All students must complete the following required assignments before they can receive a clerkship grade. It is the student's responsibility to submit evaluation of student performance in clinical curriculum, breast CEx, pelvic CEx, and observed history forms to the Clerkship Administrator by the conclusion of the clerkship (final grades will be held until received and a statement appearing under the Overall Assessment of Professional Behavior or Conduct on your final evaluation form submitted to the Registrar).

Evaluation of Student Performance in Clinical Curriculum
Due by end of week 4 of clerkship

The PDF iconEvaluation of Student Performance in Clinical Curriculum Form (completed by reviewing Faculty/Resident) is required for final grade release.  Students should solicit feedback frequently during their rotation, but are required to receive formal, mid-clerkship feedback in week 2 or 3. 

This form can be submitted to the Clerkship Administrator via or dropbox

Observed History



Students are required to be observed taking minimum of one (1) history during their OB/GYN clerkship. These can be entire histories, or can be part of the history. 

No submission necesssary for observed history.


Breast & Pelvic Mini-CEx (Clinical Examination Skill) 
Due by end of clerkship

The Obstetrics and Gynecology clerkship has chosen the performance of pelvic and breast exams, including patient communication, professional attitude, and actual performance of the examination, to be our required mini-CEx. Following are forms to be used for its evaluation and feedback. You should expect to have observed pelvic and breast examinations with the required feedback at least once during your clerkship. Students must have both CEx forms completed by the end of the clerkship.

These forms can be submitted to the Clerkship Administrator via email at or dropbox.

Two (2) Write-Ups

Students are required to complete a minimum of two (2) formal write-ups during their clerkship. The write-ups consist of complete histories and physicals and may be incorporated into the patient's chart. All write-ups will be reviewed by the physicians involved in the case and will be re-examined for the purpose of providing you with feedback. Students should obtain preceptor feedback early so they can steadily improve. All workups or other notes in charts must be signed by a physician. 

Note: while students are only required to complete two write-ups some sites may require more than the minimum.

These write-ups are submitted to preceptors and/or site directors only. Please do not send these to the Clerkship Administrator.

Patient Encounters
Logged in E*Value due by end of clerkship

Students must have active patient involvement in each category OR complete a corresponding APGO uWise quiz as an alternative:

Condition or Disease Alternative Experience
Abnormal Pap Smear Objective #3
Abnormal Uterine Bleeding Objective #45
Cesarean Section Delivery Objective #32
Complicated OB(Diabetes, preterm labor, premature membrane rupture, Hypertensive disorders, 3rd trimester bleeding) Choose 1 Objective: 2-17, 18, 19, 20, 23, 24, 25
Contraception Objective #33
1st Trimester Bleeding

Choose 1 Objective: 15, 16, 34

Intrapartum Care of Laboring Patient Objective #11
Menopausal Symptoms Objective #47
Pelvic Mass Choose 1 Objective: 53, 54, 55
Pelvic Pain Objectives: 38, 39, 46, 49
Postpartum Care Choose 1 Objective: 13, 14
Prenatal Care Choose 1 Objective: 9, 10
Vaginal Delivery Objective #32
Vaginitis or Gynecologic Infection Objective #36


Students will document these patient encounters using the Evalue on-line log. For manuals and videos on how to enter your patient encounters into Evalue please visit the Clinical Encounters page. Students should use the LCME Patient Encounter Form to keep a weekly tally before entering the data on Evalue (form available in "Forms" tab of this website).

If the student has not been actively involved with a patient in each of the above categories by the end of the clerkship, the student must fulfill an acceptable alternative experience by completing the corresponding APGO quiz using uWise (please refer to the "welcome to the obgyn clerkship email recieved on your first day of clerkship for access to uWise; mobile friendly).

Once completed, the student must:

  1. Submit the Encounter via Evalue
  2. Forward uWise confirmation to Clerkship Administrator by the final day of the clerkship (you do not need to send proof of E*Value submission). 

Clerkship Evaluation 
Due within 4 weeks of end of clerkship

To improve the basic Ob/Gyn clerkship, we need your assistance. A Student Evaluation of Clerkship and Student Evaluation of Educator (for each faculty/resident you worked with) completed thoughtfully via E*Value are required for completion of the clerkship. Final clerkship grades will be held until these are completed.