Reading Topics: Gynecology | Obstetrics
Reading is an essential complement to your clerkship learning experience. This will enable you to accomplish many of the behaviors listed above, and also prepare for the final examination. You are responsible for learning about each of the content areas in Gynecology and Obstetrics listed in this section. In order to get an "honors" in the clerkship, students will need to learn about every topic listed under the textbook section. Students may read about the topic from any source.
The recommended primary text is Blueprints Obstetrics and Gynecology 6th Edition 2013, Callahan TL, Caughey AB (shop). In addition, we suggest that you learn about contraception from Guide to Managing Contraception, 2013-2014, Hatcher et al, which is available for free download on iTunes, and also in the Reference section of this website. Although the Blueprints text is an excellent basic resource, I strongly encourage you to supplement your knowledge with other more in-depth reading from Gabbe's Obstetrics: Normal and Problem Pregnancies and Stenchever's Comprehensive Gynecology.
Seattle area students who plan to rent the Blueprints textbook (non-WWAMI site students only), should have $10.00 in cash or check payable to the University of Washington on the morning of orientation. Students are responsible for returning all rented books to the Clerkship Coordinator no later than the last day of the clerkship.
The basic texts are furnished to WWAMI sites at no cost. In addition, other reference books are available at each site. All students are responsible for using provided books with care and consideration. All books MUST be returned to their proper location BEFORE leaving the site, including materials personally loaned to you by faculty at the site. Failure to return books is considered non-professional behavior and results in an Incomplete for the course until missing books are returned or replaced. Grades will also be reported as Incomplete if students leave outstanding bills (phone, etc) at the site without making payment arrangements with the appropriate site person.
Additional resources are listed below:
Additional Basic Texts
- Comprehensive Gynecology 4th Edition: 2002; Stenchever, et al ISBN:032301402X
- Obstetrics: Normal and Problem Pregnancies 4th Edition: 2001; Gabbe et al ISBN: 0443065721
Supplementary Texts Recommended for Reference (most are available at all sites)
- Atlas of Pelvic Surgery, 3rd ed. Wheeless, 1997
- Breast Feeding, 6th ed. Ruth Lawrence, 2005
- Clinical Gynecologic Endocrinology & Infertility, Speroff, Fritz, 2004
- Clinical Gynecologic Oncology, 6th ed. DiSaia, Creasman, 2002
- Drugs in Pregnancy and Lactation, 7th ed. Ziggs, Freeman, Yaffe, 2005
- Essentials of Obstetrics and Gynecology, 4th ed. Hacker, et al, 2004
- Fetal Heart Rate Monitoring, 3rd ed. Garite, 7th ed. Nageotte, 2003
- Maternal-Fetal Medicine, 5th ed. Creasy, Resnik, Iams, 2004
- Medical Complications During Pregnancy, 6th ed. Burrow, Duffy, Copel, 2004
- Novak's Gynecology, 13th ed. Berek, 2002
- Lange Q&A Obstetrics & Gynecology Review, 9th ed. Katz, et al, 2011
- Te Linde's Operative Gynecology, 9th ed. Rock, Jervis III, 2003
- Urogynecology, Lentz, 1999
- Williams Obstetrics, 22nd ed, Cunnigham, MacDonald, Gant, 2005
Reading is essential if you wish to do well on the final exam.
Students must have active patient involvement in each category OR complete a corresponding APGO uWise quiz as an alternative:
|Condition or Disease
|Abnormal Pap Smear
||Unit 1-Quiz #3
|Abnormal Uterine Bleeding
||Unit 4-Quiz #45
|Cesarean Section Delivery
||Unit 2-Quiz #32
|Complicated OB(Diabetes, preterm labor, premature membrane rupture, Hypertensive disorders, 3rd trimester bleeding)
||Choose 1 Quiz:
Unit 2-#17, 18, 19, 20, 23, 25
||Unit 3-Quiz #33
|1st Trimester Bleeding
Choose 1 Quiz:
Unit 2-Quiz #15, 16
Uint 3-Quiz #34
|Intrapartum Care of Laboring Patient
||Unit 2-Quiz #11
||Unit 4-Quiz #47
||Choose 1 Quiz:
Unit 5-Quiz #53, 54, 55
||Choose 1 Quiz:
Unit 3-Quiz #38, 39
Unit 4-Quiz #46, 49
||Choose 1 Quiz:
Unit 2-Quiz #13, 14
Choose 1 Quiz:
Unit 2-Quiz #9, 10
||Unit 2-Quiz #32
|Vaginitis or Gynecologic Infection
Choose 1 Quiz:
Unit 3-Quiz #35, 36
Students will document these patient encounters using the Catalyst on-line log. Students should use the LCME Patient Encounter Form to keep a weekly tally before entering the data on Catalyst (form available in Reference tab of this website).
Once completed, the student must:
- Submit the Quiz
- Print the Submission Confirmation
- Present that confirmation to the clerkship coordinator by the final day of the clerkship.
Clinics or Physician's Offices
You will be assigned to work in specific clinics or offices. Participating clinical faculty have reserved time to teach you. All assigned clinics are required. Prolonged and/or unexcused absences from the clerkship may require remedial make-up time or repetition of the clerkship.
In your office experience you will probably initially observe patient care, and as your skill and rapport increase, you will probably take a more active part. For your protection, all chart notes must be signed by a physician involved with the case.
Inpatient or Outpatient Workups
The workups consist of complete histories and physicals, detailed write-ups, which may be incorporated into the patient's chart. All workups will be reviewed by the physicians involved in the case and some will be re-examined for the specific purpose of providing you with feedback. Obtain preceptor feedback early so you can steadily improve. All workups or other notes in charts must be signed by a physician. You are required to complete a minimum of 3 workups during your 6-week clerkship; many sites require more than the minimum.
Sample workups are available in PDF format in the Reference tab of this website.
There are several bioethical issues that arise in obstetrics and gynecology. There are many scenarios with potential ethical dilemmas that are handled well and others that result in conflict, either between individuals or internally.
You are required to identify a bioethical dilemma during the rotation and reflect on it.
- Choose a case observed or participated in during the rotation. Alternately, you can invent a medically plausible case, chosen from one of the following broad topics:
- Maternal-fetal conflict
- Informed consent
- Surrogate decision making
- Medical futility
- Moral objection to some aspect of obstetrics or gynecologic care (provider or patient objection)
- Write up your reflection
- 1-2 pages and reflection must:
- Describe the specific obstetric or gynecologic scenario and the medical or surgical decision. Outline the relevant medical facts.
- Frame the ethical dilemma: what were the competing rights, values, oblications, or interests?
- Describe the course of action taken and what arguments could be used to justify that course of action.
- Describe a different course of action that might have been taken and provide support for that counterargument.
- As an alternative to the 1-2 page reflectionin Section 2a (above), you can fillin the 4-box paradigm with the medical considerations, pateitne preferences, quality of life and contextual features specific to your case with a short paragraph explaining how information was applied and the outcome: http://depts.washington.edu/bioethx/tools/4boxes.html
Pelvic Exams, Breast Exams, Deliveries, Workups and other Patient Experiences
While no specific number of clinical experiences is required, it is expected that you will have opportunities for a wide variety of clinical experiences by participating at different levels of involvement from observer to primary doer. Each site will differ in the number of deliveries, pelvics, and workups available to medical students. Past experience has shown that students who demonstrate interest by being available and prepared to perform at appropriate skill and knowledge levels get to do more. Key words are "BE AVAILABLE and BE READY."
Mini-CEx (Clinical Examination Skill)
An observed performance of a skill on which you receive specific feedback is required in each of the basic clerkships. The Obstetrics and Gynecology clerkship has chosen the performance of pelvic and breast exams, including patient communication, professional attitude, and actual performance of the examination, to be our required mini-CEx. Following are forms to be used for its evaluation and feedback. You should expect to have observed pelvic and breast examinations with the required feedback at least once during your clerkship, preferably occurring after the mid-point and preferably more than one time so that you can judge your progress in this important physical examination skill. It is the student's responsibility to submit this to the clerkship coordinator by the conclusion of the clerkship (final grades will be held until received and a statement appearing under the Overall Assessment of Professional Behavior or Conduct on your final evaluation form submitted to the Registrar).
Each site will have its own schedule of the above activities. The schedule should be reviewed with you early in the clerkship. In the event that circumstances do not allow for this review, the student is responsible for finding out about the schedule. Students are responsible for making appointments for regular meetings with their preceptors. During your meetings with the faculty, a number of topics will be discussed and specific patient workups will be reviewed. This activity may be carried out differently at each site, but the aim of the department is to provide one hour of student/faculty interaction per week. Meeting with your preceptors for discussion and review of workups is your responsibility. Your preceptor should review a minimum of one of your workups each week. Contact your assigned preceptor early in the first week to arrange for weekly meetings and review of your patient workups. Workups should be reviewed each week.
Do not wait until the last week of the clerkship to have your workups reviewed!
You should also discuss the content material in OB/GYN with your designated faculty member (preceptor). The means of discussing this material may be via a case on the wards, assigned reading, or cases brought in by the faculty member or student. Feedback on your performance from preceptors and others at the clerkship site is important. We also strongly suggest that you informally request such feedback during the clerkship. Before leaving the site you should feel free to request your main preceptor(s) to review your evaluation with you. This evaluation includes your grades on the oral presentation, workups, and the student performance evaluation form.
A mid-rotation evaluation (completed by reviewing Faculty/Resident) is required for final grade release. This Student Competency Assessment card will be distributed at orientation and is also available below in PDF format. It is the student's responsibility to submit this to the clerkship coordinator by the conclusion of the clerkship (final grades will be held until this is received and a statement appearing under the Overall Assessment of Professional Behavior or Conduct on your final evaluation form submitted to the Registrar).
You are expected to prepare an oral presentation not to exceed 20 minutes on an Ob/Gyn topic of your choice. Ten minutes are allowed for questions following each 20-minute presentation. All students at each site are expected to be present and to participate in the question period.
To receive a passing grade you are required to submit a copy of your powerpoint slides and a bibliography to the faculty presentation reviewers at your clerkship site (we do not need the slides in the Seattle office). You must also use at least three different journals as references. Presentation grade is an automatic FAIL until these requirements are met. You will need to limit the scope of the topic you present so you can cover it in detail in 20 minutes. For example, do not try to cover the entire field of female genital cancers, but rather restrict your topic to one aspect of it such as epidemiology of vulvar in situ carcinoma.
Please check with your preceptor and/or site director regarding the presentation requirement at your site. Presentation dates and times differ at every clerkship site, but are typically in the fifth week of the rotation.
Examples of typical presentation topics:
- Antepartum management of high-risk pregnancy
- Diabetes and pregnancy
- Dysfunctional uterine bleeding
- Diagnosis and treatment of breast disease
Clerkship Evaluation (Required)
To improve the basic Ob/Gyn clerkship, we need your assistance. A Student Evaluation of Clerkship and Student Evaluation of Educator (for each faculty/resident you worked with) completed thoughtfully via E*Value are required for completion of the clerkship. Final clerkship grades will be held until these are completed.