Obstetrics, Gynecology & Reproductive Sciences

This elective provides medical students with a comprehensive introduction to the field of Complex Family Planning. Students will gain experience in counseling patients on reproductive health decisions, including contraception, abortion, adoption, and parenthood, with an emphasis on birth spacing and maternal–child health outcomes.

Training will include:

• Contraceptive care: Counseling and provision of a full range of contraceptive methods, including insertion of long-acting reversible contraception (LARC), such as intrauterine devices (IUDs) and contraceptive implants.
• Pregnancy-related care: Participation in first-trimester ultrasounds, medical and surgical abortion procedures, and the medical and surgical management of early pregnancy loss and intrauterine fetal demise.

Students will engage in both outpatient and operative settings, including:

• The Center for Women’s Health and Midwifery (789 Howard Avenue) for outpatient care and counseling.
• The operating room at Yale New Haven Hospital for surgical experiences.

This rotation offers a unique opportunity to develop skills in patient-centered counseling, procedural care, and the multidisciplinary aspects of Complex Family Planning.

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

Scheduling Restriction: N/A

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

Prerequisite: Core Ob/Gyn Clerkship

Accept Visiting Students: No

Learning Objectives:

1. History-taking 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 and uterine sizing 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, contraceptive counseling, selection of contraceptive options in the face of medical co-morbidity, pregnancy testing, pain medications used for oral and IV sedation, agents and methods used for cervical anesthesia, and pregnancy dating methods.
4. Attitude: Demonstrate professional responsibility in working as a team member with other members of the Complex Family Planning care team, patients and families.
5. Procedural skills: Assist in termination procedures on at least 10 patients.
6. Career/context: Know the training/career pathway for Complex Family Planning

The purpose of the gynecologic oncology elective is to enhance the student’s knowledge of the diagnosis and management of women with gynecologic malignancies. The course is offered to one student at a time for two 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 elective 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. The student has the option to request a day in the ambulatory setting where 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 elective. The recommended text for this elective is Clinical Gynecologic Oncology (DiSaia).

Length of Rotation: 2 weeks (maximum 1 student)

Student’s Class Level: 4 & 5th year

Prerequisite(s): Core OB/GYN Clerkship

Accept Visiting Students: Yes

Learning Objectives

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)

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

Prerequisite: Core Ob/Gyn Clerkship

Accept Visiting Students: Yes

Learning Objectives

The Maternal Fetal Medicine Division of the Department of Obstetrics, Gynecology & 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 France Galerneau, MD, before or during week 1.
2. Attend Patient Rounds: You are not expected to follow more than 4-5 patients at a time.
3. Present your patients at Morning Report.
4. Join the MFM team and participate in their work following morning report in the triage area, MSCU or L&D. Inpatient service is the first priority of the student.
5. Go to the clinic every Friday.
6. Work on 2 weekend days of your choice.
7. Spend Thursday afternoon on the labor floor.
8. Prepare a 30-minute evidence-based presentation.

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

Student's Class Level: 4th year only

Prerequisite: Core Ob/Gyn Clerkship

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

Learning Objectives

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: Consult elective coordinator for available rotation dates

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

Prerequisite: Core Ob/Gyn Clerkship

Accept Visiting Students: no

Learning Objectives

This 4-week sub-internship provides hands-on experience in Pediatric and Adolescent Gynecology in both inpatient and outpatient clinical settings. You will be assigned to clinics in Greenwich, Trumbull, and New Haven; some students may be assigned to a clinic in Old Saybrook as well. Some of these sites are 60-90 minutes away from New Haven. 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
• 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)

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

Prerequisite: Core Ob/Gyn Clerkship

Accept Visiting Students: Yes

Learning Objectives

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); may be taken as a 2-week elective

Scheduling Restriction: Consult elective coordinator for available rotation dates.

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

Prerequisite: Core Ob/Gyn Clerkship

Accept Visiting Students: No

Learning Objectives

This four-week elective offers medical students an immersive experience at the intersection of obstetrics, reproductive endocrinology, and clinical genetics. Under the mentorship of maternal fetal medicine (MFM) and medical genetics physicians, licensed clinical genetic counselors, and an MD-PhD-trained faculty member in reproductive infertility and genetics, students will gain a broad and integrated understanding of how genetic information informs reproductive planning, preconception and antepartum genetic screening, ultrasound evaluation and diagnosis of fetal anomalies, and management of high-risk pregnancies. Experiences include clinical care rotations through MFM clinic, REI clinic, reproductive medical genetics clinic, prenatal genetic counseling sessions, and high-risk perinatal ultrasound unit. Other learning experiences
include multidisciplinary case conferences and trainee didactics. Students will explore the management of pregnancies complicated by fetal anomalies, inherited conditions, and maternal genetic disorders. Weekly divisional teaching sessions complement clinical learning.

Length of Rotation: 2 weeks or 4 weeks (maximum - 1 student)

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

Prerequisite: Core Ob/Gyn Clerkship

Accept Visiting Students: No

Learning Objectives