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Obstetrics, Gynecology & Reproductive Services

EL Obstetrics & Gynecology Family Planning Elective

This two-week or four-week elective provides hands-on experience in family planning in diverse clinical settings. Family planning clinics provide resources to enable couples to determine whether, when, and how often to have children, with special consideration to birth spacing and maternal and child health. The student will be exposed to contraceptive counseling and options counseling (abortion, adoption, parenthood). Contraceptive counseling and care includes insertion of long-acting reversible contraceptive methods (LARC, IUDs and implants). In addition, the student will participate in first trimester ultrasound, medical and surgical abortions, medical and surgical management of early pregnancy failures, and intrauterine fetal demise. Clinical settings include outpatient visits and operating room experience at Yale New Haven Hospital and Planned Parenthood in New Haven.

During this rotation, it is necessary to travel back and forth between YNHH-YSC and up to 3 Planned Parenthood locations: 345 Whitney Avenue in New Haven; 1030 New Britain Avenue in West Hartford; and 35 6th Street in Stamford.

Length of Rotation:

2 or 4 weeks (maximum - 1 student)

Scheduling Restriction: N/A

Student's Class Level: 4th, 5th year

Prerequisite: Core Ob/Gyn Clerkship

Accept Visiting Students: Yes

Learning Objectives:

1. History skills. Gather the important information that is needed for the Ob/Gyn history and complete a history in the medical record for at least 10 patients.
2. Physical examination skills. Complete a pertinent physical examination for the evaluation of pregnancy on at least 10 patients. The student should demonstrate the ability to perform this pertinent physical examination while being observed by at least one attending or resident.
3. Knowledge/diagnostic and treatment skills: Pregnancy termination and contraceptive counseling.
4. Attitude: Demonstrate professional responsibility in working as a team member with other members of the Family Planning care team, patients and families.
5. Career/context: Know the training/career pathway for Family Planning.

SI Obstetrics & Gynecology Gynecologic Oncology Subinternship

The purpose of the gynecologic oncology subinternship is to enhance the student’s knowledge of the diagnosis and management of women with gynecologic malignancies. The subinternship is offered to one student at a time for four weeks. The student is exposed to all modalities of treatment for gynecologic malignancies including radical gynecological surgery, chemotherapy, and radiation therapy. The student is expected to be an integral part of the team in the management of the patients admitted to the service. The student admits patients and takes part in their care throughout the subinternship period. The student is assigned to the operating room, especially to assist the patient whom he or she has evaluated. In addition to operating room exposure, extensive experience is gained in the post-operative management of these patients. In the ambulatory setting, the student is exposed to the outpatient management of cancer, chemotherapy and colposcopy. On a weekly basis, students will attend divisional teaching sessions as well as the multi-discipline tumor conference. There is no night call on this subinternship. The recommended text for this subinternship is Clinical Gynecologic Oncology (DiSaia).

Length of Rotation: 4 weeks (maximum- 1 student)

Scheduling Restriction: N/A

Student's Class Level: 4th, 5th year only

Prerequisite: Core Ob/Gyn Clerkship

Accept Visiting Students: yes

Learning Objectives

SI Obstetrics & Gynecology Maternal Fetal Medicine Subinternship

The Maternal Fetal Medicine Division of the Department of Obstetrics, Gynecology, and Reproductive Sciences offers a four-week High-Risk Obstetrics elective for Fourth-Year medical students. The student will function as a Sub-Intern and team member in the care of high-risk obstetrical patients at Yale New Haven Hospital. In addition to inpatient duties, the student will attend the outpatient clinic once a week. Students will also participate in prenatal ultrasound sessions and Labor and Delivery activities. Students are expected to work two weekend days of their choice during the rotation. Numerous didactic conferences are held during the rotation. It is recommended that students use the text William’s Obstetrics (Cunningham) to prepare for this experience and for research during the rotation. The evaluation of the student will be based on clinical performance, participation at rounds and their evidence based presentation to members of the MFM Division.


KEY STUDENT RESPONSIBILITIES :

1. Faculty Mentor: the student will be contacted by Dr. France Galerneau to schedule a brief introductory meeting shortly before or during the first week of the rotation. Dr. Galerneau meets with the student weekly and is available by cell phone (203-887-1763) or

email throughout the rotation.

2. Patient Rounds are at 6:00am on the Maternity Special Care Unit (MSCU), 10th floor, West Pavilion. Student will start each day by rounding on the patients assigned to them by the HR-OB Chief Resident. The student will follow those patients until discharge from the

hospital.

3. Morning Report- 7:30am, 4th Floor Labor & Birth Conference Room: The student will present his or her assigned patients at Morning Report.

4. Join the MFM team and actively participate in their work following morning report. This includes assessing patients in the triage area, admitting patients to MSCU or L&D, participate in vaginal and cesarean deliveries and other procedures including obstetrical

ultrasounds on MSCU.

The day ends with sign-out rounds at 6:00 where each member of the team, including the sub-I, presents his or her patients briefly to the night team. Inpatient service is the first priority of the student.

5. MFM Outpatient Clinic (One Long Wharf): the student will go to the clinic every Friday. Clinic rounds start at 8:15 and take place in the main charting room. After rounds, the student will see high-risk obstetrics patients with the MFM resident, fellow or attending.

6. On-Call: the student is expected to work on 2 weekend days of his/her choice, from 8am to 7pm, during the rotation. Dates selected must be approved by the elective director and coordinator. The student will join the on-call Ob team for all of their activities. This

is the best opportunity for the student to spend time on Labor and Delivery and be involved in the care of all patients (MFM and low-risk patients).

7. Thursday afternoon: the student will work closely with the MFM fellow and attending on service while the third year medical students and Ob-Gyn residents are attending their half-day didactic session. Time permitting, the student may attend the MFM conferences

(see didactic programs below).

8. Oral Presentation: the student is expected to give a 30-minute evidence-based presentation on a topic of his/her choice. The presentation takes place on the last Thursday of the rotation, as part of the MFM weekly didactic program.

9. Didactic programs: the student is encouraged to participate in the following didactic activites:

- MFM Fellows-Division weekly didactic session, Thursdays, 1:00-4:00, L&B Conference Room

- Department Grand Rounds: Thursdays, 4:00pm, Brady Auditorium

- MFM/Ob-Gyn Research in Progress: Fridays, 3:00pm, FMB 340

- Fetal Care Patient Management Conference: Wednesday, 1-2 pm, WP 1074

- Fetal Board Meeting: monthly, Tuesday 5:30-6:30, WP 1074

- If there are no clinical activities and no MFM conferences, the student may participate in the Ob-Gyn residents’ didactic session on Thursday afternoon.

10. Evaluation: the MedHub System is used for evaluation of Yale students. The student will evaluate the program and be evaluated. Students will provide names of those they wish to evaluate them to the elective coordinator if they do not receive an automated

request from MedHub. A final grade is given by the Course Director after review of all evaluations.


Length of Rotation: 4 weeks (maximum- 1 student)

Scheduling Restriction: Not offered 12/31/2018 - 03/22/2019

Student's Class Level: 4th year only

Prerequisite: Core Ob/Gyn Clerkship

Accept Visiting Students: yes, offered to both Yale and visiting students within the 4-week elective rotation dates

Learning Objectives

SI Obstetrics & Gynecology Pediatric and Adolescent Gynecology Sub-Internship

This 4-week sub-internship provides hands-on experience in Pediatric and Adolescent Gynecology in both inpatient and outpatient clinical settings. In the mornings, students attend rounds with supervising attending and Ob/Gyn & Pediatric and/or pediatrics residents. Students are exposed to acute, common as well as rare pediatric and adolescent gynecologic disorders. The sub-I can expect to participate in the care of girls and adolescent females presenting with

  • Vulvar conditions: vulvovaginitis, lichen sclerosus, labial adhesions, labial hypertrophy
  • Abnormal pubertal development: precocious and delayed puberty, ambiguous genitalia in the newborn and young children
  • Bleeding disorders, thrombophilias and childhood hematologic cancers
  • Gastrointestinal diseases, such as inflammatory bowel disease and IBS
  • Reproductive issues stemming from endocrine disorders (PCOS and others)
  • Collagen vascular disorders
  • Developmental and physical delays
  • Disorders/differences of sexual development
  • Postoperative complications

The students will obtain histories and perform examinations on newly admitted patients or consult patients. Bedside discussions regarding diagnosis, work up and treatment are encouraged. Students will mainly work in the Pediatric and Adolescent Gynecology consultation service and outpatient clinics. The consultation service exposes students to various acute conditions in Pediatric and Adolescent Gynecology.

The sub-I will generally be exposed to a mixture of outpatient and inpatient clinical care in Pediatric Gynecology with exposure to pediatric surgery, urology, and endocrinology.

Length of Rotation: 4 weeks (maximum - 1 student); may be taken as a 2-week elective

Student's Class Level: 4th, 5th year

Prerequisite: Core Ob/Gyn Clerkship

Accept Visiting Students: Yes

Learning Objectives

SI Obstetrics & Gynecology Reproductive Endocrinology & Infertility Subinternship

The Reproductive Endocrine and Infertility (REI) division offers a Subinternship to students. In addition to gaining knowledge of human reproductive endocrine function, students are introduced to disruptions in physiology and function, which can lead to endocrinological and infertility disorders. Common problems seen in REI practice include female and male infertility, recurrent pregnancy loss, polycystic ovarian syndrome, anovulation, amenorrhea, endometriosis, chronic pelvic pain, abnormal uterine bleeding, and uterine leiomyomas. Exposure to Advanced Reproductive Technologies (ART) is integrated into this elective. In addition to clinical activities in the office and the hospital, students will have the opportunity to attend division conferences. Evaluation will be based on clinical performance in the office and the operating room, and an evidence-based presentation on an REI topic of interest. Recommended text: Clinical Gynecologic Endocrinology & Infertility (Speroff)

Length of Rotation: 4 weeks (maximum - 1 student)

Scheduling Restriction: Not Available 08/12/2019 - 09/06/2019, 09/09/2019 - 10/04/2019, 11/04/2019 - 11/29/2019

Student's Class Level: 4th, 5th year only

Prerequisite: Core Ob/Gyn Clerkship

Accept Visiting Students: no

Learning Objectives

SI Obstetrics & Gynecology Urogynecology & Reconstructive Pelvic Surgery Service Subinternship

The Section of Urogynecology & Reconstructive Pelvic Surgery offers a sub-internship to medical students. Students will be taught about the normal and abnormal physiology and function of the female pelvic floor. Students will be introduced to the diagnosis and management of female pelvic floor disorders, namely lower urinary tract disorders, pelvic organ prolapse and defecatory disorders. Common problems encountered by Urogynecologists include urinary incontinence, recurrent urinary tract infections, cystocele, rectocele, uterine prolapse, vaginal vault prolapse after hysterectomy, microscopic hematuria, dyspareunia, interstitial cystitis, anal incontinence and constipation. Exposure to advanced pelvic floor reconstructive surgery is also integrated into this elective. In addition to clinical activities in the office and the hospital, students will have the opportunity to attend section didactics. Evaluation will be based on clinical performance in the office and the operating room, participation in didactics and an evidence-based presentation on a urogynecology topic of interest. Below, we have provided a list of learning objectives and a suggested readings list in order to enhance your experience on our service.

Length of Rotation: 4 weeks (maximum - one student)

Scheduling Restriction: N/A

Student's Class Level: 3rd, 4th, 5th year (3rd year after completion of ob/gyn clerkship)

Prerequisite: Core Ob/Gyn Clerkship

Accept Visiting Students: yes

Learning Objectives