During this two-week clinical block, students will learn about outpatient care of the pregnant and non-pregnant female patient. Students will be assigned five to six (5-6) half days in the clinics, one half day of structured educational activities on Wednesday afternoons, and two to three half days of study time each week of this block. 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.

Learning Objectives:

Students should become familiar with the following topics:

Obstetrics:
Prenatal Care in the low risk patient

• New OB visit, schedule of testing and clinic visits
• Weight gain recommendations
• Prenatal Diagnosis
• 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-based learning:

• Triage of abnormal pap smears at ASCCP (American Society of Colposcopy and Cervical Pathology)
• Virtual Hospital - patient education on OB/Gyn topics

1. Reviewing Office practice-related sample questions/ answers to prepare for NBME shelf examination.
   (Binder of sample questions available through Clerkship Coordinator)
2. Reading the assignments for that week's Wednesday faculty teaching sessions.