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481 GYN           Obstetrics & Gynaecology

 

11 (4+7)

 

Theoretical:                  

Tutorials & Practicals:    

 

 

 

Summary of Course Contents

Students spend 12 weeks in the department. This constitutes their entire obstetrics training. Due to the cycle system, every batch may do obstetrics straight after finishing Level 12 or after rotating through other cycles e.g. medicine, surgery, etc. Students, however, have been given courses in medicine and surgery during or before Level 12 and, therefore, they should have the background in clinical practice. During these 12 weeks, it is impossible to cover all topics in details. Emphasis is put on graduating general physicians who have enough basic knowledge in obstetrics.

The following is a concise outlook at the curriculum.

1.       Course Objectives

1.1     General Objectives

·         To graduate a physician who:

·         To make students aware of the personal qualities and attitudes required by a physician caring for women.

·         To help  students acquire adequate basic knowledge and skills in obstetrics which enable him/her to proceed into subsequent general practice, specialty training or research activities.

1.2     Specific Objectives

At the end of the course the student is expected to:

·         Perform, record, and interpret a full obstetrics and gynaecology history.

·         Carry out, record, and interpret a complete physical examination in all obstetrics and gynaecology groups.

·         Identify and solve common clinical problems in obstetrics and gynaecology by providing a provisional diagnosis and appropriate differential diagnosis.

·         Recognize urgent and emergency situations in obstetrics and gynaecology and be able to outline an appropriate plan of action.

·         Outline a general plan of investigations and management of common obstetrics and gynaecology problems as they relate to Saudi Arabia.

·         Demonstrate an understanding of how to use the laboratory to reach a diagnosis of common obstetrics and gynaecology problems.

·         Demonstrate knowledge of community problems related to woman's health.

·         Demonstrate knowledge of preventive aspects of woman's health problems and how to implement them.

·         Recognize her limitations concerning management of obstetrics and gynaecology patients and the need to consult and cooperate with others to provide optimum care.

·         Interact with women or relatives in a gentle, emphatic and appropriate manner.

2.       Instructional strategies

2.1     Didactic teaching: Lectures, tutorials and seminars

Series of lectures, tutorials and seminars covering selected topics in obstetrics and gynaecology will be delivered to all students together at the beginning of the course.

 2.1.1 Obstetrics

Anatomy of female pelvis and foetal skull.           

Anatomy of female genital organs and pelvic floor.

Fertilization, Implantation, Embryology of female genital tract, foetal circulation.

Physiology - Normal menstrual cycle ovulation.

Physiology - Changes in pregnancy, haematological, bio-chemical  Physiology –

Changes in pregnancy, genito - uri­nary, endocrine.

First stage of labour - Active.

Second stage of labour - Management.

Third stage of labour - Pain relief in Obstetrics.

Puerperium and lactation; breast changes, complications.

Placenta and its functions; placental abnormalities; umbilical cord; amniotic fluid.

Placental hormones and functions, placental insufficiency and placental function tests; I.U.F.G.R.

Antenatal care; lie; presentation position.

Pregnancy diagnosis and differential diagnosis.

Foetal and maternal monitoring in pregnancy and labour.

High-risk pregnancy - Identification and follow-up. Grand multipara.

Bleeding in early pregnancy.

Bleeding in late pregnancy.

Postpartum collapse and uterine rupture.

Coagulopathy in OB/GYN.

Anemias in pregnancy.

Haemolytic disease of the newborn blood groups and Rh-factors.

Heart and Respiratory disease in pregnancy.

Diabetes in pregnancy.

Drugs in pregnancy and teratogenic effects.

Hypertensive disorders in pregnancy.

Endotoxic shock and renal failure.

ABU and UTI in pregnancy.

Congenital anomaly and A/N diagnosis.

Fertility control-hormonal and barrier methods.

Haemoglobinopathies.

Abnormal menstrual cycle - DUB.

Amenorrhoea; primary, secondary.

Male and female infertility; causes, investigation, manage­ment.

Vaginal flora, discharge; bacterial STD's.

Viral STD's.

2.1.2  Gynaecology

Physiology - changes in puberty.

Menopause and its problems.

Malignant tumors of vulva, vagina and uterus.

Abnormalities of the pelvic support.

Urinary and fecal incontinence.

Uterine fibroids; Adenomyosis.

Benign ovarian tumors.

Malignant ovarian tumors.

Trophoblastic disease.

CIN; cytology and colposcopy.

Malignant tumors of cervix.

Cytogenetics and gender diagnosis.

PID, acute and chronic.

2.1.3  Tutorials

Malpositions, abnormal presentation

Cephalo-pelvic disproportion, pelvimetry, trial of labour, abnormal labour.

Foetal distress, abnormal CTG, IUFGR.

Preterm labour, PROM, cervical incompetence.

Acute abdomen in OB/GYN.

Perinatal and maternal mortality.

2.2     Clinical teaching

2.2.1  Formal teaching

During the first week of clinical teaching, sessions are spent explaining obstetric history taking and physical examination of different systems. During the subsequent weeks, bedside teaching, clinic attendance and theater sessions are conducted by teaching staff each week. One of these is utilized as a supervised ward round on all t he patients followed by the students.

2.2.2  Ward, Labour Ward, Accident & Emergency and Ultrasound rotations

During rotations, students are divided into groups of 12-15 students each. They rotate through the gynae, postnatal and antenatal wards, Labour ward, Accident and Emergency and Ultrasound.

2.3     Attending the continuous medical education in the department.

3.       Evaluation of students

            During each rotation, medical students will be evaluated by:

3.1        Continuous assessment exam, which constitutes 40% of the total marks and consists of a:

Written exam (MCQs)

Clinical exam

Spot exam

3.2.       Final examination,  which makes 60% of the total marks and consists of a:

Written exam (MCQs)

Clinical exam

Spot exam

 

Recommended Books

1.         Obstetrics - Illustrated

            Garrey/Govan - Hodge - Callender

            Churchill Livingstone

            Third Edition

2.         Fundamentals of Obstetrics and Gynaecology

            Volume 2, Gynaecology

            Derek Llewellyn - Jones

            Elbs Fourth Edition

3.         Gynaecology - Illustrated

            A.D.T. Govan - Hodge - Callender

            Churchill Livingstone

            Third Edition

4.         Obstetrics by Ten Teachers

            Stanley G. Clayton

            T.L.T. Lewis and G.D. Pinker

            Arnold

            14th Edition                              

I.       Course 481

Obstetrics & Gynaecology during 1 Academic year, 3 (12/52) courses will be held,  one for female students and 2 for male students. In addition, a Summer Course of 8 weeks will be run for those who have failed during the previous year.

II.      Course Organization

            The integrated course will contain 50 Lectures, 6 Tutorials, Case Presentation,

            Grand Rounds and On-Calls (covering A&E and Labour Ward).

III.     Daily Activities

            These include Ward rounds with bedside teachings, clinics attendance and

            theater sessions.

IV.        Three sessions of training in instruments, obstetrics and gynaecological X-rays

            + USS and Museum specimens will be held.

V.       Tutorials

            Same as above.

In addition to the above activities students are required to keep log books containing his-her attendance and activities. It will also contains 3 written case histories and one long commentary.

V.       Examination

1.       Theoretical

Includes 2 examinations. Continuous written exam carrying 40 marks and Final written exam carrying 60 marks.

2.       Clinical

It also includes 2 exams, one ontinuous clinical and one Final clinical. It includes long case, short case and spot exam. The Marking System is as follows:

Continuous Clinical Exam Marks

Course 451

Short Case                                 15

Spot Exam                                 10

Tutorials                                    15

Course 452

Long case                                  40

            Final Clinical Exam

Course 451

Short Case                                 20

Spot exam                                 40

Course 452

Long case                                  60

 
 

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