GENERAL OBJECTIVES:
1. To provide safe, effective, compassionate care to women at all stages of life.
2. To provide postgraduate training for the Physician Assistant in a women’s health clinic, including preventive care, obstetrics, and gynecology.
3. To provide exposure to and experience in the management of labor, delivery (both vaginal and cesarean), and the postpartum course.
4. To provide exposure to and experience in surgical assisting and the care of gynecologic inpatients.
5. To provide exposure to and experience in common outpatient gynecologic procedures.
6. To provide exposure to gynecologic subspecialties and maternal fetal medicine.
DIDACTIC GOALS AND OBJECTIVES:
1. Understand normal female anatomy demonstrated by the following competencies; repairing an episiotomy or laceration, first assisting in the operating room, and recognizing abnormal findings on a pelvic examination.
2. Understand normal female reproductive physiology and changes throughout the lifespan, including those associated with puberty, pregnancy, parturition, and menopause. This will be demonstrated by ability to care for patients experiencing hormonal and menstrual cycle changes at puberty and menopause, as well as the variety of physical changes that occur with pregnancy and parturition.
3. Care appropriately for women at their well woman exam, including ordering the appropriate screening tests and counseling on preventative medicine and contraception.
4. Appropriately diagnosis, work-up, and manage common gynecologic complaints, such as abnormal uterine bleeding, genital tract infections, pelvic masses, pelvic relaxation, urinary incontinence, vaginal and vulvar complaints, and cervical dysplasia.
5. Provide prenatal care appropriately, including assessment of risk for complications and possible need for referral or consultation, screening, nutritional assessment and advice, monitoring of fetal growth, indications for antepartum surveillance, and management of common pregnancy complications, including recognizing possible obstetric emergencies.
6. Understand the process of normal labor and delivery, and recognize when an abnormal labor pattern is occurring. Recognition of abnormal labor patterns should be observed when working on labor and delivery, including knowledge and recognition of when an operative delivery may be indicated.
7. Provide appropriate pre-operative assessment and evaluation.
8. During gynecologic surgeries demonstrate the following: knowledge regarding the indication for a procedure, principles of asepsis, wound healing, tissue handling, and choice of incisions and sutures.
9. Triage common ob-gyn emergencies in a timely appropriate manner. Demonstrate the ability to recognize the appropriate intervention for spontaneous abortion, ectopic pregnancy, pelvic inflammatory disease, placenta previa, placenta abruption, as well as promptly informing attending physician.
10. Give respectful, compassionate care for women. Demonstrate good communication skills and psychosocial assessment skills when evaluating patients during rounds, in the clinic and on labor and delivery.
11. During journal club and conference discuss evidence-based practice and critical review of the literature.
CLINICAL GOALS AND OBJECTIVES:
1. Demonstrate good history-taking, physical examination, and laboratory assessment skills when presenting to attending physicians, and demonstrate knowledge of routine health care provided to women at all stages of life.
2. Appropriately diagnose and manage common gynecologic complaints when presenting patient evaluation and management to attending physicians.
3. Correctly identify when common office procedures are indicated, and develop skill in performing them, including endometrial biopsy, vulvar biopsy, colposcopy and cervical biopsy, Word catheter placement, pessary fitting, and IUD insertion. These skills will be observed and evaluated by attending physicians in clinic.
4. Demonstrate an understanding of the work-up and management of complicated gynecologic conditions such as urinary incontinence, infertility, and chronic pelvic pain, by the appropriate presentation of the patients’ symptoms and exam to the attending physician. Demonstrate knowledge of the lab tests or studies necessary to aid in diagnosis.
5. Provide complete obstetrical care to low-risk pregnant patients, and demonstrate understanding of the additional laboratory studies and referrals that are needed in caring for high-risk patients, including their prenatal, intrapartum, and postpartum care.
6. Accurately perform limited ultrasounds, including first trimester evaluation of viability, estimated fetal age and weight, assessment of Amniotic Fluid Index and fetal position checks.
7. Accurately interpret the fetal heart rate tracing and contraction patterns and adequacy during labor and in routine fetal surveillance.
8. Skillfully perform artificial rupture of amniotic membranes and placement of fetal scalp electrode and intrauterine pressure catheter.
9. Perform normal vaginal deliveries, accurately assess when to perform an episiotomy and how to repair it, as well as skillfully repair first and second degree perineal lacerations.
10. First Assist cesarean sections and postpartum tubal ligations.
11. Demonstrate knowledge of appropriate postpartum care for both vaginal and cesarean deliveries. Will be evaluated by attending physicians on daily rounds.
12. Respond quickly and appropriately to obstetrical emergencies in the inpatient setting. Adequately access fetal condition and recognize the need for immediate action due to maternal or fetal distress.
13. Perform skillfully as a surgical assistant for both open and endoscopic gynecologic procedures.
14. Manage postoperative gynecologic patients appropriately. Recognize common postoperative complications, including fever, atelectasis, and ileus.
15. Demonstrate knowledge in the pre-operative evaluation and postoperative management of patients with complex conditions such as gynecologic malignancies.
16. Perform Emergency Department consultations regarding the following common conditions (incomplete abortion, pelvic inflammatory disease, ovarian cysts, ovarian torsion, menorrhagia, etc). Order correct laboratory studies and imaging to obtain diagnosis and admit patients appropriately.
17. Understand significance of findings on gynecologic/pelvic ultrasound.
18. Demonstrate good interpersonal skills and expertise in communication with patients and coworkers.
19. Maintain professionalism throughout the residency, and become aware of ethical issues in women’s health.
20. Become knowledgeable of community resources available to patients as well as the systems of care in which they are currently served.
21. When presenting a patient or discussing case management reference evidence-based medicine whenever possible.
22. Demonstrate an understanding of ones limitations, and appropriately use consultants and other resources.