ࡱ> q` bbjbjqPqP .::b        DwDwDwDwLw z2|||||}}}$h }}  ||4kkk | |kkk|  || 3cۑDwo 7J0zIy$J Y}1Lk}!x}}}a }}}z   $rDw   Dw          Department of Obstetrics and Gynecology Residency Curriculum Goals and Education Objectives Revised: February 2008 PGY-1 Obstetrics- Labor Floor Day Team GOALS AND OBJECTIVES: General exposure to all aspects of inpatient obstetrics including intrapartum and postpartum management CORE COMPETENCIES: Patient Care-Manage patients on Postpartum Service including all order writing, test ordering, discharges -Participate in management of patients admitted to Labor Floor including vaginal deliveries, cesarean deliveries -Triage second and third trimester patients presenting to the Perinatal Evaluation Center Medical Knowledge-Understand possible postpartum complications of normal vaginal delivery and cesarean delivery -Become familiar with post-operative care as relates to cesarean delivery -Understand normal and abnormal labor as well as indications for operative and cesarean delivery -Understand fetal monitoring -Perform OB ultrasound for dating, biophysical profiles -Become adept at vaginal delivery and operative skills needed for cesarean delivery and laceration repairInterpersonal and Communication Skills-Be able to counsel patients regarding contraceptive options -Work with Social Work team to optimize conditions for mother and child upon discharge -Communicate with patients and families in an urgent care setting -Optimize care provided by healthcare team by communicating with nursing staff, anesthesia, pediatricsProfessionalism-Demonstrate respect, compassion, integrity, and responsiveness to needs of patients in labor and postpartumPractice-Based Learning and Improvement-Participate in work and teaching rounds on Labor Floor and Postpartum Service -Attend Morning and Noon ConferencesSystems-Based Practice-Attend monthly M+M conferences to improve patient safety, learn from errors, become informed about complex medical issues -Use Baby Tracker system for data monitoring Night Float- Obstetrics GOALS AND OBJECTIVES: General exposure to all aspects of inpatient obstetrics including intrapartum and postpartum management CORE COMPETENCIES: Patient Care-Manage patients on Postpartum Service -Participate in management of patients admitted to Labor Floor including vaginal deliveries, cesarean deliveries -Triage second and third trimester patients presenting to the Perinatal Evaluation Center Medical Knowledge-Understand possible postpartum complications of normal vaginal delivery and cesarean delivery -Become familiar with post-operative care as relates to cesarean delivery -Understand normal and abnormal labor as well as indications for operative and cesarean delivery -Understand fetal monitoring -Perform OB ultrasound for dating, biophysical profiles -Become adept at vaginal delivery and operative skills needed for cesarean delivery and laceration repairInterpersonal and Communication Skills-Communicate with patients and families in an urgent care setting -Optimize care provided by healthcare team by communicating with nursing staff, anesthesia, pediatricsProfessionalism-Demonstrate respect, compassion, integrity, and responsiveness to needs of patients in labor and postpartumPractice-Based Learning and Improvement-Participate in work and teaching rounds on Labor Floor and Postpartum Service -Attend Morning ConferencesSystems-Based Practice-Attend monthly M+M conferences to improve patient safety, learn from errors, become informed about complex medical issues -Use Baby Tracker system for data monitoring Obstetrics- Antepartum GOALS AND OBJECTIVES: Exposure to inpatient and outpatient management of complicated pregnancies CORE COMPETENCIES: Patient Care-Manage patients on Antepartum Service including all order writing, test ordering, discharges, fetal monitoring interpretation -Triage second and third trimester patients presenting to the Perinatal Evaluation Center -Participate in outpatient prenatal care for high-risk pregnancies Medical Knowledge-Manage high-risk pregnancies in inpatient and outpatient setting and understand criteria for inpatient admission -Understand and perform fetal testing and surveillance (NST, BPP) -Perform OB ultrasound for dating Interpersonal and Communication Skills-Use consultants appropriately in inpatient and outpatient settings -Communicate with patients and families regarding plan of care on inpatient service -Optimize care provided by healthcare team by communicating with nursing staff, anesthesia, pediatrics, social work, consultantsProfessionalism-Demonstrate respect, compassion, integrity, and responsiveness to needs of patients with complicated pregnanciesPractice-Based Learning and Improvement-Participate in work and teaching rounds on Labor Floor and Antepartum Service -Attend Morning and Noon ConferencesSystems-Based Practice-Attend monthly M+M conferences to improve patient safety, learn from errors, become informed about complex medical issues -Use Baby Tracker system for data monitoring Gynecologic Oncology GOALS AND OBJECTIVES: Exposure to all aspects of inpatient Gyn Oncology CORE COMPETENCIES: Patient Care-Manage patients on the Gyn Oncology inpatient service -Become adept at performing minor outpatient procedures, Benign and Oncologic including: laparoscopic BTL, LEEP, cold knife cone, hysteroscopy, D+E -Care for OBGYN patients in the outpatient Dickens Center settingMedical Knowledge-Become familiar with post-op management of patients with concurrent medical illness -Recognizing criteria for inpatient admission for women with gynecologic malignancies -Learn principles of chemotherapy -Learn surgical technique and principles of laparoscopy, hysteroscopyInterpersonal and Communication Skills-Perform as an integral team member and patient advocate -Providing compassionate care to patients who are critically ill, coping with cancer diagnosis and associated treatmentsProfessionalism-Demonstrate respect, compassion, integrity, and responsiveness to needs of patients with complicated medical illness, cancer diagnosesPractice-Based Learning and Improvement-Prepare cases for Gyn Oncology Conference -Master the organizational skills necessary to provide care for an inpatient serviceSystems-Based Practice-Attend monthly M+M conferences to improve patient safety, learn from errors, become informed about complex medical issues -Learn use of ACGME database for case collection Internal Medicine- Inpatient Wards GOALS AND OBJECTIVES: General exposure to inpatient medicine therapy and patient management CORE COMPETENCIES: Patient Care-Caring for male and female patients with chronic illness in an inpatient settingMedical Knowledge-Pathophysiology of common chronic diseases: hypertension, diabetes, cardiac, renal, gastrointestinal -Medical treatments for the above and pharmacology -Geriatric medicineInterpersonal and Communication Skills-Taking a comprehensive history from patients with illness -Recording thorough H+Ps and progress notesProfessionalism-Appropriate utilization of ancillary resourcesPractice-Based Learning and Improvement-Attending daily rounds and conferences as scheduled by Department of Internal MedicineSystems-Based Practice-Attend M+M conferences to improve patient safety, learn from errors, become informed about complex medical issues  Surgical Intensive Care Unit GOALS AND OBJECTIVES: General exposure to all aspects of intensive care of postoperative patients CORE COMPETENCIES: Patient Care-Recognition of the critically ill patient that needs intensive care -Insertion of lines for invasive monitoringMedical Knowledge-Understand principles of mechanical ventilation, equipment, and settings -Understand invasive monitoring, hemodynamics -Fluid management and principles of transfusion -ACLSInterpersonal and Communication Skills-Perform as an integral team member and patient advocate -Provide compassionate care to patients who are critically ill and communicating with familiesProfessionalism-Acting as effective member of team comprised of physicians of varying specialties -Participating in call schedulePractice-Based Learning and Improvement-Attending daily rounds as conducted by Unit Surgery or Anesthesia Chief/ AttendingSystems-Based Practice-Charting as per SICU department Emergency Medicine GOALS AND OBJECTIVES: General exposure to all aspects of emergency and acute care CORE COMPETENCIES: Patient Care-Triage patients presenting to Emergency Room and be able to make distinction between emergent/urgent/routine medical issues -Stabilize patients in need of further care -Order appropriate diagnostic tests -Understand criteria for inpatient admission -Assess need for operative interventionMedical Knowledge-Disease processes and complications -ACLSInterpersonal and Communication Skills-Calling for appropriate consultations and conveying patient history and physical in a clear and concise manner -Cooperating with physicians and ED staff to provide effective careProfessionalism-Being a reliable member of the Emergency Department team -Establishing good relationships in the EDPractice-Based Learning and Improvement-Attending daily rounds as conducted by ED attendingSystems-Based Practice-Ordering appropriate tests keeping in mind cost-effective care -Understanding the role of the ED within the scope of inpatient admission/ continuity of outpatient care Ambulatory Womens Health GOALS AND OBJECTIVES: General exposure to common womens health issues CORE COMPETENCIES: Patient Care-Perform routine well-woman examinations with familiarization of periodic health assessment based on age -Exposure to non OBGYN specialties related to womens health (Dermatology, Gastroenterology, Breast)Medical Knowledge-Periodic health assessment, age-based -Know screening tests and when appropriate -Common medical problems (diabetes, hypertension, hypercholesterolemia) and how they affect the reproductive systemInterpersonal and Communication Skills-Eliciting accurate history and performing thorough physical exam -Understanding the needs of the well-woman presenting for an outpatient visit and incorporating education, preventive medicine into a meaningful encounterProfessionalism-Maintaining a professional appearance -Develop and maintain habits of punctuality and efficiencyPractice-Based Learning and Improvement-Demonstrate responsiveness to instruction and feedback -Use knowledge from textbooks and up-to-date studies to guide patient careSystems-Based Practice-Understand the basics of insurance, documentation, and coding principles PGY-2 Obstetrics- Labor Floor Day Team GOALS AND OBJECTIVES: Continued general exposure to all aspects of obstetrics with focus on operative vaginal deliveries and cesarean delivery, maternal and fetal assessment, and development of management skills CORE COMPETENCIES: Patient Care-Actively manage laboring patients admitted to Labor Floor -Participate in operative vaginal deliveries and cesarean deliveries -Participate in management of antepartum patients admitted to Labor Floor -Care for OBGYN patients in the outpatient Dickens Center setting Medical Knowledge-Understand normal and abnormal labor as well as indications for operative and cesarean delivery -Know management of term and preterm delivery with associated medical complications -Become familiar with principles of Obstetric anesthesiaInterpersonal and Communication Skills-Be able to counsel patients regarding vaginal delivery, operative vaginal delivery, vaginal birth after cesarean, cesarean delivery -Communicate with patients and families in an urgent care setting -Optimize care provided by healthcare team by communicating with nursing staff, anesthesia, pediatrics, obstetrics -Provide thorough, concise signout to night teamProfessionalism-Demonstrate respect, compassion, integrity, and responsiveness to needs of patients in labor -Participate in team admissionsPractice-Based Learning and Improvement-Participate in work and teaching rounds on Labor Floor -Attend Morning and Noon ConferencesSystems-Based Practice-Attend monthly M+M conferences to improve patient safety, learn from errors, become informed about complex medical issues -Use Baby Tracker system for data monitoring Night Float- Obstetrics GOALS AND OBJECTIVES: Continued general exposure to all aspects of obstetrics with focus on operative vaginal deliveries and cesarean delivery, maternal and fetal assessment, and development of management skills. CORE COMPETENCIES: Patient Care-Actively manage laboring patients admitted to Labor Floor -Participate in operative vaginal deliveries and cesarean deliveries -Participate in management of antepartum patients admitted to Labor Floor -Care for OBGYN patients in the outpatient Dickens Center setting Medical Knowledge-Understand normal and abnormal labor as well as indications for operative and cesarean delivery -Know management of term and preterm delivery with associated medical complications -Become familiar with principles of Obstetric anesthesiaInterpersonal and Communication Skills-Be able to counsel patients regarding vaginal delivery, operative vaginal delivery, vaginal birth after cesarean, cesarean delivery -Communicate with patients and families in an urgent care setting -Optimize care provided by healthcare team by communicating with nursing staff, anesthesia, pediatrics, obstetricsProfessionalism-Demonstrate respect, compassion, integrity, and responsiveness to needs of patients in labor -Participate in team admissionsPractice-Based Learning and Improvement-Participate in work and teaching rounds on Labor Floor Systems-Based Practice-Attend monthly M+M conferences to improve patient safety, learn from errors, become informed about complex medical issues -Use Baby Tracker system for data monitoring Gynecology- Benign GOALS AND OBJECTIVES: Exposure to all aspects of gynecology CORE COMPETENCIES: Patient Care-Cover operating room cases, majors and minors at HUP, Presbyterian Hospital, VA -Participate in postoperative care for Benign Gynecologic surgery patients as well as inpatient admissions -Attend to emergency room and inpatient consults and become familiar with gynecologic surgical emergencies and admissions - Care for OBGYN patients in the outpatient Dickens Center setting -Counsel patients regarding medical vs. surgical management of benign gynecologic conditions Medical Knowledge-Understand and execute surgical procedures including: operative laparoscopy/ hysteroscopy, abdominal/vaginal/laparoscopic hysterectomy, myomectomy -Know medical and surgical management of ectopic pregnancy/ SAB -Understand the menstrual cycle and alterations, treatment of disturbances -Postoperative management and treatment of complicationsInterpersonal and Communication Skills-Work with other services to provide emergency and/or consult care appropriately -Pre and post-surgical counseling -Address advanced directives for gynecologic admissions -Provide informed consentProfessionalism-Respond to consult requests in a timely mannerPractice-Based Learning and Improvement-Participate in work and teaching rounds -Attend weekly GYN Case Conference Systems-Based Practice-Attend monthly M+M conferences to improve patient safety, learn from errors, become informed about complex medical issues -Continue use of ACGME database for case collection Gynecologic Oncology GOALS AND OBJECTIVES: General exposure to all aspects of inpatient Gynecologic Oncology CORE COMPETENCIES: Patient Care-Cover operating room cases, majors and minors with Gyn Onc fellows and attendings -Participate in postoperative care for surgery patients -See known Gyn Onc patients presenting through emergency room and determine need for admission - Care for OBGYN patients in the outpatient Dickens Center setting Medical Knowledge-Continue complicated management of post-operative patients with concurrent medical illness -Recognize criteria for inpatient admission for women with gynecologic malignancies -Learn principles of chemotherapy -Principles of fundamental and radical oncologic surgery and staging procedures Interpersonal and Communication Skills-Perform as an integral team member and patient advocate -Provide compassionate care to patients who are critically ill, coping with cancer diagnosis and associated treatments -Coordinate inpatient and outpatient care -Signout to gynecology night coverageProfessionalism-Demonstrate respect, compassion, integrity, and responsiveness to needs of patients with complicated medical illness, cancer diagnosesPractice-Based Learning and Improvement-Prepare cases for Gyn Onc Conference -Participate in work and teaching rounds with fellows and attendings Systems-Based Practice-Attend monthly M+M conferences to improve patient safety, learn from errors, become informed about complex medical issues -Continue use of ACGME database for case collection Ambulatory GOALS AND OBJECTIVES: Exposure to specialized and unique aspects of obstetric and gynecologic care CORE COMPETENCIES: Patient Care-Care for OBGYN patients in the outpatient Dickens Center setting -Evaluate for urogynecologic conditions under the supervision of Dr. Arya -Perform obstetric ultrasound in MFM department -Diagnose and manage breast disease with Dr. Tchou -Family planning: counsel and treat patients with complex contraceptive needsMedical Knowledge-High-risk obstetric conditions -Pelvic prolapse, urinary incontinence, and medical and surgical options -Principles of ultrasound -Understand benign and malignant breast disease, diagnosis and treatment options -Understand hormonal, non-hormonal, short-term, long term contraception, modes of action, contraindications Interpersonal and Communication Skills-Develop ability to counsel pregnant women regarding management of complex maternal and/or fetal conditions -Counsel patients with urogynecologic conditions regarding medical and surgical options for intervention -Assist women in choosing the most appropriate form of contraception Professionalism-Demonstrate respect, compassion, integrity, and responsiveness to needs of patients Practice-Based Learning and Improvement-Review of ultrasound images with MFM attendings with feedback -Learn by shadowing attending physicians -Formulate plans of care with fellows and attendings in clinicSystems-Based Practice-Compare different outpatient practice settings (resident clinic, private offices, ultrasound units, procedure units) and identify factors which contribute to effective quality care -Provide thorough and accurate documentation for various types of encounters (routine, problem visits, preoperative counseling, procedure notes) Reproductive Endocrinology and Infertility GOALS AND OBJECTIVES: Exposure to basic office infertility and endocrinology with outpatient evaluation CORE COMPETENCIES: Patient Care-Care for OBGYN patients in the outpatient Dickens Center setting -See patients in the REI faculty practice office in order to become familiar with basic office infertility and endocrinology -Perform ultrasounds and hysterosalpingogramsMedical Knowledge-Assessment of the infertile couple -Understanding normal physiology and abnormalities of the menstrual cycle -Assessment of ovulation and management of ovulatory dysfunction -Principles of ultrasound; scanning for follicular development and early pregnancy -Principles of oocyte retrievalInterpersonal and Communication Skills-Communicate effectively with patients in language appropriate to age, educational, cultural, socioeconomic background -Convey information to colleagues in a concise, effective mannerProfessionalism-Demonstrate a commitment to excellence and interest in ongoing professional developmentPractice-Based Learning and Improvement-Attend REI conferences -Attend morning resident conferencesSystems-Based Practice-Use Blackboard on-line curriculum to broaden knowledge base and improve patient care  PGY-3 Obstetrics- Labor Floor Day Team GOALS AND OBJECTIVES: Exposure to all aspects of normal and high-risk pregnancies, active management of labor, and supervision of the labor floor CORE COMPETENCIES: Patient Care-Actively manage laboring patients admitted to Labor Floor -Participate in operative vaginal deliveries and complicated cesarean deliveries -Participate in management of antepartum patients admitted to Labor Floor -Participate in postpartum care for women with complicated deliveries -Care for OBGYN patients in the outpatient Dickens Center setting Medical Knowledge-Prenatal diagnosis and treatment -Understand and teach fetal and maternal invasive and non-invasive monitoring -Repair of 3rd and 4th degree lacerationsInterpersonal and Communication Skills-Be able to counsel patients regarding vaginal delivery, operative vaginal delivery, vaginal birth after cesarean, cesarean delivery -Communicate with patients and families in an urgent care setting -Optimize care provided by healthcare team by communicating with nursing staff, anesthesia, pediatrics, obstetrics -Provide thorough, concise signout to night teamProfessionalism-Provide effective mentoring and role modeling for junior residents and studentsPractice-Based Learning and Improvement-Run Fetal High-Risk Conference in conjunction with fellows -Attend Pediatric/OB ConferenceSystems-Based Practice-Present at monthly M+M conferences to improve patient safety, learn from errors, become informed about complex medical issues -Use Baby Tracker system for data monitoring Gynecology- Benign GOALS AND OBJECTIVES: Exposure to all aspects of benign gyn surgery with further development of operative skills and techniques and expertise in postoperative management CORE COMPETENCIES: Patient Care-Cover operating room cases, majors and minors at HUP, Presbyterian Hospital, VA -Participate in postoperative care for Benign Gynecologic surgery patients as well as inpatient admissions -Attend to emergency room and inpatient consults and become familiar with gynecologic surgical emergencies and admissions - Care for OBGYN patients in the outpatient Dickens Center setting -Counsel patients regarding medical vs. surgical management of benign gynecologic conditions Medical Knowledge-Pelvic anatomy -Understand and execute surgical procedures including: operative laparoscopy/ hysteroscopy, abdominal/vaginal/laparoscopic hysterectomy, myomectomy -Perform more complex surgeries with greater independence including operative laparoscopy, vaginal surgery and reconstruction, lysis of adhesions -Postoperative management and treatment of complicationsInterpersonal and Communication Skills-Assist chief with delegation of responsibilities and with teaching of junior residents -Work with other services to provide emergency and/or consult care appropriately -Pre and post-surgical counseling -Address advanced directives for gynecologic admissions -Provide informed consent -Follow up for early pregnancy patients tracked in quant bookProfessionalism-Provide effective mentoring and role modeling for junior residents and students -Respond to consult requests in a timely mannerPractice-Based Learning and Improvement-Provide educational experiences to Gyn team with presentations of consults -Participate in work and teaching rounds -Attend weekly GYN Case ConferenceSystems-Based Practice-Present at monthly M+M conferences to improve patient safety, learn from errors, become informed about complex medical issues -Continue use of ACGME database for case collection Gynecology- Chester County Hospital GOALS AND OBJECTIVES: Exposure to all aspects of benign gyn surgery with further development of operative skills and techniques and expertise in postoperative management CORE COMPETENCIES: Patient Care-Achieve the level of first surgical assistant/ primary surgeon on gynecologic surgical cases -Provide post-operative follow up and inpatient careMedical Knowledge-Pelvic anatomy -Broaden experience with varying surgical techniques, laparoscopic and openInterpersonal and Communication Skills-Cooperate with residents from Pennsylvania Hospital to provide effective patient careProfessionalism-Maintain a good work ethic, punctuality, and efficiency as representatives of HUPPractice-Based Learning and Improvement-Use personal clinical experience to improve knowledge and surgical skills in the operating room -Seek instruction and feedback from attendings with a commitment to practice improvementSystems-Based Practice-Attend monthly M+M conferences to improve patient safety, learn from errors, become informed about complex medical issues -Continue use of ACGME database for case collection Gynecologic Oncology GOALS AND OBJECTIVES: Exposure to all aspects of Gyn Oncology including operative technique, pre and post-operative management, chemotherapy. This rotation is designed to give the resident experience in managing a surgical service as the primary decision-maker working closely with the fellows. CORE COMPETENCIES: Patient Care-Management of service as the senior resident -Organize coverage of all gyn oncology operative cases and act as first assistant/surgeon on complex surgical cases -Assess the need for admission to inpatient service for patients presenting through office or emergency room -Cover Colposcopy clinicMedical Knowledge-Advanced management of the gyn oncology surgical and post-operative patient -Surgical approach to the treatment of gynecologic malignancies and staging procedures -Principles of chemotherapy and radiation -Familiarity with GOG protocolsInterpersonal and Communication Skills-Perform as a team leader and patient advocate -Provide compassionate care to patients who are critically ill, coping with cancer diagnosis and associated treatments -Coordinate inpatient and outpatient care -Signout to gynecology night coverageProfessionalism-Provide effective mentoring and role modeling for junior residents and studentsPractice-Based Learning and Improvement-Conduct morning work rounds -Participate in afternoon rounds with Oncology fellow/attending -Participate in Gyn Onc Conferences and case presentations Systems-Based Practice-Present at monthly M+M conferences to improve patient safety, learn from errors, become informed about complex medical issues -Continue use of ACGME database for case collection Night Float- Gynecology GOALS AND OBJECTIVES: Postoperative management, emergency gyn consultation, and surgery CORE COMPETENCIES: Patient Care-Provide care/coverage for all gynecology inpatients -Act as primary consultant to the ED -Determine need for and cover OR cases for all gynecologic emergencies -Assist with the labor floor team as necessaryMedical Knowledge-Management of routine and emergent postoperative issues -Evaluation and management of patients presenting to the Emergency Department -Understanding criteria for inpatient admission of gynecologic patients -Diagnosis and management of ectopic pregnancy -Emergency surgical skillsInterpersonal and Communication Skills-Respond to ED consult requests in a timely and efficient manner -Provide whole and compassionate care to gyn patients in an urgent care setting -Triage surgical emergencies efficiently and work with OR staff to expedite cases appropriatelyProfessionalism-Provide effective mentoring and role modeling for junior residents and students -Adhere to attending supervision guidelines and protocolsPractice-Based Learning and Improvement-Follow quant book data to compare clinical impressions and outcomes -Attend weekly GYN Case ConferenceSystems-Based Practice-Practice cost-effective health care and resource allocation that does not compromise quality of care Reproductive Endocrinology and Infertility GOALS AND OBJECTIVES: Exposure to basic office infertility and endocrinology with the evaluation of outpatients CORE COMPETENCIES: Patient Care-Care for OBGYN patients in the outpatient Dickens Center setting -See patients in the REI faculty practice office in order to become familiar with basic office infertility and endocrinology -Perform ultrasounds and hysterosalpingograms -Cover major and minor cases with REI fellows and attendingsMedical Knowledge-Assessment of the infertile couple -Understanding normal physiology and abnormalities of the menstrual cycle -Assessment of ovulation and management of ovulatory dysfunction -Principles of ultrasound; scanning for follicular development and early pregnancy -Principles of oocyte retrievalInterpersonal and Communication Skills-Communicate effectively with patients in language appropriate to age, educational, cultural, socioeconomic background -Convey information to colleagues in a concise, effective mannerProfessionalism-Demonstrate a commitment to excellence and interest in ongoing professional developmentPractice-Based Learning and Improvement-Attend REI conferences -Attend morning resident conferencesSystems-Based Practice-Use Blackboard on-line curriculum to broaden knowledge base and improve patient care Elective GOALS AND OBJECTIVES: Focused project for career development CORE COMPETENCIES: Patient Care-Care for OBGYN patients in the outpatient Dickens Center setting -varies by electiveMedical Knowledge-varies by electiveInterpersonal and Communication Skills-varies by electiveProfessionalism-varies by electivePractice-Based Learning and Improvement-varies by electiveSystems-Based Practice-varies by elective PGY-4 Obstetrics- Labor Floor Day Team GOALS AND OBJECTIVES: Exposure to normal and high-risk obstetrics as the first-line decision-maker on patient management issues. This rotation is designed to promote leadership and administrative skills and promoting readiness for independent management of antepartum, laboring, and postpartum patients. CORE COMPETENCIES: Patient Care-Direct and manage care of antepartum and laboring patients admitted to the Labor Floor as the responsible decision-maker -Direct and manage care of patients admitted to the Postpartum Service -Perform cesarean sections with junior residents under attending supervision -Perform normal and operative vaginal deliveries with junior residents under attending supervision -Provide antepartum care for high-risk obstetric patients at Dickens Medical Knowledge-Understand management of normal and abnormal labor and delivery -Understand maternal and obstetric complications of pregnancy and management/ timing of delivery -Surgical skills to perform complicated repeat cesarean sections and laceration repair -Obstetric emergencies and interventions (postpartum hemorrhage, eclampsia, shoulder dystocia, malpresentation, cesarean hysterectomy) Interpersonal and Communication Skills-Be able to counsel patients regarding vaginal delivery, operative vaginal delivery, vaginal birth after cesarean, cesarean delivery -Communicate with patients and families in an urgent care setting -Optimize care provided by healthcare team by communicating with nursing staff, anesthesia, pediatrics, obstetricsProfessionalism-Provide effective mentoring and role modeling for junior residents and students -Participate in team historiesPractice-Based Learning and Improvement-Present cases at High Risk OB Conference -Lead teaching at am and pm signout -Tracing reviewSystems-Based Practice-Present at monthly M+M conferences to improve patient safety, learn from errors, become informed about complex medical issues -Use Baby Tracker system for data monitoring Obstetrics- Antepartum GOALS AND OBJECTIVES: Exposure to high-risk, inpatient, and outpatient obstetrics as the first-line decision-maker on patient management issues CORE COMPETENCIES: Patient Care-Direct and manage the Antepartum service -Direct and manage the Perinatal Evaluation Center -Provide prenatal care for high-risk patients at DickensMedical Knowledge-Complete management of high-risk obstetrical conditions (diabetes, hypertension/preeclampsia, cardiac disease, multiple gestation, IUGR, preterm labor/ PPROM) -Antepartum fetal surveillance- indications, frequency, interpretationInterpersonal and Communication Skills- Educate inpatients regarding disease and how pregnancy is affected, discuss indications for inpatient care Professionalism-Provide effective mentoring and role modeling for junior residents and studentsPractice-Based Learning and Improvement-Present cases at High Risk OB Conference -Lead teaching at am and pm signout -Tracing reviewSystems-Based Practice-Providing care in team setting with nursing, obstetrics, social work -Present at monthly M+M conferences to improve patient safety, learn from errors, become informed about complex medical issues -Use Baby Tracker system for data monitoring Night Float- Obstetrics and Gynecology GOALS AND OBJECTIVES: Complete management of all inpatients, emergency and inpatient consults, and obstetric triage patients CORE COMPETENCIES: Patient Care-Complete management of all inpatient obstetric and gynecology admissions, triage, and consultsMedical Knowledge-Understand management of normal and abnormal labor and delivery -Understand maternal and obstetric complications of pregnancy and management/ timing of delivery -Surgical skills to perform complicated repeat cesarean sections and laceration repair -Obstetric emergencies and interventions (postpartum hemorrhage, eclampsia, shoulder dystocia, malpresentation, cesarean hysterectomy) -Management of routine and emergent postoperative/ postpartum issues -Supervision of Emergency Department consults and recognition of surgical emergencies -Understanding criteria for inpatient admission of gynecologic patients -Diagnosis and management of ectopic pregnancy -Emergency surgical skillsInterpersonal and Communication Skills-Supervise junior residents and delegate responsibilities among team members to provide appropriate patient care Professionalism-Provide effective mentoring and role modeling for junior residents and studentsPractice-Based Learning and Improvement-Teaching junior residents: postoperative evaluation, labor and delivery, triage of obstetric patients, emergency room consultation, examination skills, surgical skills -Lead teaching at am and pm signout Systems-Based Practice-Providing care in team setting with nursing, obstetrics, social work -Present at monthly M+M conferences to improve patient safety, learn from errors, become informed about complex medical issues -Use Baby Tracker system for data monitoring Gynecology- Benign GOALS AND OBJECTIVES: Exposure to the full range of preoperative, operative, and post-operative gynecologic conditions as the primary decision-maker. This rotation is designed to promote leadership, operative and administrative skill, along with the clinical management of outpatient and inpatient gyn patients. CORE COMPETENCIES: Patient Care-Direct and manage the Benign Gynecology service -Oversee all Emergency Room and floor consults and formulate plan of care - Care for OBGYN patients in the outpatient Dickens Center setting, with emphasis on preoperative counseling and postoperative follow up -Prepare patients for outpatient and inpatient benign gynecologic surgery -Coordinate coverage for all cases at HUP, VA, Presbyterian Hospital -Supervise patients followed in quant book and intervene with treatment as deemed necessaryMedical Knowledge-Full range of gynecologic procedures as primary operating surgeon -Medical and surgical options/ indications for benign gynecologic disease -OR complications and management -Postoperative care and management of complications -Treatment options for early pregnancy failure and ectopic pregnancy -Treatment for acute vaginal bleedingInterpersonal and Communication Skills-Supervise junior residents and delegate responsibilities among team members to provide appropriate patient care -Communicate with Gyn attending regarding floor admissions and emergencies -Communicate with patients followed in quant book regarding diagnosis and plan of care Professionalism-Provide effective mentoring and role modeling for junior residents and students -Supervise ER and floor consults and provide coordinated, timely care -Discuss scheduled OR cases with attending prior to admissionPractice-Based Learning and Improvement-Attend morning conferences -Present cases at Tuesday Gyn Case ConferenceSystems-Based Practice-Present at monthly M+M conferences to improve patient safety, learn from errors, become informed about complex medical issues -Continue use of ACGME database for case collection Ambulatory- Dickens Center GOALS AND OBJECTIVES: Exposure to and management of outpatient obgyn primary care, allowing the establishment of continuity of care, office practice management, knowledge of ambulatory medicine, and assessment of patients requiring inpatient and surgical treatments CORE COMPETENCIES: Patient Care-Providing outpatient management of routine and complex gynecologic issues -Providing follow-up for patients seeking care through the emergency room setting and facilitating their entry into the system -Prepare patients for outpatient and inpatient benign gynecologic surgery -Assist Antepartum Chief with outpatient management of prenatal care for high-risk obstetric patients Medical Knowledge-Age-appropriate preventive medicine skills -Ambulatory procedures (colposcopy, endometrial biopsy, IUD insertion) -Appropriate follow-up treatment for abnormal screening imaging and/or lab abnormalities Interpersonal and Communication Skills-Identify patient needs and coordinate care in comprehensive fashion with awareness of clinic resources Professionalism-Provide effective mentoring and role modeling for junior residents and students -Ensure smooth and timely flow during resident clinic sessions. -Follow up lab results in a timely/ appropriate fashionPractice-Based Learning and Improvement-Attend morning resident conferences -Attend High-Risk OB conferencesSystems-Based Practice-Know proper coding for preventive and evaluation/management visits -Advise junior residents regarding patient flow and proper documentation for office visits -Appropriately use knowledge of clinic resources (nursing, social work, nutrition, financial)to optimize patient care Reproductive Endocrinology and Infertility GOALS AND OBJECTIVES: Exposure to complex surgical procedures as evaluation and treatment of infertility CORE COMPETENCIES: Patient Care-Acting as primary or assistant operating surgeon for all complex REI operative procedures such as myomectomy, operative hysteroscopy, operative laparoscopy, tuboplasty/ reanastamosis, endometriosis, treatment of ectopic pregnancyMedical Knowledge-Full range of gynecologic REI procedures as primary or assistant operating surgeon -Medical and surgical options/ indications for evaluation and treatment of infertility -OR complications and management -Postoperative care and management of complicationsInterpersonal and Communication Skills-Communicate effectively with patients in language appropriate to age, educational, cultural, socioeconomic background -Convey information to colleagues in a concise, effective manner; especially with coordination of care with benign GYN serviceProfessionalism-Demonstrate a commitment to excellence and interest in ongoing professional developmentPractice-Based Learning and Improvement-Attend REI conferences -Attend morning resident conferencesSystems-Based Practice-Use Blackboard on-line curriculum to broaden knowledge base and improve patient care =C- . ; < a e x A i #MST,()<pqz-0OPQzwvst()*h,hzh^yhV$hBFhNdh\>h6hsJhRyh~hWh,h (h*hXL(\]tu{  . ; d e $IfgdsJ $IfgdRyh^hgdW & FgdQgdXbe f x ! 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