OBGU-4054 - Introduction to the World of Infertility

OBGU-4054 - Introduction to the World of Infertility

Elective Title: Introduction to the World of Infertility
Course Number: OBGU-4054
Elective Type: career Duration/Weeks: 2 Max Enrollment: 2
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-7A, 8AB (1 max), 9A-12A including holiday period 8 
Coordinator: Brandie Denton Other Faculty: Craig Witz, MD; John E. Crochet, MD; James C. Chuong, MD; Boltros Rizk, MD; Laith Alzweri, MD
Location to Report on First Day:
335 Clinical Science Bldg. (CSB), Conf. Room in Gyn Suite (3rd Floor near CBS Auditorium), contact : 409-772-2610 or 281-785-6804

Infertility affects approximately 20% of the world's population. In western world, human reproduction is facing multifaceted challenges from the fastly evolving industrial, environmental, technological, social, cultural, and other lifestyle changes. Further, societal, and economic pressure are forcing the couples to delay family building and because of which they are ending up seeking medical help for assisted reproduction. Medical students eager to know about the reproductive health in their undergraduate medical training so that they can prepare themselves to face the ongoing as well as future fertility challenges. In this course the students will achieve the following three goals: 1) track the development and challenges in the field, 2) identify the trend in which the Infertility field will be advancing during the millennium practice of medicine and 3) develop vision about the type of training they will require to face the future challenges of fertility care.

he students will be able to: 1) record the prevalence and causes of male and female infertility, 2) determine the preventive measures to protect fertility, 3) utilize and categorize the methods of diagnosis of infertility, 4) appraise different infertility treatment methods, 5) critique the assisted reproductive technologies in infertility treatment, and 6) identify ethical and legal issues treating infertility.

Description of course activities
Course director will arrange a 2-hours session in the morning at the very first day of the elective. In this session the director will update the student with the status of Infertility as a subspecialty of medicine. The students will know the course outlines, the goals and learning objectives of the course. The students will get the specific information of their daily roles & responsibilities that have already been laid out in the weekly schedule.
In week 1, the students will explore the literatures and online resources on human infertility. They will collect the pertinent data to accomplish some of the learning objectives by the series of self-directed learning sessions. Students will have daily access to Dr. Hossain (course director) for timely consultation and guidance. During week 1, each day one hour discussion session will occur starting at 4:00 pm to review the progress of the learning. The feedback and guidance will be provided based on the learning the students made each day. On 5th day of week 1 the students will be expected to give presentation reflecting the summary of their learnings in the week. In addition, the students will be given the outlines of their anticipated learning in week 2 including infertility clinic visit if can be arranged. Since UTMB has no infertility clinic, arrangement will be made with a local Infertility clinic. The Center for Reproductive Medicine, Houston Fertility Institute, and Cooper Institute for Advanced Reproductive Medicine are expected to assist us with the clinic visit. Clinic visit will also cover UTMB Urology clinic. The students will be expected to follow standard UTMB guidelines as well as that of the clinic during their presence in the clinic. In circumstances when clinic visit could not be arranged, the students will be guided to watch infertility videos to learn the type of activities that occur in infertility clinic and infertility laboratory.
In the remaining days of the 2nd week the students will go back to online resources once again to retrieve additional information they will seek based on their new experiences from watching the activities of infertility clinic or that in infertility videos.
The students will be required to prepare a written report by synthesizing all the information they collect in the two weeks to develop their own vision about the current status and future trend of infertility care, and academic preparation they will need for that. The written report should reflect the learning objectives and course goals that are accomplished.

Type of students who would benefit from the course
The Infertility is a subspecialty of medicine where both primary care physician like family medicine, internal medicine, and general gynecology as well as specialty care physician like Reproductive Endocrinologist, Urologist, Psychiatrist and Geneticist have scope to serve. The multidisciplinary tasks are essential to take care of infertility comprehensively. Thus, students who have aspiration for any of the above subspecialties of medicine and has a general interest to human fertility can be benefited from this 2-week elective.

Weekly Schedule
  Clinical Activities (estimated schedule)  
Day of Week   AM   PM
Monday Week1/2-Day1 activities (course description) 8:00am - 5:00pm
Tuesday Week1/2-Day2 activities (course description) 8:00am - 5:00pm
Wednesday Week1/2-Day3 activities (course description) 8:00am - 5:00pm
Thursday Week1/2-Day4 activities (course description) 8:00am - 5:00pm
Friday Week1/2-Day5 activities (course description) 8:00am - 5:00pm
Sunday Written report is due by midnight via email.

 Average number of patients seen per week: 25+
 Call Schedule: N/A

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?
    2 to 3 times depending on how many days the student spend in the clinic. The student will be assessed on their learning from i) the given study materials, ii) online source and iii) clinical experiences from the clinic visit or watching infertility videos.
  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?
    Dr. Hossain and other fertility specialists
  B. Frequency / Duration of Presentation(s)?
  C. Format - What guidelines are set for the student's presentation?
    By discussion of Dr. Hossain with the student
  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)?
    1 assignment
  B. Format - What guidelines are set for the student's written work?
    Will be set jointly by the instructor 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?
    (3+ page paper (limit < or equal to 6 pages) reflecting course learning objectives) Instructor recommended way, should be < or equal to 6
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
    Faculty will discuss with student
  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)?
    In addition to oral presentation and written report, the student is expected to demonstrate interpersonal skills reflecting content knowledge during interaction with the faculty.

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.
    Written assignment (60%): The course director will evaluate the written report by checking for the quality of writing, accomplishment of learning objectives, accomplishment of course goals, and infertility knowledge depth [unsatisfactory (<75%), meet expectation (75-84%), exceeded expectation (85-90%) or outstanding (>91%)]
Oral presentation (20%): [Pass (score > 75) / Fail (score < 75)]
Clinical observation (20%): of clinic physician [unsatisfactory (<75%), meet expectation (75-84%), exceeded expectation (85-90%) or outstanding (>91%)]. In case the clinic visit could not be arranged, the student’s learning from infertility videos will be evaluated.

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.