Didactic Learning Objectives
Obstetrics & Gynecology (Tucson)
(adapted from APGO Medical Student
Educational Objectives, 8th edition)
1. Become familiar with instruments and techniques of surgical suturing and knot-
2. Become familiar with laparoscopic instruments and techniques via use of
laparoscopy simulation at the Arizona Simulation Technology and Education
3. Become familiar with the process of a normal spontaneous vaginal delivery via
use of an obstetric simulator.
1. Describe the key components of pre-operative evaluation and planning, including
complete medical histories, the informed consent process and working with
2. Describe the common peri-operative prophylactic measures, including steps
taken to reduce infection and deep venous thrombosis.
3. Compare the relative risks and benefits of various forms of anesthesia/analgesia
utilized during surgery and labor.
4. Discuss the role of nutrition in achieving optimal peri-operative outcomes.
5. Discuss common postoperative complications such as bleeding, myocardial
infarction, pulmonary embolus, and infection (including urinary tract infection,
pneumonia, wound infection, and anastomotic leak).
1. Compare the characteristics of functional cysts, benign ovarian neoplasm and
2. Describe the use of ultrasound in the evaluation of first trimester bleeding.
3. Describe the use of ultrasound in antenatal care:
a. Detection of fetal anomalies
b. Assessment of fetal growth abnormalitites
c. Assessment of fetal well-being
1. Postpartum hemorrhage
a. List the risk factors for postpartum hemorrhage.
b. Formulate a differential diagnosis of postpartum hemorrhage.
c. Describe the immediate management of the patient with postpartum
2. Postpartum infection
a. List the risk factors for postpartum infection.
b. Describe the pathophysiology of postpartum infection.
c. Identify the organisms involved in postpartum infection.
d. Describe the evaluation and management of the patient with postpartum
3. Postpartum anxiety and depression
a. Identify the risk factors and diagnose postpartum “blues,” postpartum
depression and postpartum psychosis.
b. Describe treatment options for postpartum “blues,” postpartum depression
and postpartum psychosis.
1. List history and physical finding that may suggest:
b. Fibrocystic changes
c. Intraductal papilloma
2. Discuss the diagnostic approach to a woman with the chief complaint of breast
mass, nipple discharge or breast pain.
1. Incorporate screening questions for urinary incontinence when eliciting a patient
2. Discuss the difference between stress, urge and overflow incontinence.
3. Identify pertinent history components to differentiate between incontinence types.
4. Identify the following elements on physical exam: cystocele, rectocele, vaginal
5. List behavioral, medical and surgical methods to appropriately treat incontinence
and pelvic organ prolapse.
Surgical Emergencies (or “OB/GYN in the ED”)
1. Ectopic pregnancy
a. Develop a differential diagnosis for bleeding and abdominal pain in the
b. Identify risk factors for ectopic pregnancy.
c. Discuss the evaluation and diagnosis of a patient suspected of having an
d. Describe treatment options for patients with ectopic pregnancy
2. Spontaneous abortion
a. Differentiate the types of spontaneous abortion.
b. Discuss the evaluation and diagnosis of a patient suspected of having a
c. Identify the causes and complications of septic abortion.
3. Other (ex. Ovarian torsion, Ruptured cysts
a. Develop a differential diagnosis for acute pelvic pain in the Emergency
b. Describe the evaluation and initial management of patients presenting to
the Emergency Department with acute pelvic pain.
1. Traumatic injuries
a. Review the consequences of trauma that occurs during pregnancy.
b. Describe the evaluation and management (both maternal and fetal) of
trauma that occurs during pregnancy.
2. Sexual Assault/Intimate Partner Violence
a. Identify patients at increased risk for sexual abuse/intimate partner
b. List the components of a history, physical examination, and counseling for
a victim of sexual assault/intimate partner violence.
c. Discuss the prevalence and incidence of violence against women.
d. Discuss appropriate counseling of patients for short-term safety and long-
term management (local sources of support).
1. Describe physiologic changes in the hypothalamic-pituitary –ovarian axis
associated with perimenopause/menopause
2. Perform an assessment of the symptoms and physical findings associated with
3. Describe appropriate management of menopausal/perimenopausal symptoms
4. Counsel patients regarding menopausal issues
5. List long term changes associated with menopause, including osteoporosis
1. Define the principles of teratology and their use in determining risks associated
with exposures during pregnancy
2. Recognize the importance of timing and dose on pregnancy exposures
3. Understand deficiencies in the FDA Pregnancy Labeling Categories as they
relate to pregnancy exposure information
4. Identify resources for information on exposures during pregnancy and lactation
5. Recognize the importance of framing exposures as a risk vs. benefit analysis
Normal and Abnormal Uterine Bleeding
1. Describe the normal menstrual cycle
2. Define abnormal uterine bleeding
3. Describe the etiologies of abnormal uterine bleeding
4. Describe the evaluation methods of abnormal uterine bleeding
5. Describe the therapeutic options of abnormal uterine bleeding
6. Counsel patients about each therapeutic option and sequelae
1. Differentiate the signs and symptoms of STIs
2. List the physical and clinical findings in STIs
3. Describe the methods of evaluation for STIs
4. Describe the management of STIs
5. Describe the pathogenesis of salpingitis
6. List the signs and symptoms of salpingitis
7. Describe the management of salpingitis
8. Identify the long-term sequelae of salpingitis, including: tubo-ovarian abscess,
chronic salpingitis, ectopic pregnancy, infertility
9. Counsel the patient about the public health concerns for STIs, including
screening programs, costs, prevention and immunizations, and partner
evaluation and treatment.
STIs to be discussed: Gonorrhea, Chlamydia, Herpes simplex virus, Syphilis, Human
papillomavirus infection, Human immunodeficiency virus (HIV) infection, Hepatitis B
a. Describe the pathophysiology of isoimmunization, including:
i. Role of red blood cell antigens
ii. Clinical circumstances under which D isoimmunization is likely to
b. Discuss the use of immunoglobulin prophylaxis during pregnancy for the
prevention of isoimmunization
c. Discuss the methods used to identify maternal isoimmunization and the
severity of fetal involvement
2. Multifetal gestations
a. Discuss the etiology of monozygotic, dizygotic and mutizygotic gestation
b. Describe the altered physiologic state with multifetal gestation
c. Discuss the symptoms, physical findings and diagnosis of multifetal
d. Discuss the approach to antepartum, intrapartum and postpartum
management for multifetal gestation
e. Describe the potential complications (maternal and fetal) associated with
3. Preterm labor
a. Cite the risk factors for preterm labor
b. Distinguish preterm labor from Braxton Hicks contractions
c. Identify the causes of preterm labor
d. Counsel the patient regarding the signs and symptoms of preterm labor
e. Describe the initial management of preterm labor
f. List indications and contraindications of medications used to treat preterm
g. Describe the adverse events associated with the management of preterm
h. Counsel the patient who has experienced preterm birth
i. Describe cervical incompetence
Medical Complications of Pregnancy
1. Hypertension (includes chronic hypertension, gestational hypertension, and
a. Define, classify, and diagnose hypertension in pregnancy
b. Discuss the potential impact of hypertension on the gravid patient and her
c. Discuss the potential impact of pregnancy on the course of hypertension.
d. Describe the initial management of hypertension in the pregnant patient.
2. Diabetes mellitus (includes pre-gestational and gestational diabetes)
a. Define, classify, and diagnose diabetes mellitus in pregnancy.
b. Discuss the potential impact of diabetes mellitus on the gravid patient and
c. Discuss the potential impact of pregnancy on the course of diabetes
d. Describe the initial management of diabetes mellitus in the pregnant
Contraception & Sterilization
1. Describe the physiologic basis of contraception (OCP’s, emergency
contraception, patches, rings, IUD, sterilization, etc.)
2. Describe the effectiveness of each form of contraception
3. Counsel the patient regarding the benefits and risks for each form of
4. Cite the financial considerations of the various forms of contraception
5. Describe the methods of male and female surgical sterilization
6. List the risks and benefits of procedures, including:
a. Potential surgical complications
b. Failure rates
c. Reversibility (lack of)
Gynecologic Oncology I, II (given in two parts)
1. Gestational trophoblastc disease
a. List the symptoms and physical findings of a patient with gestational
b. Describe the diagnostic methods utilized for a patient with gestational
2. Cervical cancer
a. Describe the pathogenesis of cervical cancer
b. Identify the risk factors for cervical neoplasia and cancer
c. Describe the appropriate utilization of new technologies for evaluating
d. Describe the initial management of a patient with an abnormal Pap smear
e. List the risk factors for endometrial carcinoma
3. Endometrial cancer
a. Describe the symptoms and physical findings of a patient with endometrial
b. Outline the appropriate management of the patient with postmenopausal
bleeding. Discuss the use of diagnostic methods for a patient with
4. Ovarian cancer
a. Outline the approach to a patient with an adnexal mass
b. Describe the symptoms and physical findings of a patient with ovarian
c. List the risk factors for ovarian cancer
d. Describe the histological classification of ovarian neoplasm
e. Counsel a woman with risk for ovarian cancer