Year 4 OBGYN Elective Logbook

Name:   

Elective:

If Extramural or IDE, enter identifying information here:

Elective End Week:

Date Patient Seen: 
Patient's Gender: Female Male   Patient's Age:  
Location:  Clinic OR L&D ER Other
Presenting Complaint 1:  (select one)

*None

Abortion (any type)

Abnormal labor

Abnormal uterine bleeding

Amenorrhea/Oligomenorrhea

Antepartum care

Breast disorder

Cervical disease

Cervical neoplasia

Contraception/Sterilization

Dysmenorrhea

Ectopic pregnancy

Endometrial carcinoma

Endometriosis

Fetal death

Fetal growth abnormalities

Fetal surveillance

Genetic & heredity concerns

Gestational trophoblastic neoplasia

Hirsutism and Virilization

Hyperglycemia/Diabetes Mellitus

Immediate care of the newborn

Infertility

Isoimmunization

Intrapartum care

Issues of Bad News

Lactation

Medical & surgical conditions in pregnancy

Menopause

Modes of sexual expression

Mood Disorder

Multifetal gestation

Ovarian neoplasms

Pelvic pain

Pelvic relaxation

Postpartum care

Postpartum hemorrhage

Postpartum infection

Postterm pregnancy

Preconception care

Pre-eclampsia/eclampsia syndrome

Premature rupture of membranes

Preterm labor

Preventive health care & health maintenance

Puberty

Sexuality

Sexual assault/domestic violence

Sexually transmitted disease

Sterilization

Spontaneous abortion

Substance abuse

Surgical complication

Third-trimester bleeding

Thromboembolic disorder

Urinary incontinence

Urinary tract infection

Uterine leiomyoma

Vulvar or vaginal disease/disorder

Vulvar neoplasm

Presenting Complaint 2:   (select one)

*None

Abortion (any type)

Abnormal labor

Abnormal uterine bleeding

Amenorrhea/Oligomenorrhea

Antepartum care

Breast disorder

Cervical disease

Cervical neoplasia

Contraception/Sterilization

Dysmenorrhea

Ectopic pregnancy

Endometrial carcinoma

Endometriosis

Fetal death

Fetal growth abnormalities

Fetal surveillance

Genetic & heredity concerns

Gestational trophoblastic neoplasia

Hirsutism and Virilization

Hyperglycemia/Diabetes Mellitus

Immediate care of the newborn

Infertility

Isoimmunization

Intrapartum care

Issues of Bad News

Lactation

Medical & surgical conditions in pregnancy

Menopause

Modes of sexual expression

Mood Disorder

Multifetal gestation

Ovarian neoplasms

Pelvic pain

Pelvic relaxation

Postpartum care

Postpartum hemorrhage

Postpartum infection

Postterm pregnancy

Preconception care

Pre-eclampsia/eclampsia syndrome

Premature rupture of membranes

Preterm labor

Preventive health care & health maintenance

Puberty

Sexuality

Sexual assault/domestic violence

Sexually transmitted disease

Substance abuse

Surgical complication

Third-trimester bleeding

Thromboembolic disorder

Urinary incontinence

Urinary tract infection

Uterine leiomyoma

Vulvar or vaginal disease/disorder

Vulvar neoplasm

Presenting Complaint 3:   (select one)

*None

Abortion (any type)

Abnormal labor

Abnormal uterine bleeding

Amenorrhea/Oligomenorrhea

Antepartum care

Breast disorder

Cervical disease

Cervical neoplasia

Contraception/Sterilization

Dysmenorrhea

Ectopic pregnancy

Endometrial carcinoma

Endometriosis

Fetal death

Fetal growth abnormalities

Fetal surveillance

Genetic & heredity concerns

Gestational trophoblastic neoplasia

Hirsutism and Virilization

Hyperglycemia/Diabetes Mellitus

Immediate care of the newborn

Infertility

Isoimmunization

Intrapartum care

Issues of Bad News

Lactation

Medical & surgical conditions in pregnancy

Menopause

Modes of sexual expression

Mood Disorder

Multifetal gestation

Ovarian neoplasms

Pelvic pain

Pelvic relaxation

Postpartum care

Postpartum hemorrhage

Postpartum infection

Postterm pregnancy

Preconception care

Pre-eclampsia/eclampsia syndrome

Premature rupture of membranes

Preterm labor

Preventive health care & health maintenance

Puberty

Sexuality

Sexual assault/domestic violence

Sexually transmitted disease

Substance abuse

Surgical complication

Third-trimester bleeding

Thromboembolic disorder

Urinary incontinence

Urinary tract infection

Uterine leiomyoma

Vulvar or vaginal disease/disorder

Vulvar neoplasm

OB/GYN Clinical Skills & OB/GYN Procedures  (Choose all that apply)  

(Clinical Skills are in Bold Print. Expected Performance Levels of Clinical Skills are in Parentheses.)

Amniocentesis

Amniotomy

Biophysical profile

Biopsy, cervix

Biopsy, endometrial

Biopsy, vaginal

Biopsy, vulvar

Breast exam, screening (P)

Cervical exam for dilation (O)

Circumcision, Newborn (O)

Colporrhaphy

Colposcopy

Conization of cervix (LEEP)

Delivery, Vaginal (P)

Delivery, Cesarean

Delivery, Forceps

Delivery of Placenta (P)

Delivery, vacuum

Dilation & Curretage (D&C)

Document in record:  SOAP format (P)

Episiotomy or laceration repair

Exam, rape trauma

Exam under anesthesia (EUA)

Excision, condyloma

Excision or marsupialization of Bartholin Cyst

Ferning, Identify (P)

Fetal heart tones, Obtain (P)

Fetal heart tracings, Interpret (P)

Fingerstick glucose determination

Fingerstick hemoglobin determination

Foley catheter, Insertion of (P)

Fundal height,  Measure (P)

History, complete medical

Hysterectomy, abdominal

Hysterectomy, vaginal

Hysteroscopy, diagnostic

Hysteroscopy, operative

Incision and drainage

Infertility procedure

IUD insertion/removal

Laparoscopy, diagnostic

Laparoscopy, operative

Leopold’s Maneuver (P)

Lysis of adhesions

Non Stress Test

Pap Smear (P)

Pelvic exam (P)

Pessary insertion/removal

Pregnancy test

Prescription for medications (P)

Salpingectomy

STD testing (P)

Staple insertion/removal (P)

Suturing (A)

Two-handed knots (P)

Ultrasound: OB 1st trimester (O)

Ultrasound: OB 2nd trimester (O)

Ultrasound:  Pelvic (GYN) (O)

Ultrasound: Vaginal, gynecologic

Urogynecologic procedure

Vulvar procedure

Wet mount (P)

None

Notes/Comments:

  


Problems with any entries?  Contact Jean Afflerbach

Revised: September 06, 2012