OBG 472 Family Planning and Reproductive Health Ambulatory Acting Internship
Description
The focus of this elective is to learn more about the Gynecologic Subspecialty of Family Planning. Counseling and provision of contraceptive methods, experience with pelvic ultrasounds, management of spontaneous, inevitable and induced abortion and post-abortion care by both surgical and medical techniques are included. Abortion is considered an integral part of this rotation, and the student is expected to participate in the full range of family planning services. The student is also welcome and encouraged to participate in ongoing family planning research projects.
Learning Opportunities
Clinical hours per week: 36 hours
Seminar and Didactic hours per week: 5 hours
Summary of Course Content
Medical students are expected to graduate competent in these 6 domains.
- Patient Care
- Medical Knowledge
- Interpersonal and Communication Skills
- Professionalism
- System Based Practice
- Lifelong Learning
Learning Objectives
At the end of the rotation, the student will be able to:
Contraception
- Describe the mechanism of action of different contraception methods (reading, FP and private clinic)
- Differentiate absolute versus relative contraindications for different contraceptive methods (reading, FP and private clinic)
- Discuss the efficacy and failure rate of non-hormonal methods of contraception, including barrier methods (reading, FP and private clinic)
- Discuss the efficacy and failure rate of hormonal contraception (reading, FP and private clinic)
- Counsel a patient on the efficacy, risks, and benefits of various methods of contraception in general and as they relate to the specific patient (reading, FP and private clinic)
- Help a patient compare the advantages and disadvantages of different contraceptive methods to meet her needs (reading, FP/preop and private clinic)
- Demonstrate the steps of IUD insertion (reading, FP and private clinic, OR)
- Identify the critical elements of counseling for permanent contraception, such as surety of decision, evidence of coercion, and legal or financial restrictions (reading, FP and private clinic)
- Compare the risks and benefits of various permanent contraception procedures (reading, FP and private clinic, OR)
- Compare the mechanism of action and availability of different emergency contraception methods (reading, FP and private clinic)
Abortion
- Describe the legal and social barriers of abortion in this country and how it affects patient care (reading, FP/preop and private clinic)
- Assist with the use of ultrasound in early pregnancy diagnosis or pregnancy dating (reading, FP/preop and private clinic)
- Counsel patients at different gestational ages about the indications, risks and benefits for medical and surgical termination options as appropriate
- Explain the critical components of medical abortion, including the mechanism of action of relevant medications, expected patient experience, and the options for patient follow up (reading, FP and private clinic, OR)
- Predict own role in assisting with surgical pregnancy termination, depending on the complexity of the procedure and patient
- Identify embryonic or fetal structures in gross examination of tissue specimens across different gestational ages (reading, private clinic, OR)
- Describe a patient’s experience through the abortion process from the initial consultation through follow-up in different settings (FP/preop and private clinic, OR)
- Compare how abortion is provided in different settings, including hospital outpatient clinic, freestanding clinic, and the operating room (FP/preop, private clinic, freestanding clinic)
- Recognize signs and symptoms of abortion complications and describe their treatment (reading, OR, FP/preop and private clinic)
- Diagnose early pregnancy failure and counsel patients about options for management
Rules & Responsibilities
During the four weeks of this elective, the student will work in several clinical settings under the supervision of a Family Planning faculty member, Family Planning fellow, or Volunteer Clinical Faculty who specializes in Family Planning, including:
- Family Planning clinics at the Ambulatory Care Center at UC Davis Medical Center (UCDMC), one focusing more on preoperative preparation and evaluation for abortion procedures and one focusing more on complex contraception and IUD and implant insertions;
- Private faculty office seeing general gynecology and family planning patients;
- Complex contraception clinics with other departments
- Planned Parenthood Mar Monte, B Street Clinic
- UCDMC main operating room for sterilization surgery and complex abortion procedures.
The student will also see any admitted family planning patients and in-hospital consults under the supervision of a Family Planning fellow or faculty member. Other members of the family planning team will include a first or second year resident who will work alongside the student throughout the rotation.
Abortion is considered an integral part of this rotation, and the student is expected to participate in the full range of family planning services. The amount of hands-on experience will vary from clinic to clinic. Being in clinic can be a difficult experience for some family planning patients, and the patient’s comfort will be prioritized.
L&D call is not a required component of this rotation. The student is welcome to contact the director of L&D if they are interested in a voluntary L&D experience as long as this does not detract from the student’s FP responsibilities.
Didactics
The student is expected to attend the following weekly conferences:
- GYN Preop Conference: Tuesday 7:15-8:15 AM
- OBGYN Grand Rounds: Wednesday 7:50-8:50 AM
- OBGYN Resident Didactics: Wednesday 9 AM-11 AM
- GYN Family Planning Conference: Thursday 7-8 AM (schedule in Dropbox)
At the end of the rotation, the student will present an evidence-based topic on family planning to the Family Planning faculty and residents as a capstone activity during Family Planning Conference.
Call
There is no overnight or weekend call as a family planning acting intern.
Evaluation Process
Student evaluations are compiled by the IOR after receiving feedback from the residents, fellows, and attendings on service. To receive Honors, the student is required to receive excellent clinical feedback, provide an excellent capstone presentation, AND participate in an academic exercise, such as a case report, a research project (submission of application for IRB approval), a quality improvement review, protocol development or teaching project.