MBBS Curriculum Obsterics & Gynecology

Curriculum Planning
Obstetrics
S. No. Topic Learning Objectives                                            The student should be able to… Teaching Guidelines Methodology Time (Hrs)
1 Basic Sciences Explain the  the basics of reproductive anatomy and physiology; changes & adaptations that occur in the mother during pregnancy,  along with their clinical application. ▪ Anatomy of internal and external reproductive organs,  other pelvic organs and applied anatomy related to O & G ▪ Student Interactive Sessions                                        ▪ Student  Seminars 8
▪ Physiology of ovulation, conception, implantation
 ▪ Early Development of  Embryo, fetal development & growth as gestation progresses,  drugs/teratogenic agents to be avoided in early pregnancy
 ▪ Development of Placenta and Membranes
 ▪ Anatomical & Physiological changes in circulatory system, respiratory, urinary, and GI tract during pregnancy and their clinical implications
2 Basic Clinical Skills Elicit history and examine a pregnant woman with logical interpretation to come to a provisional diagnosis and plan further management. ▪ Respectful approach & effective communication ▪ Student Interactive Sessions, 12
▪ Logical sequence of History taking in pregnancy ▪ OPD demonstrations
▪ General Examination to elicit important signs, accurate B.P. measurement, and systemic examination ▪ Ward rounds
▪ Obstetric examination to assess the gestational age, fetal lie, presentation, position, viability and growth ▪ Case Presentations
▪ Integrate  history, examination & investigation results
▪  Detailed clinical note keeping.
3 Antenatal Care Impart antenatal care, identify high risk pregnancy and acute conditions requiring  hospital admission or appropriate referral; Interpret test results of laboratory and radiological investigations as they apply to obstetric patient ▪ Clinical Diagnosis of pregnancy  ▪ Pregnancy tests ▪ Student Interactive Sessions, 12
 ▪ Objectives and patterns of antenatal care ▪ OPD demonstrations
▪ Risk approach in pregnancy ▪ Ward rounds
▪ Fetal growth assessment and antenatal fetal surveillance ▪ Case Presentations
▪ Basic and Special Investigations in pregnancy ▪ Integrated teaching with Commmunity medicine
▪ Immunisation & Prescribing Drugs in Pregnancy
▪ Nutrition counseling in pregnancy
▪ Counseling regarding common complaints in pregnancy and alert signs
▪ Pelvic assessment in late pregnancy
S. No. Topic Learning Objectives                                            The student should be able to… Teaching Guidelines Methodology Time (Hrs)
4 Normal Labor and delivery Manage normal labor and conduct normal deliveries, using safe delivery practices in the primary and secondary care settings;  Diagnose complications of labor, institute primary care and manage such cases/refer in a timely manner ▪ Anatomy of maternal pelvis and fetal skull ▪ Student Interactive Sessions, 16
▪ Labor Mechanism in occipito-anterior/transverse position ▪ Tutorials
▪ Onset of labor, stages of labor and clinical Course  ▪ Labor room posting
▪ Management of 1st stage of labor, partogram  ▪ Log books
▪ Pain relief in labor, pudendal block ▪ L.R.Teacher Seminars
▪ Fetal monitoring, fetal distress ▪ Integrated teaching with anesthesia department
▪  Management of 2nd stage, conduct of delivery
▪  Management of 3rd stage of labor: conventional/active
▪ Danger signals in labor
▪ Induction of labor-Indications, C.I.,  pre-requisites, methods , successful/failed induction, complications
5 Normal                                                         Puerperium Provide postnatal care, including education in breast‐feeding, counsel and support couples in the correct choice of contraception ▪ Physiology and course of puerperium & Lactation ▪ Student Interactive Sessions, 5
▪ Common complaints in PN period & management ▪ Ward rounds
▪ Breastfeeding and common problems like lactational failure, mastitis, breast abscess ▪ PNC clinic demonstrations
▪ Care of neonate, infant and Immunisation schedule ▪ Case Presentations
▪ Advice on discharge and alert signs
▪ Postpartum contraception.
6 Early Pregnancy Complications Diagnose and manage problems such as hyperemesis gravidarum and  vaginal bleeding in  first trimester ▪ Etiopathogenesis, complications, investigations & management of hyperemesis gravidarum ▪ Student Interactive Sessions, Tutorials 8
▪ Abortions – types,  causes, investigations,  management ▪ OPD demonstrations
▪ Ectopic pregnancy – types, diagnosis and management ▪ Ward rounds
▪ Vesicular mole – Diagnosis, management, follow up ▪ Case Presentations
7 Late Pregnancy Complications Diagnose and manage problems such as antepartum haemorrhage,  amniotic fluid volume disorders, multiple pregnancy, intrauterine growth restriction and intrauterine fetal death ▪ APH – classification, presentation, differential diagnosis, investigations, complications & management ▪ Student Interactive Sessions, Tutorials 12
▪ Hydramnios and oligohydramnios- causes, diagnosis, investigations &  management ▪ OPD demonstrations
▪ Multifetal gestation – causes, diagnosis, differential diagnosis, complications, mangement ▪ Ward rounds
▪ IUGR and IUD – causes, diagnosis and management of ▪ Case Presentations
S. No. Topic Learning Objectives                                            The student should be able to… Teaching Guidelines Methodology Time (Hrs)
8 Maternal Medicine Diagnose & manage medical problems such as anemia, hypertensive disorders, diabetes mellitus, and heart disease in pregnancy ▪ Anaemia in pregnancy – causes and classification, complications, management, prevention of nutritional anemias & mangement of non-nutritional anemias ▪ Student Interactive Sessions, 18
 ▪ Hypertension in pregnany – classification, diagnosis, complication, management of Gestational hypertension, preeclampsia, and chronic hypertension in pregnany, Predictive tests and prevention of PE & eclampsia, differential diagnosis of convulsions in pregnancy ▪ Demonstrations in high risk clinic
▪  Gestationaldiabetes mellitus, DM during pregnancy – classification, diagnosis, screening, complications, management of diabetes mellitus during pregnancy and labor,   management of neonate of diabetic mother ▪ Ward rounds
 ▪ Heart disease in pregnancy – classification, evaluation, complications, management during pregnancy & labour ▪ Case Presentations
 ▪ Postnatal care and contraceptive advice to women with medical disorders in pregnancy ▪ Tutorials
9 Special Pregnancy situations Diagnose and manage special situations such as Rh negative pregnancy, postdated pregnancy, post cesarean pregnacy, preterm labor and PROM ▪ Diagnosis, evaluation, management and prevention of Rh Isoimmunisation, In-utero management of Rh iso-immunised, management  haemolytic disease of NB ▪ Student Interactive Sessions, 10
▪ Evaluation monitoring and management of a case of post-caesarean pregnancy, vaginal birth after CS    Indications and complications of repeat CS  Caesarean ▪ Demonstrations in high risk clinic
▪ Evaluation and management of post-dated pregnancy ▪ Tutorials
▪ Preterm labour, premature rupture of membranes -causes, diagnosis, prevention, management , tocolytic drugs; neonatal problems of preterm  babies ▪ Case Presentations, Ward rounds
10 Infections during pregnancy Diagnose & manage maternal infections during pregnancy and its effects on the fetus ▪  Maternal infections during pregnancy – asymptomatic bacteriuria, UTI, malaria, dengue, tuberculosis, and TORCH infections –  Etiopathogenesis, presentation, complications, fetal effects, prevention and management ▪ Student Interactive Sessions,              ▪ Student Seminars 10
▪ Sexually transmitted infections – syphilis, hepatitis, HIV during pregnancy – risk factors, maternal and fetal complications, PPTCT program ▪ Integrated teaching with skin & STI clinic
S. No. Topic Learning Objectives                                            The student should be able to… Teaching Guidelines Methodology Time (Hrs)
11 Fetal medicine Provide periconception counseling, Apply medico‐legal principles applicable to tubectomy, MTP, and PCPNDT act ▪ Assessment of Fetal Well being (Early & late pregnancy)  ▪ Birth Injuries ▪ Student Interactive Sessions 10
▪ Congenital Malformations: hydrocephalus, anencephaly ▪ Student Seminars
▪ Preconception and prenatal diagnostic techniques PNDT Act, periconception Counselling ▪ Integrated teaching with Radiology
▪ USG  in Obstetrics, doppler USG
12 Abnormal Labor and             3rd Stage complications Diagnose abnormal labor & describe the principles of management of abnormalities in labor ▪ Shoulder Dystocia, Malpositions, Breech presentation, assisted breech delivery, extraction;  Transverse lie ▪ Student Interactive Sessions, Tutorials 6
▪  Incoordinate uterine action, contracted pelvis, CPD, obstruted labor, rupture uterus; Cord Prolapse, Unstable lie, compound Presentation ▪ Demonstrations in high risk clinic
▪ PPH atonic, traumatic; Retained placenta, adherent placenta, inversion uterus ▪ Case Presentations, Ward rounds
13 Abnormal Puerperium Diagnose abnormal puerperium  & describe the principles of management of abnormalities in purperium ▪ Puerperal sepsis diagnosis prevention & management, ▪ Student Interactive Sessions, 6
▪ Septic shock ▪ Demonstrations in ward rounds
▪  Breastfeeding problems like lactational failure ▪ Case Presentations
14 Operative Obstetrics Perform minor operative procedures,  describe the indications of major  operations , outline of technique, complications, pre- and post-operative care  ▪ Cervical cerclage, episiotomy, forceps and vaccum deliveries, destructive operations, cesarean section, ▪ Student Interactive Sessions,              ▪ Student Seminars 8
▪ Repair of vaginal/ cervical tears and rupture uterus,   cesarean hysterectomy, internal iliac ligation ▪ Observation of surgery – maternity OT
▪ Permanent contraception ▪ Medical Termination of Pregnancy – Act, methods, complications
15 Rural Obstetrics Describe  national rural health mission and government programs to reduce maternal and perinatal mortality ▪ Maternal mortality causes and prevention ▪ Student Interactive Sessions, 4
 ▪ Perinatal mortality causes and prevention ▪ Tutorials
▪ NRHM ▪ Govt health progs ▪ Integrated teaching Commmunity medicine
16 Miscellaneous Prescribe drugs safely and appropriately in pregnancy and lactation;  Identify and manage some critical conditions in obstetrics ▪ Obstetric Drugs (Uterotonics,  Muscle relaxants, anti-hypertensives, abortifacients, Cervical ripening drugs) ▪ Student Interactive Sessions, 5
▪ Recurrent Pregnancy Loss, bad obstetric history, elderly primi, grand multi ▪ Tutorials
▪ Thrombo embolism in Pregnancy
▪ Obstetric Shock, amniotic fluid embolism, critical care in Obstetrics.
Curriculum Planning
Gynecology
S. No. Topic Learning Objectives                                            The student should be able to… Teaching Guidelines Methodology Time-Hrs
1 Basic Sciences Describe the  the basics of female genital tract anatomy and physiology and their clinical application. ▪ Anatomy of external and internal genitalia, Development of Genital Organs ▪ Student Interactive Sessions                 ▪  Seminars 8
▪ Pelvic floor anatomy, utero vaginal supports
▪ Normal pubertal changes
▪ Neuro endocrine control of Menstruation ovarian, and endometrial cycles
2 Basic Clinical Skills Elicit a gynecologic history perform appropriate physical and pelvic examination and PAP smear in the primary care setting ▪ Gynaec history taking ▪ Student Interactive Sessions, 10
▪ General, systemic, abdominal examination ▪  Seminars
 ▪ Per- speculum, vaginal & rectal examination ▪ Demonstration in GOPD/ward round
▪ Taking pap smear and wet smear  of  vaginal discharge
▪ Summarise and integrate the history, examination and clinical note keeping.
3 Genital Tract Infections Recognize diagnose and manage  common reproductive tract infections in the primary care setting ▪ Physiological & pathological causes of vaginal discharge;  characteristics, investigations, predisposing conditions and management of common lower and upper genital tract infections ▪ Student Interactive Sessions                      ▪ Seminars                           ▪ Case Presentation 8
▪ Syndromic approach for vaginal discharge and genital ulcer
4 Pelvic Inflammatory disease Recognize diagnose and manage  Pelvic inflammatory disease and genital tuberculosis in the primary care setting and appropriate referral ▪ Definition, causes, sequelae and management of pelvic inflammatory disease, sexually transmitted infections and their prevention ▪ Student Interactive Sessions                  ▪  Seminars                                  ▪ Case Presentation 6
▪ Genital tuberculosis diagnosis & management
▪ Syndromic approach for pain lower abdomen
5 Abnormal uterine bleeding Recognize diagnose and manage abnormal menstrual bleeding in the primary care setting, and appropriate referral ▪ Normal menstrual pattern ▪ Student Interactive Sessions                   ▪  Tutorials                     ▪ Case Presentation 4
▪ Abnormal uterine bleeding –  classification, etiology, Investigations and management plan
S. No. Topic                 Learning Objectives                                            The student should be able to… Teaching Guidelines Methodology Time-Hrs
6 Benign lesions of female reproductive tract Recognize diagnose and manage  benign lesions of female reproductive tract ▪ Bartholin cyst, cervical erosion, polyp, fibroid uterus, endometriosis, adenomyosis, and benign ovarian cysts – causes, investigations, complications and management ▪ Student Interactive Sessions                          ▪ Tutorials                                     ▪ Case Presentation 12
▪ Conservative surgery and recent advances in management
7 Reproductive Endocrinology Recognize diagnose and manage problems related to endocrinal issues in gynecology affecting pediatric, adolescent and reproductive age groups ▪ Delayed and precocious puberty –  Causes, investigations & management ▪ Student Interactive Sessions                         ▪  Tutorials                     ▪ Case Presentation 10
▪ Classification of Primary and Secondary amenorrhoea , investigations and principles of management of PCOS, hirsutism, galactorrhea
8 Reproductive tract anomalies Recognize diagnose and manage problems related to abnormalities in development of genital tract ▪ Classification, diagnosis, reproductive outcome of genital tract abnormalities ▪ Student Interactive Sessions                     ▪  Seminars/tutorials                ▪ Case Presentation 9
▪ Indications for surgical management of anomalies and specific procedures
▪ Intersex –  Male and female pseudo-hermaphroditism
9 Infertility Recognize and diagnose problems leading to infertility and basic and advanced management techniques ▪ Defintion, Causes and investigation of a couple with infertility ▪ Student Interactive Sessions                               ▪  Tutorials                                          ▪ Case Presentation 12
▪  Semen analysis and male infertility
▪ Causes of anovulation, tests for ovulation and induction of ovulation
▪ Tests for tubal patency and management of tubal infertility
▪ Advances in assisted reproductive technology
10 Pelvic organ prolapse and Uro-gynecology Diagnose problems related to pelvic organ descent and  urinary problems in women and understand principles of prevention and management ▪ Classification, causes, diagnosis, investigations and management of pelvic organ prolapse in relation to age and parity, preventive aspects ▪ Student Interactive Sessions                        ▪  Seminars/tutorials                ▪ Case Presentation 12
▪ Pelvic reconstructive surgery
▪ Urinary Problems in Gynae (retention, UTI, urgncy)
▪ Classification, differential diagnosis, work up and management, surgical therapy of stress urinary incontinence
S. No. Topic Learning Objectives                                            The student should be able to… Teaching Guidelines Methodology Time-Hrs
11 Genital tract injuries and Genital fistulae Describe the causes of genital tract injuries, prevention and principles of management ▪ Post-coital injuries and operative injuries especially to urinary tract Causes ▪ Student Interactive Sessions                                       ▪ Tutorials                                  ▪ Case Presentation 4
▪ Clinical features diagnosis and principles of surgical management and complications of vesico-vaginal, rectovaginal fistulae and complete perineal tears
12 Pre-malignant lesions and Malignancies of genital tract Recognize diagnose and manage common pre-malignant lesions and malignancies of genital tract with appropriate referrals ▪ Etiology, pathology, classification, diagnosis of pre-malignant and malignant lesions of vulva, vagina, cervix, uterus and ovary ▪ Student Interactive Sessions                                   ▪  Tutorials                     ▪ Case Presentation 20
 ▪ Gestational Trophoblastic Disease  and Choriocarcinoma
▪ Screening for  cervical,  endometrial, ovarian and breast cancers  ▪ Tumor Markers in Gynecology
▪ Clinical & surgico-pathological Staging and principles of management of cervical, endometrial and ovarian cancer
▪ Chemo- and Radiotherapy for genital cancers
▪ Prevention of female genital Cancer                                  ▪ Colposcopy
13 Operative Gynaecology Describe the principles of major gynecological surgeries with preoperative evaluation and post operative care ▪ Indications, technique and complications of  minor surgical procedures -endometrial biopsy, dilatation and Curettage, cervical biopsy ▪ Student Interactive Sessions                        ▪ Tutorials 10
▪  Pre operative evluation and principles of major gynecological surgeries – vaginal hysterectomy, manchester repair, abdominal hysterectomy, ovariotomy, tubal recanalisation,  staging laparotomy for endometrial and ovarian malignancy ▪ Observation of procedures in OT
▪ Endoscopic procedures –  diagnostic and operative hysteroscopy and laparoscopy
▪ Post operative care & Complications
S. No. Topic Learning Objectives                                            The student should be able to… Teaching Guidelines Methodology Time-Hrs
14 Problems of  menopause Recognize diagnose and manage problems related to menopause ▪ Causes investigations and managemnt of Menopausal syndrome and premature menopause ▪ Student Interactive Sessions                   ▪ Seminars/tutorials 5
▪ Hormone replacement therapy
▪ causes and investiagtions of post menopausal bleeding
15 Miscellaneous Interpret the results of imaging techniques used for diagnosis of gynecologic lesions ▪ USG, CT and MRI in Gynecology – indications and interpretation of findings ▪ Student Interactive Sessions                  ▪ Tutorials 8
▪ Hormones and hormone therapy in gynecology
16 MTP and Contraception Able to offer appropriate counseling for medical termination of pregnancy,  various contraceptive methods and insert intrauterine contraceptive device ▪ Medical Termination of Pregnancy Act, Emergency contraception, medical and surgical methods of termination of pregancy in first and second trimester, related complications ▪ Observation of                  procedures in OPD/OT 12
▪ Contraception: natural & barrier methods, IUCD, hormonal (OCP, injectables, implants, vaginal ring), permanant contraception, WHO eligibility criteria ▪ Student Interactive Sessions                  ▪ Tutorials
▪ Counseling for MTP & contraception ▪ Role Play