REI Elective

Course Name: Reproductive Endocrinology and Infertility Elective

Course Offered: All periods

Elective Duration: 4 weeks

Enrollment Limit: 1

Facilities: Greenville Memorial Hospital

Visiting Students: Accepts visiting students

Elective Director: Bruce Lessey, M.D. PhD.

Contact: UME Clerkship Coordinator

Address:

Department of Obstetrics & Gynecology
Greenville Health System
890 W. Faris Road, Ste 470
Greenville, SC 29605

Phone: 864-455-5524

Fax: 864-455-3095

Email: obgyncoordinator@ghs.org

Format for the Course: Clinical Participation

Description: This elective is offered to students who have satisfactorily completed their third year clinical rotations. This elective provides a mentored, in-depth clinical experience in the evaluation and management of hormone related disorders at all stages of life. The rotation is conducted in the Division of Reproductive Endocrinology and Infertility (REI) under the direct supervision of attending physicians. Students will participate in clinical evaluations and procedures in the ambulatory setting, assist in surgical procedures, observe assisted reproductive technologies, and attend didactic teaching sessions.

This course is offered to students based on academic merit. Interested students should contact the program coordinator to request an application.

Course Objectives:

  1. The Menstrual Cycle
    The student should be able to understand the endocrine and paracrine events surrounding the normal menstrual cycle and to be able to describe clinical scenarios when this cycle breaks down.
  2. Approach to the Infertile Couple
    Be conversant with the causes, diagnosis and treatment of the major causes of infertility including the commonly used tests and medications. The student will be part of the team that provides medical and surgical therapy for infertility.
  3. Puberty and adolescent issues
    Be familiar with the stages of puberty and be able to discuss advanced or delayed puberty.
  4. Menopause
    The student will be expected to discuss the studies that underpin the use of estrogen replacement. Students will be able to perform appropriate history and physical assessment of the post-menopausal women and be able to select and interpret appropriate diagnostic tests.

Instructional Methodology:

Clinical Settings: All clinical activities for the Reproductive Endocrinology & Infertility (REI) elective are conducted in either the Memorial Medical Office Building (MMOB) or the Greenville Memorial Hospital. The two main venues for clinical activities are the ambulatory offices in the MMOB and the Gynecology Operating Room.

Duty Hours: Patient care responsibilities typically commence at 7:30 AM and conclude at 5:00 PM (Monday - Friday). The time to commence clinical activities will be determined by whether there are operative cases or IVF cycles being performed.

Patient Care Responsibilities (Ambulatory Office): The student will see patients referred to the REI clinic with the consent of the patient and with the appropriate supervision by the attending. He or she will be involved in new patient visits. The student will participate in development of treatment plans on all new patients.

The student will participate/observe office procedures including sonohystograms, office hysteroscopy, and ultrasounds. The student should plan on participating (perform/assist) in morning transvaginal ultrasounds with either the ultrasound technicians, nurses or physicians. These begin at 7:30 on weekdays. Other office procedures will also be available for student learning.

Patient Care Responsibilities (Operating Room): Students will have the opportunity to participate in the perioperative care of all patients undergoing surgery for infertility.

Students should prepare themselves for the OR by performing background reading on the disease condition, surgical procedure, and relevant anatomy. Students should be active participants and expect to engage in discussion of female anatomy and various basic procedures. Opportunities for surgical participation will be made available at the discretion of the chief resident and/or attending.

Patient Care Responsibilities (ART Lab): The student should attend at least 3 IVF retrievals which will also include time in the IVF laboratory or in the andrology laboratory during semen analysis and or sperm preparation for intrauterine insemination. The student will observe oocyte retrieval and embryo transfer, as part of IVF.

Conference Responsibilities: In addition to learning activities related to direct-patient care, students will participate in the following didactic conferences:

  • REI Conference (Wednesday mornings)
  • IVF Planning Meeting (Tuesday afternoons)
  • Grand Rounds (Friday mornings)

Reading on specific assigned topics will be out of the Speroff textbook. Topics will be tailored to the student, but will be focused on the course objectives outlined above. Each week will focus on a different topic.

The student will present a case report of an interesting endocrine topic from the literature or from personal experience each Wednesday morning at the REI conference, starting at 7:30 am, alternating with the resident on the service. Alternatively, preparation of a topic of choice can be arranged (with prior approval by the elective director).