RCG-0504

Course: RCG0504 – Internship in Women’s Health I
Supervised training in – Women’s Health I
Credits Lecture: 2
Credits Work: 13
Total Hours: 420 h (Internship: 390 h)
Type: Semester
Activation: 01/01/2013

Objectives

  • To solidify concepts, skills, and attitudes developed in the women’s health field, which are fundamental for the generalist medical training. This learning will occur in primary and secondary care settings.
  • To maintain the integration of theory and practice in Gynecology and Obstetrics, encouraging active student participation, small group learning, and teamwork.
  • To provide practical learning in front of the patient, under supervision.
  • To stimulate critical thinking in interpreting complementary exams and in formulating diagnoses.

Responsible Instructor(s)

  • Ana Carolina Japur de Sá Rosa e Silva
  • Carolina Sales V. Macedo
  • Elaine Christine Dantas Moisés
  • Geraldo Duarte

Brief Program
Students will rotate for 8 weeks through the following settings: Ribeirão Preto Women’s Health Reference Center-Mater (described below) and basic health units in the west district, specifically CSE-Sumarezinho (Cuiabá), CSE-Ipiranga (Dom Pedro), and Vila Lobato (temporarily under renovation). In addition, there are 2 afternoon shifts per week at the women’s prison.

Mater: Students will rotate through the following stages: CO-Mater, Outpatient Clinic, and Joint Accommodation. Three students are assigned to CO, three to the Outpatient Clinic, and three to Joint Accommodation. There are two students on night duty per day at Mater.

UBSs West District: Students will rotate through the following stages: two students at CSE-Sumarezinho (Cuiabá), and one or two students at CSE-Ipiranga (Dom Pedro). Until Vila Lobato’s renovation is complete, no students will be assigned to this setting. In addition, two students will attend the women’s prison in Ribeirão Preto on Monday and Wednesday, providing primary care in Gynecology.

Program
Objectives

  • To solidify the concepts, skills, and attitudes developed in the women’s health field that are fundamental for generalist medical training. This learning will occur in primary and secondary care settings.
  • To maintain the integration of theory and practice in Gynecology and Obstetrics, encouraging active student participation, small group learning, and teamwork.
  • To provide practical learning in front of the patient, under supervision.
  • To stimulate critical thinking in interpreting complementary exams and in formulating diagnoses.

Content
Obstetrics:

  • Basic principles of women’s health service organization during the gestational-puerperal cycle
  • Women’s health care in the context of the SUS
  • Preconception evaluation
  • Fundamental concepts and statistics in the gestational-puerperal cycle
  • Ethical and moral principles in obstetric care
  • Women’s rights during the gestational-puerperal cycle
  • Humanization of care during the gestational-puerperal cycle
  • Baby-Friendly Hospital Initiative
  • Strategies to improve women’s quality of life
  • Strategies to improve care during the gestational-puerperal cycle
  • Obstetric emergencies
  • Low-risk prenatal care
  • Care during labor and delivery
  • Postpartum care
  • Support and promotion of breastfeeding

Gynecology:

  • Menstrual disorders
  • Abnormal uterine bleeding
  • Hormonal and non-hormonal contraception
  • STDs/vulvovaginitis (including HPV and pre-neoplastic lesions)
  • Normal sexuality and main dysfunctions
  • Benign breast pathology
  • Women’s health during adolescence
  • Women’s health during reproductive age
  • Women’s health during menopause

Assessment
Method

  • Evaluation of cognitive, psychomotor, and attitudinal skills.
    Cognitive Skills: Theoretical test (Grade 1 or G1) will be conducted at the end of the internship, coordinated by the preceptors: Professors Silvana and Carolina. The subjects covered in the exam will be relevant to the course.
    Psychomotor and Attitudinal Skills: Practical assessment (Grade 2 or G2) will be conducted during the internship activities. It consists of evaluating clinical skills with a focus on the doctor-patient relationship. The evaluators will follow the student during the consultation and give feedback on positive and negative points. This evaluation, called a mini clinical exercise or Mini-CEX, will be done five times for each student, in five different settings, with five different evaluators. The settings are: prenatal outpatient clinic (HC and Mater), Joint Accommodation (Mater), Obstetric Center (HC and Mater), CSE Cuiabá, and CSE Dom Pedro. Evaluators include: Professors Silvana Quintana, Reinaldo Rodrigues, Alessandra Marcolin, Ricardo Cavalli, Carolina Sales, Caio Prado, Luiz Augusto Martins, Patrícia Melli, Erciliene Martins, Mauricio Kobayashi, Rebecca, Silvio Franceschini, Davidson Alvarenga, Vânia Buarin, and Enio Damaso. By the end of the internship, before the final exam, the student must submit the five printed practical evaluation forms. Attitudinal evaluation will include interest and participation, as well as relationship skills with patients, colleagues, and staff.
    Attendance of 100% in all programmed practical activities is mandatory.

Criteria
A student will be approved if they obtain a grade equal to or higher than 5.0 and 100% attendance in all practical activities, according to the Internship Regulations for the Medical Course at FMRP-USP.

Recovery Guidelines
Students who achieve a grade lower than 5.0 but higher than 3.0 and have 100% attendance in all practical activities will be eligible for recovery. Recovery includes cognitive and practical skills evaluation. A student will be approved if they obtain a final average equal to or higher than 5.0, calculated as the arithmetic average between the regular course grade and the recovery grade.

Bibliography
CUNNINGHAM, F. Williams Obstetrics. McGraw-Hill Professional. Ebook
REZENDE, J. et al.: Obstetrics. Rio de Janeiro, Guanabara Koogan
BUSSAMARA, N.: Basic Obstetrics. São Paulo, Sarvier
DUARTE G, et al.: High-Risk Pregnancy Protocols
DUARTE G. Diagnosis and Treatment of Gynecological and Obstetric Infections
Berek J S, Adashi E Y, Hillard P A: Novak – Gynecology Treatise, 12th Edition, Guanabara Koogan, Rio de Janeiro
Oliveira H C, Lemgruber I: Gynecology Treatise – FEBRASGO, Livraria e Editora Revinter Ltda, Rio de Janeiro