Studies & Degrees in Gynecology
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The surgical specialty that deals with the reproductive health of a woman is called Gynecology; it literally means “the science of women”. Gynecologists today also practice as Obstetricians.
Dated way back in 1800 BCE, the Kahun Gynecological Papyrus is the oldest medical text that has documented health illness cases in women such as fertility problems, methods and problems with contraception and the process of pregnancy. Each specific problem is articled in its thirty four divisions with each section tackling on the disease condition, diagnosis and treatment methods although the prognosis is not mentioned. The womb is the main site where the causes of the complaints arise. The treatments consisted mostly of non-surgical procedures such as the application of medicine into the affected body part or through oral intake.
An ancient Greek physician named Soranus of Ephesus as stated by the Suda, was able to practice medicine in Alexandria and later on in Rome. Soranus of Ephesus was a chief delegate of the school for physicians widely-known as the “Methodists”. His dissertation called Gynaikeia is well-documented and still exists collectively with Muscio’s Latin rewording, a fellow physician in the same school. In the United States on the other hand, a man by the name of J. Marion Sims is recognized as the founder and father of American Gynecology.
Gynecology is typically regarded as a consultant specialty. Women in some countries first seek the services of general practitioners prior to a referral to see a Gynecologist. Referrals happen when a woman’s condition is beyond the scope and practice of the general practitioner and involves training, adequate knowledge, surgical methods or paraphernalia that are not available to the general practitioners.
Gynecologists in the United States are required by law and several health insurance plans to supply primary care on top of the other features of their own practiced specialty. Because of this set up, women prefer going to a Gynecologist right away instead of waiting for a referral from other physicians who are not specialists.
It is generally practiced in the study of medicine to use the patient’s clinical history and physical examination as the chief tools for arriving at a successful diagnosis. Among all the physical examinations, the gynecological examination involves invading the personal boundaries of the woman because it requires the physician to examine the private parts (vagina and perinea area) with the use of an instrument called a vaginal speculum. It is used to retract the vagina of the woman for a better view and examination of the cervix, located on the upper portion of the vagina and the lower portion of the uterus. A bimanual examination done by a gynecologist requires one hand to rest on the abdominal area while one or two fingers to enter the vagina and do the palpation of the bony pelvis, cervix, uterus and ovaries. For a complete assessment and evaluation of the pelvis to rule out the presence of suspicious masses, it is very uncommon for a gynecologist to do a recto-vaginal examination.
Some of the main conditions that are dealt with in Gynecology are reproductive organs’ cancer and precancerous diseases that consists of the vulva, vagina, cervix, ovaries, fallopian tubes and uterus; urinary incontinence; absence of menstrual periods also known as Amenorrhea; intolerable pain during menstruation known as dysmenorrhea; infertility problems and heavy menstrual flow known as menorrhagia, making the patient a potential candidate for hysterectomy as well as the prolapsed of the organs of the pelvis.
Job positions for Gynecology:
Professor in Gynecology
Gynecologists can choose not to work in the hospital or clinical setting and can instead work as a professor in university hospitals. Many universities offer positions for gynecologists to work as an Assistant or Associate or a Full-time Professor in the levels of Clinical Obstetrics and Gynecology or as Clinical Professors in the field of Health Sciences. The main responsibility of a Professor is to act the role of a Faculty member in the designated department, can either function as an expert in gynecologic oncology, maternal or fetal medicine, reproductive endocrinology and infertility, urogynecology or reconstructive pelvic surgery or other subspecialty services in the inpatient and outpatient care, education and research studies. Each of these subspecialties has its corresponding certification which will remain valid provided that the board certification in obstetrics and gynecology is also up-to-date.
Among the other important responsibilities of a professor are:
• High-quality clinical care of the patient in the whole scope of general obstetrics and gynecology which deals with but not limited to prenatal care, care of the pregnant woman during labor and delivery, emergency room cases and the like
• Inpatient and outpatient case management, surgery and specific procedures applicable to high risk patients
• Involvement in educational activities with other residents, fellow interns and medical students
• Develop advancements in research and contribute in various research activities
• Contribution to the university’s and hospital’s committees
In order to apply as a Professor in a university, some of the requirements that need to be met are: eligibility in the Board or possess a Board Certification in Obstetrics and Gynecology; successful completion of subspecialty trainings and consequently hold a Specialty Board Eligibility and/or a certification in the subspecialty which takes a minimum of four years; he or she must also possess a medical license in the state applied; must manifest effectiveness in his or her teaching experience and show competence in the field of research, its corresponding and potential activities; and demonstrate skills in diagnostic testing, examination and genetics.
Derived from the Latin word “obstare” meaning to stand by, obstetrics is a surgical specialty that deals with the total care of women and the process of pregnancy from the first trimester to childbirth to puerperium – the period that directly follows childbirth. An Obstetrician focuses on women undergoing a difficult or complicated pregnancy. Because of the wonderful occurrence of life through childbirth, many medical students are drawn to this career path.
Among the responsibilities of the Obstetrician during pregnancy and delivery are:
• Monitoring the health condition of the pregnant woman who have undergone screening for risk problems
• Performing standard pregnancy examinations such as blood pressure monitoring
• Health teaching the pregnant woman on the process of pregnancy and the developmental stages of the baby
• Diagnosing impressions on fetal abnormalities
• Formation of a birthing plan
• Referral of soon-to-be mothers to other specialists to support and observe the duration of pregnancy
• Delivering the newborn as well as conduct the first examination to make certain that the newborn is free from any abnormalities and potential problems
• Proper documentation of the treatments carried out to both the mother and the newborn
The basis of a patient’s frequent health visits is follow-up on the various risk factors and potential resources noted during the previous health check-ups. An Obstetrician can also act as a primary health care provider and oftentimes serve as a consultant to other doctors. Obstetricians can choose to work in a private practice, in the hospital or clinical settings, work as professors or other teaching positions at university hospitals or become public health workers in the primary preventive measures in medication administration.
Obstetricians can also opt to specialize in any of the following areas:
• Pubescent gynecology
• Behavioral crisis
• Acute and Chronic health conditions
• Proper health maintenance of the pregnant woman
• Problems with infertility
• Disease prevention measures
• Urinary Tract Disorders
• Sexually-transmitted Diseases
• Maternal and Fetal medicine
• Critical care medicine
The American Board of Obstetrics and Gynecology (ABOG) is responsible for setting the education and training requirements of Obstetricians and Gynecologists alike. In order for a person to become an Obstetrician, he or she must have finished or graduated from one of the approved medical schools; completed a residency program in OB/GYN for the time span of at least four years which should also be recognized by the American Council for Graduate Medical Education or ACGME ; must have undergone clinical rotations in the field of obstetrics, gynecology, gynecologic oncology, reproductive endocrinology and ultrasonography; undergone a six-month residency in the role of a primary and preventive health care provider which includes experience in the in-patient and ambulatory care, breast disease diagnosis and management of dysfunctions of the lower urinary tract; reading and interpretation of diagnostic pelvic and transvaginal ultrasound results; constantly updated in patient care responsibilities in each year of training; and serve as a senior resident physician during the last year.
After all the requirements have been met, the physicians will then be allowed to obtain a board certificate after taking the examinations provided for by the ABOG. A successful board examination allows the physician to earn the status of Obstetrics and Gynecology which is necessary in acquiring a subspecialty certification. For physicians who have obtained their status after the year 1986, he or she must once again complete a recertification which takes about 10 years to process in order to maintain his or her certified status. If the certification was obtained before the year 1986, the physician is given the option to take a recertification process voluntarily.