M3 ob gyn clerkship
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welcome!. M3 OB/GYN Clerkship. Welcome! Please help yourself to refreshments provided. . Welcome to OB/GYN M3 Clerkship. *Mrs. Teresa Ingraham -M3 Student Education Coordinator *Mrs. Janice Golka -Residency Coordinator. *Karen Carlson, MD -Clerkship Director -Generalist Faculty

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M3 OB/GYN Clerkship

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M3 ob gyn clerkship

welcome!

M3 OB/GYN Clerkship

Welcome! Please help yourself to refreshments provided.


Welcome to ob gyn m3 clerkship

Welcome to OB/GYN M3 Clerkship

*Mrs. Teresa Ingraham

-M3 Student Education Coordinator

*Mrs. Janice Golka

-Residency

Coordinator

*Karen Carlson, MD

-Clerkship Director

-Generalist Faculty

*Katherine Finney, MD

-Assistant Clerkship Director

-Generalist Faculty


Orientation agenda

Orientation Agenda

Morning:

  • Video/Tour

  • Clerkship Overview and Expectations

  • Pelvic Model

  • Pictures

  • Resident presentation

    Lunch:

  • Life Course Approach to Women’s Health (Dr. Marvin Stancil)

    Afternoon:

  • Lectures:

    • M3 Survival Guide (Dr. Carlson)

      • Women’s Health History (Dr. Carlson)

    • Lecture (Dr. Olesh)

      • Bleeding in Pregnancy


Methodist site training

Methodist Site Training

  • Monday, May 20th @ 5 pm

  • All students assigned to Methodist for OB

  • Report to: Medical Office Bldg

    • (left of main hospital) 717 N. 190th St.

      2nd Floor StasnyRm

    • CERNER Training will begin at 5 pm (Kim Thorson)

    • Please try to be at the staff office 5-10 minutes before appointed time. See instructions in your booklet

  • Park in parking lot.


Methodist site orientation

Methodist Site Orientation

  • Following CERNER training, someone will take you for your Methodist Wmn’s Hospital orientation.

    • Orientation at MH will begin promptly at 6-7 pm (Linda Spittler)

  • You will be given ID cards at orientation (PLEASE: Return to Mrs. Ingraham at end of rotation).


Subspecialties in ob gyn

Subspecialties in Ob-Gyn

  • General Ob-Gyn

    • 4 year residency

  • Maternal-Fetal Medicine

    • 3 year fellowship

  • Oncology

    • 3 year fellowship

  • Reproductive Endocrinology

    • 3 year fellowship

  • Urogynecology/pelvic and reconstructive surgery

    • 3 year fellowship

  • Minimally Invasive GYN Surgery

    • 2 year fellowship

  • Pediatric and Adolescent Gynecology

    • 2 year fellowship


Overview clerkship blocks

Overview: Clerkship “Blocks”

  • Obstetrics Block (2 weeks)

    • UNMC or Methodist Women’s Hospital

  • Gynecology Block (2 weeks)

    • Gynecologic Oncology- 1 week

    • Benign Gynecology – 1 week

  • Outpatient Clinics Block (2 weeks)


Ob methodist students

OB Methodist Students

  • Obstetrics block done at Methodist

    • team with residents and MFM’s

  • Gynecology block and Outpatient Clinic blocks at UNMC and Durham Outpatient


Sample schedule

Sample Schedule

  • Student A:

  • Weeks 1-2Weeks 3-4Weeks 5-6

    ObstetricsGynecology Clinics

    (UNMC or MWH)1 wkGynOnc/1 wkGynSurg see advisor schedule

    * Clinic schedule found on Weekly Advisor Schedule


M3 ob gyn clerkship

*Sample Advisor Schedule:

Week 1 AM----

Week 1 PM -----


M3 ob gyn clerkship

Night Call

  • 24 hour call

  • Expect approximately

    • 3 weeknights and one weekend night

  • During OB

    • Methodist Hospital

    • UNMC


Course textbooks

Course Textbooks


Educational materials

Educational materials

  • www.unmc.edu/obgyn

  • Click Education tab

    • Lecture materials located here

      • Click M3 Students

      • Click Lectures

    • Orientation/Resident’s Power Point presentation

      • Click M3 Students

      • Click Orientation


4 required educational resources

4 Required Educational Resources

1.uWISE – APGO educational testing module http://www.apgo.org/student/uwise2.html

  • Create user name/password to access

  • unmc.edu extension gives access

    2. Pelvic Examination

    http://www.nejm.org/doi/full/10.1056/NEJMvcm061320


4 required educational resources1

4 Required Educational Resources

3. Fetal Heart Tones

*www.ob-efm.com

*IntrapartumFetal Heart Rate Monitoring: Nomenclature, Interpretation, and General Management Principles ACOG Practice Bulletin No. 106

4. Advanced Colposcopy CD

*check out CD from Ms. Teresa Ingraham

*available on clinic computer (bubble room)

*Luikartlibrary computers


Great resources

Great Resources

  • American Congress of Obstetricians and Gynecologists (ACOG)

    • Free for students to join

  • Association of Professors of Gynecology and Obstetrics (APGO)

    • uWise

    • APGO

      • Medical Student Education Objectives, 9th ed.


Clerkship expectations

Clerkship Expectations:

*www.apgo.org/members/medical-students.cfm

Specific expectations for each part of clerkship

*in folder


Review books

Review Books

  • Should be used as a supplement to text

  • Please read required text!


Gyn rounder and ob rounder

GYN Rounder and OB Rounder

  • GYN Rounder

    • Faculty assigned to supervise resident clinics

    • Staffs all inpatient and ED consults

    • May be same as OB Rounder

    • Varies during the week

  • OB Rounder

    • Faculty staffing UNMC inpatient OB service

    • Generalist of MFM

    • Varies during the week


Who will teach supervise and evaluate you

Who will teach, supervise, and evaluate you?

  • Obstetrics 2 weeks

    • UNMC: OB team-rounder, staff, and residents

    • Methodist-MFM faculty, generalists, and residents

  • Gynecology 2 weeks

    • Benign:

      • gyn residents

      • faculty in OR cases

    • Oncology

      • onc residents

      • Drs. Remmenga & Rodabaugh

  • Outpatient Clinics 2 weeks

    ~Two faculty per week


Who are the chief residents

Who are the Chief Residents?

Abby Delaney, MD

UROG at Methodist

Libby Crockett, MD

UNMC OB

Valerie French, MD

UNMC GYN

Jean Huff

Chakraborty MD

UNMC ONC

Amanda Buskevicius,MD

UNMC OB Starting 6/17

Heather Said, MD

UNMC OB Starting 6/17

Laura Watters

UNMC ONC Starting 6/17

Sarah Lundin, MD

UROG at Methodist


Who are the methodist residents

Who are the Methodist Residents?

Amanda Buskevicius, MD

High Risk OB

Through 5/30

Jake Gibbens, MD

High Risk OB

Beginning 6/16

Laura Watters, MD

High Risk OB

Beginning 6/1


M3 ob gyn clerkship

Methodist MFMs

Dr. Michael Levine

  • Dr. Robert Bonebrake

  • Dr. Katherine Foley

Dr. HemantSatpathy

  • Dr. Andrew Robertson

Dr. Neil Hamill

Dr. Todd Lovgren


Methodist generalists

Methodist Generalists

Mark Carlson, M.D.

Paige Berryman, M.D.

Julia Bishop, M.D.

Craig Bassett, M.D.

Judith A. Scott, DO

Sarah Gernhart, M.D.

Brianne M. Kling, MD


Methodist generalists1

Methodist Generalists

Susan Wescott, M.D.

Kristen Hoffman, M.D.

Megan Prickett, M.D. (Irwin)

Carolee Jones, M.D.

William D. Weidner, MD

Nancy Mathews, M.D.


Methodist generalists2

Methodist Generalists

Michelle S. Knolla, MD

Tifany L. Somer-Shely, MD

LanetteGuthmann, M.D.

Rebecca L. Jacobi, MD

Thomas E. Martin, MD

Allison Phillips, M.D.


Methodist physicians consistently identified by previous students as great teachers

Methodist physicians consistently identified by previous students as great teachers:


Obstetrics block

Obstetrics “Block”

  • 2 weeks on In-patient team service

    • UNMC or Methodist

  • Students follow labor patients and post-partum patients

  • Pelvic exams – not done

  • Outline for note formats included in packet

  • Be prepared for morning topics


Ob block notes

OB Block Notes

  • Schedule: On-call 3-4 nights (1 weekend night). next day students go home after morning rounds completed

  • Appropriate attire: SCRUBS

  • Introduce yourself to patients, nurses

  • Be available for checks, labor assessments, and pushing phase and deliveries

  • Make sure your gloves and an extra gown are pulled for you; we want you involved!

  • Try not to get upset with interns who are learning how to do deliveries


Obstetrics knowledge and skills expectations

Obstetrics: Knowledge and Skills Expectations

By the end of the Obstetrics block students will be expected to competently:1)  Obtain, present, and document a relevant history on patients being evaluated or admitted; examinations will be done with supervising resident/ faculty2)  Interpret and document fetal heart rate monitoring strips3)  Assess and document labor course in patients, postpartum assessments4)  Understand the normal hospital course for the patient after a normal vaginal delivery or operative C/S delivery


Preparing for morning rounds

Preparing for Morning Rounds

  • Talk with residents about abnormal assessments before morning report to faculty

    - for example, wound drainage

  • Have notes written on time


Unmc inpatient ob service scheduled ob teaching conferences

UNMC Inpatient OB Service:Scheduled OB Teaching Conferences

  • Monday-Thursday 0700 (L&D MD Interaction Rm)

    • Morning teaching rounds

      • Patient presentations

      • Scheduled OB topics

  • Fridays 0700: Diagnostics in OB/GYN (DOC 4608)

  • Fridays 0800: Morning teaching rounds (as above)

  • Additional OB topic teaching sessions based on L&D activity


Gynecology block benign and gyn onc

Gynecology Block: Benign and GYN-Onc

  • 2 weeks of in-patient team services

  • Gynecology notes and post-op course outlined in your orientation packet

  • GYN team

    • ER

    • In-patient consultations

    • OR cases

  • GYN-Onc

    • OR cases

    • Dr. Remmenga’s and Dr. Rodabaugh’s clinics


Gynecology block

Gynecology Block:

  • Appropriate attire

    • scrubs when scheduled to be in OR

    • no scrubs when going to clinics

  • Students presentations (2)

    • Benign Gyn week

    • Onc week


Preparing for an or case

Preparing for an OR case:

- Background history on patient

-why is this surgery being done?

-read chart

-review labs

-review ultrasounds, pathology, etc.

- Read about that particular surgery

- Introduce yourself

-to patient in pre-op before surgery

-to OR staff

- Assist with moving/positioning of the patient

- Get your own gloves out

- After the case

-write the brief op note with help of resident/staff

-visit the patient 4 hours postop

-read the op note

-review the pathology


Gynecology knowledge and skills expectations

Gynecology: Knowledge and Skills Expectations

By the end of the Gynecology block students will be expected to competently:1)  Write a brief operative note and formulate postoperative plan2)  Discuss the normal hospital course after a routine Gyn surgical procedure3)  Discuss the appropriate work-up and differential for postoperative common problems:low urine output, fever, and wound problems4)  Discuss the relevant history, examination, and laboratory or radiology work-upinvolved in ER assessments of 1) pelvic pain and 2) abnormal vaginal bleeding5)  Briefly describe the differences between types of hysterectomies (supracervical, simple, radical, vaginal, abdominal, laparoscopic)


Outpatient clinics block

Outpatient Clinics “Block”

  • 2 weeks of outpatient clinic exposure:

    • One on one with 1-2 faculty/ week

  • Look at faculty schedule the day before

    • prepare, for example- postmenopausal bleeding

    • Routine OB care

  • Hands-on opportunities for exams

  • Review Gynecology clinic progress note in orientation packet

  • Scrubs never appropriate

  • Study sessions assigned during this block

  • Need to attend all assigned clinic sessions


Outpatient clinics knowledge and skills expectations

Outpatient Clinics: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 group2)  Conduct a new and return obstetric patient clinic visit (exam with supervision of faculty or resident)3)  Discuss appropriate triage of abnormal Pap smears4)  Discuss indications for vulvar biopsy and endometrial biopsy5)  Appropriately counsel patients on choices of contraception/sterilization6)  Discuss issues related to risks and benefits of hormone replacement therapy


What if i feel uncomfortable with pelvic exams

What if I feel uncomfortable with pelvic exams?

- You are not alone-

many physicians do not feel comfortable with pelvic exams

- Today is the practice pelvic exam session

- We expect you to become more familiar with the mechanics of the exam and how to appropriately talk to your patient during the exam- all exams should be supervised

- It takes a lot of practice to do them well.

- “How I Learned to Stop Worrying and Do Breast and Pelvic exams”


How can i make the most of my outpatient experience

How can I make the most of my outpatient experience?

  • Be flexible and keep an open mind. . .

    -your schedule is an outline

    -be available if opportunities to learn come up


Wednesday morning teaching

Wednesday Morning Teaching

  • 8:00AM Grand Rounds

    • DRC 1004 (sign in)

  • 9:00-12:00

    • Lectures – DOC 4608

    • schedule in notebook

  • No matter which clinical block or hospital currently assigned to, every student should attend

  • NO scrubs, please


Unmc benign gyn service scheduled gyn teaching conferences

UNMC Benign GYN Service:Scheduled GYN Teaching Conferences

  • Wednesdays 7:00 (time will vary!) Pre-op conference (Luikart)

  • Thursdays 7:00 (time will vary!) GYN Topic-based session

  • Fridays 7:00 Diagnostics in OB/GYN (DOC 4608)

  • Friday: GYN student presentation (gyn topic)

    • Time and place will vary

    • 5-10 minute prepared presentation with handout

      -use evaluation form provided

      -staple copy of handout to form

    • Present to gyn rounder and gyn team

    • 5 point of final grade


Unmc gyn onc service scheduled gyn teaching conferences

UNMC GYN-ONC Service:Scheduled GYN Teaching Conferences

  • Daily AM/PM work rounds

  • Friday: ONC student presentation

    • Oncology topic

    • 5-10 minute prepared presentation with handout

      -use evaluation form provided

      -staple copy of handout to form

    • Present to oncology team

    • 5 points of final grade


Dog conference

DOG Conference

- Friday 7:00am  Diagnostics in Obstetrics and Gynecology (DOG) in DOC 4608 (OB classroom)

- Topics based on diagnostic imaging and/or testing

-3 Fridays/month: OB topic

-1 Friday : gyn topic

*ALL rotations except GYN ONC and Methodist


Vice chairman s luncheon

Vice Chairman’s Luncheon

  • Luncheon

    • Towards the end of your 6-weeks

    • Dr. Remmenga usually hosts

    • All students are expected to attend

    • Lunch is provided--Luikart library, MSB 45119

  • Your feedback is highly appreciated!


Communication

Communication

  • Please read your email

    • We all communicate by email

  • Notes on board on Wednesday am at lectures


Policies attendance absences

Policies: Attendance/Absences

  • If you are ill, please contact:

    • Contact your current assigned service faculty or chief resident as soon as you know you will be absent.

    • Send email notification to Dr. Karen Carlson as soon as you know you will be absent

    • If you leave during the day due to illness, please notify Dr. Karen Carlson via email.

    • If you miss more than 1 day in the 6-week clerkship you must make up this time. Mrs. Ingraham will coordinate any needed make up time.

      *Do not rely on a classmate to relay your information.

      *Efforts will be made to reschedule your clinic sessions if missed.


Clerkship grading structure

Clerkship Grading Structure

  • 50 % clinical evaluations

    • Based on faculty and resident evaluations

    • Department grading meeting

      • Clinic advisors, residents, and faculty

  • 40% written exam

    • Shelf Exam: NBME 2 hour and 30 min exam

    • last Friday of the clerkship @ 9 AM

  • 5% GYN presentation

  • 5% ONC presentation


Pass high pass honors

PASS, HIGH PASS, HONORS

  • Our department complies with the College of Medicine’s recommended grade distribution of

    • 20% = Honors

    • 20% = High Pass

    • 60% = Pass


Criteria for passing c lerkship

Criteria for Passing Clerkship:

*Receiving ≥ 10th% scaled percentile score on the NBME shelf exam

  • National scaled percentile scores

  • Approximately 64 raw score

    AND

    *Receiving satisfactory resident & faculty evaluations

  • clinical grade of Pass or better


M3 ob gyn clerkship

UNMC Shelf scores compared to National average


Policies marginal or fail grades

Policies: Marginal or Fail Grades

  • MARGINAL Grade:

    • Students receiving a “M” on the clinical portion of the rotation

    • < 10th% scaled score on the NBME shelf exam

      • Student may opt to re-take the shelf exam:

        • If they pass second exam then his/her grade sheet will have an addendum noting the improved exam performance, but the grade remains MARGINAL

  • FAIL Grade:

    A student may receive a FAIL grade if significant professionalism/clinical issues have occurred on the rotation.


Grade appeals

Grade Appeals

  • All students have the right to appeal a clerkship grade and/or comments for the Dean’s letter

  • Initial requests must be made by email to Mrs Ingraham @ [email protected]

  • Requests must be made within 30 days of grades being emailed to students

  • OB/Gyn department has committee to evaluate these requests


Professionalism expectations

Professionalism Expectations:

  • Attendance

  • Be on-time to activities

  • Take your professional role seriously

  • Demonstrate respect

    • patients

    • ancillary staff

    • nurses

    • supervising residents

    • faculty

    • fellow students


Professionalism problems examples

Professionalism Problems: Examples

  • Being late/not writing notes on assigned patients

  • Talking about patient information in public areas (i.e. elevators, Facebook, etc.)

  • Laughing/talking out of turn during lectures

  • Texting during Grand Rounds or lectures

  • Inappropriate discussions in front of patients during pelvic exams, labor and delivery, etc.


Professionalism problems other examples

Professionalism Problems: Other examples

  • Use of cell phones during conferences/lectures

  • Inappropriate treatment of clinic or nursing staff

  • Not following patients after surgery/delivery

  • Missing deliveries/surgeries when notified by resident/staff

  • Residents and/or faculty will give appropriate feedback and notify Clerkship director of this interaction if problems arise


Feedback

Feedback

  • Mid Clerkship meeting:

    • Dr. Finney or Dr. Carlson will meet with each student.

    • Mandatory.

    • Informal 10 min. meeting to give you feedback and receive feedback from you regarding the first half of the clerkship.

    • See schedule in your binder.

    • Please let Teresa know right away if you have any conflicts during your scheduled time.

  • End of rotation comments:

    • You will receive written comments in your Sorrell Center mailbox.


Com professionalism forms

COM Professionalism Forms:

  • Will be filled out on each student and sent to Sue Pope along with your grade at the end of the clerkship.

  • NOTE: This is separate from your actual “letter” grade received at the end of the clerkship.


Evaluations for students to complete

Evaluations for Students to Complete

  • Department evaluations

    • Evaluations of lectures

    • Evaluations of individual faculty and residents

  • COM on-line evaluation

    **We value your input!!


Student of the week

Student of the Week

  • One student may be chosen each week as Student of the Week

    • Weeks 2-6

    • Announced at Grand Rounds

  • Nominations by house staff and faculty

  • UNMC and Methodist students


Student permission form

Student Permission Form


The end

The END

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