Qualifying Exam Preparation

Provide preconception, prenatal, and antenatal care

• Provide management, counseling, and testing for routine prenatal care
• Evaluate, diagnose, and provide initial management of co-existent medical diseases (e.g., cardiovascular, chronic hypertension, pulmonary, renal, gastrointestinal including liver disease, hematologic, endocrine including thyroid, psychiatric disorders, autoimmune including DM, neoplastic, dermatologic, neurologic, obesity) during pregnancy
• Provide patient counseling regarding options, risks and benefits of genetic testing

Evaluate, diagnose, and manage the following preconception/antenatal conditions

• Select, perform, and/or interpret antepartum fetal assessment and manage associated abnormalities (e.g., biophysical profile, contraction stress test, nonstress test, vibroacoustic stimulation)
• Apply knowledge of female anatomy and pathophysiology to improve patient outcomes
• Patients at risk for preterm delivery
• Common antepartum complications (e.g., hyperemesis, first trimester bleeding)
• Medical disorders unique to pregnancy (e.g., preeclampsia, eclampsia, hyperemesis, gestational diabetes, cholestasis, acute fatty liver, peripartum cardiomyopathy, PUPPS, herpes gestationalis)
• Infectious diseases in pregnancy (e.g., HIV, Group A Streptococcus, varicella, pyelonephritis, CMV, toxoplasmosis, parvovirus)
• Surgical conditions (e.g., acute abdomen, adnexal masses) during pregnancy
• Abnormal fetal presentation (e.g., external cephalic version)
• Manage multifetal gestation
• Fetal growth abnormalities (e.g., fetal growth restriction, macrosomia)
• Post-term pregnancies
• Thrombophilia
• Fetal assessment/prenatal diagnosis (e.g., fetal anomalies, abnormal AFV, ultrasound assessment - infectious disease exposure, isoimmunization, non-immune hydrops)
• Evaluate, diagnose, and provide co-management of non-obstetric emergencies during pregnancy (e.g., trauma, intimate partner violence, sexual assault)

Provide general intrapartum care

• Evaluate, diagnose, and provide operative vaginal delivery (e.g., forceps, vacuum)
• Evaluate, diagnose, and provide operative delivery (e.g., cesarean delivery)
• Evaluate, diagnose, and repair obstetric lacerations and associate complications
• Counsel patients on analgesia options and manage intrapartum pain
• Evaluate and diagnose infants in need of resuscitation and perform initial management
• Manage induction and augmentation of labor including cervical ripening
• Prevention and management of thrombosis

Evaluate, diagnose, and manage the following intrapartum conditions

• Labor abnormalities (e.g., preterm labor, dystocia, PROM, cord problems, abnormal presentation)
• Obstetric hemorrhage
• Medical disorders
• Infections diseases
• Placental abruption
• Abnormal placentation
• Uterine rupture
• Uterine inversion
• Placental abnormalities (e.g., placenta previa and vasa previa)
• Acute maternal decompensation (e.g., amniotic fluid embolism, septic shock)
• Fetal heart rate abnormalities
• Previous cesarean delivery (e.g., TOLAC, VBAC)
• Infectious complications

Perform the following obstetrical procedures

• Amniocentesis for fetal lung maturation and genetic testing
• 1st-, 2nd-, and 3rd-degree vaginal laceration repair
• 4th-degree vaginal laceration repair
• Debridement and repair of perineal dehiscence
• Cervical laceration repair
• Breech vaginal delivery
• Vaginal delivery of twin gestation
• Internal version and extraction
• Operative vaginal delivery (low forceps, vacuum)
• Shoulders dystocia maneuvers
• Cesarean delivery
• Peripartum hysterectomy
• Management of abnormal placental location (e.g., placenta previa)
• Management of abnormal placentation (e.g., placenta accreta)
• Surgical management of uterine atony
• Management of hysterotomy extension
• Management of cystotomy
• Management of enterotomy
• Neonatal circumcision
• Cervical cerclage
• Postpartum uterine curettage
• Amnioinfusion

Provide general postpartum care

• Provide routine care (e.g., breastfeeding, contraception, pain management)
• Evaluate, diagnose, and manage postpartum complications (e.g., vulvar and vaginal hematoma, endometriosis, mastitis)
• Evaluate and manage common medical and obstetric complications or conditions (e.g., gestational diabetes, hypertension, depression, thyroid disorders, psychiatric disorders)
• Evaluate, diagnose, and manage lactation and breastfeeding complications
• Evaluate, diagnose, and manage postpartum hemorrhage
• Evaluate, diagnose, and manage postpartum hypertensive disorders

Evaluate, diagnose, and surgically manage

• Acute pelvic pain
• Pelvic inflammatory disease/TOA
• Vulvar disorders
• Gynecologic trauma
• Adnexal torsion
• Ectopic pregnancy and pregnancies of unknown location

Provide general preoperative evaluation

• Counsel patients about risks, benefits, and alternative treatment options
• Determine appropriate surgical intervention
• Evaluation, diagnose, and manage co-existing medical conditions
• Obtain informed consent

Perform the following perioperative care

• Provide interventions to reduce perioperative infection
• Provide interventions to reduce venous thromboembolism
• Communicate with interdisciplinary team members to reduce surgical error (e.g., timeouts, counts, fire hazard risk)
• Communicate with interdisciplinary team members to provide appropriate anesthesia and positioning

Provide general intraoperative care

• Apply knowledge of female pelvic anatomy to reduce intraoperative complications
• Evaluate, diagnose, and manage intraoperative hemorrhage
• Evaluate, diagnose, and initially manage small/large bowel injury
• Evaluate, diagnose, and initially manage urinary tract injury

Evaluate, diagnose, and manage postoperative care

• A hemodynamically unstable patient
• Nerve injuries
• Wound complications
• Postoperative venous thromboembolism
• Nausea and vomiting and/or diarrhea
• Fever and infections
• Urinary tract complications
• Altered mental status
• Small/large bowel injury

Perform minimally invasive surgical procedures

• Diagnostic hysteroscopy
• Diagnostic laparoscopy
• Operative hysteroscopy (e.g., endometrial ablation, myomectomy, polypectomy, septoplasty)
• Laparoscopic ablation and excision of endometriosis
• Laparoscopic hysterectomy (e.g., LAVH, supracervical, TLH)
• Operative laparoscopy (e.g., LOA, ovarian cystectomy, salpingectomy, salpingo-oophorectomy, salpingostomy)
• Laparoscopic myomectomy
• Laparoscopic sterilization
• Lysis of intrauterine adhesions
• Proximal fallopian tube cannulation (chromopertubation)

Perform gynecologic surgical procedures for benign disorders

• Abdominal hysterectomy
• Abdominal myomectomy
• Bartholin gland duct cystectomy
• Bartholin gland duct marsupialization
• Bilateral tubal ligation
• Cervical conization
• Cherney incision
• Cornual wedge resection
• Dilatation and sharp curettage
• Dilatation and suction curettage
• Exploratory laparotomy
• Hymenectomy
• Labia minora reduction
• Lysis of adhesions
• Maylard incision
• Midline vertical incision
• Oophorectomy
• Ovarian cystectomy
• Pfannenstiel incision
• Salpingectomy
• Salpingo-oophorectomy
• Salpingostomy
• Trachelectomy
• Vaginal hysterectomy
• Vaginal septum excision
• Vestibulectomy
• Vulvar abscess or hematoma drainage
• Wound debridement and secondary closure

Perform surgeries for pelvic floor disorders (e.g., prolapse, incontinence)

• Diagnostic and operative cystoscopy and urethroscopy
• Surgical repair of urinary incontinence (e.g., Burch colposespension, tension-free vaginal tape, transobturator tape sling)
• Vesticovaginal fistula repair
• Vaginal prolapse repair (e.g., anterior colporrhaphy, posterior colporrhaphy, perineorrhaphy)
• Vaginal apical suspension (e.g., uterosacral ligament suspension, sacrospinous ligament fixation, McCall culdoplasty)
• Colpocleisis

Provide general neoplasia care

• Evaluate, diagnose, and manage intraoperative findings consistent with neoplasia
• Evaluate and diagnose genetic risks of neoplasia
• Evaluate, diagnose, and manage gestational trophoblastic disease

Provide routine care

• Perform age-appropriate preventative health screening
• Provide appropriate immunizations
• Evaluate and manage at-risk patients and recommend genetic screening and cancer preventive measures
• Counsel and promote wellness (e.g., weight management, diet, smoking cessation, exercise)
• Family planning (individual reproductive priorities, contraception, optimize fertility, and pre-pregnancy health)
• Risks and benefits of ovarian preservation

Evaluate and initiate management of primary care problems

• Breast disorders
• Hypertension
• Hyperlipidemia
• Gastrointestinal disease
• Diabetes mellitus
• Thyroid disease
• Osteopenia/osteoporosis
• Obesity
• Depression and anxiety
• Acne and dermatological conditions
• Low back pain
• Headaches

Perform general office gynecology care

• Evaluate, diagnose, and initiate management of infertility disorders
• Evaluate, diagnose, and manage disorders of menopause (e.g., vasomotor, genitourinary syndrome of menopause)
• Evaluate, diagnose, and initiate management for sexual development disorders (e.g., structural, chromosomal)
• Provide cervical cancer screening and manage abnormal results
• Evaluate, diagnose, and manage adnexal abnormalities (e.g., simple and complex masses)
• Evaluate, diagnose, and manage pelvic pain disorders and endometriosis
• Evaluate, diagnose, and provide gynecologic care for women with HIV
• Evaluate, diagnose, and provide gynecologic care for women with Hepatitis B/C
• Evaluate, diagnose, and manage urinary tract infections

Evaluate, diagnose, and manage endocrine disorders

• Polycystic ovary syndrome (PCOS)
• Galactorrhea
• Hirsutism
• Disorders of puberty

Evaluate, diagnose, and manage disorders of menstruation

• Primary amenorrhea
• Secondary amenorrhea
• Abnormal uterine bleeding
• Premenstrual dysphoric disorder
• Dysmenorrhea

Evaluate, diagnose, and manage vulvovaginal conditions

• Benign conditions (e.g., infections, dermatoses, cysts)
• Vulvar intraepithelial neoplasia / Vaginal intraepithelial neoplasia
• Chronic pain/vulvodynia
• Pediatric (e.g., labial adhesions)

Evaluate, diagnose, and manage structural uterine abnormalities

• Leiomyomata
• Polyps
• Hyperplasia
• Adenomyosis

Evaluate, diagnose, and initiate management of incontinence / pelvic floor disorders

• Urinary incontinence
• Accidental bowel leakage
• Pelvic organ prolapse

Evaluate and manage early pregnancy disorders

• Abortion (e.g., spontaneous, incomplete, missed)
• Recurrent pregnancy loss
• Pregnancy of unknown location
• Ectopic

Evaluate, diagnose, and initiate management for reproductive tract cancer

• Vulva
• Cervix
• Uterus
• Ovary
• Fallopian tubes

Evaluate, diagnose, and manage sexually transmitted infections

• Chlamydia
• Syphilis
• Gonorrhea
• HPV
• Herpes Simplex Virus
• Trichomonas
• Rare STIs (Lymphogranuloma venereum, Chancroid, Molluscum contagiosum)
• Partner treatment
• Prophylaxis including PrEP

Perform office-based procedures

• Diagnostic hysteroscopy
• Endometrial ablation
• Induced abortion
• First-trimester uterine aspiration
• Loop electrosurgical excision procedure (LEEP)
• Biopsies
• Colposcopy (e.g., cervical, vaginal, vulvar)
• Placement and removal of an intrauterine device
• Placement and removal of long-acting reversible contraception
• Pessary fitting
• Incision and drainage of vulvovaginal cyst, abscess, and hematoma
• Treatment of condyloma
• Wound care

Provide care for patients with unique obstetric or gynecologic needs including

• Geriatric patients
• Pediatric (<12 years) patients and Adolescent (<21 years) patients
• LGBTQIA patients
• Substance and alcohol abuse
• Sexual health and dysfunction
• Intimate partner violence and sexual assault
• Psychiatric disorders
• Reproductive tract congenital anomalies

Communicate effectively and professionally with patients and/or family members about the following situations

• Unexpected outcomes (e.g., fetal demise, stillbirth, cancer, surgical complications)
• Crisis situations (e.g., substance abuse, intimate partner violence)
• Disclosure of adverse outcomes
• Disclosure of medical errors

Evaluating and managing the following ethical situations, personally or with colleagues

• Boundary violations (sexual)
• Signs of excess stress and burnout
• Unprofessional behavior (e.g., dishonesty, verbal abuse, disruptive behavior)
• Impaired physicians (e.g., alcohol abuse, substance abuse, psychiatric disorders)
• Personal and team member wellness
• Counsel patients on ethically complex cases

Act ethically and professionally

• Provide care with multi-disciplinary teams (systems-based practice)
• Participate in continuous quality improvement (practice-based learning and improvement)
• Participate in hospital, department, or office-based patient safety initiatives (patient safety)

Basic and applied science

• Physiology
• Anatomy
• Pathology
• Microbiology
• Immunology
• Embryology
• Pharmacology
• Epidemiology and Evidence-based medicine