The Ob‐Gyn & Women's Health Selective Pathway for Senior Medical Students: The Clinical Pelvic Anatomy Laboratory Course

Abstract

The Ob‐Gyn residency trains physicians to care for women with reproductive tract disorders & pregnancy complications. There is concern that beginning residents may be inadequately prepared for the surgical & medical aspects of the residency. To meet this challenge, CalMed‐SOM, an LCME applicant medical school with an active learning curriculum, has designed a 4th year Ob‐Gyn & Women's Health Selective Pathway for students planning to apply for an Ob‐Gyn residency comprised of 4 integrated courses: Clinical Pelvic Anatomy Laboratory (4 wks.); Ob‐Gyn Surgical Pathology (4 wks.); Diagnostic Imaging (4 wks.); Ob‐Gyn Sub‐Internship (8 wks.).ObjectiveTo describe one component of this pathway, the Clinical Pelvic Anatomy Laboratory (CPAL) course, which allows students to acquire clinically relevant anatomic knowledge of the female pelvis, perineum & abdominal wall, as well as basic procedural knowledge & skills needed to start an Ob‐Gyn residency.MethodsFaculty in Ob‐Gyn, Anatomy, & Medical Education established goals for the knowledge, skills, & attitudes desired of a beginning Ob‐Gyn resident as well as the content & pedagogies in the CPAL course based on: 1) specialty specific learning objectives (e.g. the ACOG surgical curriculum in Ob‐Gyn & the Association of Professors of Gynecology & Obstetrics Medical Student Educational Objectives; 2) broader learning outcomes (e.g. the AAMC's Core Entrustable Professional Competencies & CalMed‐SOM core competencies); 3) our collective experience educating medical students & residents.ResultsThe CPAL course will be delivered by an interdisciplinary team including an Ob‐Gyn & anatomist using cadavers, trainers, simulation & standardized patients. Formative & summative assessments have been developed to determine students' proficiency levels in the desired competencies. Curriculum mapping ensures content integration across the curriculum. Learning outcomes/competencies include: Demonstrate correct use of universal precautions & aseptic technique including surgical scrubbing, gowning & gloving. Identify & demonstrate appropriate use of surgical instruments & skill in knot tying & suturing. Use correct clinical‐anatomical nomenclature to identify female reproductive anatomy when performing a pelvic exam & in a simulated surgical experience (e.g. identifying supporting structures, surgical anatomic landmarks & common sites of injury to the bladder, ureter & blood vessels). Identify the layers of the abdominal wall & explain the steps involved in performing different abdominal wall incisions. Demonstrate in a simulated environment the steps of (a) uterine aspiration, endometrial biopsy & intrauterine device placement & (b) laparoscopic tubal ligation & salpingectomy. Demonstrate an understanding of the indications, contraindications, risks & benefits of the above procedures using informed consent. ConclusionsThe CPAL course, a key component of our 4th year pathway in Ob‐Gyn & Women's Health, has been designed to meet the aspiring Ob‐Gyn's need for a surgical curriculum that fulfills general & specialty specific competencies.