· Pre Menstrual Syndrome (PMS):
Can diagnose PMS
Describes management principles
Counsels such a patient
· Menopause and HRT:
Describes symptomatology of menopause
Can diagnose cause by relevant investigation
Describe management plan of individual case
UROGYNAECOLOGY AND PELVIC FLOOR
Learning Outcomes
Understand and demonstrate adequate knowledge, skills, and attitudes in
relation to Urogynaecology and pelvic floor disorders
· Genital fistula:
Describes causes and types
Diagnoses and describes outline of management
· Urinary stress incontinence:
Enumerates types
Can describe outline of management of urethral sphincter incontinence, and Detrusor instability
· Uterovaginal prolapse:
Enumerates types of prolapse
Describes management
· Urinary tract infections:
Enumerates causes
Discusses drug treatment
GYNAECOLOGIC ONCOLOGY
Learning Outcomes
Understand and demonstrate adequate knowledge, skills, and attitudes in relation to Gynaecologic cancers and precancerous conditions
· Preinvasive disease CIN, VIN, VAIN:
Describe types of pre invasive disease
Describe principles of management
· Screening for Gynaecological cancer:
Enumerate principles of screening and tumour markers
· Ovarian Cancer:
Diagnose cancer of Ovary
Describe principles of management
· Endometrial cancer:
Diagnose cancer of endometrium
Describe principles of management
· Cervical cancer:
Discuss prevention by cervical cancer vaccination
Diagnose cancer of Cervix
Describe principles of management
· Vulval cancer:
Diagnose cancer of Vulva
Describe principles of management
· Gestational Trophoblastic Neoplasia (GTN):
Diagnose Hydatidiform Mole and Choriocarcinoma
Describe principles of management
· Basic principles of Chemotherapy and Radiotherapy:
Select chemotherapeutic drugs and common side effects
Describe principles of radiotherapy and its complications
· Care of terminal Gynaecological cancer patient
Describe outline of care of a terminal cancer patient
OPERATIVE GYNAECOLOGY
Learning Outcome
Understand and demonstrate adequate knowledge in relation to common Gynaecological operations and instruments
Pre-operative evaluation:
Describes principles of pre-op preparation
Post-operative care:
Discusses complications and their management
Basic principles of D and C, D and E, Myomectomy, Hysterectomy, Diagnostic Laparoscopy and Hysteroscopy
REPRODUCTIVE HEALTH
Learning outcomes
Understand and demonstrate adequate knowledge, skills, and attitudes in
relation to concepts in Reproductive Health
· Vaginal discharge:
Enumerates causes and types of vaginal discharge
Discusses management options
· HIV/AIDS:
Describes management plan
Discusses precautions of staff members
Discusses prevention
· Sexually Transmitted Infections (STI):
Enumerates causes and types of STI
Discusses management options
· Contraception and Sterilization:
Discusses CPR (contraceptive prevalence rate) and its causes in Pakistan
Discusses types and side effects of various contraceptives
Discuss efficacy and compliance of various methods
· Psychosexual disorders:
Describe types of such disorders
Describe management plans
· Women‟s Rights to Reproductive Health:
Describe types of Women‟s rights, and role of doctors in their protection, promotion, and advancement
ANTENATAL CARE, NORMAL AND HIGH RISK PREGNANCY
Course Objectives:
The student should be able to demonstrate adequate knowledge, skills and attitudes in relation to antenatal care in low risk pregnancy and to recognize high risk pregnancy and manage/refer appropriately.
Course Outline:
· Book patient for confinement
· Provide antenatal care specific to the expectant mother and plan frequency of visits.
· Screen appropriately for:
Anaemia, Diabetes mellitus, pre-eclampsia
Foetal growth and placement etc. by ultrasound and its significance:
Anomaly scan at 16 18 weeks,
Second ultrasound at 28 weeks (Optional)
Ultrasound at 32 34 weeks (fetal growth etc.)
Manage minor disorders of pregnancy, including vaginal discharge during pregnancy.
Provide essential drugs with proper dosage
Prescribe safely in pregnancy for common ailments
Must be familiar with immunizations protocol during antenatal care
Screen patients for common conditions, prevalent in the population e.g.
Hepatitis B, C, HIV, Rubella and syphilis, TORCH profile (where
indicated)
Identify high risk pregnancy and its significance
Mange/ Refer appropriately and follow up as required
Understand multi-disciplinary approach for high risk pregnancy
Should be able to provide effective communication and Counseling skills
Counsel regarding labour, newborn and lactation
ABNORMAL PREGNANCY
Course Objective:
Demonstrate an understand of the etiology, risk factors for complication and
management of the major antenatal complications of pregnancy.
Course Outline:
Bleeding in early pregnancy
Abortion
Ectopic pregnancy
Gestational trophoblastic disease
Bleeding in 2nd half of pregnancy (Ante partum haemorrhage)
Placenta previa
Abruption placentae
Vasa previa and incidental causes
Polyhydramnios/oligohydramnios
Intra uterine fetal death
Mal-presentation and position
Breech presentation
Transverse lie and shoulder presentation
Face presentation
Brow presentation
Cord prolapse
Preterm labour/PROM
Prolonged Pregnancy
Intra Uterine growth restriction
Multiple pregnancy
Congenital anomalies
MEDICAL DISORDER(S) IN PREGNANCY
Course Objectives:
Should be able to identify the medical disorder diagnose and manage.
Anemia in pregnancy
Pyrexia in pregnancy
Misc. conditions e.g. UTI., Respiratory infections, allergic conditions
Identify and diagnose the condition, evaluate the severity of the medical disorders, provide initial treatment and refer to proper health care facility.
Pregnancy with hypertensive disorders
Pregnancy with cardiac disease
Pregnancy with diabetes mellitus
Pregnancy with jaundice / hepatitis
Pregnancy with renal problems
Deep vein thrombosis
Endocrine disorder / autoimmune disorders
Course Outline:
Anaemia in Pregnancy
History taking and clinical examination to identify cause and severity
Order appropriate investigation to reach the diagnoses
Treat anemia according to type, severity and gestational age
Must know the modes of treatment available, dosages, routes and side effects
Know the principles of blood transfusions & risks
Pyrexia in Pregnancy
Differential diagnose of the causes of pyrexia in pregnancy
Appropriate investigation to reach a diagnosis
Provide treatment general and specific according to cause
Take opinion of specialist when required
Safety of antibiotics/drugs with regard to fetus should be known.
Pregnancy with hypertensive disorders
Should be able to carry out differential diagnosis, assessment of severity and complications maternal & fetal
Order relevant investigation
Carry out initial management according to severity. Current drugs and doses should be known
Referral for specialized care as required
Pregnancy with cardiac disease
Recognition of complications of this condition in pregnancy
Management with help of specialized case
Pregnancy with diabetes
Should know screening/diagnostic tests for diabetes
Should be aware of maternal/fetal complication
Basic management should be known
Principles of delivery time/mode and neonatal care
Pregnancy with jaundice/hepatitis
Should be aware of screening tests for hepatitis and basic management
Renal problems in pregnancy
Awareness of changes in urinary tract physiology and its effect on renal function tests
Refer for specialized care
Deep vein thrombosis
Should be able to diagnose, order relevant investigation and refer for specialized care
Endocrine / autoimmune disorders
Recognition of these, diagnoses and referral for specialized care.
BASIC CLINICAL SKILLS IN OBSTETRICS
Course Objectives:
Understand and demonstrate adequate knowledge, skills and attitudes in relation to history taking, clinical examination, investigation and communication in obstetrics
Course Outline:
Eliciting history from obstetric patient
Performing through clinical general examination
Performing abdominal examination of pregnant lady
Order appropriate investigations and knows interpretations
Learning effective verbal and non-verbal communication skills
Provide treatment / counseling as appropriate to the condition
ANATOMY OF FOETAL SKULL AND MATERNAL BONY PELVIS
Course Objective/ specific learning objective
Should know and is able to demonstrate;
The anatomy of fetal skull and maternal bony pelvis
Identify abnormalities of maternal pelvis and the significances in relation to labor complication
Learning on the dummy and bony pelvis
PHYSIOLOGY OF PREGNANCY
Course Objectives:
Understand and demonstrate adequate knowledge, skills and attitudes in relation to physiology of pregnancy
Course Outline:
Diagnosis of pregnancy
Conception, implantation, development of placenta, fetal circulation and abnormalities of placenta
Physiological changes associated with pregnancy
NORMAL LABOUR
Course Objectives:
To understand and demonstrate appropriate knowledge, skills and attitudes in relation to labor
Course Outline:
Normal labour
Physiology
Mechanism
Diagnosis
Management of labour
Understanding and use of partogram
Intra partum fetal monitoring
Fetal heart rate monitoring and CTG interpretation
Methods of induction and augmentation of labour
Indications
Contraindications
Complications
Analgesia and anaesthesia in labour
Management of 3rd stage of labor prevention of PPH
ABNORMAL LABOR
Course Objectives:
To understand and demonstrate appropriate knowledge, skills and attitudes in relation to abnormal labour
Course Outline:
Prolonged labor/obstructed labour/ruptured uterus
Diagnosis, causes and management
Complication of III stage of labour. Diagnoses, causes and management
Primary PPH and inversion of uterus
Obstetrical shock
Operative delivery. Prerequisites, indications and complications
Episiotomy
Instrumental vaginal delivery (forceps and ventouse)
Cesarean section
PUERPERIUM AND LACTATION
Course Objectives:
Should be able to understand normal and abnormal puerperium and lactation management
Course Outline:
Physiological changes in normal puerperium
Puerperal pyrexia
Puerperal psychosis
Breasts disorder and lactation management
Contraception different methods, appropriate in the postpartum period
NEW BORN CARE (INTEGRATED WITH PAEDIATRICS)
Course Objectives:
Demonstrate an understanding of essential newborn care and is able to diagnose and manage common neonatal problems
Course Outline:
Newborn examination & Essential newborn care.
Basic resuscitation & Apgar score.
Common neonatal problems.
Breast feeding and its importance.
SAFE MOTHERHOOD
Course Objectives:
Should be able to understand the concept of safe motherhood and implement it at the community level
Act as a leader at primary health care facility utilizing local resources and personnel
Be able to provide emergency obstetric services
Organize health care teams, incorporating LHV, LHW and midwives of the area.
Act as a liaison officer in referral of patients to secondary and tertiary health care facility
Should understand the definition and causes of MMR & PNMR
Should organize seminars and workshops for health care workers as preventive strategies to reduce MMR and PNMR in the local population
SITES OF LEARNING: Antenatal clinics, outpatient departments, labour wards, maternity wards, postnatal wards and others.
INSTRUCTIONAL STRATEGY: as per section 5.11
ASSESSMENT: As per Section 5.12 Individual universities and institutions
have the flexibility to exercise their modes of assessment within guidelines from PMDC / HEC.
Regular end ward rotation assessment with Formative feedback
Professional university examinations