Obstetrics & Gynecology Clerkship
The Women’s and Children's Health (WCH) Clerkship is a 12-week integrated clerkship block that is comprised of Pediatrics with Obstetrics and Gynecology (OB/GYN). The combination of these two disciplines allows students to experience and appreciate the continuum in health between women and children. Students experience this interconnectedness through their clinical encounters, integrated didactics, and a combined postcede at the end of the integrated clerkship block.
The Obstetrics & Gynecology Clerkship is a 6-week course which incorporates clinical experiences on both inpatient (4 weeks) and outpatient (2 weeks) rotations. Two inpatient weeks will be spent on 2 of 3 surgical services: Benign Gynecology, Gynecologic-Oncology and/or Urogynecology. The other two inpatient weeks are spent on Obstetrics for day and night float shifts. Students are placed at either the York Street Campus of Yale New Haven Hospital or the Bridgeport Hospital Campus for these rotations. Students spend 1-2 weeks on each clinical service; no more than 3 students will be assigned to each clinical team. All teams will include OB/GYN attendings and interns/residents and may include sub-interns, fellows, CNMs, APRNs, PAs, sonographers, and genetic counselors. The outpatient experiences are in general and specialty OB/GYN care at Yale New Haven Hospital, Bridgeport Hospital, and various subspecialty office sites. Visits to subspecialty clinics provide opportunities to see the breadth of the field. Each clerkship block begins with a mandatory orientation day which may include activities such as pelvic exam instruction with a Gynecologic Teaching Associate, a normal labor simulation, and an ultrasound workshop. During Thursday didactics sessions, students improve their clinical reasoning skills in case-based lectures, bi-weekly simulations, as well as in workshops on shared decision-making, family planning, suturing & scrubbing.
Clerkship students spend their clinical time working within multidisciplinary teams under the direct supervision of attendings and residents. They learn through taking on responsibility for patient care consistent with their ability and skill. Education is supplemented and enhanced through didactics and simulation exercises.
Students receive mid-clerkship feedback in week 3 of the rotation and receive a final clerkship evaluation and grade after completion of the full 6 weeks of experiences. Students select preceptors to evaluate their clinical performance - attendings, fellows, residents, interns, CNMs, APRNs and PAs may be chosen for this purpose. In addition to MedHub evaluations by clinical supervisors of their choosing, students are assessed on an exit portfolio, which includes a chart note, a faculty-observed clinical encounter, and a procedure checklist which is based on the Association of Professors of Gynecology & Obstetrics’ list of recommended procedures for clerkship students. Students are encouraged to seek feedback mid-week from their residents and receive formative feedback during the simulation-based postcede activity.
By the end of the Ob/Gyn clinical component the student will be able to:
- perform the medical interview and physical examination of women incorporating ethical, social, and diversity perspectives to provide culturally competent health care.
- apply recommended prevention strategies to women throughout the lifespan.
- develop his/her role as a leader and advocate for women.
- analyze the impact of genetics, medical conditions, and environmental factors on maternal health and fetal development.
- distinguish between normal and abnormal physiologic changes during pregnancy.
- interpret common diagnostic studies.
- describe common problems in obstetrics.
- apply knowledge of intrapartum and postpartum care in simulations and clinical encounters with mothers and newborns.
- differentiate between normal and abnormal bleeding using knowledge of menstrual cycle physiology, puberty and menopause.
- outline the etiology and evaluation of infertility.
- role-play and relate knowledge of contraception, sterilization and abortion in shared decision making with patients in clinical scenarios.
- construct differential diagnoses of patients with common benign gynecological conditions.
- formulate a differential diagnosis of the acute abdomen and chronic pelvic pain.
- classify common breast conditions and outline the evaluation of (or evaluate) breast complaints.
- perform gynecological procedures using integrated knowledge of perioperative care.
- develop a preliminary assessment of patients with sexual concerns.
- analyze the quality of evidence regarding controversial topics in the field of Ob/Gyn
- assess patients for risks of domestic violence and child abuse.
- describe gynecological malignancies, including risk factors, signs and symptoms and initial evaluation.
- demonstrate effective communication strategies and professional behaviors with patients, families and all members of the health care team (including physicians and non-physician health professionals)
|Students must do the following checklist items||Minimum no. of times||Type of patient|
|Perform/observe a prenatal visit||1||real|
|Perform/observe an office gynecology visit||1||real|
|Perform/observe a pre-op visit||1||real|
|Perform/observe contraceptive management (insertion of LARC, counseling on birth control)||1||real, simulation/didactic|
|Perform/observe a discussion on pregnancy options||1||real, simulation/didactic|
|Perform/observe an evaluation of patient in OB triage||1||real|
|Observe/assist with a vaginal delivery||1||real|
|Observe a Cesarean section||1||real|
|Perform/observe postpartum rounding||1||real|
|Evaluate/help manage abnormal uterine bleeding||1||real, simulation/didactic|
|Evaluate/help manage pregnancy of unknown location||1||real, simulation/didactic|
|Evaluate/help manage adnexal mass||1||real, simulation/didactic|
|Evaluate/help manage pelvic pain||1||real, simulation/didactic|
|Participate in post-operative care||1||real|
|Perform/observe pelvic and speculum exam||1||real, GTA*|
|Perform/observe clinical breast exam||1||real, GTA*|
|Perform/observe ultrasound of pregnant patient||1||real, simulation|
|Perform/observe obtaining of PAP smear & cultures for infection||1||real|
|Perform basic suturing||1||real, simulation|
|Interpret a fetal heart tracing||1||real, simulation|
|Complete an OB admission note||1||real|
|Complete an OB progress note||1||real|
|Complete an OB postpartum note||1||real|
|Observe any type of hysterectomy (vaginal, laparoscopic, robotic, or abdominal)||1||real|
|Observe a pregnant or non-pregnant dilation & curettage||1||real|
|Observe a laparoscopic procedure||1||real|
* GTA = gynecologic teaching associate