Educational Objectives

The mission of the College of Physicians and Surgeons of Columbia University is to prepare graduates to be leaders and role models who define excellence in patient care, medical research, education and health care policy. During your clerkship in Obstetrics and Gynecology we hope to create a learning environment that fosters the knowledge, skills, attitudes and behaviors of physicians who exhibit the highest levels of professional competence in women’s health care.

You will participate directly in the care of patients in our Labor & Delivery suite, operating room, ambulatory clinics and inpatient hospital services. Didactic sessions including lectures, clinical skills workshops and case study seminars will supplement your core clinical experience.

We have generated the following set of educational objectives for the clerkship, modified from the Association of Professors of Gynecology and Obstetrics (APGO) Medical Student Educational Objectives 9th Edition. Graduating medical students must demonstrate mastery of these competencies that have been identified by the Accreditation Council for Graduate Medical Education (ACGME):

Medical Knowledge
  1. The student will be able to describe the maternal physiologic and anatomic changes associated with pregnancy and the physiologic functions of the fetus and placenta.
  2. The student will be able to describe the stages, mechanisms and management of normal labor and delivery and identify common problems in obstetrics.
  3. The student will be able to describe potential consequences of medical and surgical conditions in pregnancy.
  4. The student will be able to create a differential diagnosis of the “acute abdomen” in women of reproductive age, including pelvic infection, ectopic pregnancy, adnexal torsion, appendicitis, diverticulitis and renal calculi.
  5. The student will be able to explain the physiologic or pharmacologic basis of action, effectiveness, benefits and risks and financial considerations of various methods of contraception.
  6. The student will be able to describe age and risk-appropriate recommendations for the screening of reproductive cancers.
  7. The student will be able to describe the symptoms, physical findings, evaluation, management and public health concerns of various vaginal and vulvar disorders, including sexually transmitted infections.
  8. The student will be able to describe the endocrinology and physiology of the normal menstrual cycle, including menopause, and to describe causes, evaluation methods and therapeutic options for abnormal uterine bleeding.
  9. The student will be able to describe the basic approach to evaluating common symptoms associated with the breast, including preventive measures for maintaining breast health as well as issues related to lactation.
  10. The student will be able to describe age and risk-appropriate recommendations for the screening of reproductive cancers.
Patient Care
  1. The student will demonstrate the ability to perform a thorough Ob/Gyn history, including menstrual history, obstetric history, gynecologic history, contraceptive history and sexual history.
  2. The student will demonstrate the ability to perform an obstetric-gynecologic examination, including breast examination and complete pelvic examination.
  3. The student will demonstrate the ability to collect and interpret cervical cytology results.
  4. The student will demonstrate the ability to interpret electronic fetal monitoring.
  5. The student will demonstrate the ability to interpret a wet mount microscopic examination.
  6. The student will demonstrate the ability to communicate the results of the OB/GYN history and physical examination by well-organized written notes and oral reports.
  7. The student will demonstrate the ability to develop hypotheses, diagnostic strategies and management plans in the evaluation of antepartum, intrapartum and postpartum patients.
  8. The student will demonstrate the ability to develop hypotheses, diagnostic strategies and management plans in the evaluation of patients with gynecologic problems, including routine postoperative care following gynecologic surgery.
Interpersonal and Communication Skills
  1. The student will demonstrate the ability to interact with the patient to gain her confidence and cooperation and assure her comfort and modesty.
  2. The student will demonstrate the ability to address sensitive issues with compassion and demonstrate sensitivity to human differences and understanding of the impact of gender, ethnic, cultural, socioeconomic and other social factors.
  3. The student will demonstrate the ability to assess and counsel women for sex- and gender-appropriate reduction of risk, including lifestyle changes and genetic testing, in a manner that is sensitive to cultural beliefs.
  4. The student will demonstrate the ability to discuss social and health policy aspects of women’s health, including ethical issues surrounding sterilization, domestic violence, adolescent pregnancy, and access to health care.
  5. The student will demonstrate the ability to share knowledge effectively with peers.
Professionalism
  1. The student will show compassion in the treatment of patients and respect for their privacy, dignity and beliefs.
  2. The student will demonstrate personal integrity, ethical behavior and altruism.
  3. The student will exhibit dependability and responsibility.
  4. The student will acknowledge and accept the limitations in his or her knowledge and clinical skills and seek assistance when appropriate.
  5. The student will demonstrate the ability to develop effective therapeutic relationships with patients.
Practice-Based Learning
  1. The student will demonstrate the ability to use information technology to access medical information, critically assess current literature to support his or her own education and provide accessible educational information to patients.
  2. The student will display the ability to use feedback to identify areas for improvement.
Systems-Based Practice
  1. The student will demonstrate the ability to work effectively with other health care professionals, in inpatient and outpatient settings as well as in the operating room and labor and delivery suite, to provide patient-focused care.
  2. The student will demonstrate an ability to respond appropriately to medical errors if they arise.

The above set of learning objectives is designed to communicate clearly what is expected in terms of the knowledge, skills, and attitudes that ideally would be acquired during the obstetrics and gynecology clerkship by all students, regardless of their choice of medical specialties. A more comprehensive version of the Medical Student Educational Objectives created by the Association of Professors of Gynecology and Obstetrics (APGO) can be found in Appendix A. Although this longer list appears daunting, it is meant to be used as a reference as you proceed through the clerkship and ask the question, “What do I need to know?” It can also serve as an excellent study guide as you prepare for the NBME shelf examination at the end of the clerkship.

“To study the phenomena of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all.”

Sir William Osler 1849-1919

 

Dr. Osler said it best…in order to optimize your experience in this clerkship, and throughout your career, you must continue to read! The core text for this clerkship is Obstetrics & Gynecology by Beckmann and Ling. It is an excellent text, filled with a wealth of knowledge.

You may also find it helpful to utilize uWISE, the APGO Undergraduate Web-Based Interactive Self-Evaluation. uWISE is a 529-question interactive self-exam designed to help medical students acquire the necessary basic knowledge in obstetrics and gynecology, regardless of future medical specialty choice. This is achieved through self-assessment, using the uWISE clinical vignettes, with multiple-choice questions and five (5) possible answers with immediate explanation and feedback. Some questions are enhanced with images to augment the learning process. uWise questions are based on, and linked to, the APGO Medical Student Educational Objectives. Each quiz represents one APGO Objective and contains 10 questions for each Objective.

To access uWISE, visit http://www.apgo.org/student.html and create a new account. Select Columbia University under Name of Institution, MS Objectives Access, and uWISE Access

Some additional helpful references include:

Williams Obstetrics Obstetrics, Normal & Problem Pregnancies by Gabbe Operative Gynecology by TeLinde Clinical Gynecologic Endocrinology and Infertility by Speroff Blueprints in Obstetrics and Gynecology (good for NBME shelf review)