OBGU-4066 - Fundamentals of Human IVF

OBGU-4066 - Fundamentals of Human IVF

Elective Title: Fundamentals of Human IVF
Course Number: OBGU-4066
Elective Type: career Duration/Weeks: 2 Max Enrollment: 3
Prerequisites: Successful completion of Year 3
Additional Requirements: Consult with Dr. Hossain (amhossai@utmb.edu) at least 30 days prior to signing up for the elective. C-form is required and needs to be sent to Brandie Denton (bldenton@utmb.edu).
Responsible Faculty Director: Amjad Hossain, PhD Periods Offered: 1A-12A including holiday period 8 
Coordinator: Brandie Denton Other Faculty:
Location to Report on First Day:
335 clinical science building (CSB), Conference room in Gyn Suite (3rd floor near CSB auditorium), contact: 409-772-2610 (O) / 281-785-6804 (C)

In vitro fertilization (IVF), popularly known as IVF, is an established technology that is used worldwide as a method of human reproduction. Millions of couples conceive using IVF each year. The growth, development, and utilization of IVF has reached such a level that IVF is now recognized as an established medical industry.

In the United States two governmental agencies the FDA (Food and Drug Administration) and CLIA (Clinical Laboratory Improvement Amendments authority) are involved in monitoring the quality and safety of IVF services. According to CLIA and FDA, a gynecologist because of her MD degree is qualified to get involved with activities that fall under IVF. However, IVF work is uniquely different from other gynecologic works.

The gynecologists often do not feel the same level of comfort in engaging with IVF as they do with conventional gynecological tasks. This elective is designed to compile medical, laboratory, and management issues of IVF all in one course so that the gynecologists feel the same level of comfort with IVF as they do with conventional gynecological work.

Having more than 25 years of experience in IVF in academic and private work environments, I feel comfortable in outlining such an elective. The proposed elective will familiarize the learners with contemporary activities that occur in today's IVF clinics and laboratories. The goal is to build the competence and confidence of gynecologists in engaging with those activities.

The elective will acquaint the students with 1) activities that occur in IVF clinics and laboratories, 2) liability risks of IVF technologies and how to avoid or minimize such risks, 3) how to fulfill the requirements of regulatory agencies that monitor IVF, 4) development of quality assurance plans for safe IVF practice, and 5) how to ensure competitive IVF success.

Description of course activities
Week 1: In orientation (the first day of rotation), the course syllabus, schedule, expectations, and requirements will be discussed. How to fulfill the course objectives will also be explained. Students will be provided specific information detailing their daily roles and responsibilities as laid out in the weekly schedule. The orientation should thus sufficiently prepare the students in completing their assignments independently. In addition, daily faculty consultation will be available to further address students' needs. Emphasis will be to assist the students in completing their daily tasks.

In the first 4 days of week1, students will watch the suggested IVF videos from YouTube and complete the assigned readings of the preselected reviews on IVF. Students may watch as many videos as they desire but must watch the course director's required videos first.

On day 5 of week 1, an in-person or zoom session will be arranged to discuss the students' progress, problems encountered, and subsequent plans. Individualized feedback and guidance will be provided to carry on the project in the second week. In addition, students will be introduced to contemporary IVF journals so that they can explore the latest updates in the field on their own.

Week 2: In week 2 students expand their knowledge in the field by reading more IVF literature and revisiting IVF videos and/or by watching additional videos. Students will be required to give a presentation and prepare a written report to fulfill the course requirements. In both presentation and written product, the students must demonstrate their depth of knowledge on the required learning that are spelled out in the course learning objectives. Presentations and written essays will be due on Friday of week 2. However, students will be allowed to submit their essay via email on or before Sunday midnight for successful completion of this faculty guided elective.

Type of students who would benefit from the course
This elective will be of particular interest to 4th year medical students who wish to pursue a career in obstetrics and gynecology. Ob/Gyn residents and fellows who intend to engage in IVF program will also benefit from this elective.

Weekly Schedule
  Clinical Activities (estimated schedule)  
Day of Week   AM   PM
Monday Wk 1 & 2 (day 1 activities see description) 8:00am - 5:00pm
Tuesday Wk 1 & 2 (day 2 activities see description) 8:00am - 5:00pm
Wednesday Wk 1 & 2 (day 3 activities see description) 8:00am - 5:00pm
Thursday Wk 1 & 2 (day 4 activities see description) 8:00am - 5:00pm
Friday Wk 1 & 2 (day 5 activities see description) 8:00am - 5:00pm
Saturday week 1 & 2 Student's Choice
Sunday Wee 2: written essay due on or before midnight

 Average number of patients seen per week: N/A
 Call Schedule: none

Research Activities (estimated schedule)
Activity Hours per Week
Faculty Contact-Time
Self-Directed Study

Method of Student Evaluation
1.  Clinical Observation
  A. Where are students observed on this elective?
    Inpatient Service   Ambulatory   Surgery   Standardized patients
Patients simulators   Other
  B. Frequency - How often are students observed clinically?
  C. Format - What method(s) are used to document the student's clinical performance?
    Daily oral feedback   End of period oral feedback   Written feedback

2.  Oral Presentation
  A. Audience - To whom does the student present?
    Peers and faculty
  B. Frequency / Duration of Presentation(s)?
    Each student will present one formal presentation not exceeding 25 minutes. Since it is a guided study, the students' presentations should contain identical contents.
  C. Format - What guidelines are set for the student's presentation?
    Standard presentation in-person or zoom
  D. Assessment - Who assesses the student's presentation performance?
    Self-assessment   Peer assessment   Faculty assessment
  E. Method of content selection
    Current cases  Student-selected topic   Assigned topic

3.  Written Assignment (H&P's, notes, papers, abstracts, etc.)
  A. Frequency of written assignment(s)?
    One written report (essay) or take-home exam should be due at the end of the rotation.
  B. Format - What guidelines are set for the student's written work?
    Will be set jointly by the faculty and student upon discussion.
  C. Length of written assignment(s)?
    Abstract   Annotated bibliography   1 - 2 page paper   3+ page paper
  D. Are recent references required?   No    If yes, how are they selected?
    The final written product should be at least 8 pages in length not including figure, table, and reference. Written essay or take-home exam should reflect course learning objectives. Since this is a guided study, the references are selected following instructor's recommendation, should not exceed 10 pages.
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
    selected cases
  F. Audience - Who assesses the student's written performance?
    Peer Assessment     Faculty Assessment     Other

4.  Examination
    Oral   Written multiple choice   Written essay / short answer   OSCE

5.  Extra Course Activities
  What expectations do you have for the student to demonstrate participation in the elective (e.g. small group activities, seminars, thoughtful questions, providing resources, journal club, resident lecture attendance)?
    Students should exhibit expected professional behavior during the rotation in terms of attending all meetings and turning in their written report on time and taking the initiative to schedule their oral presentation with faculty. Further, the student is expected to demonstrate interpersonal skills reflecting content knowledge during interaction with the faculty and peers.

6.  Additional Costs
  Please list any additional costs and/or purchases (books, materials, movies to watch, etc.) that are required for this course. Include an estimated total cost. If there are no additional costs, please enter "None".

7.  Other Modes of Evaluation
  Please explain below.

8.  If this course is an Acting Internship, please complete the following:
  A. Objectives for the AI should relate directly to the Entrustable Professional Activities (EPAs). Each AI should describe how the four key Year-4 EPAs that our school has identified as being Year-4 skills are assessed. The Year-4 objectives are:
1. Entering and discussing orders/prescriptions.
2. Give or receive patient handover to transition care responsibility.
3. Recognizing a patient requiring urgent or emergent care and initiating management.
4. Obtaining informed consent for tests and procedures.
Specify how the student will be given formative feedback on their clinical skills.

Year-4 students should demonstrate mastery of EPAs they developed in the clerkship year, including recommending and interpreting common diagnostic and screening tests, and performing general procedures of a physician. They should be able to demonstrate masterfully and independently skills they mastered in Years 2-3, including efficiently performing comprehensive admission-notes and succinct daily progress notes and perform accurate, concise, and hypothesis-driven clinical presentations, form clinical questions and retrieve evidence to advance patient care. They should be able to demonstrate basic understanding of and beginning mastery of collaborate as a member of the interprofessional team and identify system failures and contribute to a culture of safety improvement.

List advanced clinical skills that a student will be assured an opportunity to practice.

How specifically will this AI build on developing skills from the clerkship year to prepare students for internship?

What opportunities will typically be available to all students who take this AI (procedures, required presentations, etc.)? What opportunities may be available based on patient load/presentation or student initiative (ie. Writing a case report)?

An AI should have expectation of a minimum of 32 hours per week of clinical responsibilities. Duty hours should be capped at ACGME limits for an intern, thus up to 24 hours followed by 4 hours of activities related to patient safety, education, and handoff. Students cannot work more than 80 hours per week averaged over 4 weeks. They can only have 1 day off in a 7-day work week with 8 hours off between shifts.

Clinical responsibilities will vary depending on specialty, but how is the student functioning with work commensurate to a PGY1 with an appropriate level of training?

How is the student demonstrating drawing clinical conclusions and/or developing a management plan and documentation as an intern would do?

How and by whom will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?

Acting Internship students often seek letters of recommendation following their experience. How many different Faculty will work directly with the student and have knowledge of the student's abilities to detail in a written evaluation? Describe the degree of supervision and interaction with faculty vs. residents or other providers and how feedback will be obtained if more direct work is with residents or other providers.