Obstetrics

Rotation Goals and Objectives

  1. General Description
    1. Family Physicians actual practices vary considerably in the extent to which they provide obstetrical care. This portion of the curriculum is designed to provide residents with the skills and expertise expected of family physicians with active practices in this area.
    2. During this rotation, the resident will work with faculty obstetricians who are providing obstetrical care. The resident will be on a one on one basis with the obstetrician so didactic material will be given to the resident on an informal basis. The resident will work alongside the obstetrician and, under supervision, provide comprehensive care to the obstetrical patients assigned to them.
    3. Residents are expected to follow their patients in the Family Medicine Center during this rotation.
    4. Level - PG 1 year
    5. Location - Renown Regional Medical Center, The Pregnancy Center
    6. Duration - One month rotation, twice during the PG 1 year
    7. Obstetrics is a full time rotation
    8. One half day per week will be spent in the Family Medicine Center.
    9. Work hour form submission is required at the completion of this rotation.
    10. Evaluation of Rotation
      1. The evaluation of the resident on this rotation will be done by the completion of an evaluation form by the attending physicians at the end of the rotation.
      2. The resident will fill out a rotation evaluation for at the end of the rotation.
      3. The knowledge, skills and competencies acquired during this rotation will be evaluated by a Family Medicine attending as the resident provides care to patients in the Family Medicine Center.
      4. The resident's performance on the American Board of Family Medicine In-Training examination will also be used to assess knowledge in this area.
  2. Patient Care skills to be mastered
    1. Performance of complete history gathering and documentation regarding obstetrical care
    2. Performance of complete physical examination of female patients
    3. The management of all aspects of prenatal care
    4. Antepartum, Labor and Delivery, and Postpartum care
    5. The recognition of high risk pregnancies
    6. Limited skills in the use of obstetrical ultrasound
    7. The education of patients regarding the care and expected course during their pregnancy
    8. Recognition of the role of the family and other psychosocial factors in obstetrical care.
    9. Develop an understanding of what consultative services are available and useful to the care of pregnant patients
    10. Develop an understanding of the multidisciplinary services that are useful to pregnant patients.
    11. The arrangement of discharge and follow up care for postpartum patients
    12. Procedural competence in vaginal delivery, episiotomy and repair, laceration repair, surgical assisting at cesarean sections, vacuum assisted deliveries, management of shoulder dystocia
  3. Medical Knowledge skills to be mastered
    1. An increasing knowledge base of obstetrical care will be achieved. Specific topics that will be addressed include:
      1. Normal anatomy and physiology of pregnancy
      2. Normal growth and development of the fetus
      3. Pregnancy dating
      4. Pharmacology of medications used in obstetrics
      5. Nutrition during pregnancy
      6. Obstetric complications including breech presentations, post partum hemorrhage, Thromboembolic disease, preterm labor, pre-eclampsia and eclampsia, HELLP syndrome, endometritis, group B strep disease, and miscarriage
      7. Family Planning
  4. Practice Based Learning and Improvement
    1. This competency is addressed longitudinally throughout the rotation.
      1. Scientific evidence will be reviewed by the resident and attending physician in the context of their patients.
      2. The practical implementation of evidence-based medicine will be discussed as the medical decision making is reviewed.
      3. Information technology will be utilized by the resident as he or she is required to research topics as directed by the attending physician.
      4. Information technology will be utilized as the hospital implements its electronic health record.
      5. The resident will also be evaluated on the steps they took during the rotation to improve their shortcomings.
  5. Interpersonal and Communication Skills
    1. This competency is addressed longitudinally throughout the rotation.
      1. The resident will observe and be observed, taught and evaluated in the performance of obtaining patient histories, documenting histories, writing prescriptions, educating patients about treatment plans and prognosis, teaching medical students and other learners, and interactions with patients, families, office staff and physicians.
  6. Professionalism
    1. This competency is addressed longitudinally throughout the rotation.
      1. The attending physician will observe and assess the resident's sense of personal responsibility including attendance, promptness, motivation, completion of duties, and appropriate dress.
      2. Ethical and legal practice skills will be taught
      3. Respect for cultural, age, and gender differences will be taught, observed and evaluated.
      4. The resident is expected to treat patients, families and colleagues with respect, understanding, sympathy and honesty
  7. Systems Based Practice
    1. This competency is addressed longitudinally throughout the rotation.
      1. The resident will learn to become aware of available resources and the cost effectiveness of testing and therapeutic options
      2. The resident will gain an increasing understanding of the role of the patient, physician, support staff, and insurer in the health care environment
      3. The resident will gain an increasing understanding in the role of the hospital in the health care environment.
      4. Through the coordination of care for the obstetrical patients, the resident will become aware of the breadth of available resources in our community as well as to the limitations of the resources in our community. In this regard, the resident will be expected to work very closely with social workers and hospital case coordinators to assist in providing the best care available to our patients.

Revision:

April 13, 2018 by Lacy Fettic, MD