Student Internship in Maternal Fetal Medicine
OVERVIEW
Duration of elective programme:
6 weeks
Aims
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To provide final year medical students with hands-on training in the management of obstetrics
patients by acting as student interns.
To provide final year medical students a flavor of what MFM in O & G entails.
To develop core competencies / professional skills required to function as a first year intern in O
& G.
Learning Objectives - Morning Meetings (0730 hrs – 0830 hrs)
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To experience how different multidisciplinary members contribute to the care of obstetric
patients (eg. joint neonatology and obstetrics perinatal meeting)
To experience how different team members of the department contribute to the care of our
patients (eg. case presentations of previous nights’ admissions)
To understand the contribution of audit and research to the care of O & G patients (eg. Science
Tuesday, Gynaecology and Obstetrics M & M meetings)
Learning Objectives - W48 (0830 hrs -)
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To shadow house officers in the daily running of ward 48. SIP students are expected to take the
lead in presenting all the in-patient cases to the Registrar conducting the ward rounds each
morning.
To present all inpatient cases to the whole MF team during Wednesday bedside teaching.
SIP students are expected to take charge of the documentation at Ward Rounds under the
supervision of House Officers.
SIP students are expected to order investigations under the supervision of House Officers. They
are also required to chase up investigation results for documentation in the notes.
SIP students are expected to prepare the discharge summaries of patients going home under
the supervision of House Officers.
Learning Objectives - DS (0830 hrs-)
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To shadow house officers in the daily running of DS.
To present cases at the daily WR on DS.
To present cases at the grand bedside teaching round on Wednesday mornings.
To clerk all admission cases.
To complete K2 CTG package and certification for interpreting CTG.
To perform at least 3 Normal Vaginal Deliveries and 3 episiotomies repair. (Skill to be formally
assessed with OSAT form.)
To witness at least 2 instrumental deliveries, and perform the role as an assistant.
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To assist at least 3 caesarean sections. To attempt sheath closure and skin closure under the
supervision of the surgeon.
To shadow the Medical Officer / Registrar to see acute presentations in A & E. Understand the
different acute presentations of O & G cases in the A & E setting.
Learning Objectives - Specialist Clinics (High Risk Clinics / Diabetic Clinic)
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To understand how different multidisciplinary members (dietician, diabetologist, obstetricians,
medical physicians) work together in the care of high risk obstetric patients.
SIP students are expected to clerk cases in clinic and take the lead in consultation in cases.
Assessment to be performed in the form of CBD, CEX.
Learning Objectives - G Clinic / Kent Ridge Wing Clinic
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To understand some of the common O & G problems encountered in the general O & G clinics.
SIP students are expected to clerk cases in G clinic and take the lead in consultation in cases.
Assessment to be performed in the form of CBD & CEX.
Learning Objectives - ADC
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To observe invasive procedures (eg amniocentesis, CVS)
To understand the role of detailed scans in the role of fetal anomalies screening.
To understand the role of NT scan in the screening of Down’s Syndrome.
To be able to scan for: presentation and orientation of fetus, confirmation of viability of fetus,
placenta location, and liquor volume assessment.
Learning Objectives – Project Work
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To understand the principles of research / project / audit work in O & G.
To develop important skills and techniques in presentation, when presenting project findings to
members of the department faculty.
To develop writing skills, aiming for presentation of poster at meetings /publication in a journal.
Reading List
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Oxford Handbook of Obstetrics and Gynaecology, 2008. Professor Arulkumaran
High Risk Pregnancy 2007. James Drife
Effective Care in Pregnancy and Childbirth. 2008. Oxford University Press
Generic Skills – Obstetrics History Taking
Subject
Knowledge
Skills
Attitudes
Obstetric History Taking
Ascertain maternal and fetal wellbeing
Elicit a detailed obstetric history
Consider impact of pregnancy on psychological and social
well being of woman and her family.
Assessment
Mini CEX
Mini CEX
Case based discussion
Check patients concerns, expectations and
understanding.
Respect privacy and dignity.
Understands the importance of cultural factors in
particular those relating to ethnicity, race, religion, and
disability.
Sensitive and non judgemental approach.
Appropriate recognition, assessment and initial
management of acute obstetric emergency.
Generic Skills – Examining an obstetric patient
Assessment
Subject
Knowledge
Skills
Attitudes
Obstetric Examination
Recognition of normality and abnormality as pregnancy
progresses.
Examination of pregnant abdomen.
Breast examination.
Bimanual examination.
Use of Cusco’s speculum.
Taking microbiology swabs from vagina, cervix.
Consider patient privacy and dignity during intimate
examination.
DOPS
MSF
Understands importance of chaperon.
Explains the need for examination and gains appropriate
consent and minimizes patient discomfort.
Clinical Skills - Acute Obstetrics
Subject
Knowledge
Management of the acutely unwell pregnant patient.
Recognise deviation from normality.
Assessment of women within delivery suite.
Common presenting symptoms and signs of the acutely
unwell patient including bleeding, rapidly rising BP, acute
Assessment
CbD
Mini-CEX
Skills
Attitudes
abdominal pain.
Follow delivery suite protocols. Organise appropriate
investigations. Institute initial intervention. Recognise
personal limitations in the acute situation and
communicate effectively to ensure quick and safe
continuity of care.
Demonstrate empathy, honesty, and sensitivity.
Awareness of the needs of partner and relatives in the
acute emergency situation. Respect for midwives.
Understands the importance of team approach to
obstetric patients.
Seeks help and advice as appropriate.
Clinical Skills – Intrapartum / Postnatal Care
Assessment
Subject
Knowledge
Skills
Attitudes
Normal labour
Deviation from normality
Postnatal care
CTG
Management of normal labour and delivery including
undertaking at least 5 normal deliveries. Interpretation
of CTG and recognition of abnormal FHR pattern.
Understand principles behind need for an assisted vaginal
delivery and emergency CS.
Postnatal complications. Appropriate analgesics.
Undertaking at least 5 normal deliveries. Undertaking at
least 5 episiotomy and episiotomy repairs. Basic surgical
skills (knot tying, tissue handling)
Direct observation of assisted vaginal delivery and
emergency CS to allow informed discussion with women.
Obtaining consent.
Recognition and management of common postnatal
problems.
Evaluates patient pain type. Understands safe use of
opiod and non-opiod.
Ensure a calm approach in all acute situations.
Clear and concise communication with woman and
partner.
Documentation.
Understands the guidance and team approach to the staff
and patients.
Protects patients and supports colleagues appropriately.
Must complete K2
package and obtain
certification.
Mini-CEX
MSF