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R1 Objectives

Ultrasound

The ultrasound rotation is six to seven weeks in length. The R1 rotates with the MFM faculty at the ultrasound facility at SMH. One and a half days a week the R1 rotates in the Contraception Family Planning clinic, if he or she chooses to participate. The R1 is on call 3-4 Saturdays at SMH during the block and 3-4 weekdays at HH.

Medical Knowledge

  • Develop a core knowledge of obstetrical and gynecological ultrasound
  • Describe the indications for an ultrasound procedure
  • Recognize the components of a basic obstetrical and gynecological ultrasound as defined by ACOG and AIUM
  • Describe ultrasound findings using the correct terminology
  • Describe the components of a biophysical profile
  • Develop a core knowledge of management of elective termination of pregnancy

Patient Care

  • Identify:
    • Placental location
    • Fetal presentation
    • Fetal number
    • Fetal heart rate
    • Normal uterus and adnexa
  • Measure:
    • Amniotic fluid index
    • Head circumference
    • Biparietal diameter
    • Abdominal circumference
    • Femur length
    • Cervical length
    • Endometrial thickness
  • Perform:
    • Biophysical profile
    • IUD placement
    • First trimester medical termination of pregnancy
    • First trimester surgical termination of pregnancy
    • Laminaria placement
    • Transvaginal ultrasound in the first trimester for dating
  • Understand conscious sedation techniques

Interpersonal and Communication Skills

  • Counsel patients on the limitations of ultrasound
  • Communicate pregnancy abnormalities such as a missed abortion to the patient and family
  • Counsel patients regarding options for termination of pregnancy with empathy

Professionalism

  • Demonstrate sensitivity when performing an transvaginal ultrasound
  • Interact with patients requesting termination of pregnant in an impartial manner

Practice Based Learning

  • Analyze the value of screening ultrasounds
  • Analyze the value of targeted ultrasounds
  • Analyze the value of ultrasound for the detection of Trisomy 21

System Based Practice

  • Understand how anomaly detection affects the cost of health care
  • Understand indications for an ultrasound that are billable and the ones the patient is financially responsible for
  • Become aware of state and federal regulations regarding termination of pregnancy

Learning Resources

  • The Resident Resource Room has major obstetrics and gynecology textbooks, instructional videos and access to computers. The ultrasound reading room has additional pertinent reading material. Images are stored for viewing on computers available in various locations in the hospital.
  • Residents attend Thursday morning Grand Rounds followed by protected teaching time.

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.