PGY5 Obstetrical Ultrasound
Supervisor: Dr. Stephanie Jackman, Janeway
Goal: To become competent in the interpretation and technical aspects of Obstetrical Ultrasound.
The assessment tools utilized during the rotations include global faculty ratings such as the ITER rotation evaluation sheet. An examination assessing knowledge obtained as per the listing curricula at each stage of training will be given on the last day. The examination will assess the acquisition of knowledge throughout the rotation. A pass mark is 70%. The inability to pass the exam will render the rotation incomplete, and the rotation will be completed at a later date. 360 degree evaluations by the pediatric technologists will also be included in the ITER evaluation sheet. This will also include nursing staff.
Duties and Responsibilities
Supervise and review all obstetrical ultrasonographic examinations. These will subsequently be reviewed with the staff person prior to dictation by the resident.
Completion of Daily Encounter Cards (ITERs) are required for each day of this rotation. These cards are located in the residents' reporting area of the Janeway.
Be available for consultation with the technologists and referring physicians/house staff.
Attend biweekly antenatal rounds as necessary.
Be responsible for i) Medical/Surgical rounds with staff supervision and ii) selective subspecialty rounds.
Code any interesting case using the ACR system
Avail of the opportunity to review the gynecological cases as time permits.
Protocol and arrange any fetal MRI’s which arise during the rotation.
Required Reading List
- Rumack and Wilson
- Society of Obstetrics and Gynecology of Canada web site http://www.sogc.org/guidelines (Clinical Practice Guidelines for Diagnostic Imaging):
a) Fetal Soft Markers in Obstetric Ultrasound
b) Prenatal Screening for Fetal Aneuploidy
c) The Use of First Trimester Ultrasound
d) Ultrasound Evaluation of First Trimester Pregnancy Complications
e) Content of a Complete Routine Second Trimester Obstetrical Ultrasound Examination and Report
Please read the corresponding RSNA physics module, as outlined in the physics curriculum
- Medical Expert
Know the normal anatomy of 1st and 2nd trimester sonography, including fetal echocardiography.
Be able to perform a complete 2-3 trimester obstetric ultrasound by completion of this rotation. It is recommended that this be achieved in a step-wise fashion.
Become familiar with transvaginal sonography.
To know the radiology, pathology and clinical aspects of at least the following:
(i) normal 1st trimester sonography
(ii) abnormal 1st trimester sonography including a) blighted ovum; b) missed complete and incomplete abortions; c) ectopic pregnancy; d) subchorionic hemorrhage
(iii) manifestations of trophoblastic disease
(iv) multiple gestations – normal and abnormal
(v) amniotic fluid index, biophysical profile, fetal well-being
(vi) common trisomies (21, 18, 13)
(vii) common fetal anomalies in all organ subsystems
(viii) placental abnormalities, particularly previa and abruption
(ix) manifestations of IUGR and use of Doppler
(x) fetal hydrops
(xi) prenatal diagnosis
Establish a therapeutic relationship with patients and communicate well with family. Provide clear and thorough explanations of diagnosis, investigation and management.
Produce succinct reports that describe findings, most likely diagnosis, and, where appropriate, recommend further investigation or management.
Develop techniques for communication of adverse outcomes with pregnant patients.
Establish good relationships with peers and other health professionals, particularly the Antenatal Assessment Unit. Effectively provide and receive information. Learn to deal with conflict situations.
The skills of being a collaborator are developed on a day to day basis. Residents are strongly encouraged to interact with house staff and referring physicians as “first contact” in order to better develop these skills. In addition, residents will be required to be active participants in inter and intra discipline rounds.
Consult effectively with other physicians and health care professionals.
Contribute effectively to other interdisciplinary team activities.
Learn competence in and make use of computer science/information technology as it pertains to Diagnostic Radiology.
Learn to set realistic priorities and use time effectively in order to optimize professional performance.
Understand the fundamentals of quality assurance.
Utilize resources effectively to balance patient care, learning needs, and outside activities.
- Health Advocate
Learn to recognize the Radiologist’s role in ensuring appropriate radiological investigation and to act as an advocate for patients in terms of their diagnostic imaging needs.
Understand and communicate the benefits and risks of radiological investigation and treatment, including population screening and the risk of radiation exposure to the pregnant patient.
Recognize the burden of illness upon the patients served by Radiology.
Know the benefits/risks of radiologic investigation. Consult CAR and ACR appropriateness guidelines.
Demonstrate an understanding and a commitment to the need for continuous learning.
Develop and implement an ongoing and effective personal learning strategy.
Be able to critically appraise medical information and demonstrates basic knowledge in biostatistics and experimental design with respect to Radiology.
Demonstrate an ability to be an effective teacher of radiology.
Work up cases for the teaching file.
Identify potential research project with supervisors.
Demonstrate integrity, honesty, compassion and respect for diversity.
Fulfill medical, legal and professional obligations of a Diagnostic Radiologist.
Demonstrate timeliness, reliability and conscientiousness.
Understand the principles of ethics and apply these in critical situations.
Demonstrate an awareness of personal limitations, seeking advice when necessary. Accept advice graciously.