The rotation is divided into four components:

 

  1. Outpatient experience with community gynecologists:  This experience is intended to provide a wide variety of gynecologic cases in two focused ½ days per week.  Coupling the cases with independent reading will improve the quality of the rotation
  2. “GYN clinic”: One full day of gynecological procedural training at Swedish Family Medicine attended by the OB fellow and Dr. Hutchinson or Tuggy for ½ day each.  Prior to your first day, please prepare by doing the recommended procedural tutorials and reading (marked by « below). Also, please obtain the two colposcopic training CDs from E. Hutchinson to view prior to starting your rotation.
  3. “Elective” time: Alternate Thursday AM (or other ½ days when clinic can not be scheduled) please arrange (in advance) experiences with physical therapy, fertility or other community providers based on your interests. 
  4. Independent reading is a core component of this rotation.

Medical Knowledge

Core areas listed below

Healthlinks care provider toolkit provides overviews on these topics. Up to date is a valuable tool and has articles on most every topic below.  Some topics have other resources indicated that have been additionally helpful.

 

Topic                            

Web resources 

Normal pubertal development and variants:  Precocious Puberty, delayed puberty  

Endocrinology: Text and cases eMedicine

Endocrinology: Text and cases eMedicine

Menstruation:

Physiology of menstruation

Abnormal uterine bleeding in pre and post menopausal women

Premenstrual syndrome

 

Menopause:

Hormone therapy                           

Non-hormonal therapy                    

Emotional and sexual impact  

NEJM

FPIN

Sexually transmitted infections:

Gonorrhea, Chlamydia, HIV, Herpes, Syphilis

Pelvic inflammatory disease

http://www.cdc.gov/DiseasesConditions  

http://clinicalevidence.bmj.com

 

Vaginitis

Bacterial vaginosis, candidiasis, vulvovaginitis-prepubertal

FPIN: Abnormal Vaginal Discharge

Endometriosis

 

Polycystic Ovarian Syndrome      

UW Women’s Health: Case

BMJ Clinical Evidence

 

Breast fibrocystic disease

 

 

Breast cancer

UW Women’s Health: Case AMA: Hereditary Breast & Ovarian CA

Breast Cancer Risk Calculator  
BMJ Clinical Evidence: Non-Metastatic

BMJ Clinical Evidence: Metastatic         

Ovarian cancer  

AMA: Hereditary Breast & Ovarian CA                                                         

FPIN
USPSTF

Endometrial cancer  

eMedicine: Text  

Vulvar disease, intraepithelial neoplasia, cancer

ASCCP monograph  

Lichen sclerosis

 

«Cervical disease: screening, abnormal pap, cervical cancer, diagnosis and management

aapf.org/afp/2009715/147.html

www.asccp.org (asccp monograph)

cdc website

Effects of DES  

CDC Web Site

Reproduction:

Normal physiology, infertility, contraception

 

Sexuality: Normal sexual response, female sexual dysfunction, sexual trauma

 

The sexual healing Journey by Wendy Maltz (borrow from E. Hutchinson)

 

Female circumcision

 

Screening/Prevention/Early Detection  

 

Nutrition

Harvard: Nutrition Web Site

American Dietetic Association

Merck Manual: Text

Breast exam  

Mammography

 

USPSTF

AAFP: Cochrane for Clinicians
FPIN: Screening 40 – 49 yo
 

Exercise

 

eMedicine: Tex

smoking

@TobaccoCME: Text and cases  

FPIN

Osteoporosis

                                                  

                                                  

FPIN: Osteoporosis Screening
FPIN: Repeat DEXA   

 

 

 

Pelvic Floor Dysfunction 

UW Women’s Health: Case

eMedicine: Text  

 

Urinary incontinence

UW Women’s Health: Case
AAFP: Monograph

BMJ Clinical Evidence: Stress Incont.
 

 

Fecal incontinence  

 

Miscellaneous

 

Obesity         

FPIN: Indications for Bariatric Surgery

Breastfeeding

 

Breastfeeding Basics

USPSTF  

       

                                                     

Patient Care

Topic                            

Web resources 

Perform appropriate history and physical exam for all age groups.

 

      Adult 

 

      Child

 

Perform an appropriate and sensitive sexual history

 

Counsel patients and conduct physical examinations in a sensitive and culturally competent manner

ISCOPES: Learning Modules

EthnoMed

CultureClues

Identify patients requiring gynecologic consultation or referral.

 

Collect appropriate urine, cervical, and vaginal specimens.

 

«Perform colposcopy, endocervical curettage, and biopsy.

Procedures consult

«Perform LEEP.

Procedures consult

Perform paracervical and cervical block.

Procedures consult

Perform endometrial biopsy.

Procedures consult

Insert and remove IUD.

Procedures consult

Perform cervical polypectomy.

Procedures consult

Perform vulvar and vaginal biopsy.

Procedures consult

Recognize gynecologic emergencies.

 



Interpersonal and Communications Skills

Demonstrate clear communication with patient regarding their medical issues in a culturally sensitive manner

Demonstrate team oriented communication and foster working relationships with other member of the care team or specialist colleagues

 

Professionalism

Demonstrate a high degree of professional responsibility in managing patients with Gynecology-related problems by referral coordination, direct management and follow up.

Demonstrate professional demeanor, attire and appearance in all settings.

 

The resident should develop attitudes that encompass:

An understanding of the desire of women to be treated as competent participants in their health care, in a caring and compassionate fashion.

An awareness of the role that being female plays in bringing women into the health care system more frequently than men.

An appreciation of the role that women play in the health of the family by choosing a health care provider, making meal selections and providing family care at home.

The realization that a woman's health is affected not only by medical factors, but also by family, life cycle, relationships and community.

An understanding of the importance of disease prevention and health promotion.

An understanding of the role of the gynecologic consultant.

 

Practice-Based Learning

Assess the practice models on this rotations for evidence of practice-based learning and identify opportunities that would be appropriate for the this medical area.

Identify a learning opportunity within your clinic practice that could be studied to improve the care for patient with Gynecology-related problems.

 

Systems-Based Practice

Learn how to access the appropriate services for patients with Gynecology-related problems and the impact of utilization management for these patients.

Demonstrate understanding of the role of the PCP in the immediate and after-care of patients with Gynecology-related diagnoses.