MD Courses — Obstetrics and Gynecology

First year

As a component of the course in Clinical Medicine offered by the Department of Medicine, the student is introduced to the essentials in the medical history and examination for the gynecological evaluation of the adult woman patient.

Second year

Second-year students are introduced to obstetrics and gynecology with lectures in reproductive biology that apply and expand upon pelvic anatomy and gynecologic and obstetric physiologic principles taught in the first year.

M45 635B OBSTETRICS AND GYNECOLOGY
Instructor:  Kenan R. Omurtag, MD, 314-286-1384
The obstetrical component of this course emphasizes the physiologic basis of normal pregnancy, parturition, labor and delivery, and adaptations of other organ systems to pregnancy. Pathophysiology of pregnancy, pregnancy complications and deviations from normal labor will also be introduced. The gynecologic component of the course reviews embryology and genetics of practical use for clinicians. This provides a foundation to overview adolescent gynecology, amenorrhea, abnormal uterine bleeding, reproductive endocrinology, infertility, menopause, surgical anatomy, and diagnosis and treatment of gynecologic neoplasm.

Third year

M45 730 OB/GYN CLERKSHIP
Clerkship Director: Tammy Sonn, MD
Clerkship Coordinator: Trish Werner, 314-362-3126
All third-year medical students participate in a six-week clinical clerkship in Obstetrics and Gynecology. This is divided into three two-week components of outpatient OB/GYN, inpatient obstetrics and inpatient gynecology. Comprehensive study of the reproductive health needs of women in both the office setting and the surgical setting is the focus of the curriculum. Students are actively involved in all settings of health care delivery: outpatient faculty clinics within all specialties, resident ambulatory clinics, operating rooms for all obstetric or gynecologic cases, inpatient floors of L&D and Gynecology, and the emergency department/hospital inpatient consults. Faculty, fellows, residents, and nurse practitioners provide teaching for this rotation. Student-directed didactics include the faculty and chief resident lecture series, procedural skill station session and faculty-assigned preceptor groups that meet throughout their six-week rotation.

Fourth year

Fourth-year students wishing to take an externship or research elective can choose from a variety of courses.

Electives

M45 804 / OB/GYN OUTPATIENT CARE SUBINTERNSHIP
Instructor(s): Laura A. Parks, MD, parksla@wudosis.wustl.edu, 314-362-1016
Location: Room 308, Maternity Hospital, Barnes-Jewish Hospital, South Campus
Elective Contact: Casey Lindemann, 314-362-4591

Other Information: Students should contact Casey Lindemann one to two weeks before rotation for instructions of start time/location for first day of elective.
Enrollment limit per period: 2
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This experience is designed to primarily acquaint the student with the diagnosis and care of outpatients. Students will work one-on-one with attending staff, to focus on an overview of evaluation, diagnosis, and treatment of common obstetric and gynecologic concerns. The sub-intern will spend one to three half days weekly participating in outpatient surgery under the supervision of attendings and house staff, and five to six additional half days in clinic and private offices. Overnight OB call will be selected over a weekend to acquaint the student with the house staff and hospital, providing opportunity to participate in deliveries.  A 30-45 minute presentation to attendings and house staff will culminate the rotation on a selected OB GYN topic.

Student time distribution: Outpatient 100%; Primary Care 100%
Major teaching responsibility: Attending staff
Patients seen/weekly: 5-20/day
On call/weekend responsibility: See above description

M45 810 / OB/GYN ENDOCRINOLOGY-INFERTILITY SUB-INTERNSHIP
Instructor(s): Randall Odem, MD; Kenan Omurtag, MD; Emily Jungheim, MD; Sarah Keller, MD; Kelle Moley, MD;  and Valerie Ratts, MD; 314-286-2419
Location: 4444 Forest Park Avenue, Suite 3100
Elective Contact: Sarah Keller, MD, kellers@wudosis.wustl.edu

Other Information: Students report to Dr. Keller first day of elective. Please email Dr. Keller the prior week.
Enrollment limit per period: 1 (will consider two students if faculty presence allows)
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

The sub-intern will participate (in the office and hospital) in the study and treatment of women with reproductive endocrine disorders and infertility. The student will attend and present in conferences, attend surgery, observe assisted reproductive technology procedures, have assigned reading and be an integral part of the reproductive endocrine service. Opportunities for clinical research projects in reproductive endocrinology are also available.

Student time distribution: Inpatient 10%; Outpatient 75%; Conferences/ Lectures 15%; Primary Care 10%; Subspecialty Care 90%
Major teaching responsibility: Attendings, fellows, and resident
Patients seen/weekly: 75
On call/weekend responsibility: None

M45 830 / GYN ONCOLOGY SUB-INTERNSHIP
Instructor(s): David Mutch, MD, 314-362-3181
Location: Maternity Hospital, Barnes-Jewish Hospital, South Campus
Elective Contact: David Mutch, MD, 314-362-3181, Dana Schenck, 314-362-3218

Other Information: Students report to 17300 Conference Room, 6 a.m. first day of elective to round with the Fellows.
Enrollment limit per period: 2
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37 and 41.

The sub-intern will take part in the work-up of tumor patients prior to surgery and/or radiotherapy, assist in pelvic operations, help render perioperative care, and review pathology specimens and slides. The student will participate in GYN Tumor Clinic sessions, make hospital rounds with house staff, accompany chief residents on consultations, and attend OB/GYN conferences. Opportunities for clinical or basic research project in gynecologic malignancy are also available.

Student time distribution: Inpatient 70%; Outpatient 20%; Conferences/ Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Attendings, fellows, and residents
Patients seen/weekly: 40
On call/weekend responsibility: Weekend rounds

M45 833 / SPECIAL TOPICS IN REPRODUCTIVE HEALTH
Instructor(s): David Eisenberg, MD, MPH
Location: Dept of OB/GYN, Maternity Building, 3rd floor
Elective Contact: David Eisenberg, MD, MPH, 314-362-3751

Other Information: Students should contact Dr. Eisenberg (eisenbergd@wudosis.wustl.edu) and Michele Curran (curranm@wudosis.wustl.edu), who will coordinate scheduling at least two weeks prior to the beginning of the rotation.
Enrollment limit per period: 1
Valid start weeks for four-week blocks are: Weeks 17, 21, 29, 33, 37, and 41.

Students will attend a variety of outpatient clinics to interact with patients seeking different reproductive health services. These clinics include family planning and abortion services at Planned Parenthood of the St. Louis Region, the St. Louis County STD clinic, Adolescent and Pediatric Gynecology, Child Sexual Abuse, Teen OB, The SPOT, Ultrasound and Prenatal Diagnosis, and Gynecology clinics. Clinical experiences will be ambulatory. Conferences include Obstetrics and Gynecology Grand Rounds every Wednesday at 7 am, Family Planning service meetings, and monthly Journal Club. Reading will include relevant articles and chapters. Students will be responsible for a brief (15-20 minute) presentation on a reproductive health topic at the conclusion of the course. Opportunities for clinical research in contraception are also available.

Student time distribution: Outpatient 100%; Primary Care 30%; Subspecialty Care 70%
Major teaching responsibility: Attendings and Nurse Practitioners when at Planned Parenthood
Patients seen/weekly: Varies
On call/weekend responsibility: None.

NOTE: It is important that students have access to a car for portions of this rotation as some of the clinical locations are best reached by car.

M45 843 / MATERNAL-FETAL MEDICINE OUTPATIENT CARE SUB-INTERSHIP
Instructor(s): Roxane Rampersad, MD, 314-747-0739
Location: 5th Floor, Center for Advanced Medicine, Ob/Gyn office
Elective Contact: Roxane Rampersad, MD, 314-747-0739

Other Information: Students report to the 5th Floor, Center for Advanced Medicine, Ob/Gyn office, 8:00 a.m. first day of elective.
Enrollment limit per period: 1
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

Students will see a variety of high risk obstetrical patients in the outpatient setting in the Center for Advanced Medicine and the Center for Outpatient Health. The student will evaluate various types of reproductive age patients with medical or obstetrical complications, including preconception consultations, prenatal care consultations and initial prenatal visits. The student will also see return patients to experience the continuity of prenatal care. Students will participate in antenatal testing and learn basic ultrasonography skills. The student will be responsible for one presentation to be given to the OB teams at the end of the rotation. Students are provided independent study time to put together the presentation which should be in power point and on a topic of their choice, inspired by a patient-related clinical conditioned that peaked their interest during the block. In addition, the student will have the option to take overnight call, or call in the Pregnancy Assessment Center in order to gain more hands-on experience with in-patient obstetrics. This is voluntary and not a requisite.

Student time distribution: Inpatient 5%; Outpatient 85%; Conferences/ Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Maternal-Fetal Medicine Attendings and fellows
Patients seen/weekly: 40
On call/weekend responsibility: None

M45 844 / MATERNAL-FETAL MEDICINE INPATIENT (ANTEPARTUM) SUB-INTERNSHIP
Instructor(s): D. Michael Nelson, MD, 314-747-0738
Location: Maternity Hospital, Barnes- Jewish Hospital, South Campus
Elective Contact: D. Michael Nelson, MD, 314-747-0738, Shannon Johme, 314-362-8895

Other Information: Students report to Antepartum Service (ward 5300), 7:30 a.m. first Monday of elective. If the first day is a holiday, email Dr. Nelson prior to start date for instructions.
Enrollment limit per period: 1 (unless cleared by Course Master)
Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

Sub-interns will participate in the antepartum and intrapartum management of high-risk hospitalized patients. There is limited interaction with outpatients through the High-Risk Obstetrics Clinics and the Center for Diabetes in Pregnancy. Examples include diabetes, hypertension, renal disease, hematologic abnormalities, preterm labor, and others. Antepartum evaluation and monitoring of the pregnant woman and her fetus are emphasized. Supervision is by the antepartum chief resident and a maternal-fetal medicine faculty member and fellow. An opportunity for intense labor and delivery experience with the Night Team is also encouraged. Students will spend time observing diagnostic obstetric ultrasound examinations. The student will prepare a brief talk on a topic of his/her interest during the course of the rotation.

Student time distribution: Inpatient 80%; Outpatient 15%; Conferences/ Lectures 5%; Subspecialty Care 100%
Major teaching responsibility: Attendings and residents
Patients seen/weekly: Inpatient: 20; Outpatient: 5
On call/weekend responsibility: Overnight/weekend call optional (student self-scheduled)

M45 856 / OB/GYN ULTRASOUND – GENETICS
Instructor(s): Jeffrey Dicke, MD, 314-454-8135
Location: The Women’s Health Center, 5th floor, Center for Advanced Medicine and The Center for Women’s Wellness, 4th floor, Building D, Missouri Baptist Medical Center
Elective Contact: Jeffrey Dicke, MD, 314-454-8135, Shannon Johme, 314-362-8895

Other Information: Students should contact Dr. Dicke one week prior to first day of elective.
Enrollment limit per period: 1 (will consider two students if faculty presence allows)
Valid start weeks for two-week blocks are: Weeks 1, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33, 35, 37, 39, 41, and 43.

Working with the attending physicians in the Ultrasound Units at the Center for Advanced Medicine and the Center for Women’s Wellness at Missouri Baptist Medical Center, the student will learn the principles and techniques of non-invasive screening for fetal disorders and observe the performance of invasive prenatal diagnostic procedures. The student will also learn the standards and guidelines for performance of the antepartum obstetrical ultrasound examination and female pelvic examination. Normal and abnormal fetal and gynecologic anatomy will be reviewed. Experience will be gained in pedigree analysis and familial risk factor assessment by working with genetic counselors. One day is spent in the Cytogenetics Laboratory observing the preparation of prenatal specimens for karyotype analysis. Opportunities for participation in clinical research are also available.

Student time distribution: Outpatient 90%; Conferences/Lectures 10%; Primary Care 30%; Subspecialty Care 70%
Major teaching responsibility: The attendings of the ultrasound section
Patients seen/weekly: 40
On call/weekend responsibility: None

M45 861 / GYN FEMALE PELVIC MEDICINE & RECONSTRUCTIVE SURGERY (UROGYNECOLOGY) SUB-INTERNSHIP
Instructor(s): Chiara Ghetti, MD, and Jerry Lowder, MD, 314-747-1402
Location: Maternity Hospital,
Barnes-Jewish Hospital, South Campus
Elective Contact: Chiara Ghetti, MD, and Jerry Lowder, MD, 314-747-1402

Other Information: Students report to Drs. Ghetti or Lowder, Center for Advanced Medicine, 13th Floor, Suite C at 8:00 a.m. first day of elective.
Enrollment limit per period: 1
Valid start weeks for four-week blocks are:  Weeks 1, 5 and 9.

The sub-intern will take part in the office evaluation of patients (with pelvic floor disorders including pelvic organ prolapse, urinary incontinence, fecal incontinence, birth injuries), assist in pelvic floor reconstructive surgical procedures, and participate in perioperative care. The Sub-I will participate in office sessions, surgical cases and will be responsible for rounding with the Urogynecology resident on service as well as participating in consultations. The Sub-I will attend FPMRS didactic educational sessions and OB-GYN conferences. The Sub-I will be required to do a 45 minute presentation on an urogynecologic topic of choice by the end of the rotation. Opportunities for clinical research projects in Urogynecology are also available.

Student time distribution: Outpatient 50-60%; Inpatient 20-30%; Conferences/ Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Attendings and Residents
Patients seen/weekly: 30
On call/weekend responsibility: Weekend rounds may be necessary.

M10 823 / OBSTETRICAL ANESTHESIA
Instructor(s): Swarup Varaday, MD, 314-362-6252
Location: Barnes-Jewish Hospital, South Campus
Elective Contact: Swarup Varaday, MD, 314-362-2628
Other Information: Students should report to 5400 Labor and Delivery, 7:00 a.m. first day of elective.

Enrollment limit per period: 1
Valid start weeks for two- or four-week blocks are: Weeks 1, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33, 35, 37, 39, 41, and 43.

The medical students will learn the different analgesia/anesthetic options for the labor patient. They will also learn how the physiological adaptations of pregnancy influence anesthetic management. They will be actively involved in the parturient’s management, i.e., starting an IV, placement of spinal, epidural or CSE (combined spinal epidural) anesthetics. They will also attend the OB anesthesia conferences and interview patients in labor (with an OB anesthesia attending).

Student time distribution: Inpatient 90%; Conferences/Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Attending, Senior Resident
Patients seen/weekly: 20
On call/weekend responsibility: None (optional)