Competency Objectives

PREAMBLE: GOALS AND COMPETENCY-BASED OBJECTIVES

The Department of Obstetrics and Gynecology is a Clinical Department of the Stritch School of Medicine, Loyola University Chicago which is primarily responsible for educating its medical students in the reproductive sciences. We are composed of a culturally diverse faculty and administration. In addition, a number of our faculty members hold their primary appointments in the Primary Care Division. All of our faculty members, whether in the Department proper or the Primary Care Division, are committed as teachers, mentors, and role models to support the development of the student competencies.

GOALS AND COMPETENCY-BASED OBJECTIVES

At this juncture, as guided by the Liaison Committee on Medical Education, we are converting our curriculum and evaluation of the student-physician to a Competency Basis. Thus, whenever possible, the student-physician will be expected to establish competency in various areas of their educational development, not just didactic knowledge. The Six Primary Competencies in the Curriculum are considered below.

A. Competency: MEDICAL KNOWLEDGE
Students will be expected to demonstrate a knowledge of:

1. Maternal physiologic alterations during pregnancy
2. Diagnosis, mechanisms and conduct of normal labor and vaginal delivery
3. Clinical circumstances when an instrument assisted delivery is indicated
4. Immediate assessment and care of the newborn
5. Risk factors, diagnostic methods and management of ectopic pregnancies
6. Etiologies, physical findings and treatment options for spontaneous abortion
7. Effects of medical and surgical conditions upon pregnancy including anemia, diabetes, cardiac disease, asthma, infectious diseases, chronic hypertension and drug abuse
8. Impact, diagnosis and management of pregnancy-induced hypertension
9. Impact, management and prevention of Rh isoimmunization during pregnancy
10. Mechanisms, diagnosis and impact of multiple gestations on neonatal morbidity and mortality.
11. Etiologies, management and treatment of fetal death in-utero
12. Recognition and treatment of abnormal labor including cephalopelvic disproportion, dystocia, use of oxytocin, abnormal fetal presentations and vaginal birth after cesarean section
13. Differential diagnoses and management plans for a patient with third-trimester vaginal bleeding
14. Etiologies, impact and management of preterm labor/premature rupture of membranes
15. Recognition and management of intrapartum fetal distress
16. Diagnosis and management of postpartum hemorrhage
17. Diagnosis and management of postpartum infections
18. Diagnosis and management of postpartum depression
19. Definition and common causes of maternal mortality
20. Management of the post term pregnancy
21. Etiologies, diagnosis and management of fetal growth abnormalities
22. Definitions, indications, risks and contraindications for common obstetrical procedures including:
    1. ultrasonography
    2. episiotomy
    3. cesarean delivery
    4. instrument assisted delivery
    5. induction of labor
    6. Non stress testing (NST), oxytocin stress testing (OCT), and biophysical profile (BPP) testing
    7. antenatal genetic testing
    8. newborn circumcision
23. Methods, effectiveness and risks of contraception
24. Methods and risks of sterilization
25. Etiologies, diagnosis and management of vulvovaginitis
26. Etiologies, diagnosis and treatment of sexually transmitted diseases
27. Pathophysiology, etiologies, diagnosis and therapeutic options for pelvic inflammatory disease
28. Etiology, diagnosis and treatment of pelvic organ prolapse
29. Pathogenesis, symptoms, diagnosis and treatment of endometriosis
30. Symptoms, diagnosis and treatment of adenomyosis
31. Benign and malignant disorders of the female breast including pathology, examination techniques, diagnostic methods and therapy
32. Physiology and pathophysiology of normal and abnormal puberty
33. Definitions, causes and diagnostic approach to amenorrhea
34. Presentation, causes and diagnostic approach to hirsutism and virilization
35. Definitions, causes and evaluation of abnormal uterine bleeding
36. Definitions, causes and treatment of dysenorrhea
37. Physiology, symptoms and diagnosis of menopause including risks, benefits and methods of hormone replacement therapy
38. Definition, causes and evaluation of the infertile couple
39. Etiologies, diagnosis and treatment of premenstrual syndrome
40. Etiologies, diagnosis and management of gestational trophoblastic disease
41. Etiology, diagnosis and management of cervical dysplasia including colposcopy, directed biopsy, endocervical curettage and cone biopsy
42. Diagnosis, management and indications for surgical treatment of uterine myomas
43. Etiologies, diagnosis, staging and management of:
1. vulvar neoplasia
2. cervical neoplasia
3. endometrial neoplasia
4. ovarian neoplasia
44. Physiologic, emotional and societal influences regarding female sexuality including issues of sexual dysfunction, alternative sexual expression, sexual assault and physical sexuality
45. Definitions, indications, risks and contraindications for common
1. gynecologic procedures including:
2. dilatation and curettage
3. colposcopy and cervical biopsy
4. endometrial biopsy
5. culdocentesis
6. hysterosalpingography
7. laparoscopy
8. hysterectomy
9. pregnancy termination
10. hysteroscopy
11. laser vaporization
12. vulvar biopsy
13. cryotherapy
14. mammography
15. staging laparotomy
16. needle aspiration of breast

B. Competency: PATIENT CARE
Students will:

1. Develop history taking skills in ob/gyne
2. Develop physical exam skills in ob/gyne
3. Be able to provide routine antepartum care
4. Be able to perform a cervical evaluation on a laboring patient
5. Be able to recognize an abnormal fetal heart rate tracing
6. Be able to perform an uncomplicated vaginal delivery
7. Be able to provide routine postpartum care
8. Be able to perform a routine pelvic examination to include the taking of a Pap smear and endocervical swabbing
9. Be able to diagnose and manage a patient with an abnormal vaginal discharge
10. Be able to make decisions for patient care in regard to pelvic ultrasound findings for possible ovarian pathology, fetal conditions or ectopic pregnancy

C. Competency: COMMUNICATION SKILLS
Students will:

1. Establish professional interactions with female patients
2. Establish professional interactions with residents, faculty and other health care professionals
3. Learn to formulate differential diagnoses and management plans for obstetrical and gynecologic patients

D. Compentency: PROFESSIONALISM
Students will:

1. Create thorough, yet concise, medical records
2. Reinforce self-learning skills
3. Learn to interact with peers and supervisors in a constructive manner.
4. Establish and foster professional role models

E. Competency: PRACTICE BASED AND LIFE LONG LEARNING
Students will:

1. Realize the economic impact of health care decisions in obstetrics and gynecology
2. Develop a constructive attitude towards the importance of human reproduction as it pertains to individuals, families and society
3. Foster and reinforce self-learning skills
4. Foster professional library skills and information acquisition skills using computer-based models

F: Competency: SOCIAL AND COMMUNITY CONTEXT OF HEALTHCARE

1. Be aware of the many non-medical factors that influence disease, disability, and access to adequate health care.
• (a) Show an awareness of the ways in which family, culture, age, gender, physical and mental disabilities, and religious beliefs can influence healthcare decisions and outcomes.
• (b) Engage the various social supports (familial, cultural and spiritual) of the patient when rendering care.
• (c) Be aware that inappropriate and stereotypical language and categorizing of patients and all humanity is unacceptable.
• (d) Recognize the barriers that non-medical factors may impose on the delivery of healthcare.
• (e) Demonstrate a sophisticated knowledge of the social determinants of child abuse and domestic violence, as well as the economic, psychological, social, and cultural factors that may have an impact on their development and continuation.
• (f) Demonstrate an understanding that many people in our society are at risk for inadequate healthcare. Among these are the poor, uninsured, underinsured, children, unborn, single parents, the elderly, racial minorities, immigrants, refugees, the disabled, chemically dependent, and those with incurable diseases.
2. Begin to partner with health care managers and other health care providers to assess, coordinate, and improve your delivery of medical care. Know how these activities can promote health, prevent disease, and manage illness.
• (a) Demonstrate knowledge of the role for--and the services provided by--community resources.
• (b) Demonstrate an ability to arrange referrals to community resources for patients and their families.
• (c) Learn to work cooperatively with social service providers and to value their input into the comprehensive treatment plan for your patients.

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© 2001 Loyola University Chicago Stritch School of Medicine. All rights reserved.
Please send questions or comments to: Scott Graziano, M.D.
Updated: 12/12/05 ... Created: 05/02/00