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R1 Objectives

SMH Gynecology

The gynecology rotation is a six to seven week block. R1s provide coverage of the gynecology floors, take consultations from the emergency room and assist on appropriate cases in the operating room. The R1 takes 3-4 Saturday calls at SMH.

Medical Knowledge

  • Develop a core knowledge of:
    • Contraceptive options
    • Gynecological emergencies
    • Infections that primarily affect the vagina and vulva
    • Physiology of a normal menstrual cycle
    • Pelvic anatomy
    • Types of abortion
    • Sterile technique
    • Informed consent process
    • Normal postoperative care
    • Postoperative pain management
  • Differentiate between types of abortions
    • Threatened
    • Incomplete
    • Complete
    • Inevitable
    • Septic
  • Recognize an intrauterine pregnancy, an ectopic pregnancy and adnexal mass on ultrasound
  • Interpret BHCG results in normal and abnormal pregnancy

Patient Care

  • Perform:
    • Pelvic exams
    • Pap smear
    • Wet prep
    • pH of the vagina
    • Nonpregnant dilation and curettage
    • Insertion of Ward catheter
    • Diagnostic hysteroscopy
    • Diagnostic laparoscopy
    • Laparoscopic bilateral tubal ligation
    • Cervical conization (LEEP)
    • A forensic exam on the sexually assaulted patient
    • Endometrial ablation via various techniques
    • Postpartum tubal ligation
  • Prescribe:
    • Medical contraception
    • Patient controlled analgesia
    • Medical therapy for an ectopic

Interpersonal and Communication Skills

  • Counsel patients regarding:
    • Safe sex
    • Sexually transmitted disease
    • Family planning
    • HIV testing
  • Provide an adequate check out to the on call team to ensure excellent patient care
  • Provide care to the sexually assault patient in a emotionally sensitive manner

Professionalism

  • Demonstrate sensitivity to patient’s anxiety regarding a pelvic exam
  • Become tolerant of value systems different than your own

Practice Based Learning

  • Obtain an informed consent
  • Dictate operative notes and discharge summaries
  • Practice proper sterile technique

System Based Practice

  • Become familiar with the criteria for inpatient versus outpatient surgery
  • Increase awareness of the cost of surgical versus medical options for treating a disease such as fibroids and ectopic pregnancies
  • Understand the legal issues involved in gathering evidence after sexual assult

Learning Resources

  • The Resident Resource Room has major gynecology textbooks, instructional videos and access to computers.
  • Residents attend Thursday morning Grand Rounds followed by protected teaching time.
  • Prior to cases on weekdays the team and the attending review current patients and a short educational presentation is given.

Evaluations

  • Faculty and resident colleagues are encouraged to provide direct verbal feedback so that resident performance can be commended or improved during the rotation
  • Residents are evaluated via a Web-based evaluation system at MyEvaluations.com at the end of each rotation using a standardized evaluation form given to supervising OB/GYN attendings and upper-level residents. Attending evaluations are available for immediate review by the resident once completed.
  • Problems , , which appear to be of a more urgent nature, will be brought immediately to the attention of the resident and residency program director for discussion.
  • Residents will receive a form at the end of each rotation via MyEvaluations.com soliciting feedback regarding the rotation, upper-level residents, and faculty. This information is shared anonymously and used for course/faculty improvement activities.