Course syllabus for Clinical medicine 6: Obstetrics and Gynaecology

Klinisk medicin 6: Obstetrik och Gynekologi

Specific entry requirements

A passing grade is required in the following courses:

• Basic Science 1–6, Medical diagnostics integrated with basic science, Medical scientific theory and methodology, Clinical Medicine 1–3, and Degree Project in Medicine (semesters 1–8)
• The course components “Neurology and Rehabilitation Medicine,” “Psychiatry and Addiction Medicine,” and “Ophthalmology and Otorhinolaryngology from the course Clinical Medicine 4: Neuro, senses and psyche.

A student who has failed workplace-based learning (VFU) or equivalent due to serious deficiencies in knowledge, skills, or professional conduct that have jeopardized patient safety or public trust in healthcare, is eligible for a new VFU opportunity only once the individual action plan has been completed.

Outcomes

The course focuses on developing clinical knowledge and skills in obstetrics and gynaecology. The aim is to deepen the clinical competencies acquired in previous clinical medicine courses. This includes the ability to diagnose, initially assess, and manage common, serious, and acute medical conditions based on symptoms and clinical findings, as well as to prescribe pharmacological and non-pharmacological treatments. The course also includes an understanding of how preventive work in sexual and reproductive health contributes to improved public health. Professional and interprofessional competence is further developed during the course.

Students will apply basic scientific and pathophysiological explanatory models, as well as scientific, global, health-promoting, and equity perspectives to the course content. Knowledge, skills, and practical training in a physician’s role within the healthcare team are based on evidence-based and person-centered care and are developed through supervised clinical training with feedback. Skills training follows a progression model aligned with the nationally agreed framework of Entrustable Professional Activities (EPA).

Learning outcomes
The intended learning outcomes of the course are aligned with the national learning objectives for the medical degree as stated in the Swedish Higher Education Ordinance (SFS 1993:100). Learning outcomes related to knowledge and understanding are categorized according to the SOLO taxonomy (S2–S5), and those related to skills and abilities are categorized according to Miller’s pyramid (M3–M4).

Knowledge and understanding

To pass the course, the student must be able to:

• Explain the diagnostics, management, and etiology of normal, common, acute, and serious conditions in obstetrics, gynaecology, and reproductive medicine (S4).
• Describe how exposures, lifestyle factors, and common, acute, and serious medical conditions may pose risks during pregnancy, and analyze their short- and long-term health impacts (S4).
• Analyze ethical issues related to sexual and reproductive health, obstetrics, and gynaecology (S4).
• Analyze how obstetric and gynaecological conditions, as well as preventive measures to promote sexual and reproductive health, affect health from national, global, and health economic perspectives, and apply preventive measures at the individual level (S4).
• Explain how gender, gender identity, and sexual health influence general health, and understand the relevance of applicable regulations, laws, and conventions concerning sexual and reproductive health and rights (S4).
• Analyze individuals’ vulnerability within families, close relationships, and society (S4).

Competence and skills

To pass the course, the student must be able to:

• Collect, interpret, document, and communicate medical history in a safe and patient-centered manner in both non-acute and acute obstetric and gynaecological situations, including routinely inquiring about intimate partner violence (M4).
• Perform relevant physical examinations, clinical procedures, and sampling adapted to the clinical context (M4).
• Develop a plan for initial management, investigation, and monitoring of common, acute, and serious obstetric and gynaecological conditions, and critically assess the reliability of diagnostic results in relation to the characteristics and limitations of the methods used (M3).
• Explain diagnostic findings, formulate a management and follow-up plan, and carry out pharmacological or non-pharmacological treatment in consultation with the patient (M3).
• Identify the need for, and implement, preventive and health-promoting measures at the individual level (M3).
• Collaborate effectively in group settings and contribute to peer learning by being well-prepared, actively participating in discussions related to course content, and using peer feedback as a tool for professional development (M4).
• Interact respectfully and professionally with patients, relatives, fellow students, teachers, and staff (M4).

Judgement and approach

To pass the course, the student must be able to:

• Analyze the importance of personal values, empathy, and professional conduct in interactions with patients, relatives, and colleagues, with particular focus on obstetric and gynaecological contexts.
• Take responsibility for their own learning in relation to the course’s learning objectives and future professional role, and formulate goals for continued professional development.
• Act and behave with sound judgement and professionalism.

Content

The course content focuses on the fields of obstetrics, gynaecology, and reproductive medicine. Students will deepen their ability to work independently in clinical settings, conduct scientific analysis of clinical questions, and make medical decisions with consideration for the patient’s individual circumstances. This includes discussing the scientific basis of current clinical guidelines as well as ongoing research and development aimed at strengthening the evidence base in the field.

Legal and ethical aspects of communication, including communication via digital systems, are addressed. The course also includes further development of professional and interprofessional competencies.

The course is divided into four modules:

Obstetrics and Gynaecology, 3.5 credits

This module covers knowledge and skills in the fields of obstetrics, gynaecology, and reproductive medicine, with a focus on normal, common, acute, and serious conditions. Teaching includes both theoretical instruction and practical exercises, as well as a diagnostic test. Emphasis is placed on symptoms and clinical findings, clinical reasoning, diagnostics, and management of normal, common, acute, and serious conditions. Significant attention is also given to disease prevention from both national and global perspectives. This module also addresses the individual’s vulnerability within families and society, as well as relevant regulations and laws concerning sexual and reproductive health and rights.

Clinical placement, 3.0 credits

This module consists of workplace-based learning (VFU) at obstetric and gynaecological units. During clinical training, students practice taking medical histories, performing appropriate physical examinations, engaging in differential diagnostic reasoning, proposing interventions, and initiating treatment for patients with common, serious, and acute conditions in the respective fields. Students also deepen their general medical competencies acquired in previous courses, with the goal of achieving greater independence in clinical work. Emphasis is placed on increased independence in general and targeted examination techniques, prioritization of relevant differential diagnoses, planning of investigations, and practical management in collaboration with the patient and, when applicable, their relatives. This module also includes understanding of interprofessional collaboration through teamwork with other healthcare professionals

Application and integration, 2.0 credits

This module includes review and integration of the course content through self-directed learning and formative assessment. It also includes the final examinations of the course, consisting of an Objective Structured Clinical Examination (OSCE) and a written exam. In connection with the examinations, time is provided for self-study and reflection.

Professionalism, responsibility and learning, 0.5 credits

Teaching, training, and assessment of professional conduct, responsibility, and learning are integrated throughout the course and specifically addressed during Team-Based Learning (TBL) sessions. Examination (grading) of professional conduct outside of workplace-based learning is carried out within this module through continuous assessment based on the established criteria of the programme.

Professional conduct in authentic clinical situations is assessed and graded within the workplace-based learning module.

Teaching methods

The following teaching methods are used in the course:

- Workplace-based learning (VFU)

- Team-Based Learning (TBL)

- Seminars

- Skills training

- Simulation

- Lectures

The core learning methods of the course are workplace-based learning and workplace-integrated learning.

Examination

To be eligible to participate in the written examination, students must have completed all mandatory course components, including workplace-based learning.
To be eligible for the practical examination (OSCE), at least 50% of the workplace-based learning (VFU) in both obstetrics and gynaecology must be completed.

Obstetrics and Gynaecology, 3.5 credits

Mandatory participation

- Team-Based Learning (TBL)

- Seminars

- Skills training

- Simulation

- Themed study day (Intimate partner violence)

- Diagnostic test

Clinical placement, 3.0 credits

Mandatory participation

- Workplace-based learning (VFU)

Mandatory formative assessments

- Continuous assessment during workplace-based learning*

Examination

- Assessment during workplace-based learning**

Application and integration, 2.0 credits

Examination

- Objective Structured Clinical Examination (OSCE)

- Written examination

Professionalism, responsibility and learning, 0.5 credits

Mandatory formative assessments

- Self-assessment and peer evaluation in TBL

Examination

- Assessment of professional conduct

\* The learning objectives related to professionalism are continuously assessed, based on established criteria, in all contexts where the student acts in their role as a student or participates in activities related to the university or healthcare services, including communication and digital media. If a lack of goal fulfillment is identified (based on relevant documentation), the examiner may fail the student in the module \*Professionalism, responsibility and learning (PFAL)\* or in the \*Workplace-based learning\* module, if the deficiency occurs during clinical training. In such cases, an individual action plan must be established.

Students are entitled to two examination attempts for the assessment of professional conduct in both PFAL and Workplace-based learning. A failed assessment of professional conduct during workplace-based learning counts as one used examination attempt. Re-examination requires the student to retake the entire module, supported by the action plan. Re-examination of a failed PFAL module takes place during a subsequent course as specified in the action plan.

**) Examination in workplace-based learning is summative and based on repeated formative assessments conducted during clinical training. These assessments are documented using validated tools such as MiniCEX, MSF, DOPS, EPA, or structured dialogue instruments.

The examiner decides whether and how absence from compulsory course elements can be compensated. Before the student has participated in the compulsory elements or made up for absence in accordance with the examiner’s instructions, the study results cannot be finalized. Absence from a compulsory element may mean that the student cannot make up the occasion until the next time the course is given.

The examiner may immediately terminate a student’s workplace-based learning (VFU) if the student demonstrates such serious deficiencies in knowledge, skills, or professional conduct that patient safety or public trust in healthcare is at risk. In such cases, the student will fail the module, and one attempt will be considered used. An individual action plan must then be established, outlining the activities and assessments required before the student may resume clinical training in the course. If the termination is due to serious deficiencies in professional conduct outside of workplace-based learning, the student will fail the PFAL module, and one examination attempt will be considered used. The student may not participate in any further course activities until an action plan has been established.

Students who do not pass the regular examinations are entitled to five additional examination attempts. After six failed attempts at the same examination, no further attempts will be granted. Each participation in the same examination counts as one attempt. Submitting a blank exam counts as an attempt. Registering for but not attending an exam does not count as an attempt. For workplace-based learning assessments (VFU), students are entitled to two examination attempts.

If there are special circumstances or if the student has a documented disability, the examiner may decide to deviate from the course syllabus regarding the form of examination, number of examination attempts, opportunities for supplementary work, or exemptions from mandatory components. However, the content, learning objectives, and required level of knowledge, skills, and abilities must not be altered, removed, or lowered.

To take an examination scheduled for a different course instance than the one the student is registered for, the student must have attempted the corresponding examination during their original course instance or have had valid reasons for not attending.

Other directives

Language of instruction
The primary language of instruction is Swedish, although teaching in English may occur. The extent of English-language instruction depends on whether the course instance is offered to incoming exchange students. Both Swedish and English literature are used in the course.

Learning portfolio
Support for the student’s development across various competency areas is continuously documented in the student’s individual learning portfolio. The responsible department provides information on which documents should be retained for the current course instance.

Scheduling
Course activities may be scheduled during evenings, nights, and weekends.

Course evaluation
Course evaluations are conducted in accordance with the guidelines of Karolinska Institutet.

Literature and other teaching aids

Recommended literature and other teaching aids

Ajne, G., Blomberg, M. & Carlsson, Y. (2021) Obstetrik (3:dje uppl.). Lund : Studentlitteratur.

Bixo, M., & Poromaa Sundström, I., (2022) Problemorienterad gynekologi och obstetrik (2:a uppl.) Stockholm: Liber

Bäckström, T., Kjølhede, P., Kirkegaard, Landgren, BM (2022) Gynekologi (3:dje uppl.). Lund : Studentlitteratur.

Casanova, R., Connolly, AM., Goepfert, AR., Hueppchen, NA; Weiss, PM. (2024) Beckmann and Ling's obstetrics and gynecology (9th ed.) American College of Obstetricians and Gynecologists. Philadelphia : Wolters Kluwer

Oats, J., Llewellyn-Jones, D., & Boyle, J. (2023). Llewellyn-Jones fundamentals of

obstetrics and gynaecology (11th ed.). Amsterdam : Elsevier.

”Obstetrics and Gynecology - online textbook for medical students”, open source

NFOG Obstetrics and Gynecology eTextbook

https://www.sundhed.dk/sundhedsfaglig/opslag-og-vaerktoejer/laereboeger/obstetrics-gynecology/

In addition, course materials—including references to current scientific publications—are provided via the learning platform.