P. G. Curriculum

M.D. Obstetrics & GynaecologyIndex

 

1. Goals
2. Objectives
3. Syllabus
4. Teaching Program
5. Posting
6. Thesis
7. Assessment
8. Job Responsibilities
9. Suggested books
10. Model Test Papers 

 

Curriculum

M.D. Obstetrics & Gynaecology

 

• The infrastructure and faculty of the department of Obstetrics & Gynaecology will be as per MCI regulation.

 

1. Goal

The goal of MD course in Obstetrics & Gynaecology is to produce a competent Obstetrician & Gynecologist who:

•  Recognizes the health needs of adolescents, females in reproductive age group & post menopausal females & course out professional delegations in keeping with principles of National Health Policy and professional ethics.
•  Is competent to manage the pathological states related to reproductive system with knowledge of Anatomy, Physiology, Pharmacology & Pathophysiology.
•  Is aware of contemporary advances & developments in the field of maternal health & other related issues.
•  Is oriented to principles of research methodology.  Has acquired skills in educating medical and
•  paramedical professionals.

 

2. Objectives

•  Provide quality maternal care in the diagnosis and management of Antenatal, Intra-natal & Post natal period of normal and abnormal pregnancy.
•  Provide effective & adequate care to the obstetrical and early neonatal emergencies.
•  Provide counseling & knowledge regarding family planning methods & perform medical termination of pregnancy.
•  Organize & implement maternal components in the “National Health Programs”.  Develop adequate surgical skills to manage common Obstetrical & Gynaecological problems.
•  Medical genetics – Elementary genetics as applicable to obstetrics.
•   Normal & Abnormal pregnancy during Antenatal, Intra-natal & Post-natal. 
•  Gynaecological Endocrinology & Infertility knowledge.   Benign & malignant Gynaecological disorder. 
•  Operative procedures including Endoscopy (Diagnostic & therapeutic) & its related complications. 
•  Knowledge of interpretation of various laboratory investigations & other diagnostic modalities in Obstetrics & Gynaecology. 
•  Medical & Surgical problems and Anesthesiology related to Obstetrics & Gynaecology. 
•   Knowledge of essentials of Pediatric & Adolescent Gynaecology. 
•  Reproductive & Child Health, Family Welfare & Reproductive tract infections. 
•  STD & AIDS & Government of India perspective on women’s health related issues. 
•  Demonstrate skills in documentation of case details and of morbidity & mortality data relevant to the assigned situation. 
•  Knowledge of medico legal aspects in Obstetrics & Gynaecology. 
•  Be familiar with research methodologies & use of newer information technologies. 
•  Keep abreast with advances in the field of  Obstetrics & Gynaecology. 
•  Facilitate learning of medical / nursing students, para medical health workers as a teacher trainer. 
•  Demonstrate empathy & humane approach towards patients and their families. 
•  Function as a productive member of a team engaged in health care, research & education.  

 

3. Syllabus 

 

3.1. Theory

 Obstetrics

•  Gametogenesis fertilization, implantation and early development of embryo  Normal Labour
•  Anatomical and Physiological changes in female genital tract during pregnancy. 
•  Pharmacology of drugs used during pregnancy, Labour, Post-partum period.
•  Development of placenta.
•  Amniotic fluid.
•  Anatomy of fetus, fetal growth & development, fetal physiology & circulation.
•  Puerperium – Normal
•  Malpresentation & malposition of labour
•  Abnormal Puerperium
•  CPD & its management
•  Complications of 3^rd stage of labour
•  Hypertensive disorders in pregnancy
•  Antepartum Hemorrhage
•  PROM, Poly Hydramnios, Oligo Hydramnios
•  Obstetrical Hemorrhage (includes Antenatal & postpartum)
•  Hypertensive disorders of pregnancy
•  Medical disorders in pregnancy
•  Emergency Obstetric Care (Intensive Obstetrics)  Antepartum & intrapartum fetal monitoring. 

 Gynaecology

•  Normal and abnormal microbiology of genital tract & bacterial, viral & parasitic infections responsible 
•  for maternal fetal & Gynae disorders.
•  Endocrinology related to reproduction
•  Physiology of menstruation, ovulation, fertilization & menopause.
•  Methods of contraception.

 Fibroid uterus

•  Colposcopy & vaginal and cervical cytology
•  Endometrial Hyperphasia, DUB, Abnormal bleeding.
•  Endometriosis, Adenomyosis
• Endocrine  abnormalities,      Menstrual   abnormalities     Amenorrhoea, PCOD, 
•  Hirsutism,   Hyperprolactinemia,   Thyroid disorders.

 Laparoscopy & Hysteroscopy

•  Ca Cervix
•  Ca Endometrium
•  Carcinoma Ovary
•  Menopause
•  Genital Fistulae / Urinary Incontinence
•  Prolapse
•  Contraception / Family Planning  / Sterilization methods
•  Endometriosis, Adenomyosis
•  Infertility. 

 

 

3.2. Practical

 Obstetrics

•  Venepuncture
•  Amniotomy
•  Conduct of normal Vaginal delivery
•  Perineal infiltration & Pudendal block
•  Episiotomy
•  Ventouse delivery
•  Forceps  delivery
•  Management of Genital tract injuries
•  Exploration of Cervix
•  Lower Segment Caesarean Section
•  Manual Removal of Placenta
•  Breech vaginal delivery
•  External Cephalic Version
•  Delivery of twins
•  Management of shock
•  Management of Postpartum hemorrhage
•  Cervical Cerclage
•  Amnio infusion
•  Instillation  of extra amniotic & intra amniotic drugs
•  Non stress Test
•  Suction  Evacuation
•  Dilatation & Evacuation
•  Repair of complete perineal tear
•  Repair of cervical tear
•  Caesarean Hysterectomy
•  Internal iliac ligation
•  Uterine & Ovarian Artery ligation
•  Destructive operations
•  Reposition of inversion uterus
•  Amnio centesis

 Gynaecology

•  Pap  Smear
•  Wet smear examination
•  Post Coital Test
•  Endometrial Biopsy
•  Endometrial Aspiration
•  Dilatation and Curettage/Fractional Curettege / Polypectomy
•  Cervical Biopsy
•  Cryo / Electrocautery of Cervix
•  Hystero Salpingography
•  Diagnostic Laparoscopy & Hysteroscopy
•  Opening & closing of abdomen
•  Operations for utero vaginal prolapse
•  Operations for Ovarian tumors
•  Operations for Ectopic pregnancy
•  Vaginal hysterectomy
•  Abdominal Hysterectomy
•  Myomectomy
•  Colposcopy
•  Loop Electro Surgical Excision Procedure
•  Tuboplasties
•  Paracentesis
•  Culdocentesis
•  Endoscopic surgery (Operative Laparoscopy & Hysteroscopy)
•  Repair of genital fistulae
•  Operations for Urinaryincontinence
•  Radical operations for gynaecological malignancies
•  Vaginoplasty
•  Intrauterine insemination
•  Basic ultrasound / TVS
•  Hydrotubation
•  Vulval Biopsy
•  Incision & drainage

 Family Planning

•  Intra Uterine Contraception Device Insertion / removal
•  Female sterilization 
•  Post Partum & Interval
•  Open & Laparoscopic
•  MTP
•  Male Sterilization

 

 

4. Teaching Programme

4.1 General Principles

•  Acquisition of practical competencies being the keystone of postgraduate medical education, postgraduate training should be skills oriented.
•  Learning in postgraduate program is essentially self-directed and primarily emanating from clinical and academic work.  The formal sessions are meant to supplement this core effort.

 

4.2 Teaching Sessions: 

 Clinical case discussions:

•  PG Bed side
•  Teaching rounds
•  Seminars / Journal Club
•  Statistical meetings:  Weekly./ monthly
•  Mortality meetings
•  Interdepartmental Meetings : Pediatrics, Radiology
•  Others – Guest Lectures / Vertical Seminars / Central Stat Meets 

 

 

4.3 Teaching Schedule

The Suggested departmental schedule is as follows

 

1. Seminar / Symposium	Once a week
2. Journal Club	Once a week
3. PG Case discussion / Bed Side teaching	Once a week
4. Intradepartmental Statistical Meet (with all the staff, incharge, residents & faculty)	Once a month
5. Interdepartmental meet which includes meet with other specialties viz. Medicine, Pathology, Microbiology, Gastroenterology,  Anaesthesia.	Twice a month
6. Perinatology Meet with Pediatric department discussing any neonatal death in inborn babies and other topics of common interest	Once a month
7. Thesis meet to discuss thesis being done by the PG residents.	Once a week
8. Grand round of the wards	Twice a month
9. Interdepartmental Meet with the Radiology department.	Once a month
10. Central session (held in hospital auditorium regarding various topics like CPC, Guest	Once a week
11. Lectures, Student Seminars, Grand Round, Sessions on basic Sciences,
12. Biostatistics, Research Methodology, Teaching Methodology, Health Economics
13. Medical Ethics & Legal issues).

 

 

5. Postings

•  Emphasis should be self-directed learning, group discussions, case presentations & practical hands on learning.  
•  Student should be trained about proper history taking, clinical examination, advising relevant investigations, 
•  their Interpretations and instituting medical surgical management by posting the candidates in OPD, specialty 
•   clinics, wards, operation theatres, labour room, family planning clinics & other
• departments like neonatology, 
•   radiology, anesthesia.  The candidates must be trained to manage all emergency
• situations seen frequently.
•  Gynaecology Ward
•  Labour-room
•  Emergency
•  Family Planning
•  Gynaecology  Operation Theatre

 

6. Thesis 

6.1  Every candidate shall carry out work on an assigned research project under the guidance of a recognized Postgraduate Teacher, the project shall be written and submitted in the form of a thesis.

6.2  Every candidate shall submit thesis plan to the University within nine months from the date of admission.

6.3  Thesis shall be submitted to the University six moths before the commencement of theory examination 

i.e. for examination May/June session, 30th November of the preceding year of examination and for November/December session 31st May of the year of examination.

6.4 The student will identify a relevant research question; (ii) conduct a critical review of literature; (iii) formulate a hypothesis; (iv) determine the most suitable study design; (v) state the objectives of the study;  (vi) prepare a study protocol; (vii) undertake a study according to the protocol; (viii) analyze and interpret research data, and draw conclusions; (ix) write a research paper. 

 

 

7. ASSESSMENT

• All the PG residents are assessed daily for their academic activities and also periodically.

 

7.1. General Principles

•  The assessment is valid, objective, and reliable. 
•  It covers cognitive, psychomotor and affective domains. 
•  Formative, continuing and summative (final) assessment is also conducted.,   Thesis is also assessed separately.  

 

7.2. Formative Assessment

• The formative assessment is continuous as well as periodical. The former is be based on the feedback from the senior residents and the consultants concerned. Assessment is held periodically. Formative assessment will not count towards pass/fail at the end of the program, but will provide feedback to the candidate.

 

7.3. Internal Assessment

The performance of the Postgraduate student during the training period should be monitored throughout the course and duly recorded in the log books as evidence of the ability and daily work of the student. Marks should be allotted out of 100 as followed.

                          Sr. No.                      Items                                                         Marks

1. Personal Attributes                                          20
2. Clinical Work                                                    20
3. Academic activities                                          20
4. End of term theory examination                     20
5. End of term practical examination                 20         

 

1. Personal attributes:

Behavior and Emotional Stability: Dependable, disciplined, dedicated, stable in emergency situations, shows positive approach.

Motivation and Initiative: Takes on responsibility, innovative, enterprising, does not shirk duties or leave any work pending.

Honesty and Integrity: Truthful, admits mistakes, does not cook up information, has ethical conduct, exhibits good moral values, loyal to the institution.  

 Interpersonal Skills and Leadership Quality: Has compassionate attitude towards patients and attendants, gets on well with colleagues and paramedical staff, is respectful to seniors, has good communication skills. 

 

2. Clinical Work:

 Availability: Punctual, available continuously on duty, responds promptly on calls and takes proper permission for leave. 

 Diligence: Dedicated, hardworking, does not shirk duties, leaves no work pending, does not sit idle, competent in clinical case work up and management.

 Academic ability: Intelligent, shows sound knowledge and skills, participates adequately in academic activities, and performs well in oral presentation and departmental tests.  

 Clinical Performance: Proficient in clinical presentations and case discussion during rounds and OPD work up. Preparing Documents of the case history/examination and progress notes in the file (daily notes, round discussion, investigations and management) Skill of performing bed side procedures and handling emergencies.

 

3. Academic Activity: Performance during presentation at Journal club/ Seminar/ Case discussion/Stat meeting and other academic sessions. Proficiency in skills as mentioned in job responsibilities.  

 

4. End of term theory examination conducted at end of 1^st, 2^nd year and after 2 years 9 months

 

5. End of term practical/oral examinations after 2 years 9 months.

 

•   Marks for personal attributes and clinical work should be given annually by all the consultants under whom the resident was posted during the year. Average of the three years should be put as the final marks out of 20.
• Marks for academic activity should be given by the all consultants who have attended the session presented by the resident. 
•   The Internal assessment should be presented to the Board of examiners for due consideration at the time of Final Examinations.                     

7.4. Summative Assessment

•  Ratio of marks in theory and practicals will be equal. 
•  The pass percentage will be 50%. 
•  Candidate will have to pass theory and practical examinations separately.  

 

A. Theory examination (Total = 400 marks)

               Paper                                   Title                                                    Marks

Paper 1:  Basic sciences as related to Obstetrics &       

Gynaecology                                                              100

Paper 2:  Obstetrics including diseases of Neonates                100

Paper 3:  Principles and Practice of Gynaecology and

Gynaecological Pathology                                          100

Paper 4:  Recent Advances in Obstetrics & Gynaecology         100

          

B.  Practical & Viva voce examination (Total = 400 marks)                     

            

•                Long Case(s)                                                                                          
•             Short Case(s)
•                Viva                                                                                                                     

                                                                                                             

8. Job Responsibilities

 OPD : 

•  History & Work up of all cases and presentation to the consultants.
• This includes all the special clinics including infertility, endocrinology,     oncology, Menopause & adolescent clinic.  Documentation in OPD Card, register completion and maintenance.

  Minor Procedures

•   Aseptic Dressings / Stitch removal / Pap smear collection / Colposcopy /   Cryo Cautery / Electrocautery / HSG.

 Family Planning

•  Counselling for contraception / Sterilization / IUCD insertion / Removal.  Indoors

 Labour–room / L-room Recovery

•  History & work up of all cases.  Examination of all patients and documentation in the files.
•  Sending investigations & filing investigation forms. 
•   Performing NST, Maintaining partogram in in labouring patients. 
•  Monitoring vitals, uterine contractions and fetal heart rate in labouring patients , conducting deliveries, 
•  Episiotomy stitching and neonatal resusciation. 
•  I/V Line insertion, RT insertion, Catheterization, preparation of Synto drip, instillation of misoprostol or  Cerviprime for induction of labour. 
•   Management of sick patients including those with Eclampsia, Abruption & PPH Assessment & shifting of sick patients to ICUs.   Completion of files
•  Preparation of discharge summary
•  Preparation of weekly, monthly and annual stat.

 Post Partum & Gynae Ward / Recovery

•  Care of post partum patients
•  Advise to post partum patients regarding breast feeding, immunization of baby
• & contraceptive  advise to mother.
•  History and workup of all gynae cases, examination of all patients, sending investigations and 
•  filling forms
•  Pre operative assessment and preparation of all patients before surgery
•  Aseptic dressing, suture removal

 Operation Theatre

•  Performing minor procedures like D&C, MTP, Endometrial biopsy, Cervical biopsy, Cryo Cautery,  Electro cautery etc.
•  Assisting major procedures listed above.

 

 

9. Suggested Books

9.1 Core Books 

 Obstetrics

•  Holland and Brews Manual of Obst. .  Williams Obstetrics 
•  Text book of Obstetrics by Dutta DC
•  Practical guide to High Risk Pregnancy and delivery – Arias Fernando  Gynaecology
•  Shaw’s Text book of Gynaecology 
•  Novak’s Gynaecology
•  Jeffcoate’s Principles of Gynaecology 

 

9.2 Reference Books  

 Obstetrics

•  Medical Disorders in Pregnancy by Barnes
•  Medical Disorders in Pregnancy by FOGSI
•  MunroKerr’s Operative Obstetrics
•  Care of the Newborn 6^th ed. Meharban Singh
•  Obstetrics and Gynaecology 5^th ed. Krishna Menon Sauerberi E.E
•  USG in Obst. & Gynaecology by Callens
•  USG in Obst. & Gynaecology by Kuldeep Singh
•  Medicolegal aspects in Obst. & Gynae – Mukherjee GG
•  Clinical Obstetrics – by Mudaliar
•  Text book of Obstetrics by Sudha Salhan

 Gynaecology

•  Te Linde’s Operative Gynaecology .
•  Bonneys’s Gyn Surgery 10^th ed.
•  Shaws Operative Gynaecology
•  Practice of fertility control 7^th ed. – Chaudhary S.K.
•  Text book of Gynae contraception 14^th ed. C.S. Dawn
•  Infertility – R. Rajan
•  Speroff – Leon
•  Year book of Obst. & Gynae
•  Principles & Practice of Colposcopy by B. Shakuntala Baliga  Laparoscopy & Hysteroscopy by Sutton  Hormone replacement Therapy by White Head M.

 Gynae & Obst. Procedures – Parulikar S.V.

 Surgery in infertility & Gynaecology – Jain Nutan  Principles & Practice of Colposcopy – Balya B.S.

 Infertility Manual – Rao Kamini A.

 Operative Laparoscopy – Soderstrom R

 Chemotherapy of Gynaecological Malignancies - Borker C

 

9.3 Journals

•  Indian Journal of Obstetrics & Gynaecology
•  British Journal of Obstetrics & Gynaecology
•  American Journal of Obst. & Gynae
•  Clinics of North America
•  Recent Advances in Obst. & Gynaecology by John Bonnar  Progress in Obst. & Gynae by Studd.
•  Clinics of Obst. & Gynaecology

 

10.  Model Test Papers