JORDAN UNIVERSITY OF SCIENCE& TECHNOLOGY

FACULTY OF MEDICINE DEPARTMENT OF OBSTETRICS AND GYNECOLOGY

COURSE TITLE: Obstetrics and gynecology COURSE CODE: MED 640 CREDIT HOURS: 9 CALENDAR DESCRIPTION: 8 weeks / 6th year COURSE COORDINATOR: DR.OMAR ALTAL E-MAIL:OFALTAL@JUST.EDU.JO COURSE DESCRIPTION This is an eight weeks rotation; during these 8 weeks rotation, students are introduced to different settings through rotation in 5 different hospitals. Students rotate in six different hospitals during the course:

1. Al-Ramtha Hospital 2. Princess Badeea Teaching Hospital 3. King Abdulla university hospital (KAUH) 4. Al-Mafraq Hospital 5. Princess haya military hospital 6. Prince Rashid Ben Al-Hasan Military Hospital

The course includes seminars that covers topics that have not been covered in fifth year. Also they have bed side teaching sessions with instructors that focus more on the management part of different cases in obstetrics and gynecology. Also students spend more time with patients in their sixth year as they have specific rotations in delivery suite, ward management rounds and outpatient gynecology and obstetrics clinics. Also we involve the students to participate in the on calls. Students are also encouraged to act at the level of interns in preparation for graduation requirement GENERAL OBJECTIVES: By the end of this course, students are expected to:

1- Put plan of management for common obstetrics and gynecology diseases. 2- Take focused clinical history and relevant examination, and able to integrate

these into disease process and differential diagnosis list 3- List common investigation used to establish diagnosis and recognize indication

and limitation of these investigations. 4- Build communication skills and appropriate behavior that is needed to interact

with patients, their families and other medical colleagues and staff member. 5- Participate in caring for patient by present cases in morning report,

management round, out patient department and night calls.

METHODS OF INSTRUCTIONS:

- Daily morning report - Bed- side teaching sessions - Seminars - Delivery suite rotation - Outpatient clinic encounter - Clinical skill labs

LEARNING OBJECTIVES OF THE COURSE: By the end of their rotation in this course, the students are expected to achieve the following specific objectives: A. Clinical skill labs In skill lab, students are divided into small subgroups each with an instructor. During these session the instructor demonstrate some of the gynecologic and obstetric procedures e.g. smear taking, forceps delivery, repair of an episiotomy, management of third stage of labor…etc. In addition students will have the opportunity to see instruments and equipments that are used in obstetrics and gynecology e.g.. see all types of available contraception, different types of vacuums and forceps…etc.

A.SKILL LAB No Skill lab Objectives of skill lab

1

Labor and partogram

1. Recognize the method used to observe fetal wellbeing in labor

2. Learn how to interpret partogram 3. Identify the types of episiotomy incision 4. Demonstrate the role of obstetrician in the delivery of the

fetus in the second stage of labor 5. Describe the active management of the third stage of labor

2

Cervical smear

1. Demonstrate the procedure of taking cervical smear in model

2. Discuss the role of colposcopy in managing abnormal cervical smear

3. Case scenarios

3

Operative vaginal delivery

1. Identify different types of forceps and vaccum 2. Recognize the indications of operative vaginal delivery 3. List the prerequisites for operative vaginal delivery 4. Discuss the complication of operative vaginal delivery

4

Contraception

1. Identify the different types of available contraception 2. Demonstrate the application of some contraception e.g.

insertion and removal of an implanon, insertion of Mirena coli,…etc.

3. Discuss the cons and pros of each method

B. Seminars

No Title of Seminar Objectives of seminar

1

Thrombophilia and

recurrent miscarriage in

pregnancy

1. Define thrombophilia 2. Identify the clinical presentations of thrombophilia in

obstetrics 3. List investigations for congenital and acquired

thromphobilia 4. Outline the strategies to prevent thromphophilia

complications during pregnancy 5. Define recurrent miscarriages 6. List the causes and the investigations in recurrent

miscarriage 7. Discuss treatment options in patients with recurrent

miscarriages

2

Management of patients with

severe PET & Eclampsia

1. Define sever preeclampsia 2. Define eclampsia 3. Identify the risk of sever preeclampsia and eclampsia on the

mother 4. Describe drugs that use to prevent and to treat seizure in

preeclampsia 5. Discuss management of preeclampsia and eclampsia

antenatally, intrapartum and postpartum 6. Discuss preventive measure too reduce the risk of sever

preeclampsia in future pregnancies

3

Management of abdominal pain in

pregnancy

1. List non obstetrics causes of abdominal pain in pregnancy 2. List obstetrics causes of abdominal pain in pregnancy 3. Recognize the signs and symptoms of each differential

diagnosis 4. Plan the initial and specific workup for patient with

abdominal pain in pregnancy 5. Discuss the treatment of each cause

4

Management of obstetric

emergencies

1. List obstetrics emergencies 2. Recognize the risk factors and the clinical presentations of

each emergency 3. Discuss the treatment of each emergency 4. Highlight the importance of team work in obstetrics

emergencies 5. Discuss the importance of having hospital guidelines for the

management of obstetric emergencies in delivery suite

5

Management of

obstetric hemorrhage (APH,PPH)

1. Define massive APH & PPH 2. Discuss the indication and the complication of blood

transfusion in obstetrics 3. Name the main drugs used in the management of uterine

atony 4. Recognize the main surgical techniques used to treat uterine

atony 5. Define placenta accrete. 6. Recognize the main surgical techniques used to treat

placenta accrete 7. Outline the principle of management in patient with DIC

6

Approach to fetal

anomalies

1. List the most common fetal anomalies 2. List risk factors for fetal anomalies 3. List strategies that reduce the incidence of some fetal

anomalies 4. Recognize in utero treatment of some fetal anomalies 5. Discuss the prognosis of the main fetal anomalies

7

Abnormal labor

1. Define obstructed labor 2. List risk factors of obstructed labor 3. Recognize signs and symptoms suggestive of obstructive

labor 4. Define precipitate labor 5. List the main risk of precipitate labor 6. Outline the principle of management in obstructed labor

8

Management of

patients with abnormal cervical

smear

1. Identify Bethesda system for classification of abnormal cervical smear

2. Discuss the management of squamous smear abnormalities 3. Discuss the management of glandular smear abnormalities 4. List the complication of excisional cone biopsy 5. Understand the role of colposcopy in management of

abnormal cervical smear 6. Understand the role of HPV test in management of

abnormal cervical smear 7.

9

Principles of gynecological

surgery

1. Identify the main procedures performed in gynecology 2. Recognize the different approach for each procedure e.g.

laparoscopic hysterectomy vs. total abdominal hysterectomy 3. Discuss the perioperative care in gynecology procedures 4. Recognize the main complications of each procedure

10 Management of pelvic mass

1. List the differential diagnosis of pelvic mass 2. Recognize the role of ultrasound as an initial assessment

method

3. Recognize the role of tumor markers in the approach to ovarian mass

4. Identify the clinical and radiological feature of malignant pelvic mass

5. Identify the clinical presentation of ovarian torsion

11

Cesarean section

1. Identify the types of uterine incision in cesarean section 2. Recognize the risk of uterine rupture in each type 3. Discuss the indication of cesarean section 4. Recognize the short and long term complications of

cesarean delivery 5. Discuss the perioperative care of patient with cesarean

section

12 Management of infertile couple

1.To approach an infertile couple. 2.To recognize the causes of infertility 3.To know the basic investigations that needed 4.Outline management plan for infertility

13 Operative vaginal delivery

1. Identify different types of forceps and vaccum 2. Recognize the indications of operative vaginal delivery 3. List the prerequisites for operative vaginal delivery

4.Discuss the complication of operative vaginal delivery

14 Management of early pregnancy bleeding

1. To identify the causes of early pregnancy bleeding including (ectopic , miscarriage & molar pregnancy

2. To differentiate between types of miscarriage. 3. To identify the symptoms, signs & management of

ectopic pregnancy 4. To recognize the etiology , management of molar

pregnancy 15 Management of

abnormal uterine bleeding

1.To identify the causes of abnormal uterine bleeding 2. To know the basic investigations should be done for each case. 3. To discuss the management options.

RECOMMENDED TEXT BOOKS:

Hacker & Moore's Essentials of Obstetrics and Gynecology Obstetrics by Ten Teachers by Philip N. Baker and Louise Kenny Gynecology by Ten Teachers by Ash Monga and Stephen Dobbs Williams Gynecology by Barbara L. Hoffman Williams Obstetrics by Marlene M. Corton

Assessment Assessment Type Expected Due Date Weight

First Exam -- Second Exam -- Midterm Exam (Theory) -- Evaluation 20 Quizzes -- Research activity -- OSCE 15 Mini-OSCE 15 Final Exam (Practical) 40 Final Exam(Oral) 10

Total 100

Students Learning Outcomes

Student Learning Outcomes(SLOs) (4-8 Maximum)

Upon successful completion of this course, students should be able to:

SLOs

Related ILO(s)*

(numbers only)

Evaluation Criteria (MCQ, OSCE, Homework…)

Type of Criteria (MCQ, OSCE, Homework…)

Weight (%)

Develop competence in the medical interview and physical examination of women

1

OSCE & Mini-OSCE and instructors evaluation

30

Demonstrate knowledge of preconception care 2

MCQ, OSCE and Mini-OSCE

5

Demonstrate knowledge of intrapartum and postpartum care

3 MCQ, OSCE and

Mini-OSCE 10

Describe common problems in obstetrics 4

MCQ, OSCE and Mini-OSCE

20

Develop a thorough understanding of contraception & infertility .

5 MCQ, OSCE and

Mini-OSCE 5

Demonstrate knowledge of common benign gynecological conditions including STD

6 MCQ, OSCE and

Mini-OSCE 20

Describe gynecological malignancies including risk factors, presentation and initial evaluation.

7 MCQ, OSCE and

Mini-OSCE 5

Demonstrate knowledge of perioperative care and familiarity with gynecological procedures

MCQ, OSCE and

Mini-OSCE 5

100

Intended Learning Outcomes (ILOs)

1) Demonstrate a sufficient understanding of the structural organization and functions of the following systems of the human body: circulatory, respiratory, gastrointestinal, endocrine, hematopoietic & lymphatic, musculoskeletal, nervous, and genitourinary systems.

2) Conceptualize the cellular, molecular, genetic, and biochemical mechanisms that maintain body’s homeostasis and their derangements in disease states.

3) Apply their knowledge of human anatomy and function to solve questions regarding major clinical cases and diseases.

4) Attain appropriate and systematic clinical history of different medical conditions and settings.

5) Demonstrate proficiency in performing clinical skills and procedures. 6) Perform relevant physical examination on patients professionally and ethically. 7) Identify the major signs and symptoms of disease states, recognizing risk factors and

etiologies, in an interdisciplinary approach to differentially diagnose patients. 8) Order and interpret results of relevant basic diagnostic procedures, such as laboratory

investigations and conventional imaging procedures. 9) Apply safe and accurate methods of pharmacotherapy of major disease states. 10) Critically appraise research studies guided by evidence-based medicine. 11) Demonstrate ability to work in diverse settings and communities.