Out-patient Clinics Block


During this two-week clinical block, students will learn about outpatient care of the pregnant and non-pregnant female patient.  Students will be assigned to five to six (5-6) ½ days in the clinics, one ½ day of structured educational activities on Wednesday mornings, and two to three ½ days of study time each week of this block.  Each student will be assigned to a faculty Clinic Advisor and will do the majority of their outpatient clinics with that advisor.   To get to the expected 5-6 ½ days in clinic, each student will, in addition to their clinic advisor’s clinics, be scheduled in other “filler” clinics to round out their outpatient experiences.  Every attempt will be made to make sure all students have some exposure to both outpatient gynecology and obstetric patients.  Clinic advisors have been given a list of the clinical block objectives, knowledge and skills expectations, and recommended directed studying assignments and will help guide students into fulfilling these goals.

Students on the outpatient clinics block will be expected to attend daily GYN teaching rounds at 7 a.m. at UNMC.  Exceptions to this include Tuesday mornings for Methodist students who meet with Dr. Basset.

Learning Objectives:

Students should become familiar with the following topics:

            Obstetrics:
          Prenatal Care in the low risk patient
             i.   New OB visit, schedule of testing and clinic visits
             ii.  Weight gain recommendations
             iii.  Prenatal Diagnosis
             iv.  Counseling Vaginal Birth after Cesarean 
                  section (VBAC)

          Gynecology:
          Contraception and Sterilization
          Spontaneous and Induced Abortions
          Medical and Surgical Alternatives to Hysterectomy
          Care of the Aging Female Patient
          Hormone Replacement Therapy
          Annual exam recommendations by different age groups
          Sexually Transmitted Disease counseling, testing, 
          and treatment
          Triage of abnormal Pap smears
          Abnormal Uterine Bleeding
          Vulvar Diseases
          Minor clinic procedures:  IUD placement, 
             pessary fitting and cleaning, biopsies of vulva, 
             cervix, uterus
          Counseling on genetic testing


Knowledge and Skills Expectations:

By the end of this clinical block, students will be expected to competently
1)  Conduct a normal annual gyn examination:  obtain and present history, under supervision do an appropriate physical exam, and counsel patient appropriately on screening recommended by age group
2)  Conduct a new and return obstetric patient clinic visit (exam with supervision of faculty or resident)
3)  Discuss appropriate triage of abnormal Pap smears
4)  Discuss indications for vulvar biopsy and endometrial biopsy
5)  Appropriately counsel patients on choices of contraception/ sterilization
6)  Discuss issues related to risks and benefits of hormone replacement therapy


Directed Studying Recommendations:

1)  Web- base learning:

Association of Professors of Gynecology & Obstetrics - uWISE:
http://www.apgo.org/elearn/uwise/index.cfm?doc=uWISE Units
username: unmc
password: uwise

Clinical Case Studies:  http://www.asccp.org/edu/case_studies/archives/case_archives.shtml

Triage of abnormal pap smears at ASCCP (American Society of Colposcopy and Cervical Pathology) at: www.asccp.org
         
Virtual Hospital- patient education on OB/Gyn topics:
http://www.vh.org

2)  Reviewing Office practice-related sample questions/ answers to prepare for NBME shelf examination. 
(Binder of sample questions available through Clerkship Coordinator)

3)  Reading the assignments for that week’s Wednesday faculty teaching sessions- available through Clerkship Coordinator.
 

Updated Last:  August 23, 2007