Department of Obstetrics and Gynecology
St. Francis Hospital & Medical Center
PGY-1 Learning Objectives
Ultrasound Rotation
I. Educational Purpose
The PGY-1 ultrasound rotation is intended as a practical and hands-on introduction to basic
obstetric and gynecologic ultrasound.
II. Goals and Objectives
By completion of the PGY-1 year, the resident should have the ability to perform basic
obstetric and gynecologic ultrasound procedures.
By the end of the rotation, the resident should be able to:
1. Medical Knowledge
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Describe the basic principles of ultrasonography
Describe the concepts of Penetration and Resolution
Know the basic controls of a standard ultrasound machine
Explain what the gain is and how to adjust it
Explain the difference between the common types of probes
Optimize the image obtained by using the depth, zoom and focal zone appropriately
List the components of the basic obstetrical sonogram in the first, second, and third
trimesters
Describe and demonstrate how the basic obstetrical measurements are obtained
Describe the anatomical landmarks for the basic obstetrical sonogram and
demonstrate how to obtain them
List the possible anomalies ruled out when a normal anatomical structure is
demonstrated
Describe the components of the Level II or targeted or genetic sonogram
List indications for a Level II ultrasound
Describe methods of amniotic fluid assessment
Describe the components of the Biophysical Profile (BPP)
Describe the concept of Doppler flow
Demonstrate the ability to obtain a cervical length on endovaginal ultrasound
Describe the methods used to determine chorionicity of multiple gestation
Describe the components of a standard pelvic, non-obstetrical ultrasound and how to
obtain them
2. Patient Care (Clinical Skills)
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Choose the appropriate ultrasound probe for any given study
Perform a basic obstetric ultrasound in the first, second, and third trimesters
Perform a transvaginal examination
Perform a basic gynecologic ultrasound in a non-pregnant woman
Use the measurements charts to produce a clinical interpretation of fetal biometry
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Department of Obstetrics and Gynecology
St. Francis Hospital & Medical Center
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Convey pertinent findings to the supervising Attending Physician
Produce a clinical interpretation of a basic obstetrical and pelvic sonogram (‘report’)
3. Patient Care (Management Skills). By end of the rotation, the resident should be
comfortable using ultrasound technology to perform the following procedures:
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Fetal viability
Identify multiple pregnancy
Gestational age assessment
Placental location
Fetal presentation
Amniotic fluid volume
Fetal biometry
Biophysical Profile (BPP)
Cervical length
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 the 80-hour work week
Keep an updated patient log as detailed in the ACGME website
Participate in quality assurance activities of the department (such as team training)
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 ultrasound findings to team members and consultants in a clear,
concise fashion
Demonstrate caring and respectful interactions with the patient and her family
Counsel patients in language and manner appropriate to their level of education and
understanding
Interact respectfully and professionally with all members of the patient care team,
including: attending physicians, sonographers, resident staff, medical students,
social services, translators, etc.
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
Advocate for patients within the healthcare system
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Department of Obstetrics and Gynecology
St. Francis Hospital & Medical Center
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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
Abide by the HIPPA regulations and other SFHMC regulations
Abide by the guidelines set forth in the Residency Handbook, including: logging in
work hours, acting on MyEvaluation.com evaluations, logging in the ACGME work
log, and consistently attending the Thursday 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 ultrasound tests with attention to clinical relevance and cost-effectiveness
Demonstrate judicious and efficient resource utilization
Demonstrate an understanding for the roles and responsibilities of healthcare team
members
Participate in quality improvement activities of the department
Acquire basic understanding of accessing hospital computer systems
Types of Clinical Encounters
The PGY-1 resident on this rotation is responsible for performing ultrasound examinations
on patients assigned to them by the supervising sonographer, and/or Attending Physician.
Women are scheduled for ultrasound examinations for a wide variety of medical conditions
and pregnancy-related complications, including:
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Pelvic mass
Pelvic pain
Abnormal vaginal bleeding
Vaginal discharge (to ruptured membranes)
Ectopic pregnancy
Screening for fetal aneuploidy
Screening for fetal structural anomalies
High-risk for preterm birth (for cervical length measurements)
Infectious diseases
Substance abuse
Emergency care / trauma
Post operative complications
III. Rotation Structure
The PGY-1 resident will review in detail the goals of this rotation before starting the rotation.
The PGY-1 resident on this rotation will actively participate in:
 Assist in rounding on all obstetric inpatients
 Coverage of the 4th floor ultrasound unit (Monday through Friday)
 Responsibilities include: daily observation of ultrasound; hands-on performance of
parts of ultrasound examinations, and ultrasound examinations in the ED and in the
Delivery Room
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Department of Obstetrics and Gynecology
St. Francis Hospital & Medical Center
IV. Resident Supervision
The resident’s activities fall under the supervision of the sonographers, and Attending
Physicians. All ultrasound procedures are performed under the direct supervision of the
Attending Physician.
V. Reading List and Educational Materials
 Required reading:
(i) Obstetric Ultrasound made easy. Smith NC, Smith PM, Churchill Livingstone, 2002.
ISBN 0443 07013X
(ii) Making sense of Obstetric and Doppler Ultrasound. Lees C, Deane C, Albaiges G.
Arnold Publishers, 2003. ISBN: 0 340 80919 1
 Suggested reading:
(i) Structural Fetal Abnormalities; the total picture. Sanders RC, editor. Mosby, Inc.,
1996. ISBN: 0 323 01476 3
(ii) Doppler Ultrasound in Obstetrics and Gynecology. Copel JA, Reed KL. Lippincott
Williams & Wilkins, 1995. ASIN: 0 781 70206 2.
(iii) Fetology. Bianchi DW, Crombleholme TM, D’Alton ME. McGraw Hill Publishers,
2000. ISBN: 0 838 52570 9.
 ACOG Compendium
 UpToDate Clinical Reference Library
 Emedicine
 PubMed
 Cochrane Perinatal Database
VI. Method of Evaluation
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Residents will prepare a list of ultrasounds performed during the rotation. The resident
will print out a copy of thermal prints from a single case representing their best images
(showing fetal presentation, placental localization, amniotic fluid volume, and fetal
biometry) and have the images reviewed and signed off by a supervisor.
The PGY-1 resident will receive on-site timely formative feedback from the
sonographers, and Attending Physician(s) during this rotation.
Global evaluations of PGY-I residents are performed at the completion of the 4-week
rotation by select faculty and reflect input from the attending staff, sonographers, nurses,
medical students, and patients. These evaluations will be available to the residents via
the MyEvaluations.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’ ultrasound skills is achieved by the ultrasound
score from the CREOG examination.
Ultrasound reports
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
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