Department of Obstetrics and Gynecology
St. Francis Hospital & Medical Center
PGY-1 Learning Objectives
Gynecology Rotation
I. Educational Purpose
The PGY-1 gynecology rotation provides core knowledge of basic surgical skills and
postoperative patient care as well as triaging patients from the Emergency Department.
Residents develop competence in performing outpatient gynecological surgery and assisting
during minor surgeries.
II. Goals and Objectives
By completion of the PGY-1 year, the resident should demonstrate proper surgical
technique, have the ability to perform basic gynecological procedures, skillfully manage
postoperative patients, and perform a basic consultation on GYN patients.
By the end of the rotation, the resident should be able to:
1. Medical Knowledge
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Describe the hemodynamic changes associated with blood loss
Describe the physiology of wound healing
Describe the physiology of blood pressure maintenance
Describe the physiologic changes related to maintaining adequate urine output
Describe the anatomic relationship between the reproductive organs and the nongynecologic abdominal and pelvic viscera, i.e., bladder, ureters, and bowel
Describe the gross and histologic anatomy of the external genitalia pelvic organs and
the breast
Summarize the pharmacology of medications used in the treatment of common
gynecologic disorders
Describe the normal bacteriologic flora of the lower genital tract
Describe the principal infections that affect the vulva and vagina
Describe the follow-up for patients with a sexually transmitted disease (STD),
including assessment of the patient’s sexual partner, discussion of preventive
measures, and review of serious sequelae
Describe the appropriate diagnostic tests to confirm pelvic inflammatory disease
(PID), including:
i. indications for the tests,
ii. how to perform them, and/or
iii. how to interpret the results
Describe the typical history of a patient with endometriosis
Describe the differential diagnosis of early spontaneous abortion
Describe the differential diagnosis of ectopic pregnancy
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Department of Obstetrics and Gynecology
St. Francis Hospital & Medical Center
2. Patient Care (Clinical Skills)
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Perform a focused physical examination
Perform and/or interpret the results of selected tests used in the diagnosis and
management of early pregnancy loss
Perform a focused physical examination in a patient with suspected ectopic
pregnancy
Evaluate a patient with abnormal vaginal bleeding
Choose appropriate pain control based on the surgical procedure, degree of patient
discomfort, and patient characteristics, including age and presence of co-existing
morbidities
Manage and counsel patients about normal postoperative recovery
Manage a patient with pelvic infection
Evaluate patients with postoperative complications such as fever, hypertension,
hypotension, tachycardia, hypoxemia, decreased urine output
Assess and triage ED consults and convey pertinent findings to the supervising
resident
3. Patient Care (Management Skills). By end of the rotation, the resident should be
comfortable performing the following procedures:
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Cervical conization
Dilation and curettage
Hysteroscopy
Incision and drainage of an abscess or hematoma
Polypectomy
Uterine evacuation (for pregnancy termination, incomplete abortion, fetal death)
Wound care
4. Practice-Based Learning
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Formulate and answer basic clinical questions that arise from patient care
interactions to discuss with faculty and the healthcare team
Use personal experience with challenging patients to optimize future relationships
with patients
Accept and incorporate feedback from evaluations to improve skill base
Update work-hour logs on a weekly basis and work efficiently to maintain compliance
with Duty Hours Requirements
Keep an updated patient log as detailed in the ACGME website (ADS)
Participate in quality assurance activities of the department as requested
Read core textbooks and demonstrate the ability to use information technology:
UpToDate, Emedicine, PubMed literature search, Cochrane Database, etc.
Complete annual on-line certification courses and other requirements for hospital
privileges (such as PPD testing) in a timely manner
5. Communication / Interpersonal Skills
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Present pertinent gynecological history and physical findings to team members and
consultants in a clear, concise fashion
Demonstrate caring and respectful interactions with the patient and her family
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Department of Obstetrics and Gynecology
St. Francis Hospital & Medical Center
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Counsel patients in language and manner appropriate to their level of education and
understanding
Continually update gynecology team (attending physician, nursing staff, etc) on
status of patient(s)
Interact respectfully and professionally with all members of the patient care team,
including: attending physicians, nursing staff, resident staff, medical students, social
services, translators, etc.
Interact respectfully and professionally with departmental and hospital administrative
staff
Provide constructive feedback to medical students
6. Professionalism
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Acknowledge limitations in knowledge and skills and exercise good judgment in
seeking assistance from peers, attendings, and nurses
Demonstrate accountability for one’s actions and clinical decisions
Acknowledge errors or omissions in patient care, and work toward timely resolution
or alleviation of such
Demonstrate truthful and timely disclosure of adverse outcomes to the appropriate
staff members
Advocate for patients within the healthcare system
Maintain sensitivity to issues of diversity with patients and staff
Uphold the ethical principles of our specialty, as detailed by ACOG and AMA
Participate actively in the education of fellow residents and medical students
Actively seek assistance from fellow residents, attendings, or nurses when unsure
about patient care decisions
Abide by the HIPPA regulations and other SFH regulations (such as annual
recertification on PPD Screening, Infection Control, Compliance, etc.)
Abide by the guidelines set forth in the Residency Handbook, including: logging in
work hours, acting on MyEvaluations.com evaluations, logging in the ACGME work
log, and consistently attending the Friday Resident lecture series
Demonstrate ability to receive both positive and negative feedback with appropriate
insight and professionalism
7. Systems-Based Practice
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Order diagnostic tests with attention to clinical relevance and cost-effectiveness
Effectively use consultants & ancillary services to create an effective patient care
team
Demonstrate judicious and efficient resource utilization
Demonstrate an understanding of roles and responsibilities of the healthcare team
Participate in quality improvement activities of the department
Perform operative dictations for GYN patients
Perform discharge dictations for GYN in-patients
Acquire basic understanding of accessing hospital computer systems, including:
Carelink and Diagnostic Imaging
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Department of Obstetrics and Gynecology
St. Francis Hospital & Medical Center
Types of Clinical Encounters
The PGY-1 resident on this rotation is responsible for the care of all patients who present to
the gynecology consult service. These patients include, but are not limited to, emergency
room and inpatient consultations.
The PGY-1 resident will assist in the management of a wide variety of medical conditions
affecting the gynecological health of a woman as well as gynecology-related complications,
including:
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Diseases of the urinary system
Infectious diseases
Psychiatric disorders
Substance abuse
Emergency care / trauma
Pelvic inflammatory disease
Endometriosis
Reported sexual assault
Post operative complications
First trimester pregnancy loss
Pelvic mass
Ectopic pregnancy
Abnormal vaginal bleeding
Vaginal discharge
III. Rotation Structure
The PGY-1 resident will review in detail the goals of the rotation before starting the rotation.
The resident will report to 6-1 or other GYN floors between 6:00-6:30 AM on Monday
through Friday to round on GYN in-patients. Morning Report begins promptly in the 4-9
classroom at 7:15 AM. All daily progress notes on patients and discharge planning should
be completed before that time.
The PGY-1 resident will actively participate in:
 6:00-7:00 AM: Round on inpatients
 7:15-8:00 AM: GYN Morning Report (Monday through Friday )
 Coverage of all in-patient GYN patients
 Initiate, investigate, and complete ED consults with supervision from senior GYN
residents (carry and respond to the ED beeper)
 Assist on minor and occasionally major GYN surgeries as assigned by GYN Chief
Resident (remember to pass the ED beeper on to a fellow GYN resident)
 Actively Participate in evening Sign-out Rounds
IV. Resident Supervision
The resident’s activities fall under the supervision of the GYN Chief Resident and GYN
Attending of the day during daily rounds, ED consults, inpatient consultations, etc., which
provides opportunity for immediate feedback. All surgical procedures are performed under
the direct supervision of the Attending Physician at all times, including nights, weekends,
and holidays.
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Department of Obstetrics and Gynecology
St. Francis Hospital & Medical Center
V. Reading List and Educational Materials
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Textbooks: (i) Katz’s Comprehensive Gynecology and Te Linde’s Operative
Gynecology; (ii) Novak’s Gynecology
ACOG Compendium
UpToDate Clinical Reference Library
Emedicine
PubMed
Cochrane Perinatal Database
VI. Method of Evaluation
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The PGY-1 resident will receive on-site timely formative feedback from the Chief
Resident and Attending Physician(s) during this rotation.
Global evaluations of PGY-I residents are performed at the completion of 3 month blocks
by select Gynecological faculty and reflect input from the attending staff, nurses, medical
students, and patients. These evaluations will be available to the residents via the
MyEvaluation.com system and will be reviewed by the resident with the Ob/Gyn
Residency Program Director and/or Chairman during the resident’s semi-annual
evaluation meetings.
Cognitive assessment of the residents’ gynecological competence is achieved by the
gynecological score from the CREOG examination.
Clinical Skills will be assessed utilizing CREOG Competency cards: S-fac, C-fac, and
Fac-1 cards
Dictations-to be performed immediately after a procedure
Completion of work-hours log- done weekly
Completion of ACGME procedure log-done weekly
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Department of Obstetrics and Gynecology
St. Francis Hospital & Medical Center
Resident
I have/have not accomplished the educational aims and objectives as noted above for
this rotation.
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Resident Printed Name
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Resident Signature
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Date
Faculty
Based upon written evaluations, and observed competency assessment, The Clinical
Competency Committee of the faculty has determined that the resident has/has not met
educational aims and objectives for this rotation.
Program Director
Based upon self evaluation and the Methods of Evaluation listed in VII above, the
resident has/has not met the educational aims and objectives as noted above for this
rotation.
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Program Director/Associate Program Director
Signature
Last Updated:
August 18, 2010
has
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Date