Obstetrics/Gynecology (clinical practice)

Code:

MI623

Acronym:

G/O

Keywords
Classification	Keyword
OFICIAL	Medicine

Instance: 2019/2020 - SP (of 09-09-2019 to 31-07-2020)

Active?	Yes
Responsible unit:	Departamento de Ginecologia-Obstetrícia e Pediatria
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	264	Mestrado Integrado em Medicina- Plano oficial 2013 (Reforma Curricular)	6	-	6	57	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 integrate theoretical knowledge in daily clinical practice, 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;


• most prevalent gynecological diseases: hemorhagic


•  urogynecological, associated to infertility, benign and maligne tumours;


• gynecological emergencies


• pré-conception; 


• identification of obstetrical risk factors;


• prenatal care in low-risk gestation;


• prenatal screening and diagnosis;


• labour and puerperium;


• obtetrical emergencies.

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:                                                     -Centro Hospitalar de Vila Nova de Gaia /Espinho- Vila Nova Gaia
  - Hospital de Pedro Hispano- Matosinhos
  - Hospital Padre Américo - Penafiel
  - Hospital S. Sebastião – Santa Maria da Feira
  - Instituto Português de Oncologia do Porto
  - Centro Hospitalar de Póvoa de Varzim / Vila do Conde
  - Centro Hospitalar de Tondela - Viseu
  - Centro Hospitalar de Trás-os-Monter e Alto Douro-Vila Real
  - Centro Hospitalar do Médio Ave - Famalicão
  - Hospital de Ponta Delgada - Açores
  - Hospital do Funchal - Madeira
  - Hospital de Santa Luzia - Viana do Castelo
  - Hospital de Bragança
  - Hospital CUF - Porto
  - Hospital Privado da Boa Nova - Matosinhos
  - Hospital Privado da Arrábida - Vila Nova de Gaia
  - Hospital Privado Lusíadas - Porto
  

 Hospitalar clinical activity supervised by 1/2 tutors:

• Monday to Friday: 8:30am - 1:30pm
• Emergency and labour ward, at least once a week between 9:00am - 7:00pm.
• 30h per week (including 10h weekly of emergency room) of tutorized clinical activity

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 2 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 2 case reports (ideally one gynecological case and another obstetrical.

 
Absence in clinical sessions will only be allowed to compensate during the attending pedagogic model and after presentation of accepted justification by the responsible teacher.

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	10,00
Frequência das aulas	4,00
Realização de Estágio	148,00
Total:	162,00

Eligibility for exams

• Evaluation of clinical activity by the tutor


• Log-book


• Evaluation of clinical cases 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 10 points) include the evaluation parameters: assiduity, punctuality, technical skills, human interrelational interaction / comunication / professional atitude, theoretical knowledge aplication. 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 - even when the student does't accomplish the totality of the activities he will obtain the two points if he has 100% assiduity).

• Presentation and discussion of clinical reports. During the clinical sessions all students will have the possibility to present and discuss a total of 2 case reports observed during the 4 weeks. The case report presentation will be verbal, without audiovisual support, abstract form. The clinical report will include the relevant positive and negative data of the clinical story (past relevant history and risk  factors, present short relevant history, physical examination and complementary exams and ending with active problems list and therapeutic plan. The presentation and discussion will be assessed by the teacher during the clinical session with the following evaluation parameters:

  1 – Format of clinical short report (Medical language/nomenclature, ability to synthetize, Struture of short report) – 1 value;

  2 – Clinical short report (Past medical history/ risk factors / acutal gynecologycal/obstetrical problem, symptoms, physical exam, relevant medical exams and justification for them  – 2 values;

  3 –Clinical discussion (List of active medical problems, Therapeutic orientation, medical knowledge integration) – 1 value.

  (maximum 8 points, 4 points for each clinical report).

Final classification (1 to 20 points) = (supervisor assessmentx10)/20 + clinical sessions assessment + loogbook.

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

Examinations or Special Assignments

not applied

Internship work/project

not applied

Special assessment (TE, DA, ...)

Student satisfaction inquiry (anonimous):

- on the first day of internship the responsable of the UC will distribute to the students;
- after its fullfilment the student should give it to the secretary of UC (Level 4).

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 the oral presentation (without audiovisual support) and discussion of a case with aproximately 90 minutes duration.

The student will have the morning to colect all the relevant clinical data and to approach the pacient selected by the teacher.

The evaluation criteria for grade improvement are:

1.Case report format (5 maximum points):

• Medical language / nomenclature
• Synthetic capacity
• Structure

2.Clinical case report (9 maximum points):

• Comorbidities
• Gynecological / Obstetrical active problem
• Symptoms
• Physical examination
• Complementary medical exams

3.Clinical report discussion (6 maximum points):

• List of medical problems
• Therapeutical options
• Integration of medical knowledge

The final classification will be the result of the highest grade obtained (grade improvement or final grade).

Observations

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

Basic:
 Beckmann CRB, Ling F, Smith RP, Barzansky BM, Herbert WNP and Laube DW (Eds). Obstetrics and Gynecology. Lippincott Williams & Wilkins (8th edition), 2018
 Graça LM. Medicina Materno-Fetal (5ª edição). Lidel, 2017
 www.alert-student. Clinical problems. 
   www.uptodate.com

Advanced:
 Cunningham FG, Leveno KJ. Williams Obstetrics. McGraw-Hill, 2018
 Berek JS et al. Novak's Gynecology. Lippincott, Williams& Wilkins, (16th edition), 2019.


Portuguese Ginecological Consensus: www.spginecologia.pt  
Consenso Nacional sobre Uroginecologia (2018);
Consenso Nacional sobre Hemorragias Uterinas Anormais (2018);
Consenso Nacional sobre Vacinas Contra HPV (2018);
Consenso Nacional sobre Menopausa (2016);
Miomas Uterinos (2017);
Cancro Ginecológico (2016);
Consenso Livro Endometriose (2015)
Consenso sobre Infeção por HPV e Neoplasis Intraepitelial do Colo, Vulva e Vagina (2013);
Revisão dos consensos em Infeções Vulvovaginais (2012);
Livro de Consensos sobre Contraceção (2012);
 
 


Obstetrics
 Diogo Ayres-de-Campos, Isabel Santos Silva, Fernando Jorge Costa. Emergências Obstétricas. Lidel, Lisboa, 2011.
 Montenegro N, Rodrigues T; Ramalho C; Ayres-de-Campos D. Protocolos de Medicina Materno-Fetal. LIDEL, Lisboa, 3rd edition, 2014.