use of 3D ultrasound before ART

1. TRAINING OF A GRADUATE
MEDICAL STUDENTS IN THE
FIELD OF OBSTETRICS AND
GYNECOLOGY
Prof. Ahmed Mohamed Abbas
OB-GYN MD., Assiut University
Egypt
Thursday 16/2

2. Introduction
 Graduate medical education is the crucial
step of professional development between
medical school and autonomous clinical
practice.
 It is in this vital phase of the continuum of
medical education that residents learn to provide
optimal patient care under the supervision of
faculty members.
 They serve as role models of excellence,
compassion, cultural sensitivity, professionalism,

3. Introduction
 Graduate medical education transforms
medical students into physician scholars who
care for the patient, patient’s family, and a
diverse community; create and integrate new
knowledge into practice; and educate future
generations of physicians to serve the public.
 Practice patterns established during graduate
medical education persist many years later.

4. Professionalism
 Residents must demonstrate competence
in:
1. Compassion, integrity, and respect for
others,
2. Responsiveness to patient needs that
supersedes self-interest,
3. Cultural humility,
4. Respect for patient privacy and autonomy,
5. Accountability to patients, society, and the
profession,

5. Professionalism
 Residents must demonstrate competence
in:
6. Respect and responsiveness to diverse patient
populations, including but not limited to diversity
in gender, age, culture, race, religion, disabilities,
national origin, socioeconomic status, and
sexual orientation,
7. Ability to recognize and develop a plan for
one’s own personal and professional well-being.

6. Curriculum
 The three-years of Ob/Gyn residency training provide an
opportunity for residents at each level of training to
progressively develop their clinical skills and judgment
and to assume increasingly greater responsibility for
patient management.
 There should be an annual assessment of resident’s
experiences and quarterly resident assemblies. This
feedback is used to help modify, expand and improve
the training curriculum every year.
DR. AHMED ABBAS
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7. First year residency

8. First year residency
 Surgery:
 R1 must have formal training in basic surgical skills
including incision management, soft tissue
management, and suturing.
 This could be helpful in essential procedures:
1. Episiotomy
2. Cervical tears suturing
3. First Cesarean sections

9. First year residency
 Ultrasonography:
 R1 must have formal training in basic sonographic
skills regarding physics and probe movements.
 Essential ultrasound in obstetrics:
1. Fetal assessment (viability, position, presentation,
gender)
2. Fetal biometry (gestational age, weight)
3. Assessment of amniotic fluid and placenta
 Essential ultrasound in gynecology:
1. Basic scan of the uterus and ovaries regarding

10. First year residency
 Obstetrics:
 R1 must have clinical skills in dealing with cases of:
1. Routine antenatal care,
2. Low- risk pregnancy during labor,
3. Miscarriage (medical termination, evacuation),
4. Obstetric hemorrhage (first aid measures),

11. First year residency
 Gynecology:
 R1 must have clinical skills in dealing with cases of:
1. Genital tract infections,
2. Minor gynecological complaints (dysmenorrhea,..),
3. Perform minor gynecological procedures
(endometrial biopsy, cervical smear, curettage, …)
4. Know basics of investigations and treatment of
infertility.

12. First year residency
 Family planning:
 R1 must have clinical skills in:
1. Counselling about all contraceptive methods,
2. Insert and remove IUDs,
3. Insert and remove subdermal implants.

13. Second year
residency

14. Second year
residency
 Surgery:
 R2 should be adequately trained to perform:
1. Repeat cesarean sections
2. Cervical cerclage

15. Second year
residency
 Ultrasonography:
 Essential ultrasound in obstetrics:
1. Use of Doppler for fetal assessment
2. Basics of normal anatomy scan
 Essential ultrasound in gynecology:
1. Ovulation monitoring

16. Second year
residency
 Obstetrics:
 R2 must have clinical skills in dealing with cases of:
1. Obstetric complications (PROM, PTL,…)
2. Evaluation and triage of patients in labor,
3. Evaluation of early pregnancy problems (VM, EP)
4. Multiple pregnancy,

17. Second year
residency
 Gynecology:
 R2 must have clinical skills in dealing with cases of:
1. Irregular uterine bleeding,
2. Genital prolapse,
3. Amenorrhea.

18. Second year
residency
 Endoscopy:
 R2 must have formal training in basic endoscopic
skills.
 R2 should be trained about simple diagnostic
procedures wither laparoscopy or hysteroscopy.

19. Third year residency

20. Third year residency
 Surgery:
 R3 should be adequately trained to perform:
1. Complicated cesarean sections
2. Abdominal explorations (Ectopic pregnancy, repair
of UR, surgical interventions for PPH,..)
3. Peripartum hysterectomy

21. Third year residency
 Ultrasonography:
 Essential ultrasound in obstetrics:
1. Diagnosis of congenital malformations,
2. Genetic ultrasound,
3. Fetal echocardiography and neurosonography,
4. Some invasive procedures (amnioreduction,
amniocentesis).
 Essential ultrasound in gynecology:
1. Gynecologic oncology
2. Adnexal masses

22. Third year residency
 Obstetrics:
 R3 must have clinical skills in dealing with cases of:
1. Medical disorders of pregnancy,
2. Ectopic pregnancy (medical or surgical intervention),
3. Management of High-risk antepartum patients
during labor,
4. Operative vaginal delivery,
5. Obstetric hemorrhage (definitive treatment).

23. Third year residency
 Gynecology:
 R3 must have surgical skills in dealing with cases of:
1. Genital prolapse (conservative procedures vs.
vaginal H.)
2. Fibroids (myomectomy vs. hysterectomy)
3. Benign adnexal masses (cystectomy vs.
oophorectomy)
 R3 must have clinical skills in dealing with cases of:
1. Infertility (induction of ovulation, ARTs)
2. Gynecologic oncology

24. Third year residency
 Endoscopy:
 R3 should be trained about simple operative
procedures wither laparoscopy or hysteroscopy (PCO
drilling, adhesolysis, polypectomy,...)

25. Finally,
At completion, the resident is expected to have sufficient
knowledge and technical skill in
1. Outpatient gynecologic and obstetric care of women,
2. Inpatient medical management of gynecologic problems,
3. Inpatient management of labor & delivery,
4. Decision for and performance of gynecologic surgery and
5. Appropriate postoperative care
To be able to function independently as a general obstetrician and
gynecologist.
DR. AHMED ABBAS
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26. DR. AHMED ABBAS
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