Exploring New Horizons in Obstetrics and Gynecology (What to do next after MD in Obstetrics and Gynecology?) Tushar Kar, Parag Biniwale, Aswath Kumar R, Nilesh Balkawade, S Shantha Kumari
INDEX
ABCDEFGHIKLMNOPRSTUVWX
Page numbers followed by b refer to box, f refer to figure, and t refer to table.
A
Adrenal function 59
American Academy of Family Physicians 106
American Board of Obstetrics and Gynecology 72
American College of Obstetricians and Gynecologists 37, 53
American Society of Clinical Oncology 37
Amniocentesis 55
Andrology 61
laboratory 60
Anesthesiology 100
Aneuploidy screening 55
Angoff method 92
Anxiety disorder 115
Asherman's syndrome 7
Asia-Pacific Association for Gynecologic Endoscopy 27
Assisted reproductive technology 60
Audit/research related activities 55
Australian Medical Council 99
B
Ball placement 33
Barker's hypothesis 53
Basic electrocautery 33
Biostatics and data management 62
Blastocyst culture 61
Blunt tissue dissection 33
Body dysmorphic disorder 115
Brachytherapy 40
British Society for Gynaecological Endoscopy 25
Burch colposuspension 31
C
Camera control 33
Cell culture 61
Central nervous system, lesions of 73, 76
Chorionic villus sampling 55
Civil services aptitude test 120
Clinical medicine, advanced 104
Clinical psychology and sexology 59
Clitoral hood reduction 112
Coital incontinence 74, 76
Colles’ fascia 112
Colposcopy 3
Common admission test 124
Competence progression, annual review of 88
Complete da Vinci technology
in-service with da Vinci representative 32
online
assessment 32
training 32
skills drills session 33
Complete live standard case observation 32
Completion of training, certificate of 87
Complex da Vinci procedure observation 34
video review 34
Controlled ovarian stimulation 60
Cosmetic gynecology 3, 110, 115
opportunities in 115
surgical procedures in 111
Cryopreservation 61
principles of 61
Culture media 61
D
da Vinci surgery
procedure 32, 33
webinar 34
da Vinci surgical system 32
da Vinci technology 32
skills drills 32
training 32
da Vinci training
certificate, sample of 34f
passport technology training pathway 32
Delivery, management of 89
Designer laser vaginoplasty 111, 113
Detrusor overactivity 75
Diverticula 73, 76
E
Early pregnancy
after ART treatment
monitoring of 62
treatment of 62
ultrasound 55
Ebel's method 90
E-learning 90
Electronic
residency application service 50
urodynamics studies 74
Embryo
donation 62
freezing 61
hatching 61
transfer 61, 62
Embryology 60
lab 59, 60
quality control and maintenance 61
Emotional and behavioral disorders 73, 76
Endocrine disturbances 59
Endocrinology 59
Endometrial receptivity assay 61
Endometriosis 7, 31
Endometrium, transcervical resection of 7
Endoscopic surgery 60
European Academy of Gynecological Surgery 25
European Board and College of Obstetrics and Gynecology 24
European Society of Aesthetic Gynecology 115
European Society of Gynaecological Endoscopy 24, 29
European Urogynecological Association 72
Evidence-based medicine, principles of 74
F
Family medicine 100
Family planning 85, 108
program 85
Fecal incontinence 73
Federation of Obstetrics and Gynaecological Society of India 133, 134
Federation of State Medical Boards 100
Fellowship 108
admission test 57
clinical 27
programs in India, map of 49f
Female genital plastic surgery 111
Female infertility
diagnosis of 60
management of 60
Female pelvic medicine 71
and reconstructive surgery 108
Female reproductive system 59
Fertility preservation 62
Fertilization 60
abnormal 61
normal 61
Fetal anomalies, targeted imaging for 55
Fetal autopsies 55
Fetal medicine 42, 55
and perinatology 59
fellowships 50
foundation 50
Fetal origin of adult disease 53
Fibroids 7, 31
Fluid management 77
Foreign medical graduates, education commission for 100
Fourth arm control 33
Freezing techniques 61
Frenkel hypothesis 53
G
Gametes
storage of 61
use of 61
Gametogenesis 60
Genetic 60
history and counseling 61
German Academy of Obstetrics and Gynecology 29
German Association of Gynecological Endoscopy 29
German Society of Gynecological Endoscopy 26
German Society of Urogynecology 72
Grafenberg spot 113
Growth scans 55
Gynecologic malignancies 41
Gynecologic oncologist, role of 36
Gynecologic oncology 108
fellowship 41
programs 39
Gynecological endoscopic surgeries, advanced 28
Gynecological endoscopy
task force for accreditation of 27
training 6
Gynecological oncology 31, 36
H
Hands-on live surgery 28
Hands-on practice 27
Health professional shortage area 107
High-risk pregnancy 54
and perinatology 53
Hormone
autocrine 59
deficiency states 76
on pelvic floor 74
Human Organ Transplant Act 132
Human reproduction 59
Hymenoplasty 112
Hyperandrogenic states 60
Hypothalamic-pituitary-ovarian hormones 59
Hysterectomy
benign 31
laparoscopic 7
Hysteropexy 31
Hysteroscopic surgeries 7
Hysteroscopy 2, 60
I
In vitro fertilization 60, 64
Indian College of Obstetrics and Gynaecology 133
Indian Corporate Law Service 117
Indian Council of Medical Research 36
Indian Defence Accounts Service 117
Indian Defence Estates Service 118
Indian Federal Law Enforcement Agencies 119
Indian Foreign Service 117, 118
Indian Forest Service 117
Indian Information Service 118
Indian Ordnance Factories Service 118
Indian Police Service 117, 119
Indian Post and Telecommunication Accounts and Finance Service 117
Indian Postal Service 118
Indian Railway Accounts Service 118
Indian Railway Personnel Service 118
Indian Railway Traffic Service 118
Indian Revenue Service 117, 118
Indian Trade Service 118
Infertility 60
management, ethical and medicolegal aspects of 62
Insemination 61
Internal medicine 100
International Fellowship Programs, map of 50f
International horizon 85
International Society of Cosmetogynecology 115
International Society of Gynecological Endoscopy 26
International Urogynecological Association 72
Interstitial cystitis 73
Intracytoplasmic sperm injection 60
techniques of 61
Intrauterine insemination 60
Italian School of Endoscopy 28
K
Kiel School of Gynecological Endoscopy 26
Knot tying 33
L
Labia majora
augmentation 112, 113
laser reduction of 113
liposculpturing of 113
reduction 112
Labia minora thickness, reduction of 113
Labiaplasty 112
Labor, management of 89
Laparoscopic Institute for Gynecology and Oncology 25
Laparoscopic training centers outside India, list of 24
Laparoscopy 2, 24, 28, 60
operative 62
process of 2f
Laser labiaplasty 112
Laser vaginal
rejuvenation 111, 113
tightening 113
Laser vulval lightening 114
Law courses available in India 130t
Law study 128
in medical college curriculum 129
List of Indian College of Obstetricians and Gynecology recognized centers for certificate course in reproductive medicine 65
Lower bowel urinary tract 76
Lower gastrointestinal tract
fistulae 76
function, disorders of 76
Lower intestinal tract, disorders of 73
Lower urinary and intestinal tract
fistulae 73
function 73
Lower urinary tract 76
and pelvis
anatomy of 77
function of 77
M
Majora reduction 112
Male infertility
diagnosis of 60
management of 60
Male reproductive system 59
Maternal and child health 4
Maternal fetal medicine 3, 42, 49, 50, 53, 56, 108
certification in 51
Medical Council of Canada Qualifying Examination 99
Medical Council of India 57, 99
Medical School and Law School 128
Medical statistics 62
Medical teaching 81
Medicolegal and ethical aspect 62
Medicolegal cases 3
Medicolegal Committee 5
Mentors’ evaluation 27
Minimal access surgery 108
diploma 28
training 27
Minimal hysteroscopy surgeries 28
Minimal invasive surgery 24, 28, 30, 39
Minimal invasive surgical
procedures 30
techniques 24
Minimal invasive therapy 27
Mons pubis, liposculpturing of 113
Mons reduction 112
MRCOG exam, tips for 91b, 95b, 98b
N
National Board of Examinations 53, 54, 57
National Board of Medical Education 100
National Eligibility Cum Entrance Test 36, 58
National Health Mission 83
National Resident Matching Program 104
National Training Number 87
Neurology 77
Nonelectronic urodynamics studies 74
Nuchal translucency 54
O
Obstetric anal sphincter injury 73, 76
Obstetrical and gynecological ultrasound, certification in 51
Oocyte
donation 62
freezing 61
identification and grading 61
Orthopedic surgery 100
Ovarian
hormones 59
hyperstimulation syndrome 61
tumors, benign 7
Overactive bladder syndrome 73, 75
Ovulation 59
induction 60
monitoring of 60
Ovum pick-up 61
P
Painful bladder syndrome 73, 76
Paracrine hormones 59
Pediatric labial hypertrophy 110
Pelvic floor 73, 76
defects 7
disorders 73, 74
function 73
trauma, childbirth related 73
Pelvic organ prolapse 73, 76
Pelvic pain 76
syndrome 73
Pelvic problems 89
Pelvic surgery, effects of 76
Personality test 120
Pharmacological therapies 77
Platelet rich plasma 112, 113
Polycystic ovary syndrome 60
Port placement, instrument control 33
Postgraduate diploma in medicolegal systems 130
features of 131b
Pregnancy
care, inverted pyramid of 53
multiple 61
Preimplantation genetic diagnosis 61
screening 61
Prenatal invasive diagnostic procedures 55
Professional and linguistic assessment board test 99
Proximal tubal cannulation 7
Psychiatry 100
Psychosis 115
Puberty disorders, normal 60
Public health sector and family planning 80
R
Reconstructive pelvic surgery 71
Rectal prolapse 73
Reproductive
endocrinology 59
and infertility 108
genetics, basics of 61
immunology 60
medicine 3, 59
and surgery 57, 64, 68t
application of 4f
ultrasonography in 60
Revirgination procedure 112
Robotic gynecology 31
Robotic operating system 30f
Robotic surgery 3, 30, 108
process of 3f
Royal College of Obstetricians and Gynaecologists 28, 51, 53, 72, 87, 87f
membership of 50, 87
Royal College of Physicians of Ireland, member of 134
S
Sacrocolpopexy 31
Saudi Medical Licensing Examination 99
Science and Engineering Research Board 36
Semen
analysis 60, 62
freezing 61
Septal resection 7
Sex development, disorders of 60
Sexual and reproductive health 89
Sexual dysfunction 74
Sexually transmitted diseases 74, 76
Sir Nicolaides hypothesis 53
Skills
drills 32
simulator 32
Slow freeze techniques/vitrification 61
Society of Laparoscopy Surgeon 26
Society of Obstetricians and Gynaecologists 72
Spatial control 33
Sperm
donation 62
function tests 60
wash procedures 62
Studying law, benefits of 128
Submucus fibroid removal 7
Surgeon lecture program 34
Surgery
effects of 73
laparoscopic 7
Surgical video editing 27
Surrogacy 62
T
Teratogenesis, fuel mediated 53
Testicular/epididymal sperms, processing samples of 60
Testis
PESA 62
TESA 62
TESE 62
Third party reproduction 62
Thyroid 59
Tissue
cutting 33
retraction 33
Training centers, details of 7
Training programs 37
aims and objectives of 39
Tubal recanalization procedures 62
Tubal surgeries 7
U
Union Public Service Commission 80, 81, 117
United States Medical Licensing Examination 4, 99
Course, three-step process of 102f
University Hospital for Gynecology 29
University recognized fellowship, list of 69t
Urethral lesions 73, 76
Urinary
disorders in
childhood 73, 76
pregnancy 73, 76
incontinence types assessment 73
problems 74, 76
retention 73, 75
tract infection 73
Urodynamic stress incontinence 75
Urogynecology 72, 73
condition, conservative management of 77
fellowship 71
laparoscopic 77
Urology 59
USMLE
and future prospects 99
exam details 105t
steps 102
Uterine bleeding, abnormal 60
V
Vaginal rejuvenation 112, 113
Vaginal skin lightening 114
Vaginal tightening, nonsurgical 111f
Vessel dissection 33
Voiding disorders 75
Voiding dysfunction 73
Vulvar disorders 74
Vulvar structures, suprapubic lift of 113
V-wedge technique, modified 111
W
Wedge resection 112
World and Kaplan pretest 100
W-plasty 112
X
Xavier aptitude test 124
×
Chapter Notes

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EXPLORING NEW HORIZONS IN OBSTETRICS AND GYNECOLOGY
EXPLORING NEW HORIZONS IN OBSTETRICS AND GYNECOLOGY: (WHAT TO DO NEXT AFTER MD IN OBSTETRICS AND GYNECOLOGY?)
Editors Aswath Kumar R MD FICOG Diploma in Advanced Laparoscopy (France) Diploma in Laparoscopic Management of Advanced Endometriosis (Austria) Fellow (Gynec-Oncology) The Gujarat Cancer and Research Institute (GCRI), Ahmedabad, Gujarat Professor Department of Gynecology Jubilee Mission Medical College Thrissur, Kerala, India FOGSI Quiz Committee Chairperson (2012–2015) Vice President, FOGSI, 2019 Vice President, KFOG, 2017 Nilesh Balkawade MS DNB MNMAS FIAGE Fellow, Reproductive Medicine Consultant, IVF and Endoscopy, Indira IVF, Pune, Maharashtra Ex-Assistant Professor Department of Obstetrics and Gynecology Dr DY Patil Medical College, Pune, Maharashtra, India National Coordinator FOGSI Quiz Committee (2018–2020) Jt Treasurer, POGS (2015–2016) Co-Editors S Shantha Kumari MD DNB FICOG FRCPI (Ireland) FRCOG (UK) Chairperson, ICOG, 2018 Consultant, Yashoda Hospital Hyderabad, Telangana, India ICOG Secretary (2015–2017) Member, FIGO Working Group (on Violence Against Women) Vice President, FOGSI 2013 Tushar Kar MD MICOG FICOG FICMCH Fellowship Laparoscopic Surgery (USA) Department of Obstetrics and Gynecology SCB Medical College Cuttack, Odisha, India Chairperson, ICOG (2019–2020) Vice President, FOGSI (2010–2011) Chairperson, Oncology, FOGSI (2004–2009) Parag Biniwale MD FICOG FICMCH Consultant Obstetrician and Gynecologist Pune, Maharashtra, India Secretary, ICOG Foreword Nandita Palshetkar
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Exploring New Horizons in Obstetrics and Gynecology (What to do next after MD in Obstetrics and Gynecology?)
First Edition: 2019
9789352708291
Printed at:
All Postgraduate Students and Consultants.
Contributors Foreword
Dear Readers,
Greetings from the FOGSI President and her team!
Youngsters today are poised on the cusp of a technological revolution. With the easy availability of mobile networks and internet accessibility, scientific and educational materials in print and online, video courses, discussion forums, training workshops and programs being regularly conducted nationally and overseas, there is no dearth of high quality materials in the quest for updated knowledge.
The scenario today is much different from two or three decades ago when quality training and accessibility to such courses was limited and highly sought after. However, the entire gamut of options available to young trainees today can be overwhelming and confusing. After completion of postgraduation, there are so many options available currently that it is difficult to summarize and weigh the risks, benefits, and long-term viability of the different paths that one can take.
“Believe in yourself. Have faith in your abilities. Without a humble but reasonable confidence in your own powers you cannot be successful or happy”—Norman Vincent Peale
This excellent compendium is an attempt to provide a precise and detailed outline of the many options available to young gynecologists after they complete their postgraduation. Dr Aswath Kumar R, Vice President FOGSI, is a dynamic, hardworking and enthusiastic teacher who has trained several young gynecologists in endoscopic surgery and other allied branches of our specialty.
This book is his brainchild and he has worked hard along with his co-authors to provide the latest information to today's trainees, including fellowship courses, short diplomas, international traveling courses, and superspecialty training, among others. There is no similar text available in India, as of today!
I have no doubt that this book will go a long way toward helping young doctors make informed career choices, guide them regarding available courses and help to plan their future with a particular subspecialty in mind.
I wish the readers all the very best for their future, hope they join FOGSI, become committed FOGSIans and strengthen this amazing organization!
Dr Nandita Palshetkar
President FOGSI 2019
Preface
Obstetrics and Gynecology is a constantly evolving field! New things and innovations are coming up fast. So are options of what to do after MD gynecology!
It is not just the superspecialty, but also the varied branches which are attracting the Gen Next!
We could hardly imagine doctors as business administrators or entrepreneurs few decades ago! But things are changing rapidly! Doctors are seen to be successful in many walks of life. Be it their own field such as endoscopy or completely newer ones such as Law or MBA!! Life has taken a 360° turn when it comes to choosing professional course.
Some fields, although a part of Obstetrics and Gynecology, have now grown into huge superspecialty. Endoscopy, robotics and reproductive medicine has grown as a specialty field in Obstetrics and Gynecology. Cosmetic gynecology has just started to spread its wings and occupy the horizon. Public health is an old branch but is now being rejuvenated.
Civil services or MBA or international dimensions are few of the new horizons left to explore!
More is yet to come! You may be contended with yourself as an obstetrician or may be not!
Always remember that your present situation is not your final destination; the Best is yet to come!!!
We do not say that this book provides you with all options to look for after doing your MD/MS. But certainly, it will give you the right food for thoughts while thinking of, “What to do next?”
You have to think out of the box to be a successful person.
William Faulkner has rightly said,
You cannot Swim for new Horizons until
you have courage to Loose Sight of the Shore
Acknowledgments
We sincerely thank our postgraduate students for showing the faith in us and asking us the million dollar question, “What to do after MD?”
This made us to think about all options we could explore…Some were practical and are included here. Some might not be included in this first edition. Sky is the only limit when it comes to FLYING!
We thank our families for giving us that much needed energy in our wings, so that we can fly high, explore new horizons and bring some glimpses to you in form of this book.
We thank all our mentors, friends and seniors at FOGSI who helped us achieve different milestones in our lives.
We are thankful to M/s Jaypee Brothers Medical Publishers (P) Ltd, India, for bringing out this book wonderfully well.
Last but not the least, we thank all our teachers who have showed us the right path throughout our lives!!