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The rotation is divided into four components:
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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
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“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.
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“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.
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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 |
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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 |
|
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Menopause:
Hormone
therapy
Non-hormonal therapy
Emotional and sexual impact |
NEJM
FPIN |
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Sexually transmitted infections:
Gonorrhea, Chlamydia, HIV, Herpes, Syphilis
Pelvic inflammatory disease |
http://www.cdc.gov/DiseasesConditions
http://clinicalevidence.bmj.com
|
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Vaginitis
Bacterial vaginosis, candidiasis,
vulvovaginitis-prepubertal |
FPIN: Abnormal Vaginal Discharge |
|
Endometriosis |
|
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Polycystic
Ovarian Syndrome |
UW Women’s Health: Case
BMJ Clinical Evidence
|
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Breast fibrocystic disease
|
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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 |
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Reproduction:
Normal physiology, infertility, contraception |
|
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Sexuality:
Normal
sexual response, female sexual dysfunction, sexual trauma
|
The sexual
healing Journey by Wendy Maltz (borrow from E. Hutchinson)
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Female
circumcision |
|
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Screening/Prevention/Early Detection |
|
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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. |
|
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Fecal
incontinence |
|
|
Miscellaneous |
|
|
Obesity |
FPIN: Indications for Bariatric Surgery |
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Breastfeeding |
Breastfeeding Basics
USPSTF |
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Patient Care
|
Topic |
Web resources |
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Perform appropriate history and physical exam
for all age groups. |
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Adult |
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Child |
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Perform an appropriate and sensitive sexual
history |
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Counsel patients and conduct physical
examinations in a sensitive and culturally competent manner |
ISCOPES: Learning Modules
EthnoMed
CultureClues |
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Identify patients requiring gynecologic
consultation or referral. |
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Collect appropriate urine, cervical, and
vaginal specimens. |
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«Perform colposcopy, endocervical
curettage, and biopsy. |
Procedures consult |
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«Perform LEEP. |
Procedures consult |
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Perform paracervical and cervical block.
|
Procedures consult |
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Perform endometrial biopsy. |
Procedures consult |
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Insert and remove IUD. |
Procedures consult |
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Perform cervical polypectomy. |
Procedures consult |
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Perform vulvar and vaginal biopsy.
|
Procedures consult |
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Recognize gynecologic emergencies.
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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.
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