This edition is designed to provide an organized and understandable set of objectives for all medical students, regardless of future specialty plans. The knowledge, skills and attitudes are intended to be both a resource for course design for faculty and clerkship directors, and a useful study guide for medical students.  Each educational objective is linked to the level of competence a student should be expected to achieve, the best methods of evaluation and the representative general competency as defined by the ACGME.  

At a minimum, we expect all of our students to master Priority 1 objectives (the essential elements are listed below) and be exposed to the majority of Priority 2 objectives and skills. These essential objectives and skills have been adapted from APGO and are summarized below:

• Clinical skills in the medical interview and physical exam with attention to OB Gyn history and genitourinary examination.

• Collect and interpret cervical cytology results

• Understand and be able to counsel women on  modern contraceptive technology

• Differential diagnosis of the “acute abdomen” – pelvic infection, ectopic pregnancy,

       adnexal torsion, appendicitis, diverticulitis, renal calculi

• Physiologic adjustments that accompany normal gestation, including effects on lab test results

• Social and health policy aspect of women’s health, ethical issues, sterilization, abortion, domestic violence, adolescent pregnancy, access to health care, etc.

• Menstrual cycle, normal and abnormal function, including menopause

• Infertility

• Intrapartum care and common problems in obstetrics

• Breast health, including breastfeeding

• Vaginal and vulvar disorders

• Screening for reproductive cancers

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The OB Gyn clerkship directors from all three UA SOM campuses met, developed, and quantitated a list of OB Gyn procedures that all students must meet as minimum requirements during the 8 week clerkship rotation.  These minimum requirements were developed using the Priority 1 Objectives from the APGO Medical Student Educational Objectives 8th Edition document as a guide. The procedures have been identified by APGO as requiring a "show how" or "do" competency level and the quantity selected was based on prior experiences from all 3 campuses. The goal is for students to gain as much clinical experience as possible and not be limited by these minimum guidelines.

MINIMUM REQUIREMENTS: Minimum requirements were set for each, as noted in ( ):

1.  Inpatient Obstetrics –

• Evaluate OB patients presenting to Labor and Delivery Triage Unit.(5)

• Follow patients intrapartum (during labor). (5)

2.  Outpatient Obstetrics - Perform prenatal evaluations in the OB Clinics. (5)

3.  Inpatient Gynecology – Follow and manage postoperative Gyn patients. (5)

4.  Outpatient Gynecology - Evaluate patients with gynecologic problems. (5)

5.  Conferences –Must attend at least 80% of scheduled student conferences.

6.  Procedures –

• Perform a breast exam and counsel patient on self-examination (5)

• Perform a patient-centered pelvic examination (5).

• Perform an adequate Pap smear and obtain specimens to detect STDs (5).

• Assess gestational age via physical exam of the pregnant woman (5)

• Describe/demonstrate or perform a vaginal delivery (5)

• Perform fetal auscultation and interpret electronic fetal monitoring (5)

• Counsel patients on contraception (5)

• Diagnose and manage patient with vulvovaginal symptoms (5)

• Interpret a wet mount microscopic examination (5)

Click Here to print these minimum requirements in a Check List format.

The members of the Medical Education Committee University of Alabama School of Medicine developed the Core Clinical Competencies. These are a compilation of the professional behavior, clinical skills, medical knowledge and issues regarding family and societal influences in health care that each graduate of the UASOM must have acquired prior to graduation. The following objectives will be stressed during the Ob-Gyn clerkship.

I.  Professional Behavior

All areas of this section will be addressed during clinical interactions with patients, staff, faculty and peers.

• Enhancing communication skills through interpersonal skills

• Professionally and compassionately relating news of serious acute or chronic illness or congenital abnormality to patients and family.

• Identifying, organizing, and recording accurately in the patient record the information needed to appropriately address the patient’s problem/condition

• Self education by utilizing key information sources, literature searches, decision support systems, and assessing the quality of this information/studies and application to clinical practice.

• Developing a productive interaction with patients, encouraging patient autonomy, maintaining confidentiality and maintaining continuing personal responsibility for the patient’s health care.

• Describing the professional and ethical issues facing physicians when encountering and treating the economically disadvantaged.

• Identifying and presenting in an unbiased manner potentially controversial health care issues, including reproductive choice, maternal-fetal conflicts and religious conflicts with the provider

• Professional dress and manner in patient care areas -

II.  Clinical Skills

Interviewing, History and Physical Examination

• Sexual, menstrual and obstetrical history

• Family history as it relates to risk factors for disease and possible congenital anomalies/risks

Exam: Abdominal, genito-urinary-rectal, and breast

Diagnostic Skills: Indications and interpretation of the results for the following tests:

• Pap smear (cytology results)

• Pathology of the genital tract-cervix, endometruim, uterus, ovaries

• Pregnancy tests - urine & serum

• Cultures for sexually transmitted diseases

• Hormonal assays

Screening and Health Maintenance:

• Risk factors for common chronic illnesses and gynecologic disease

• Indications and interpretation of periodic screening tests including the impact of age, ethnicity and other risk factors in women

• Routine prenatal care and deviations from the routine course

• The impact of life style choices on health and disease

Pharmacology and Therapeutics

• Identify pharmacokinetics and volume distribution of medication in the pregnant woman, utilize the pregnancy classification system in the PDR to select drugs

Patient Education

• Prevention/Health Screening: self breast exam, mammograms, pap smears, safe sex, osteoporosis

• Hospital discharge education: postpartum care, breastfeeding, wound care, use of medication, activity restrictions,

Technical Skills

• Pelvic and breast examination

• Place and remove skin staples

• Demonstrate surgical scrub and sterile techniques

• Perform a vaginal delivery

• Obtain a pap smear and cervical cultures

• Episiotomy repair

• Assist with common surgical procedures: hysterectomy, cesarean section, laparoscopy

Emergency Situations

• Recognize hemorrhagic and septic shock, either obstetrical or surgical

• Recognize an acute abdomen

Critical/Perioperative Care

• Complications of labor and delivery including pre-eclampsia, preterm labor, premature rupture of membranes, hemorrhages, abruption, fetal distress, and dysfunctional labor and shoulder dystocia.

• Pre-surgical evaluation of surgical risks factors, indication for surgery, principles of informed consent

III. Medical Content Knowledge

Ambulatory Problems (female reproductive)

• Pre-conceptive counseling for women with chronic common medical conditions affecting the prenatal course and delivery

• Common causes of acute and chronic pelvic pain

• Common breast complaints

• Common causes of abnormal vaginal bleeding patterns including complications of pregnancy

• Primary and secondary amenorrhea

• Vaginitis

• Common causes of urinary problems: UTI, urinary incontinence

• Management of estrogen deficiency

• Contraceptive counseling and management

Inpatient Problems

• Labor, delivery and postpartum

• Pyelonephritis

• Pregnancy complications such as hypertension

Infectious Conditions

• HIV infection

• STD

• Post operative/post-delivery infections

• Infectious agents as they pertain to pregnancy

Neoplastic Conditions

• Cancer of uterus, ovaries, cervix

• Benign neoplasms of uterus, ovaries, cervix and breast

Genetics

• Identify those diseases/conditions for which screening is appropriate preconceptively or during pregnancy

Age-Related Issues

• Normal life cycle physiology and how it impacts on the pathology with particular emphasis on menstrual cycle, puberty and menopause

• Anticipation of female reproductive life cycle changes including physiologic factors and provide education to the patient to help maximize the acceptance of and adaptation to these normal life stages.

• Physiological, emotional, and societal influences of sexuality throughout life stages and their relationship to illness and health in traditional and alternative expression of sexuality.

Gender, Ethnic, Cultural Issues

• Respect for the individual’s values, goals and concerns regarding reproductive choices, infertility, safe sex, and contraception

• Effects of family relationships on health and illness

• Complex behavioral change and other factors involved in patient compliance with medical plan

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