The University of Southampton
Courses

MEDI3045 Obstetrics and Gynaecology & Genitourinary Medicine (O&G & GUM)

Module Overview

The module will normally take the format of an 8 week placement for each individual student which will be repeated several times throughout the year for different groups of students. The year starts on 5th September 2016 and ends in 10 June 2017. A variety of UoS partner trusts across the South & South Coast of England and also across Germany, primarily Klinikum Kassel. This module focuses on the Obstetrics & Gynaecology (BM(EU) Urology) and Genitourinary Medicine knowledge and understanding, practitioner and professional skills required of an F1 doctor, and the assessments within this module will focus on these areas. The BM programmes are however highly contextualised and integrated programmes in which the application of knowledge and understanding, clinical skills and professional practice applicable to medicine are learned through a range of modules none of which are stand alone modules and therefore this module should be recognised by teachers and students alike as part of the whole year and programme. The O&G & GUM Module in year 4 of the BM programmes is studied along with 4 other clinical teaching modules in Acute Care, Specialty Weeks, Psychiatry and Child Health; a year long Clinical Ethics & Law (CEL) module; and an assessment module called Year 4 Written Assessment. The emphasis of the assessments for each of the modules aligns with the focus of learning for that module, however the integrated nature of the course means that there will undoubtedly be overlap and aspects of the assessment in each module will draw upon learning from modules studied in earlier years as well as modules studied in that year. In addition, the CEL module and Year 4 assessment modules have been purposely designed to assess learning outcomes covered in any of the 5 clinical modules from the year. The module will normally take the format of an 8 week placement in one or more of our University of Southampton partner trusts. The timing will vary for different student groups and the teaching staff will vary for different trusts and student groups. As is the nature of clinical placements, the exact learning experiences of each student will be variable however all students will receive the same broad opportunities sufficient to achieve the learning outcomes of the module and it is expected that students will take responsibility for making the most of the opportunities provided and being pro-active in securing experiences in areas in which they feel they have weak and/or they have had least learning experiences. Clinical Obstetrics and Gynaecology (BMEU – Urology) and Genitourinary Medicine will be taught over a period of eight weeks in Year 4 during which time students will see a broad range of clinical presentations, in both acute and chronic settings. Students will experience those elements of clinical practice unique to this field, such as the management of labour and birth, the investigation and management of common gynaecological conditions, the investigation of sexually transmitted infections and the provision of individualised and tailored contraception. In their clinical years we encourage students to practically apply the basic core-knowledge acquired in the earlier years of medical teaching (especially from the second year Endocrinology and Life Cycle module).

Aims and Objectives

Module Aims

The aim of the Obstetrics and Gynaecology element of this module is to familiarise students with a range of acute and chronic conditions in this specialty, as well as gain some understanding of ethical issues and legal issues, and medical professionalism. Aside from acquiring appropriate theoretical knowledge relevant to the specialty, students should acquire the clinical skills and attitudes in relation to the delivery suite as well as on the obstetric and gynaecological (BMEU – and urological ) wards and in the specialised outpatient clinics), with the ultimate aim of being able to diagnose, investigate and provide a basic management strategy for patients. The aim of the Genitourinary medicine element of the module is to familiarise students with the range of common sexually transmitted infections, their epidemiology, pathology, investigation and management. There is a focus within the module on developing history taking skills. Sexual history taking requires the ability to put patients at their ease, to use language that is unambiguous, non-judgmental and clear. Students will be taught how to use language that is neutral and techniques for managing what can be professionally challenging consultations. The attachment will also teach students the principles of contraception and the considerations that underpin the range of options that patients may safely choose from. Students will develop familiarity with the provision of hormonal and physical contraception as well as the options for long acting and postcoital contraception.

Learning Outcomes

Learning Outcomes

Having successfully completed this module you will be able to:

  • Discuss normal reproductive physiology and provide definitions for common conditions in obstetrics and gynaecology [1.1a]
  • Take a comprehensive gynaecological and obstetric history and observe management of urgent admissions to gynaecology and labour wards [2.1a, 2.2a, 2.2b, 2.2g, 2.5a, 2.6c]
  • Take a sexual history [2.1a]
  • Examine patients in obstetrics and gynaecology (specific detail covered in section on syllabus content) [2.1c]
  • Perform genital examination in both male and female patients [2.1c]
  • Select appropriate investigations [1.1c, 1.1d]
  • Present and interpret findings together and discuss their significance with regard to management [2.3a, 2.2a, 2.2b, 2.2e, 2.2g]
  • Communicate effectively with women in sensitive matters relating to reproduction [2.1a, 2.3d]
  • Assess risk factors for HIV infection [2.1a,2.3a, 2.3d]
  • Explain the principles behind HIV pre- and post-test counselling [2.3d]
  • Describe the range of options for management and formulate a management plan for obstetrics and gynaecology cases and sexually transmitted infections [2.2b, 2.2e, 2.2g, 2.5b]
  • Demonstrate an understanding of the pathophysiology, relevant investigations and differential diagnosis for each of the obstetric and gynaecological conditions outlined below [1.1b]
  • Demonstrate a non-judgmental approach in managing sensitive health issues [3.1c, 3.1d, 3.1e]
  • Describe the particular importance of confidentiality, and ethical and legal aspects of it [3.1a]
  • Apply management strategies involving immediate treatment, case finding, behaviour modification and methods of partner notification for the benefit of individual patients [3.1b]
  • Describe the role and importance of a multidisciplinary specialist team [3.3a, 3.3b]
  • Acknowledge and discuss the ethical issues in reproduction [3.1a]
  • Take responsibility for your own learning and your continuing professional development [3.2b]
  • Able to continually and systematically reflect on experience and practice, translate that reflection into action whenever necessary using improvement techniques
  • Understand the principles behind commonly performed gynaecological and obstetric operative procedures [1.1a, 1.1b]
  • List the range of sexually transmitted infections (STI), their presentation, pathogenesis and complications [1.1a, 1.1b, 1.2a]
  • Explain the microbiology of STI, including the behaviour and mode of spread, and risk groups for particular STIs [1.1b]
  • Describe strategies for prevention and control of STIs [1.1b, 1.2a, 1.2d, 1.3a, 1.4b]
  • Discuss the pitfalls of poorly managed common STIs [1.1b]
  • Acknowledge the practical problems around patient education and behaviour-modification [1.2a, 1.2d, 1.2e]
  • Demonstrate knowledge and sensitivity to the socio-cultural factors influencing women’s reproductive health care [1.2c, 1.3d, 3.1d]

Syllabus

Application of core knowledge to clinical problems in the specialty. For all content identified below, students will de expected to demonstrate achievement of specifics. The student will be expected to: 1. Examine patients in obstetrics and gynaecology • Obstetrics i. examine the pregnant abdomen (measure fundal height, establish fetal lie and presentation, comment on engagement of fetal head) ii. identify fetal heart beat using Doppler ultrasound • Gynaecology iii. identify gynaecological masses from pelvic / abdominal examination iv. discuss when bimanual pelvic examination is appropriate and understand principles of how it is carried out 2. Present and interpret findings together and discuss their significance with regard to management. Students would be expected to present and examine in a structured manner, at least one obstetric and one gynaecological patient to a senior doctor during each week of their attachment 3. Communicate effectively with women in sensitive matters relating to reproduction. Communicate with patients about sensitive issues, such as menstrual disturbance and problems of sexual function 4. Understand the principles and have observed commonly performed gynaecological and obstetric operative procedures Gynaecology • Menopause • Menstrual disorders • Contraception • Infertility • Pelvic inflammatory disease • Early pregnancy care & complications/termination of pregnancy • Benign gynaecological conditions • Common gynaecological procedures & postoperative care • Malignancies in gynaecology • Urogynaecology/genital prolapse Obstetrics • Antenatal care • Pregnancy complications • Medical conditions complicating pregnancy • Management of labour & delivery • Obstetric emergencies • The puerperium & postpartum complications • Newborn • Maternal and perinatal mortality Genitourinary Medicine • Bacterial and viral STIs • Sexually acquired blood bourne infections • Diseases of men who have sex with men • Ectoparasites • Limiting STI complications, transmission and acquisition • Genital infections in pregnancy and the neonate • Investigating and managing genital symptoms in males and females • Clinical therapeutics and pharmacology of STI management • Post exposure prophylaxis for HIV • STIs and the law University of Southampton 6 Module Profile 2016-17 MEDI3045 Obstetrics and Gynaecology/ GUM BM(EU) Structured genital examination: female genital examination should take place in O&G and male genital examination should take place in urology. Dermatological manifestations of sexually transmitted infections should be taught in dermatology in the Specialties module.

Learning and Teaching

Teaching and learning methods

The module will be taught through a range of learning and teaching strategies which will include: • Tutor led tutorials/workshops • Practical sessions (clinical skills demonstrations) • Guided self-study • Problem solving scenarios • Role play • Group work • Portfolios • Study packs • eLearning & virtual patients • Patient based learning (ward and clinic work) • Lectures Doctors work in shift patterns and rotas throughout much of their working lives and to prepare you for such working once you graduate, throughout your programme you will be expected to undertake placements in the evenings, at nights and at weekends. This will not be an onerous requirement and will be negotiated well in advance so that students with carers’ requirements will be able to ensure appropriate arrangements are in place for cover Within this module there may be some core/compulsory activities that will take place in the evenings, nights or weekends therefore students will commitments that will be affected by these should be pro-active in securing details of these activities well in advance of the start of the module. In addition, many non core learning opportunities will be available during these times and students are encouraged to take advantage of them

TypeHours
Independent Study95
Placement Hours280
Total study time375

Resources & Reading list

Rogstadd (2011). ABC of STIs. 

Blackboard. Resources for this module will be signposted to you through the Blackboard Page for this module. An indicative content is provided below, however the blackboard module and/or log book will provide the most up to date guidance on resources for this module. – log book Key information in Southampton University GUM Handbook

Assessment

Assessment Strategy

ADDITIONAL ASSESSMENT OF THIS MODULE LEARNING As stated in the overview section the integrated nature of the BM programmes means that material learnt within this module is likely to be assessed in other modules. In particular material from this module are likely to be assessed in the following modules. • Year 4 Written Exams • Clinical Ethics and Law • Finals Assessment Further Details of Module Assessment Each element (O&G and GUM) must be passed satisfactorily and there is no compensation between the elements. 1. Compulsory activities/elements include: O&G • Meetings with lead consultant • Feedback in clinics • Feedback on case presentations • Sign off sheets (for both mandatory and recommended minimal clinical experiences pages within the learning portfolio) GUM • Feedback on Portfolio completion • Discussion of clinical cases and feedback in clinics 2. Learning Portfolio • meeting with the consultants • sign off sheet for mandatory training /minimal clinical experience requirements • self assessment • Case presentations and feedback which includes history and examination -description of the pathological basis of a the condition, an evidence based discussion of the challenges of management of the condition with a focus on the practical problems around patient education and behaviour-modification. 3. Reflective practice University of Southampton 8 Module Profile 2016-17 MEDI3045 Obstetrics and Gynaecology/ GUM O&G End of attachment assessment form. Elements covered:: • History taking • Physical examination • Data interpretation • Theoretical knowledge • Record of learning (Portfolio/Logbook) • Professionalism • Reflective practice GUM: End of attachment assessment form. Elements covered: • History taking • Physical examination • Data interpretation • Theoretical knowledge • Record of learning (Portfolio/Logbook) • Professionalism • Reflective practice Students will have to undertake three Assessments of Clinical Competence (ACC) during the attachment and will need to gain satisfactory marks in them to achieve exemption from the ACC in the Year 5 exams. However, the ACC will not be an integral element of the assessment of the module itself.

Summative

MethodPercentage contribution
Tutor evaluation 100%

Referral

MethodPercentage contribution
Supplementary activity 100%

Repeat Information

Repeat type: Internal

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