Anatomy and physiology

a. Tanner Staging
b. Hormonal and growth effect

2. Describe the sex hormonal changes that occur neonatally and in the first two years of life and in childhood.
3. Describe the hormonal changes that occur as part of normal puberty.

A. Adolescent gynecology

a. Normal and abnormal pubertal development
b. Normal psychosocial development
c. Primary amenorrhea
d. Breast mass
e. Menstrual irregularities
f. Dysmenorrhea
g. Vulvovaginitis
h. Sexuality
i. Contraceptive needs
j. Sexually transmitted diseases
k. Pregnancy
l. Sexual abuse
m. Ovarian diseases and masses
n. Endometriosis
o. Chronic pelvic pain

2. Elicit a pertinent medical and sexual history from an adolescent patient.
3. Perform a focused physical examination with proper technique and instrumentation to identify specific conditions in an adolescent patient with special attention to the appropriateness of sexual development.
4. Provide for the primary care needs of the adolescent, demonstrating knowledge of the following:

a. Psychologic health
b. Immunizations
c. Confidentiality issues
d. Facilitation of parent-child communication
e. Safety and prevention or morbidity and mortality
f. Substance abuse
g. Nutrition and dietary management

5. Perform and/or interpret selected tests to confirm the diagnosis of specific gynecologic disorders, such as:

a. Microbiologic tests
b. Endocrinologic assays
c. Ultrasonography and MRI
d. Laparoscopy
e. Examination under anesthesia

6. Interpret other diagnostic tests, such as:

a. Qualitative and quantitative hCG
b. MRI
c. Serum gonadotropin assays

7. Treat adolescent gynecologic disorders medically and surgically.
8. Describe the indications for referral to a subspecialist.
9. Counsel the patient and her family about the long-term prognosis of her condition and its effect on reproduction and general health.
10. Provide patient and parent education concerning the following:

a. Normal anatomic and psychosocial development
b. Personal hygiene
c. Menses
d. Sexuality
e. Prevention of pregnancy and STDs, including emergency contraception
f. Psychosocial concerns, eg, eating disorders, substance use, safety

B. Precocious puberty

a. Ultrasonography
b. Gonadotropin assays
c. X-ray studies to determine bone age
d. CT or MRI scans

6. Describe the treatment and long-term prognosis for patients with precocious puberty.

C. Delayed puberty

a. Vaginal cytology
b. X-rays for bone age
c. Endocrinologic assays
d. Peripheral blood karyotype
e. CT scan or MRI of the head

5. Describe the treatment of a patient with delayed puberty. Consult with a subspecialist as needed.
6. Describe the indications for referral to a subspecialist.
7. Counsel a patient and her family about her long-term follow-up and prognosis and the effect of her condition on reproduction.