Overview
The gynecology rotation is a preceptorial rotation lasting 1 block. The rotation occurs at Memorial Hospital, in the gynecologist’s office and in other locations included in the gynecologist’s usual practice. The teaching of gynecology in the program includes this rotation as well as experiences in the Family Medicine Center, the noon conference series and on other rotations (See other curricula).
Goals
At the completion of this rotation, the resident will have an understanding of the practice of gynecology in a community setting, which will facilitate appropriate referral practices in the future.
At the completion of this rotation, the resident will have knowledge and skills in the areas of gynecology pertinent to the practice of family medicine.
Objectives
At the completion of this rotation, the resident will have demonstrated to the satisfaction of the gynecology preceptor:
- medical knowledge in gynecology pertinent to the practice of family medicine, including the appropriate evaluation and treatment of (MK): abnormal uterine bleeding, amenorrhea, anorgasmia, anovulation, gynecologic infections, abnormal Pap smears, contraception, cystocele, dysmenorrhea, endometriosis, urinary incontinence, infertility, menopause, osteoporosis, gynecologic cancers, polycystic ovary syndrome, puberty and sexual development and uterine prolapse.
- the ability to perform an appropriate history and physical examination on the gynecology patient and to present these findings to another physician in an appropriate manner (PC).
- the ability to interpret appropriate data related to the gynecology patient and arrive at reasonable diagnostic and management decisions, weighing alternatives, benefits and risks of diagnostic and therapeutic options, and co-managing patients appropriately with other specialists (PC).
- the ability to make appropriate decisions to assure high-quality care in a cost-effective manner (SBP).
- communication and interpersonal skills, which facilitate positive and therapeutic relationships (ICS).
- the ability to work cooperatively with other health professionals as part of a healthcare team (PC).
- compassion, respect and integrity; responsiveness to the needs of patients and society that supersedes self-interest; accountability to patients, society and the profession; a commitment to excellence and on-going professional development (P).
- a commitment to ethical principles pertaining to the provision or withholding of clinical care, confidentiality of patient information, informed consent and business practices (P).
- sensitivity and responsiveness to a patient’s culture, age, gender and disabilities (P).
There are no specific procedural requirements for this rotation. However, there is a separate Procedures Curriculum, and residents may gain experience meeting these requirements during this rotation. Procedures typically performed by residents on this rotation with the gynecologist include (PC): pap smear, assist in surgery, IUD insertion, colposcopy with cervical biopsy and endocervical curettage, cryotherapy, endometrial biopsy and LEEP.
Implementation
This is a preceptorial rotation, so the resident is assigned to a particular gynecologist or gynecology group. The resident will accompany the gynecologist during his/her professional activities in Memorial Hospital, in the gynecologist’s office and in other locations involved in the preceptor’s usual practice. In the course of seeing patients, the gynecologist will provide experiential learning, role-modeling and one-on-one teaching to the resident. At the discretion of the preceptor, the resident may be assigned to research specific topics in gynecology.
The resident is responsible for contacting the gynecologist prior to the start of the rotation to arrange a schedule for the rotation. The resident must continue to meet usual residency obligations to his/her Family Medicine Center population including attending scheduled clinics, caring for continuity patients admitted to Memorial Hospital and rounding in the nursing home. The resident is expected to attend noon conferences and abide by duty-hour restrictions in keeping with usual program policies. Upon completion of the rotation, the resident must complete and return the evaluation form provided by the program.
Evaluation
The gynecology preceptor will complete an evaluation form at the end of the rotation. Residents will specifically be evaluated on the following ACGME Milestones:
- PC-1: Cares for acutely ill or injured patients in urgent/emergent situations and in all settings.
- PC-2: Cares for patients with chronic conditions.
- MK-1: Demonstrates medical knowledge of sufficient breadth and depth to practice family medicine.
- MK-2: Applies critical thinking skills in patient care.
- PROF-2: Demonstrates professional conduct and accountability.
- C-2: Communicates effectively with patients, families, and the public.
