Obstetrics & Gynecology Component

Women’s and Children's Health (WCH) 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 component 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.

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:

• Apply recommended screening and prevention strategies to women throughout the lifespan.
• Learn the clinical knowledge and apply basic science concepts to evaluate and treat common presentations in obstetrics and gynecology including infertility, acute abdomen, chronic pelvic pain, abnormal bleeding, breast complaints, benign gynecologic conditions, and gynecologic malignancies.
• Analyze the impact of genetics, medical conditions, and environmental factors on maternal health and fetal development.
• Apply knowledge of intrapartum and postpartum care in simulations and clinical encounters with mothers and newborns.
• Use clinical reasoning to synthesize data into a prioritized differential diagnosis and plan.
• Demonstrate behaviors consistent with the highest standards of professionalism and medical ethics in all patient encounters and interactions with colleagues.
• Demonstrate effective communication with patients, families, and all members of the healthcare team.
• Demonstrate knowledge of core obstetrics and gynecology related health issues including contraception, sterilization and abortion in shared decision making with patients in clinical scenarios through role-plays.
• Obtain an accurate and appropriately detailed medical history in a logical and organized manner for a given clinical setting.
• Complete an appropriate and accurate hypothesis-driven physical examination with a particular emphasis on the breast and pelvic exams.
• Deliver an effective oral and written presentation, appropriately tailored for a given clinical setting.
• Recognize whether to obtain and how to interpret common diagnostic and screening studies in obstetrics and gynecology, including ultrasound, urine pregnancy testing (UPT), complete blood count (CBC), urinalysis, sexually transmitted infection (STI) panel, beta-human chorionic gonadotropin (B-hCG), and cervical and urine cultures.
• Perform gynecological procedures using integrated knowledge of perioperative care.
• Develop a preliminary assessment and plan for patients with sexual concerns.
• Assess patients for risks of domestic violence and child abuse.
• Demonstrate sensitivity and responsiveness to diverse patient populations.
• Appreciate how patient health care needs are impacted by social and structural determinants of health.
• Recognize the physician’s role as advocate for quality and equity in patient care and optimal patient care systems.
• Utilize effective methods of acquiring and applying evidence-based practices to guide diagnosis and treatment decisions.
• Appreciate the overlapping skills, knowledge, and approach to patient care in obstetrics & gynecology and pediatrics through shared learning activities.