|
PGY I
PGY II
PGY III
PGY IV
4 Year Cumulative Goals
Conferences
Overall Goals
|
Curriculum Goals for the PGY2 Resident:
A
At the completion of
the second year, the resident should be able to demonstrate an ongoing
development of the skills learned in the first year as well as:
General:
-
Perform focused and efficient Histories and Physicals
with an increasing recognition of disease patterns and
presentations.
-
Communicate efficiently with staff and colleagues
-
Demonstrate continued commitment to the field of
obstetrics and gynecology.
-
Demonstrate progress in learning through regular
study, reading, literature review, conference attendance and
participation
-
Show a commitment to continuing education by
assisting in the education of medical students and acting as a role
model for junior residents
-
Begin to understand cost and other systems-issues
with respect to diagnostic and therapeutic technology
Ambulatory Care:
-
Provide more extensive counseling and education of
patients and their families
-
Manage basic non-gynecologic ambulatory problems
including but not limited to: URI, otitis media, HTN, DM, asthma,
gastritis, arthritis etc.
-
Understand religious, political and cultural issues
surrounding contraception and abortion, and discuss them with
patients and families
Obstetrics:
-
Recognize and counsel patients regarding the normal
physiologic changes of pregnancy
-
Understand and recognize normal and abnormal fetal
anatomy and physiology and begin to understand the implications for
management of the pregnancy
-
Develop a more detailed understanding of genetics,
genetic counseling, and prenatal diagnostic tests including
amniocentesis, CVS and blood studies.
-
Provide preconception/prenatal care and counseling to
uncomplicated patients as well as some high risk patients with
supervision (eg Hypertensives, diabetics etc)
-
Provide first line management of obstetric
emergencies such as post-partum hemorrhage, dystocia and eclampsia.
-
Understand and interpret more complicated antenatal
surveillance tests and develop management plans
-
Understand the category system for the use of drugs
in pregnancy and choose appropriate medical therapy for pregnant
patients with medical conditions.
-
Identify and manage 2nd trimester pregnancy losses,
PTL, PROM, bleeding in pregnancy, multiple gestation IUGR, Rh
disease, post-date pregnancy, IUFD, VBAC
-
Perform normal vaginal deliveries and complicated
deliveries with dystocia with assistance
-
Repair more difficult obstetrical lacerations (3rd
and 4th degree) with supervision
-
Place a pudendal block
-
Manage complicated labors
-
Perform outlet and low forceps deliveries with
assistance
-
Perform uncomplicated cesarean sections with
assistance
-
Develop a more thorough understanding of obstetrical
anesthesia and analgesia and complications
-
Initiate care of a neonate in distress
-
Provide post-partum care for uncomplicated and
complicated patients, and recognize and manage most post-partum
complications
-
Provide counseling about lactation
-
Perform basic ultrasound, including assessment of
gestational age and basic fetal anatomy with supervision
Gynecology:
-
Identify and develop management plans for common
gynecologic disorders including but not limited to abnormal uterine
bleeding, vaginal and vulvar infections, dermatologic conditions,
STD's, pelvic masses, chronic pelvic pain, endometriosis, benign
breast disease
-
Identify pelvic support defects, learn to evaluate
them and learn about management options
-
Manage patients in the intensive care unit
(Toxic-shock syndrome, sepsis, ARDS, PE etc)
-
Manage early pregnancy loss, including
surgical/medical therapy for ectopic pregnancy
-
First assist on abdominal procedures including TAH,
ovarian cystectomy, oophorectomy, myomectomy, salpingostomy,
salpingectomy, basic laparoscopy/hysteroscopy and understand the
principles of repair of bladder and bowel injuries and indications
for these procedures
-
Demonstrate an ability to provide appropriate
preoperative counseling, informed consent and evaluation for routine
GYN procedures
-
Identify, evaluate and develop management plans for
patients with recurrent pregnancy loss
-
Place cervical cerclage with supervision
-
Perform colposcopy, polypectomy, I&D of vulvar
abscesses, vulvar biopsies, cone biopsies, cryosurgery under
supervision
Reproductive
Endocrinology
-
Assist with infertility procedures including egg
retrieval, IUI, ET, laparoscopy, hysteroscopy, HSG and
sonohysterogram
-
Develop an understanding of common endocrine
presentations in OB/GYN and their management
-
Demonstrate an ability to read and interpret REI
literature
-
Construct a differential diagnosis for reproductive
endocrine and infertility disorders
Oncology:
-
Independently perform the initial evaluation of a
patient with a suspected gynecologic malignancy.
-
Demonstrate an understanding of the principles of
radiotherapy.
-
Demonstrate an understanding of the histology of
gynecologic malignancies
-
Demonstrate an understanding of the principles of
chemotherapy for gynecologic malignancies
Laparoscopic Surgery:
Skills:
1.
Demonstrate the ability to safely
place a veress needle and the primary trocar.
2.
Routinely demonstrate the course of
the ureters with minimal assistance.
3.
Perform simple adhesiolysis with
guidance.
4.
Utilize laparoscopic clips, the
endoloop, and the endobag in an appropriate manner.
5.
Learn the principles of diagnostic
cystoscopy.
6.
Perform diagnostic hysteroscopy with
minimal assistance.
7.
Begin to develop skills in operative
hysteroscopy
Knowledge
-
Demonstrate
knowledge of how to recognize and manage an enterotomy or cystotomy.
-
Understand the
various approaches to management of adnexal masses. .
-
Begin to
understand procedure specific complications and their management.
-
Begin to
understand post-operative complications and their management.
-
Begin to
understand the principles of fluid management during hysteroscopy
-
Begin to
understand the principles of global endometrial ablation devices.
-
Begin to counsel
patients regarding complications of hysteroscopy.
Research:
1. Demonstrate
an ability to perform a literature search on a particular clinical
question and utilize this information to improve patient care.
2. Prepare
and give educational talks on advanced topics in obstetrics and
gynecology utilizing the medical literature.
3. Continue
to work with a faculty mentor to develop a research project if desired.
4. Demonstrate
an understanding of the principles of evidence-based medicine, including
epidemiology, statistics and critical analysis of the literature.
Curriculum & Description of
Rotations:
Gynecology:
At Holy Cross Hospital the second year resident spends one block
assigned to assist on private and clinic cases in the operating room
including basic laparoscopy cases as well as abdominal hysterectomies
and myomectomies. The resident is responsible for postoperative care of
all patients. An additional 5 weeks are spent in the busy ob-gyn
clinic, where patients present with a variety of problems as well as for
routine care. The resident will gain experience in the evaluation of
gynecologic patients as well as in their pre-operative evaluation. A
dedicated gynecology clinic is held once a week. Supervision is provided
by the 24-hour in-house attending physician, with whom surgical cases
can be scheduled if necessary. A weekly dysplasia clinic is held, during
which the resident begins to learn the principles of managing abnormal
PAP smears, colposcopy and LEEP. This is supervised by Dr Palmer, and
the 24-hour staff. On-call responsibilities include coverage of both
Obstetrics and Gynecology for service as well as private patients.
Faculty Contact: Dr. Imad S.
Mufarrij
At Fairfax Hospital
the second year
residents have both a basic gynecology rotation as well as an endoscopy
rotation. As a member of the gynecology team, both of these residents
will be assigned to a wide variety of level appropriate cases in the
operating room. They will also assume care of patients who are admitted
to the gynecology service through the emergency department. There is
ample surgical experience with private physicians as well as with clinic
cases. The resident is responsible for the post-operative care of all
patients. On call responsibilities include backup for the obstetrics
service, triaging of patient phone calls, coverage of the ER and
assisting with emergency GYN surgery as well as weekend obstetric call.
Residents are expected to present at GYN conference during this
rotation.
Faculty Contact: Dr. Fred E. Mecklenburg
Obstetrics and High
Risk Obstetrics:
At Fairfax Hospital a second year resident spends one month on
the High Risk Obstetrics service. There is intensive involvement in the
care of hospitalized antepartum patients on a busy High Risk Perinatal
unit, with daily rounds led by perinatologists. Immediate supervision is
provided by the chief resident on the service. There are weekly day-call
responsibilities, with increasing responsibility for interpretation of
antenatal testing of hospitalized patients and outpatients. There is a
weekly high risk clinic as well as a weekly diabetic clinic, supervised
by chief residents and perinatologists, where the resident primarily
evaluates and increasingly takes more responsibility in the development
of management plans for high risk obstetric patients. The second year
resident also spends 5 weeks as the daytime labor and delivery resident
where uncomplicated and high-risk obstetrics are learned through the
care of service patients on Labor and Delivery. Evaluation is by the MFM
attending during the antepartum rotation and by the 24 hour attendings
during the time spent on Labor and Delivery. Residents are expected to
present at AP conference during this rotation.
Faculty Contact: Dr Alfred N. Khoury
At Holy Cross Hospital the
resident spends one block on the antepartum service. A weekly high risk
clinic is held, supervised by chief residents and perinatologists where
the resident primarily evaluates and increasingly takes more
responsibility in the development of management plans for high risk
obstetric patients. There is some exposure to ultrasound, advanced fetal
monitoring, and amniocentesis. Residents are responsible for the care of
all hospitalized antepartum patients (service and private).
Uncomplicated obstetrics is learned through the care of service patients
in the clinic and L&D suite as well as by assisting on cesarean sections
with private physicians. Second year residents also spend 6 weeks as the
Labor and Delivery Night Float resident at Holy Cross, where they work
directly with the 24 hour attending to manage the clinic patients on
labor and delivery. During this rotation the residents begin to gain
autonomy in management of these uncomplicated patients, and to feel more
comfortable managing complicated laboring patients. This resident also
serves as the assistant to private cesarean sections occurring during
the night time hours.
Faculty Contact: Dr Imad Mufarrij
Reproductive
Endocrinology:
This is a one-month rotation at GWU. The resident is integrated into all
division activities during this rotation. Didactic teaching occurs
during REI journal club, medical student presentations, faculty
presentations and case discussions. Residents are provided a schedule of
regular weekly sessions (journal clubs, case reviews, research meetings)
and are expected to attend. The resident is assigned to clinic sessions,
ultrasound monitoring, hysterosalpingogram and sonohysterogram sessions.
Depending on the interest of the resident rotation in the IVF-genetics
lab can be arranged as well. Introductory knowledge of REI and medical
endocrinology will be reviewed.
Residents are also
expected to spend one half-day per week in the breast center (see below)
and to spend two half days per month learning both obstetric and
gynecologic ultrasound in the MFA with Dr Keller and Dr Gaba.
Faculty Contact: Dr. Paul R. Gindoff
Breast Diseases:
The resident spends a half-day per week over a 6-week rotation (the GWU
REI rotation) evaluating patients in the GWU breast clinic with the
general surgery service. There is exposure to mammography, FNA, follow
up of patients with cancer who have had treatment, and evaluation of
patients with new diagnoses of cancer or other breast diseases.
Faculty Contact: Dr. Christine Teal
Teaching:
-
Residents are always expected to provide informal
teaching to medical students and junior residents, in the clinics,
ORs and on labor and delivery.
-
Residents are expected to set an example of
professional behavior at all times for medical students.
-
During the latter half of the PGY 2 year each
resident is assigned to be "teaching resident" These
responsibilities include daily meetings with medical students for
formal and informal educational conferences and student
presentations.
-
The teaching resident is responsible for providing
verbal feedback to each student at the midpoint of the rotation, and
notifying the clerkship director of any problems.
-
A meeting of all the residents at each site is held
at the end of the student rotation period and the teaching resident
is responsible for leading a grading conference and writing an
evaluation of each students with the help of the chief resident.
-
Evaluations of students are to be submitted to the
clerkship director's office no later than one week after the
completion of each rotation.
-
If the resident has a vacation during the month they
are assigned as teaching resident they are responsible for finding a
"sub" in their absence.
-
Residents are expected to attend seminars on teaching
skills provided as part of the didactic curriculum each year.
Faculty Contacts:
Dr. Nancy D. Gaba, Dr Charles Macri, Dr Samantha Buery (FFX)
|