Delemne 4.3: Obstetrics and Gynaecology

Part of Curriculum: MED-2520 International semester

Revised and updated: February 2018

Approved by the Programstyret for medisindate: 20.06.2013

Author:Åshild Bjørnerem

Duration of the course: 17 weeks, part time

Learning objectives

The main objective of the course is to develop and consolidate the knowledge, skills and attitudes required to achieve competence in managing common and important clinical problems in the field of women`s health.

Knowledge:After completion of the course, the student should be able to:

  • K1: Describenormal and pathological anatomy of the reproductive organs including physiology of the menstrual cycle and the physiological changes in pregnancy and puerperium.
  • K2:Account for common benign and malignant diseases in gynaecology including their epidemiology, aetiology, pathogenesis, diagnosis, management, screening and prevention.
  • K3: Recognise and describe the management of commongynaecological and obstetrical emergencies.
  • K4:Account for causes of infertility and describe important investigations to diagnose the causes of infertility and know how to interpret investigation results. Describe the most common forms of assisted reproductive technology.
  • K5: Account for causes of urinary and faecal incontinence in women. Describe investigation and management of urinary incontinence.Describe the etiology, classification and management of utero-vaginal prolapse.
  • K6:Describe the most common contraceptive methods and be able to discuss appropriate uses of the different methods.
  • K7:Describe the most common forms of hormone replacement therapy, and be able to discuss pros and cons of this form of treatment.
  • K8: Demonstrate knowledge and understanding of the Abortion Law.
  • K9:Recognisethe importance of exposure to teratogenicfactors during periconceptionalperiod and its impact on subsequent pregnancy outcome.
  • K10: Describe routine antenatal care, and be able to stratify pregnancies in low and high-riskcategories.
  • K11: Describe the routine screening program in pregnancy and the basic principles, indications and methods of prenatal diagnostics.
  • K12: Describe methods used to evaluate foetal well-being. Describe the aetiology, pathophysiology, diagnosis, investigations and management of common pregnancy associated disorders.
  • K13: Describemethods used for induction of labour and pain relief in labour.Describe the management of women during and after normal and operative delivery. Diagnose and manage important puerperal conditions.
  • K14:Describe the definition and classification of an early and latemiscarriage, stillbirth and neonatal death. Describe important causes of maternal and perinatal mortality.
  • K15:Understand and describe themost common operations in obstetrics and gynaecology, the complications and their management, and principles of pre- and postoperative care.

Skills:By the end of the course the students should be able to:

  • S1: Exhibitappropriate communication skills to take a medical history and discuss issues relevant to women’s health.
  • S2: Explain clinical examination findings and results of investigations, and discuss management plan with the patient in a clear and sensitive manner.
  • S3: Exhibit basic communication skills in breaking bad news such as intrauterine foetal death, gynaecological malignancy etc.
  • S4: Perform vaginal speculum examination and bimanual pelvic examination.
  • S5: Take appropriate and relevant microbiological and cytological samples.
  • S6: Insert and remove an intrauterine contraceptive device and implant.
  • S7: Perform obstetric examination antenatally, during labour and postpartum.

Attitude:The student should be able to:

  • A1: Practise with a professional appearance and caring attitude. Support and respect the women’s choices and decisions. Understand the importance of teamwork.
  • A2: Set at ease a woman presenting with gynaecological problems so that she feels comfortable and confident enough to give a complete history and consent to examination.
  • A3:Show respect and understanding to various emotions that a pregnancy may cause and use appropriate wording to the questions asked.

Teaching and Learning Methods

  • Lectures, seminars and group work
  • Practical laboratory work, training in the skills laboratory using phantoms and models (for training on pelvic examination and gynaecological procedures as e.g. smears and devices)
  • Seminars and group work (simulation training for international students only)
  • Clinical case presentations

Clinical Practice:

  • Clinical teaching performing obstetric examination of patients at antenatal clinic (1-3 hrs)*
  • Clinical teaching performing vaginal and pelvic examination of gynaecological patients atthe gynaecological outpatient clinic (1-3 hrs)*

* Norwegian students can sign up individually for a session, while international students have this training during a special 3 weeks program for international studentsonly

  • Shadowing on-duty doctors (1 day from 15:00 to 23:00 hours): this is optional

Mandatory attendance/ approval required

Participation of the Skills laboratory training

Performing 1 obstetric examination of a pregnant women

Performing 1 vaginal and pelvic examination of a gynaecological patient

Clinical aspects from the list of 115

82 Urinary incontinence (female) 86 Vaginal discharge

87 Pregnancy /labour 88 Infertility/sexual dysfunction

89 Menstrual disorders 90 Abnormal vaginal bleeding

91 Pelvic pain 92 Vulval itching/ulceration

Recommended Learning Resources

  • Philip N Baker and Louise Kenny: OBSTETRICS by Ten Teacher, 19th edition, 2011
  • Ash Monga and Stephen Dobbs: GYNAECOLOGY by Ten Teacher, 19th edition, 2011
  • Maltau Jan Martin, Molne Kåre, Nesheim Britt Ingjerd: Obstetrikk og Gynekologi. Gyldendal Akademisk 2015.

International exchange students may use textbooks as advised by their respective institutions.