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Case List Instructions

There has been concern expressed over the reduction in categories for the GYN case list.  In an effort to align the case list to the blueprint, there was a decrease in categories and a shift of categories in some cases to other case lists.    

 

To better meet your needs and ensure a fair examination, GYN case list categories have been added.  In this expansion, you may note a duplication with other case lists. One example is the categories for abortion management on both the OB and Office Practice case lists. In these instances, please populate the area that allows you to meet category requirements. All examiners are trained in test administration and scoring guidelines before each exam cycle and will be made aware of the category variance.

 

If you would like to speak in person, please email exams@abog.org to schedule a phone call. 

 

 

 

Below are the categories for the 2024 Certifying Exam.

 

The candidate must list 40 patients with conditions that fit into the listed Office Practice categories:


Follow these rules when listing office practice patients:


a. Do not list more than two patients in any one category;


b. It is not necessary to include a patient in every category;


c. Do not include any patient that appears as an admitted patient on the Obstetrics or Gynecology lists; and


d. Do not include any patients that had procedures performed in any location except the office. Specifically, patients who had an outpatient procedure in a surgical center must be listed on the Gynecology case list. Patients who had virtual visits may be listed if they fit into one of the categories in the following list.



Office Practice Categories

  1. Preventive health screening and immunization for all age groups
  2. Screening of mental health and social determinants
  3. Cancer prevention and genetic testing for at-risk patient
  4. Wellness counseling (exercise, diet, weight, alcohol or tobacco use, stress, sexual health)
  5. Reproductive counseling (priorities, optimizing fertility and reproductive health, genetic screening)
  6. Counseling on contraceptive or abortion options
  7. Pediatric or adolescent patient
  8. LGBTQIA+ patient
  9. Victim of intimate partner violence or sexual assault
  10. Psychiatric disorder (depression, anxiety, substance use disorder, eating disorder, PMDD)
  11. Compromised health (mental or physical disability, immunocompromise)
  12. Breast disorders (mass, discharge)
  13. Cardiovascular disease risks (HTN, hyperlipidemia, DM, obesity)
  14. Gastrointestinal disease
  15. Musculoskeletal disease (low back pain, abdominal wall hernia)
  16. Headache
  17. Asthma
  18. Osteoporosis/osteoperia
  19. Infertility and recurrent pregnancy loss
  20. Menopausal symptoms (vasomotor, genitourinary syndrome of menopause)
  21. Sexual development disorders and transition to adulthood (genetic, structural)
  22. Abnormal cervical cancer screening results (colposcopy, biopsy, LEEP, etc.)
  23. Adnexal abnormality (simple and complex masses, rupture)
  24. Urinary tract infection
  25. Chronic genital pain disorders (dysmenorrhea, vulvodynia, interstitial cystitis, inflammatory bowel disease)
  26. Endometriosis
  27. Female sexual dysfunction
  28. Contraceptive management (initiation, complications, benefits)
  29. Androgen excess
  30. Hyperprolactinemia
  31. Disorders of puberty
  32. Thyroid disease
  33. Amenorrhea
  34. Abnormal uterine bleeding (endometrial biopsy, office hysteroscopy, manage AUB)
  35. Vaginal discharge and STIs
  36. Vulvar or vaginal intraepithelial neoplasia
  37. Vulvar dermatologic conditions (lichensclerosus, lichen planus, contact dermatitis, vitiligo, hidradenitis suppurativa)
  38. Leiomyoma
  39. Endometrial or cervical polyp
  40. Hyperplasia or endometrial intraepithelial neoplasia
  41. Adenomyosis
  42. Urinary or fecal incontinence or fistula
  43. Pelvic organ prolapse (evaluation, nonsurgical options)
  44. Initial care of reproductive tract cancer
  45. Gestational trophoblastic disease
  46. Induced abortion (medication, procedural)
  47. Office procedure pain management (oral agents, topical agents, cervical block)
  48. Abdominal or transvaginal pelvic ultrasonography
  49. Uncategorized (cases in this category do not count toward the required 40 cases)


List each patient separately and include the problem (one of the categories listed above), diagnostic procedures, treatment, results and number of office visits during the 12-month period.

A minimum of 20 gynecologic patients must be entered. All hospitalized and short-stay gynecological patients must be entered as follows:


a. List all gynecologic patients managed during the 12-month collection period (or 18-month period, if an extended time case list is submitted; and/or patients chosen from fellowship or senior year of residency).


b. A minimum of 20 gynecologic patients are required. In order to meet the minimum requirement, a candidate cannot count more than two patients from any one of the gynecology categories listed below.

Example: A candidate has 5 patients who had a diagnostic laparoscopy. They all must be entered on the case list, but only 2 of the 5 will be counted as meeting the minimum requirement of 20 gynecological cases.


c. A preoperative diagnosis should appear for all major and minor surgical procedures. The size of ovarian cysts and neoplasms must be recorded. For non-surgical conditions, the admission diagnosis should be recorded. Non-surgical admissions will not have a surgical pathological diagnosis. The treatment recorded should include all surgical procedures, as well as primary non-surgical therapy. “Surgical diagnosis” is the final pathology diagnosis. For hysterectomy specimens, the uterine weight in grams must be recorded. In cases without tissue for histologic diagnosis, the final clinical diagnosis should be listed. If the preoperative and postoperative diagnoses are the same and there is no pathology, you do not need to relist the diagnosis.


d. “Nights in hospital” is the arithmetic difference between the date of discharge and the date of admission. Specific dates of admission and discharge should not be provided. If a patient had an outpatient procedure and was not admitted, list the number of nights in hospital as “0.”


e. List any remaining patients that do not fit into any of the listed categories in the “Uncategorized” category.


Gynecology Categories

  1. Adnexal emergency (PID, TOA, torsion, ruptured cyst with hemorrhage
  2. Vulvar emergency (Bartholin gland duct or vulvar abscess, fasciitis, straddle injury, sexual assault trauma)
  3. Ectopic pregnancy and pregnancy of unknown location
  4. Acute uterine complications (heavy abnormal uterine bleeding; Myoma prolapse, degeneration, or torsion; hematometra)
  5. Acute genitourinary complications (renal stone, procidentia, urinary retention, urethral diverticular abscess)
  6. Operative hysteroscopy (diagnostic, polypectomy, myomectomy, ablation, adhesiolysis)
  7. Minimally invasive hysterectomy (vaginal, laparoscopic, robotic, trachelectomy)
  8. Operative laparoscopy (diagnostic, ovarian cystectomy, oophorectomy, sterilization, salpingectomy, etc.)
  9. Cervical conization and LEEP
  10. Dilation and curettage (not pregnancy related)
  11. Vulvar or vaginal surgery (hymenectomy, labiaplasty, septum excision, vestibulectomy, etc.)
  12. Diagnostic cystoscopy
  13. Abdominal incisions (Pfannenstiel, midline vertical, Cherney, Maylard, wound debridement)
  14. Abdominal hysterectomy
  15. Abdominal myomectomy
  16. Abdominal adnexal surgery (cystectomy, oophorectomy, sterilization, salpingectomy, etc.)
  17. Intraoperative gynecologic malignancy identified
  18. Uncategorized (cases in this category do not count toward the required 20 cases)


If a candidate cannot list 20 gynecological cases in the above categories, an 18-month case list and/or an appropriate number of cases from fellowship or senior residency case logs may be included. If prior fellowship or senior resident cases are used, only list 20 cases.


If a candidate cannot meet the minimum number of cases after using an 18-month case list and/or using fellowship or residency cases, they should email the Assessment Department at exams@abog.org as soon as possible to gain assistance in meeting the case list requirements.

A list of a minimum of 20 obstetrical patients must be entered. Separately enter each patient with a complication or abnormality, as well as medical and surgical intervention during pregnancy, labor, delivery, and the puerperium. Normal, uncomplicated obstetrical patients should not be listed.


The term “normal obstetrical patient” for this listing implies that the:


a. pregnancy, labor, delivery, and the puerperium were uncomplicated; and labor began spontaneously between the 39th and completion of the 41st week of gestation; patients delivering before 39 weeks gestation should be listed in the “preterm,” “late preterm” or “early term” categories;


b. membranes ruptured or were ruptured after labor began;


c. presentation was vertex, position was occiput OA, LOA or ROA, and labor was less than 24 hours in duration;


d. delivery was spontaneous with or without episiotomy, from an anterior position;


e. the infant had a five-minute Apgar score of 6 or more and weighed between 2500 and 4500 grams and was healthy, and


f. placental delivery was uncomplicated, and blood loss was ≤ 500 mL


All deliveries not fulfilling these criteria must be listed individually. Include the gestational age at admission.


A minimum of 20 obstetrical patients is required. In order to meet the minimum, a candidate cannot count more than two patients in any of the categories listed below.


Example: A candidate has 5 obstetrical patients with diabetes mellitus. They all must be entered on the case list, but only 2 of the 5 will be counted as meeting the minimum requirement of 20 obstetrical cases.


The “nights in hospital” includes all prenatal and postnatal nights. The number of nights listed is the arithmetic difference between the admission and discharge date.


If a candidate cares for a patient in the hospital, but does not deliver the patient, the information on the delivery and infant should not be listed. For example, a patient who has preterm labor without delivery would not have delivery or infant information listed.


List any remaining patients that do not fit into any of the listed categories in the “Uncategorized” category.


Obstetrical Categories

  1. Management of co-existing disease (cardiovascular, pulmonary, endocrine, psychiatric, etc.)
  2. Genetic screening and testing (counseling, screen or test performed)
  3. Antepartum fetal assessment (biophysical profile, nonstress test, vibroacoustic stimulation, etc.)
  4. Preterm labor; preterm delivery (affected or at-risk patients)
  5. Fetal anomaly diagnosed by second-trimester ultrasound examination
  6. Multifetal gestation
  7. Fetal growth abnormalities
  8. Postterm gestation
  9. Stillbirth
  10. First-trimester complications (miscarriage, threatened abortion, uterine incarceration)
  11. Second-trimester complications (miscarriage, cervical insufficiency, PPROM)
  12. Hypertensive disorders of pregnancy (chronic hypertension, pre-eclampsia, eclampsia)
  13. Pregestational and gestational diabetes mellitus
  14. Medical disorders unique to pregnancy (hyperemesis, acute fatty liver, PUPPP/PEP, peripartum cardiomyopathy, etc.)
  15. Antepartum infections (HIV, STIs, pyelonephritis, pneumonia, TORCH viruses, etc.)
  16. Nonobstetrical surgical conditions and emergencies (renal stone, appendicitis, trauma, adnexal mass, etc.)
  17. Operative vaginal delivery
  18. Cesarean delivery with or without intraoperative complications
  19. Obstetrical lacerations (vulvar, perineal, OASIS, vaginal, cervical)
  20. Intrapartum analgesia (options counseling, provision)
  21. Neonatal resuscitation; neonatal circumcision
  22. Labor induction or augmentation
  23. Labor abnormalities (dystocia, PROM, cord problems, abnormal position or presentation, etc.)
  24. Postpartum hemorrhage (atony, inversion, retained products, etc.)
  25. Placental abnormalities (placenta or vasa previa, placenta accreta spectrum, abruption, etc.)
  26. Acute maternal decompensation (amniotic fluid or pulmonary embolism, high spinal analgesia, sepsis, cardiovascular shock, etc.)
  27. Fetal heart rate abnormalities
  28. Prior cesarean delivery (TOLAC, VBAC, uterine rupture)
  29. Intrapartum infection management (chorioamnionitis, group B streptococcus, HIV, HSV, etc.)
  30. Singleton breech fetus (vaginal delivery or external cephalic version)
  31. Vaginal delivery of twin gestation
  32. Shoulder dystocia release maneuvers
  33. Peripartum hysterectomy
  34. Cerclage
  35. Immediate postpartum sterilization or IUD insertion
  36. Acute postpartum complications (hematoma, endometritis, surgical site infection, etc.)
  37. Postpartum care of medical conditions (gestational DM, hypertension, depression, etc.)
  38. Lactation complications
  39. Uncategorized (cases in this category do not count toward the required 20 cases) 


If a candidate cannot list 20 obstetrical cases in the above categories, an 18-month case list and/or an appropriate number of cases from fellowship or senior residency case logs may be included. If prior fellowship or senior resident cases are used, only list 20 cases.


If a candidate cannot meet the minimum number of cases after using an 18-month case list and/or using fellowship or residency cases, they should email the Assessment Department at exams@abog.org as soon as possible to gain assistance in meeting the case list requirements.