Obstetrics (clinical practice)

Code:

MI603

Acronym:

OBST

Keywords
Classification	Keyword
OFICIAL	Medicine

Instance: 2014/2015 - SP

Active?	Yes
Responsible unit:	Obstetrics and Gynaecology Department
Course/CS Responsible:	Integrated Master in Medicine

Cycles of Study/Courses

Acronym	No. of Students	Study Plan	Curricular Years	Credits UCN	Credits ECTS	Contact hours	Total Time
MIMED	275	Mestrado Integrado em Medicina 2007	6	-	6	64	162
		Mestrado Integrado em Medicina- Plano oficial 2013 (Reforma Curricular)	6	-	6	64	162

Teaching language

Portuguese

Objectives

The main objective is to introduce the medical student into general obstetrical and gynecological clinical practice.

The preferred areas are the prevention, screening, diagnosis and treatment of the most frequent pathologies and obstetric and gynecological emergencies.

 

Learning outcomes and competences

 

At the end the student will be able to recognize and establish the clinical approach to the most prevalent and important obstetric and gynecological diseases.

Working method

Presencial

Pre-requirements (prior knowledge) and co-requirements (common knowledge)

 

• Theorical knowledge teached at UC 5th year Ginecologia e Obstetrícia
• Technical competences teached at simulation centre UC 5ºano Ginecologia e Obstetrícia

Program

• Family planning;


• genital infections;


• preventive gynecology – screenings;


• menopause – hormonal treatment of menopause;


• pré-conception and pré-natal care;


• identification of obstetrical risk factors;


• prenatal screening and diagnosis;


• labour and puerperium.

Mandatory literature

Beckmann CRB, Ling F, Smith RP, Barzansky BM, Herbert WNP and Laube DW ; Obstetrics and Gynecology. , Lippincott Williams & Wilkins (6th edition), 2010 , 2010

Teaching methods and learning activities

Four weeks clinical supervised clerkship in the Department of Obstetrics and Gynecology of:

• Main hospital: Hospital de S. João
• Affiliate hospitals:

1. Centro Hospitalar de Vila Nova de Gaia /Espinho
2. Hospital Pedro Hispano
3. Hospital Padre Américo
4. Hospital S. Sebastião
5. Hospital de Vila Real
6. Hospital de Viseu
7. Hospital Privado da Boa Nova - Matosinhos

 Hospitalar clinical activity supervised by 1/2 tutors:

• Monday to Friday: 8h30am - 1h30pm
• Emergency and labour ward, at least once a week between 9h00am - 7h00pm.

Each student gets:

• log-book with description of clinical gynecological and obstetrical activities (n=20)
• assessment of professional behavior by the supervisor

Clinical sessions:

Clinical case report presentations and discussions by the student will take place 1 time, each week (total 3 sessions) at Faculty of Medicine of Porto – Hospital de São João, scheduled at the beginning of the clerkship). These clinical meetings will prevail over the clinical activity. The students will present and discuss a total of 3 case reports.

 

Evaluation Type

Distributed evaluation without final exam

Assessment Components

Designation	Weight (%)
Participação presencial	100,00
Total:	100,00

Amount of time allocated to each course unit

Designation	Time (hours)
Estudo autónomo	5,00
Frequência das aulas	2,00
Total:	7,00

Eligibility for exams

• Evaluation of clinical activity by the tutor


• Log-book


• Evaluation of clinical casses presented and discussed during the clinical sessions

Calculation formula of final grade

The assessment of the performance during the 4 weeks is the sum of the information obtained by the supervisors, the fulfillment of the gynecological and obstetrical gestures and the presentation and discussion of the clinical reports during the clinical sessions.

• Information obtained by the supervisors (maximum 9 points) include the evaluation parameters: assiduity, punctuality, availability, communication capacity and global performance. The assessment of each parameter includes: 0 – null performance;1 – performance inferior to 50%; 2 – performance between 50 a 75%; 3 – performance between 75 e 100% and 4 – 100% performance. If the student had 2 supervisors, a average of the assessment of the 2 tutors will be made.

• Fulfillment of the gynecological and obstetrical loogbook (number of activities=20) Clinical activities observed and performed during the 4 weeks, corroborated by the supervisor (maximum 2 points).

• Presentation and discussion of clinical reports. During the clinical sessions all students will have the possibility to present and discuss a total of 3 case reports observed during the 4 weeks. The case report presentation will be verbal, without audiovisual support, abstract form, with maximum 4 minutes for presentation and 5 for discussion. The clinical report will include de relevant positive and negative data of the clinical story, physical examination and complementary exams and ending with active problems list and therapeutic plan. Every student will discuss the clinical report of another student. The presentation and discussion will be assessed by the teacher during the clinical session with the following evaluation parameters: 0 – absence; 3 – presence with excellent presentation and discussion (maximum 9 points, 3 points for each clinical report).

Final classification (1 to 20 points) = (supervisor assessmentx9)/20 + clinical sessions assessment + loogbook.

The students will present the log-book and the supervisor assessment at the end of the clerkship to the Department secretary – 4th floor.

Examinations or Special Assignments

not applied

Internship work/project

not applied

Classification improvement

The knowledge assessment is optional.

The students, who desire an improvement of the classification, can request at the end of the clerkship a theoretical evaluation.

This session will take place at the last day of the clerkship and will be performed by the main teacher of the discipline. This assessment includes a discussion of a case report or/and a clinical guideline chosen by the teacher.

The final classification results from 2/3 of the previous obtained classification and 1/3 of the theoretical evaluation.

Observations

BIBLIOGRAPHY: to be requested for consultation at the Ginecologics and Obstetrics Department secretary – 4th floor.

Basic:
 Beckmann CRB, Ling F, Smith RP, Barzansky BM, Herbert WNP and Laube DW (Eds). Obstetrics and Gynecology. Lippincott Williams & Wilkins (6th edition), 2010
 Graça LM. Medicina Materno-Fetal (4ª edição). Lidel, 2010
 www.alert-student. Clinical problems:
o Genital hemorrhage
o Disfunctional uterine hemorrhage
o Endometrial hyperplasia
o Endometrial polyp
o Cervical polyp
o Cervicitis
o Genital laceration
o Dismenorrhea
o Abortion
o Ectopic pregnancy
o Neoplastic trophoblastic disease
o Placentation anomalies
o Abruptio placentae
o Post-partum hemorrhage
o Vulvar cancer
o Vaginal cancer
o Uterine cervical cancer
o Uterine cancer
o Tubar cancer
o Ovarian cancer
o Infertility
o Endometriosis
o Adenomiosis
o Polycystic ovarian syndrome
o Anovulation/amenorrhea
o Premature ovarian failure
o Menopause
o Pelvic inflammatory disease
o Repetitive misscarriages
o Asherman syndrome
o Cervical incompetence
o Uterine leyomiomatosis
o Ovulation induction
o Intrauterine insemination
o In vitro fertilization
o Intracytoplasmatic sperm injection
o Ovarian hyperstimulation syndrome
o Fertility preservation in case of cytotoxic treatment
o Gamete doation
o Genetic pre-implantation diagnosis
o Pregnancy
o Physiological alterations during pregnancy
o Diet, exercise and pregnancy
o Infections screening
o Gestational diabetes
o Multiple gestation
o Aloimunization and pregnancy
o Hepatic diseases and pregnancy
o Hematological diseases and pregnancy
o Hypertensive diseases and pregnancy
o Pre-natal diagnosis
o Obstetric ultrasound
o Fetal monitoring
o Labour
o Labour induction
o Labour anomalies
o Instrumental delivery
o Cesarian section
o Pre-term labour
o Post-term pregnancy
o Puerperium
o Breast feeding
o Familiar planning
o Obstetrical emergencies
o Pruritus associated to gynecological disease
o Feminine genital inferior trac ulcer
o Urinary incontinence
o Abdominal pain of gynecological origin


Advanced:
 Cunningham FG, Leveno KJ. Williams Obstetrics. McGraw-Hill, 2005
 Berek JS et al. Novak's Gynecology. Lippincott, Williams& Wilkins, 2002

Manuals:
Ginecology
 Fernando Mota. Compêndio de Ginecologia Oncológica. Lidel, Lisboa, 2012.
 Ana Rosa Costa, Jorge Beires, Nuno Montenegro. Protocolos de Ginecologia e Medicina da Reprodução. Lidel, Lisboa, 2011.
 Ana Rosa Costa, Jorge Beires, Nuno Montenegro. 4Teen – Ginecologia na Adolescência. Edições 1ST News, Lisboa, 2010.
 Oliveira C et al. Manual de Ginecologia (Volume I e II). Permanyer Portugal. 2009.
 Havens C, Havens CS, Sullivan N. Manual of Outpatient Gynecology. Lippincott, Williams& Wilkins, 2002.

Obstetrics
 Diogo Ayres-de-Campos, Isabel Santos Silva, Fernando Jorge Costa. Emergências Obstétricas. Lidel, Lisboa, 2011.
 Luisa Machado, Alexandra Matias, Nuno Montenegro. Guias de Saúde – Diagnóstico Pré-Natal. Quidnovi, Vila do Conde, 2010.
 Ayres-de-Campos D, Montenegro N, Rodrigues T. Protocolos de Medicina Materno-Fetal. LIDEL, Lisboa, 2008.