Ward 18

AIMS AND OBJECTIVES OF THE MSN gynae

AIM:

The aim of four years MS programme in Obs/Gynae is to train residents to acquire the competency of a specialist in the field of Obs/Gynae so that they can become good teachers, researchers and clinicians in their specialty after completion of their training.

GENERAL OBJECTIVES:

1. To provide a broad experience in Obs/Gynae, including its interrelationship with other disciplines.
2. To enhance Obs/Gynae knowledge, skills, and competence in bedside diagnostic and therapeutic procedures.
3. To achieve the professional requirements, to prepare the consultants for the sub specialty in Obs/Gynae.
4. To cultivate the correct professional attitude and enhance communication skill towards patients, their families and other healthcare professionals.
5. To enhance sensitivity and responsiveness to community needs and the economics of health care delivery.
6. To enhance critical thinking, self-learning, and interest in research and development of patient service.
7. To cultivate the practice of evidence-based practice and critical appraisal skills.
8. To inculcate a commitment to continuous medical education and professional development.
9. To provide a broad trammg and in-depth experience at a level for trainees to acquire competence and professionalism of a specialist in Obs/Gynae especially in the diagnosis, investigation and treatment of obstetrical and gynaecological problems towards the delivery of holistic patient care.
10. To acquire competence in managing acute Obs/Gynae emergencies and identifying Obs/Gynae problems in patients referred by primary care and other doctors, and in selecting patients for timely referral to other specialty appropriate tertiary care or the expertise of another specialty.
11. To develop competence in the inpatient and outpatient management and in selecting patients for referral to tertiary care facilities and treatment modalities requiring high technology and/or the expertise of another specialty.
12. To manage patients in general Obs/Gynae units in regional/District hospitals; to be a leader in the health care delivery team and to work closely with networking units which provide convalescence, rehabilitation and long-term care.
13. To encourage the development of skills in communication and collaboration with the community towards health care delivery.
14. To foster the development of skills in the critical appraisal of new methods of investigation and/or treatment.
15. To reinforce self-learning and commitment to continued updating in all aspects of Obs/Gynae.
16. To encourage contributions aiming at advancement of knowledge and innovation in Obs/Gynae through basic and/or clinical research and teaching of junior trainees and other health related professionals.
17. To acquire professional competence in training future trainees in Obs/Gynae at Nishtar Medical University.

SPECIFIC OBJECTIVES

1. OBS/GYNAE KNOWLEDGE
2. The development of a basic understanding of core Obs/Gynae concepts.
3. Etiology, clinical manifestation, disease course and prognosis, investigation and management of common Obs I
4. Gynae diseases.
5. Scientific basis and recent advances in diagnosis and management of complicated Obs/Gynae diseases.
6. Spectrum of clinical manifestations and interaction of multiple problems diseases in the same patient.
7. Psychological and social aspects of Obstetrical and gynaecological complications.
8. Effective use and interpretation of investigation and special diagnostic procedures.
9. Critical analysis of the efficacy, cost-effectiveness and cost-utility of treatment modalities.
10. Patient safety and risk management
11. Audit and quality assurance
12. Ethical principles and medico legal issues related to concerned specialty.
13. Updated knowledge on evidenced-based practice and its implications for diagnosis and treatment of patients.
14. Familiarity with different care approaches and types of sub specialties in Obs/Gynae, including urogynecology, fetal medicine, gynecological oncology and subfertility.
15. Knowledge on patient safety and clinical risk management.
16. Awareness and concern for the cost-effectiveness and risk-benefits of various advanced treatment modalities.
17. Familiarity with the concepts of administration and management of overall running of Obs/Gynae unit.

1. SKILLS
2. Ability to take a detailed history, gathers relevant data from patients, and assimilates the information to develop detailed management plan.
3. MS trainee are expected to effectively record an initial history and physical examination and follow-up notes. She should be capable to present case in an elaborative and comprehensive manner to her seniors on round and to guide their team members regarding case management.
4. Competence in eliciting abnormal physical signs and interpreting their significance.
5. Ability to select appropriate investigation and diagnostic procedures for confirmation of diagnosis and patient management.
6. Residents should be able to interpret all laboratory data relevant to basic antenatal care.
7. Basic understanding of routine baseline investigations for subfertility biochemistry, hormonal profile, pelvic ultrasound and semen analysis. In addition MS trainee should be capable of judicially advising all these laboratory investigations based on patient history and examination.
8. The Trainee should be capable enough to advise and interpret basics radiological investigations including trans abdominal ultrasound, trans vaginal ultrasound, CT and MRI.
9. The formulation of a differential diagnosis based on patient history and investigation and with up-to-date scientific evidence and the development of list of risk factors to make therapeutic decisions.
10. Assessing the risks, benefits, and costs of varying effective treatment options.
11. Residents must be able to perform competently all Obs/Gynae procedures and skills required in their allocated time interval during the training of Obs/Gynae. This includes efficiency in taking consent based on appropriate indications.
12. Residents should be instructed in additional procedural skills that will be determined by the training environment, trainees expectations and availability of skilled teaching faculty.
13. Skills in performing important bedside diagnostic and therapeutic procedures will be marked by supervisor or mentors as desired competency level achieved I not achieved by trainee. The required number of DOPS and MiniCEX during four year training will be enlisted in Log Book.
14. Ability to present clinical cases in ward rounds and teaching classes.
15. Good communication skills and interpersonal relationship with patients, families, colleagues, paramedics, nursing and allied health professionals.
16. Ability to mobilize appropriate resources for management of patients at different stages of Obs/Gynae illnesses, including critical care, consultation of Obs/Gynae specialties and other disciplines, ambulatory and rehabilitative services, and community resources.
17. Competence in the diagnosis and management of obstetrics emergencies particularly postpartum hemorrhage, eclampsia, septic induced abortion, ruptured ectopic and rupture uterus.
18. Competence in the diagnosis and management of benign and malignant gynecological tumor and treatment modalities available around vicinity.
19. Diagnostic skills to effectively manage complex cases with unusual presentations.
20. Ability to implement strategies to prevent antenatal complication and early detection of diseases.
21. Ability to understand and critically appraise published work and clinical research on disease presentations and treatment outcomes. Experience in basic and/or clinical research within the training programme should lead to publications and/or presentation in seminars or conferences.
22. Practice based learning with reference to research and scientific knowledge pertaining to their discipline through comprehensive training in Research Methodology.
23. Ability to recognize and appreciate the importance of cost-effectiveness of treatment modalities.
24. The identification of key information resources and the utilization of literature to expand one’s knowledge base and to search for answer to problems.
25. ATTITUDES
26. The well-being and restoration of health of patients must be the top priority .
27. Empathy and good rapport with patient and relatives are essential attributes.
28. An aspiration to be the team-leader in total patient care involving nursing and allied Obs/Gynae professionals should be developed.
29. The cost-effectiveness of various investigations and treatments in patient care should be recognized.
30. The privacy and confidentiality of patients and the sanctity of life must be respected.
31. The development of a functional understanding of informed consent, and the physician-patient relationship.
32. Ability to appreciate the importance of the effect of disease on the psychological aspects and socio-economic burden of individual.
33. Understand patients’ psycho-social needs and rights, as well as the professional ethics involved in patient management.
34. Willingness to keep up with advances in Obs/Gynae and concerned specialties.
35. Understand the need of timely referral of patients to the appropriate specialty.
36. Aspiration to be the team leader in patient care involving paramedics nursing and allied Obs/Gynae professionals.
37. The promotion of women health via awareness programmes regarding contraception immunizations, periodic health screening, and risk factor assessment and modification.
38. Recognition that teaching and research are important activities for the advancement of the profession.
39. OTHER REQUIRED CORE COMPETENCIES:
40. PATIENT CARE
    1. Residents are expected to provide patient care that is compassionate, appropriate and effective for the promotion of health, prevention of illness, treatment of disease and at the end of life.
    2. Gather accurate, essential information from all sources, including history, physical examinations, investigations, clinical record and diagnostic/therapeutic procedures.
    3. Make informed recommendations about preventive, diagnostic and therapeutic options and interventions based on clinical judgment, scientific evidence, and patient preference.
    4. Develop, negotiate and implement effective patient management plans and integration of patient care.
    5. Perform competently the diagnostic and therapeutic procedures considered essential to the practice of internal medicine.
41. INTERPERSONAL AND COMMUNICATION SKILLS
    1. Residents are expected to demonstrate interpersonal and communication skills that enable them to establish and maintain professional relationships with patients, families, and other members of health care teams.
    2. Provide effective and professional consultation to other physicians and health care professionals and sustain therapeutic and ethically sound professional relationships with patients, their families, and colleagues.
    3. Use effective listening, nonverbal, questioning, and narrative skills to communicate with patients and families. · Interact with consultants in a respectful, appropriate manner.
    4. Maintain comprehensive, timely, and legible Obs/Gynae records.
42. PROFESSIONALISM
    1. Residents are expected to demonstrate behaviors that reflect a commitment to continuous professional developmental, ethical practice, an understanding and sensitivity to diversity and a responsible attitude toward their patients, their profession, and society.
    2. Demonstrate respect, compassion, integrity, and altruism in relationships with patients, families, and colleagues.
    3. Demonstrate sensitivity and responsiveness to the gender, age, culture, religion, sexual preference, socioeconomic status, beliefs, behavior and disabilities of patients and professional colleagues.
    4. Adhere to principles of confidentiality, scientific/academic integrity, and informed consent.
    5. Recognize and identify deficiencies in peer performance.
    6. Understand and demonstrate the skill and art of end-of-life care.
43. PRACTICE-BASED LEARNING AND IMPROVEMENT
    1. Residents are expected to be able to use scientific evidence and methods to investigate, evaluate, and improve patient care practices.
    2. Identify areas for improvement and implement strategies to enhance knowledge, skills, attitudes and processes of care.
    3. Analyze and evaluate practice experiences and implement strategies to continually improve the quality of patient practice.
    4. Develop and maintain a willingness to learn from errors and use errors to improve the system or processes of care.
    5. Use information of technology or other available methodologies to access and manage information, support patient care decisions and enhance both patient and physician education.
44. SYSTEMS-BASED PRACTICE
    1. Residents are expected to demonstrate both an understanding of the contexts and systems in which health care is provided, and the ability to apply this knowledge to improve and optimize health care.
    2. Understands accesses and utilizes the resources, providers and systems necessary to provide optimal care.
    3. Understand the limitations and opportunities inherent in various practice types and delivery systems, and develop strategies to optimize care for the individual patient.
    4. Apply evidence-based, cost-conscious strategies to prevention, diagnosis, and disease management.
    5. Collaborate with other members of the health care team to assist patients in dealing effectively with complex systems and to improve systematic processes of care.