encourage debriefing as critical component of |

| |team-based care and practice-based learning |

|Systems-Based Practice |-Use Baby Tracker system for data monitoring |

| |-Adopt Pitocin protocol, Second stage protocol |

III. Gynecology- Benign

GOALS AND OBJECTIVES: Exposure to all aspects of gynecology including but not limited to:

1. Outpatient preoperative evaluation

2. Medical and surgical treatments for common benign gynecologic conditions

3. Surgical procedures

4. Postoperative care of patients undergoing surgical procedures for benign gynecologic conditions

5. Gynecologic consultation

6. Diagnosis and management of early pregnancy

CORE COMPETENCIES:

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

| |Presbyterian Hospital |

| |-Perform abdominal hysterectomy |

| |-Assist vaginal hysterectomy |

| |-Perform advanced laparoscopic surgery |

| |-Assist with robotic procedures |

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

| |patients as well as inpatient admissions |

| |Participate in postoperative care for Urogynecology and REI |

| |surgical 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 |

| |-Attend colposcopy clinic—1000 Courtyard |

| |-Attend Dickens preop clinic |

| |-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 |

| |-Use ultrasound to diagnose ectopic pregnancy/ SAB |

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

| |disturbances |

| |-Know ASCCP guidelines for management of abnormal pap smears and |

| |risks associated with preinvasive cervical disease |

| |-Recognize the acute abdomen and know gyn differential diagnosis |

| |-Understand preop evaluation of the gynecologic patient |

| |-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 for all outpatient procedures |

| |-Learn how to provide informed consent for hysterectomy |

| |-Perform Quant book follow up phone calls and letter |

| |correspondence |

|Professionalism |-Prepare for cases by reviewing patient chart and reviewing |

| |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 Gyn preop conference and lead article reviews |

| |-Attend Colposcopy 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 |

|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. Urogynecology

GOALS AND OBJECTIVES: Exposure to subspecialty of urogynecolopgy with in-depth exposure to outpatient referral-based specialty and complex surgical procedures for treatment of urinary incontinence and pelvic organ prolapse

CORE COMPETENCIES:

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

| | |

| |-Evaluate patients in outpatient setting for urinary incontinence|

| |and pelvic organ prolapse |

| |-Fit pessaries |

| |-Perform and interpret urodynamics |

| |-Perform outpatient cystoscopy |

| |-Participate in data collection to quantify symptoms and QOL |

|Medical Knowledge |-AUGS modules |

| |-Pelvic anatomy including support structures |

| |-Understand urinary system and nerves, musculature that play role|

| |in maintaining continence |

| |-Understand sexual function and factors that lead to dysfunction |

| |-Understand chronic pelvic pain, treatments especially diagnosis |

| |and treatment of interstitial cystitis/ painful bladder syndrome |

| |-Interpretation of urodynamic parameters |

| |-Medical options for urinary incontinence |

| |-Be familiar with various types of pessaries and indications for |

| |use |

| |-Be comfortable with assessment of pelvic organ prolapse using |

| |POP-Q |

| |-Be familiar with Baden-Walker classification for pelvic organ |

| |prolapse |

| |-Understand indications for and use of biofeedback |

| |-Know surgical options for correction of urinary incontinence and|

| |pelvic organ prolapse |

|Interpersonal and Communication Skills |-Counsel patients with urogynecologic conditions regarding |

| |medical and surgical options for intervention |

| |-Shadow fellows and attendings to learn how to present |

| |recommendations |

| |-Develop dynamic interaction with fellows and attendings to |

| |maximize educational experience |

| |-Present case at fellows urogynecology conference |

| |-Work with benign gynecology team to care for post-op inpatient |

| |service |

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

| |to needs of patients |

| |-Learn how to perform outpatient consultation and provide summary|

| |of recommendations to requesting physician |

|Practice-Based Learning and Improvement |-Participate in and attend fellows urogynecology conference |

| |-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. Ambulatory-- 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 transvaginal 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 |

| |-Perform accurate and focused history and physical exam, develop |

| |an appropriate differential diagnosis and be able to discuss |

| |treatment options |

| |-Appropriately consult with other medical specialties as needed |

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

| |professional development |

| |-Exposure to ASRM |

|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 |

| |-Recognize disparities with ART access based on race, |

| |socioeconomic status, insurance |

I. Ambulatory—Penn Family Planning and Pregnancy Loss

GOALS AND OBJECTIVES: Exposure to comprehensive family planning, options counseling, and induced and spontaneous abortion. Experience in this rotation includes but is not limited to:

1. Working with Divisions of Maternal Fetal Medicine and Genetics in the management of pregnancies with diagnosed fetal anomalies, second-trimester pregnancy complications, and serious maternal conditions

2. Providing a range of options for the management of pregnancy loss or miscarriage

3. Providing education, access to contraception, and counseling to prevent unplanned pregnancies.

CORE COMPETENCIES:

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

| | |

| |-Care for women referred from MFM and Genetics with diagnosed |

| |fetal anomalies, second-trimester pregnancy complications, and |

| |serious maternal conditions |

| |-Care for patients presenting with pregnancy loss or miscarriage |

| |-Care for patients in need of contraception, especially those |

| |with serious medical conditions |

| |-Perform transvaginal ultrasound to assess early pregnancy |

| |-Perform office MVA |

| |-Perform D+E in first and second trimester |

| |-Perform medical management of pregnancy loss or miscarriage |

| |-Provide LARC- Mirena, Paragard, Implanon |

|Medical Knowledge |-Be familiar with history of contraception |

| |-Understand mechanism of COCs, progestin-only contraception, LARC|

| |-Understand physiologic effects of pregnancy and contraception |

| |-Be familiar with fetal anomalies and maternal and fetal |

| |conditions that complicate pregnancy |

| |-Understand HCG, TVS and diagnosis of PUL vs. IUP vs. ectopic and|

| |management |

| |-Understand medical management of early pregnancy loss or |

| |miscarriage |

|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 |

| |-Perform accurate and focused history and physical exam, develop |

| |an appropriate assessment and be able to discuss treatment |

| |options |

| |-Appropriately consult with other medical specialties as needed |

| |-Exhibit appropriate sensitivity to patients during a critical |

| |decision-making process |

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

| |professional development |

| |-Discuss opt-out with supervising attendings on as needed basis |

| |-Practice with consideration of values exercise and address on as|

| |needed basis |

|Practice-Based Learning and Improvement |-Present monthly contraception talk at Resident Didactics |

| |-Attend morning resident conferences |

| |-Present cases at M+M |

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

| |improve patient care |

| |-Recognize disparities with contraceptive access based on race, |

| |socioeconomic status, insurance |

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