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Electives - Obstetrics and Gynecology

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ACE - AI in Ambulatory Gynecology - Student Health (arranged)

Elective Number: 1902

Rotation Supervisors: Dr. Lisa Christianson

Designated Signer: Karen Ahern; kaa7p@virginia.edu; phone: 924-2773; fax 243-6689

Duration: 4 weeks

Available: Rotations 1, 7, 8, 12

IMPORTANT NOTE: This rotation has a 6-week ADD/DROP deadline!!!

Report to: Karen Ahern, BSN, RN

Time to Report: 8:00 am

Place to Report: Student Health Gyn reception desk - 400 Brandon Ave.

Typical day: 8:00 am - 5:30 pm

Attendance: Attendance at elective activities is mandatory. A student may not take time off during an ACE.

  • Anyone who is ill or has a personal or family emergency must contact Student Affairs and the Attending on Service by calling 924-1541 and leaving a message - do NOT email.
  • Students are allowed to take off up to 1 day per week to interview between October 1 and February 1.
    • Specific days missed must be approved by the Attending on Service.

Number of students per rotation: 1-2

Course Description: This elective provides an opportunity for fourth year medical students to increase their proficiency in ambulatory gynecology knowledge, skills, and attitudes by participating in the care of university students. The trainees will have significant autonomy in patient care, medication and disease management, and the ability to gain excellent experience in physical exam skills. Elective participants are expected to increase their knowledge of: well-woman care, normal and problematic aspects of contraception, evaluation and management of menstrual problems, and evaluation and management of vaginal and pelvic infections (including sexually transmitted diseases). They will enhance their skills in gynecologic exams (with emphasis on breast and pelvic exams and microscopic evaluation of genital samples) and in communicating about sensitive topics, particularly sexual practices. They will also enhance their patient education skills. Elective participants will be expected to demonstrate and refine attitudes that are sensitive, non-judgmental, and compassionate toward patients. Elective participants will attend and present at weekly didactic sessions. Trainees will work closely with the clinic staff, including gynecologists, nurse practitioners, and certified nursing assistants. There will be a packet of information (how the clinic functions, tips on documentation/charting, and resources for learning) given to the students, that they can keep after the rotation. There is also a binder with more learning resources, including practice guidelines and relevant articles, which the students may borrow for the rotation, or purchase at the end of the rotation, if desired. There will also be access to on-line health sciences library resources and multiple texts and print-outs of national guidelines available to the students during their rotation. The formal learning objectives for the clerkship are listed in the following paragraph.

Student Health Ambulatory Gynecology Learning Objectives

I. Knowledge Base and History-Taking
a. Be able to take a comprehensive history, including menstrual history, sexual history, contraceptive history, obstetric history, other gynecologic history, medical and surgical history, family history, and social history, with sensitivity to the diversity of cultures and lifestyles.
b. Assess risk for unintended pregnancy, sexually transmitted infections, nutritional problems (obesity/eating disorders), and intimate partner violence, as well as assess patient’s adherence to, and need for, recommended screening tests.
c. Identify risk factors in a patient’s personal or family history for diseases of the breast, cervix, colon, cardiovascular system, skin, and bone.
d. Know appropriate screening recommendations for women of reproductive age, and appropriate health promotion & education topics for anticipatory guidance.
e. Understand the natural course, screening strategies for, and management of HPV, as well as indications for vaccination.
f. Be able to generate a problem list, formulate a diagnostic impression (including differential diagnosis), and develop a management plan that includes appropriate testing, consideration of treatment options, patient education, and follow-up planning.
g. Be able to approach, diagnose, and initiate management of common gynecological disorders in reproductive age women, including:
i. Irregular vaginal bleeding
ii. Irregular menstrual patterns
iii. Abdominal pain
iv. Sexually transmitted infections
v. Vaginitis & common vulvar complaints

II. Clinical Exam and Procedural Skills
a. Be able to perform a complete pelvic and breast examination, assuring patient’s comfort, confidence in her healthcare provider, and dignity.
b. Be able to proficiently collect specimens for cervical cytology and STI screening tests, and perform microscopy for common causes of vaginitis.

III. Professionalism and Communication Skills
a. Be able to develop rapport and work cooperatively with patients, their social supports, and other members of the health care team.
b. Be able to communicate to the patient the examination findings, assessment, and plans for evaluation and management, as well as any additional patient education needed.
c. Be able to write and present a succinct but comprehensive note that accurately communicates the history, physical exam findings, assessment, and plan of care.
d. Be able to provide comprehensive counseling on the following topics :
i. Contraception
ii. Intimate partner violence
iii. Prevention of sexually-transmitted infections
iv. Immunizations
v. Diet/nutrition
vi. Exercise
vii. Alcohol and substance use
viii. Tobacco use
ix. Stress management and mental health
x. Sun exposure
xi. Seat belt use

Note: adapted from the APGO medical student educational objectives, 10th edition