School of Medicine

Program aims:

1. To educate and train skilled, superb, and inquisitive physicians according to the six ACGME core competencies in the field of Obstetrics and Gynecology (Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Professionalism, Practice-Based Learning and Improvement and Systems-Based Practice), and OB/GYN Milestone Project
2. To make a confident OB/GYN specialists who are well rounded in clinical practice and research, and can improve the standards of women's health in the Republic of Kazakhstan and internationally.
3. To provide program graduates with the foundation competencies in Obstetrics and Gynecology to continue their post-graduate medical training in OB/GYN sub-specialties (Family Planning, Female Pelvic Medicine and Reconstructive Surgery, General Obstetrics and Gynecology, Gynecologic Oncology, Maternal-Fetal Medicine, Reproductive Endocrinology and Infertility).

Learning Outcomes

By the end of the Obstetrics and Gynecology Residency Program, the residents should achieve the graduation target in the majority of the ACGME-I Milestones for Obstetrics and Gynecology, as follows:

1. Medical Knowledge (MK). Residents must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological and social-behavioral sciences, as well as the application of this knowledge to patient care. Residents must demonstrate proficiency in their knowledge of:

• reproductive health care and ambulatory primary health care for women, including health maintenance, disease prevention, diagnosis, treatment, consultation for co-management, and referral;
• health care, from puberty through adolescence, the reproductive years, menopause, and the geriatric years;
• the fundamentals of basic science as applied to clinical obstetrics and gynecology; applied surgical anatomy and pathology; physiology and pathophysiology related to reproductive function;
• basics of risk-benefit analysis, epidemiology, statistics, data collection and management, and use of medical literature and assessment of its value;
• the behavioral and societal factors that influence health among women of differing socioeconomic and cultural backgrounds.

2. Patient Care (PC). Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. Residents must demonstrate proficiency in:

• evaluating a patient's complaint, providing an accurate examination, employing appropriate diagnostic tests, arriving at a correct diagnosis, and recommending appropriate treatment;
• the essential areas of obstetrics and gynecology, including:
• normal physiology of reproductive tract;
• high-risk behaviors, such as multiple sex partners, no contraception, no protection from sexually transmitted disease, or substance abuse;
• diagnosis and non-surgical management of breast disease;
• medical and surgical complications of pregnancy;
• delivery, including the use of obstetric forceps and/or the vacuum extractor;
• gynecologic surgery;
• care of critically-ill obstetric and gynecology patients;
• obstetric and gynecologic pathology;
• the care and management of care of menopausal women;
• diagnosis and management of pelvic floor dysfunction, including surgical correction;
• reproductive endocrinology and infertility;
• family planning, genetics, and abortion;
• psychosomatic and psychosexual counseling;
• the management of complications of non-reversible methods of contraception and the performance of these procedures; and,
• geriatric medicine, including ambulatory primary care problems.
• the full range of commonly employed obstetrical diagnostic procedures, including ultrasonography and other relevant imaging techniques;
• counseling women regarding nutrition, exercise, health maintenance, high-risk behaviors, and preparation for pregnancy and childbirth;
• counseling women who have undergone genetic amniocentesis; continuous management of the care of women of all ages;
• appropriate use of community resources and other physicians through consultation when necessary;
• behavioral medicine and psychosocial problems, including domestic violence, sexual assault, and substance abuse;
• emergency care; and, community medicine, including health promotion and disease prevention.

3. Interpersonal and Communication Skills (ICS). Residents must demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals. Residents must:

• communicate effectively with patients, families, and the public, as appropriate, across a broad range of socioeconomic and cultural backgrounds;
• communicate effectively with physicians, other health professionals, and health-related agencies;
• work effectively as a member or leader of a health care team or other professional group; act in a consultative role to other physicians and health professionals;
• maintain comprehensive, timely, and legible medical and administrative records;
• provide counseling, engage in shared decision making, and obtain informed consent for procedures, including alternative treatments, risks, benefits, complications, and peri-operative course of those procedures;
• inform patients and families about a medical error that caused harm, incorporating risk management in this process;
• lead interprofessional and interdisciplinary health care teams to achieve optimal outcomes; lead effective transitions of care and team debriefings;
• respond to requests for consultation in a timely manner and communicate recommendations to the requesting team;
• organize and participate in multidisciplinary family/patient/team member conferences.

4. Professionalism (P). Residents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Residents must demonstrate:

• compassion, integrity, and respect for others; responsiveness to patient needs that supersedes self-interest;
• respect for patient privacy and autonomy; accountability to patients, society, and the profession;
• sensitivity and responsiveness to a diverse patient population, including to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation;
• ability to coach others to improve punctuality and responsiveness;
• ability to offer assistance to others so that patient care duties are completed in a timely fashion;
• self-awareness of fatigue and stress, and ability to mitigate the effects.

5. Practice-based Learning and Improvement (PBL). Residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self- evaluation and life-long learning. Residents are expected to develop skills and habits to be able to meet the following goals:

• identify strengths, deficiencies, and limits in one’s knowledge and expertise;
• set learning and improvement goals; identify and perform appropriate learning activities;
• systematically analyze practice using quality improvement methods, and implement changes with the goal of practice improvement;
• locate, appraise, and assimilate evidence from scientific studies related to their patient’s health problems;
• participate in the education of patients, families, students, residents and other health professionals;
• participate in departmental or institutional quality processes or committees.

6. Systems-based Practice (SBP). Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. Residents must:

• work effectively in various health care delivery settings and systems relevant to their clinical specialty;
• coordinate patient care within the health care system relevant to their clinical specialty;
• incorporate considerations of cost awareness and risk-benefit analysis in patient and/or population-based care as appropriate;
• work in inter-professional teams to enhance patient safety and improve patient care quality;
• participate in identifying system errors and implementing potential systems solutions;
• report errors and near-misses to the institutional surveillance system and to superiors;
• analyze patient care options from a quality of life/cost-of-care perspective, and includes in patient counseling;
• actively participate in quality improvement/patient safety projects.

These overall learning outcomes represent the core of our residency program’s educational efforts. Our mission is to train physicians who will provide the highest quality care for their patients and who will make meaningful contributions to women’s health throughout their careers.

Clinical rotation sites

The clinical activities of OBGYN Program will be carried out in two main hospital sites - UMC National Research Center for Mother and Child Health (NRCMCH) and City Hospital #2 (CH2).

Program structure

The clinical curriculum relies upon the ACGME Program Requirements for Obstetrics and Gynecology Residencies and fulfills the ACGME Competencies and Milestones required for all residencies, as described previously.

PGY1

The “Intern” year (1st year residents) focuses on the clinical experience with patients affected with acute and chronic illnesses and admitted into several inpatient departments, with appropriate supervision from UMC Attending Physicians, NUSOM Preceptors and Faculty.

Indeed, all the clinical activities of our 1st-year Program will be carried out in 2 (two) hospitals:

-  National Research Center for Mother and Child Health (NRCMCH);

-  City Hospital #2 (CH2)

The residents will pass through a series of 3-months rotations on inpatient departments (both obstetrics and gynecology):

1. Obstetrics (NRCMCH)
2. Gynecology (NRCMCH)
3. Obstetrics (CH2)
4. Gynecology (CH2)

PGY2

The second year will be devoted to acquiring additional clinical skills, develop more independence, and gain more experience in leadership and supervision.

Supervisory roles will be provided on inpatient and outpatient services, in both general and subspecialty OB/GYN teams.

These clinical skills are developed through a series of 3 months rotations on inpatient and outpatient departments (obstetrics and gynecology, REI, ultrasound/colposcopy):

1.Obstetrics ( NRCMCH)

2.Gynecology  (NRCMCH)

3.REI (NRCMCH)

4.Ultrasound/Colposcopy (CH2, NRCMCH)

Concomitantly, the residents will have their longitudinal clinical experiences, to be defined through an individual plan, taking advantage of both UMC hospitals/centers or other affiliated and certified centers.

Moreover, the residents will be encouraged to cultivate and broaden their potential research interests, through mentored and individual quality improvement and NUSOM scholarly research projects.

PGY3

The third year will be devoted to acquiring additional clinical skills, develop more independence, and gain more experience in leadership and supervision.

Supervisory roles will be provided on inpatient and outpatient services, in both general and subspecialty teams.

These clinical skills are developed through a series of 3 months rotations on inpatient and outpatient departments (obstetrics and gynecology, antepartum care, oncology):

1. Obstetrics ( NRCMCH)
2. Gynecology (NRCMCH)
3. Antepartum care ( NRCMCH)
4. Oncology (CH2 and another center which will be defined later)

PGY4

The fourth year will be devoted to acquiring additional clinical skills, develop more independence, and gain more experience in leadership and supervision.

Supervisory roles will be provided on inpatient and outpatient services, in both general and subspecialty teams.

These clinical skills are developed through a series of 3 months rotations on inpatient and outpatient departments (obstetrics and gynecology, antepartum care, oncology):

1. Obstetrics ( NRCMCH)
2. Gynecology (NRCMCH)
3. Antepartum care ( NRCMCH)
4. Oncology (CH2 and another center which will be defined later)