A profile of directors of clerkships in obstetrics and gynecology in the United States and Canada.

OBJECTIVE: To describe current professional activities, demographic profiles, and attitudes of directors of clerkships in university and community teaching sites. METHODS: Written surveys were mailed to departments of obstetrics and gynecology in the United States and Canada. Results were analyzed for differences in demographics, professional activities, and responses to statements describing career development of medical teachers and levels of institutional support. RESULTS: Responses from 132 of 148 (89%) medical schools and 67 of 96 (70%) known community-based clerkship directors showed no significant differences between the two groups in demographics or professional responsibilities. Three-quarters were men. The mean age was 47 years, mean duration as a faculty member 11 years, and mean tenure as clerkship director 8 years. One-half had been a clerkship director less than 5 years. The average clerkship director reported working approximately 56 hours per week, of which 44% was devoted primarily to patient care, 24% to teaching, and 18% to administration. These faculty members describe the activities of their position as fulfilling and worthy of recognition in the academic promotions process. CONCLUSION: Directors of clinical clerkships in obstetrics and gynecology in both university- and community-based programs spend about one-half of their time in teaching and administration. They find their work fulfilling and worthwhile. Profiles are consistent over time and comparable to those described by clerkship directors in other specialties.

Women's health care issues for medical students: an education proposal.

This outline of objectives in women's health care education is intended to provide a model for reviewing medical school curricula by interdisciplinary educators on a national basis to identify core knowledge, skill, and attitudes for medical student education. Review of the core objectives identified for internal medicine, pediatrics, family medicine, and surgery allows us to identify those that are essential to good patient care so they can be reinforced and evaluated at various outcome points. Developing learning objectives that are complementary rather than additive, that clarify important objectives for students, that bring course directors into collaborative communication, and that ultimately improve communication will require an atmosphere of cooperation among disciplines.

Calcifications of the benign endometrium.

A 28-year-old woman underwent a dilatation and curettage procedure in the course of an infertility evaluation, with the finding of multiple psammoma bodies in the tissue from the lower uterine segment. A repeated dilatation and curettage procedure performed five months later again revealed psammoma bodies in the lower endometrium and normal fundal endometrium. The patient previously had been treated with clomiphene. Psammoma bodies in the gynecologic tract most often have been associated with malignant neoplasms; however, a few cases of psammoma body formation or dystrophic calcification of the endometrium in benign conditions have been reported.

Amniotic fluid cultures: post-cesarean section endomyometritis and neonatal infections.

Amniotic fluid cultures in 54 consecutive patients undergoing cesarean section were compared in regard to intrapartum and postpartum events. Neonatal outcome and cultures were also compared with amniotic fluid findings. Positive amniotic cultures were obtained in 57% and showed a multiplicity of organisms. Development of endomyometritis was correlated with a heavy growth of bacteria in culture. Positive cultures were significantly associated with duration of labor greater than eight hours and presence of ruptured membranes at the time of cesarean section. Thirty-three percent of the patients with positive cultures had intact membranes at the time of operation. Eighty-eight percent of cultures from infants and amniotic fluid grew organisms in common. Implications of the study for the pathogenesis of postcesarean endomyometritis and neonatal morbidity are discussed.