Reproductive

1. Anatomy of the Man

• Understand the functions of the male reproductive system
• Be aware of the anatomy of the male reproductive system, its components and their individual roles
• Understand where the sperm is produced and its path from the testes during ejaculation
• Be aware of the venous and arterial supplies to the testes and how these vessels can be involved in disease
• Understand the structure of the spermatic cord (the cord that suspends each testis and runs up through the groin)

2. Anatomy of the Woman

• Understand the structure of the internal and external genitalia (reproductive organs) of the woman
• Identify the cervix (the neck of the uterus), plus an overview of its pathologies and their causes
• Identify the uterus, plus an overview of its pathologies and their causes
• Understand how to identify the long axes of the vagina, cervix and uterus, and how to work out the angles between them
• Identify the fallopian tubes (the tubes that carry the egg from the ovary to the uterus), plus an overview of their pathologies and their causes
• Identify all of the main ligaments of the ovaries and uterus
• Have an understanding and awareness of Female Genital Mutilation (FGM: cutting, injuring or changing the female genitals for no medical reason), its classifications and legality in the UK

3. The Pelvic Floor

• Understand the functions of the pelvic floor muscles (the sling of muscles forming the bottom of the pelvis)
• Be aware of the muscles that make up the pelvic floor
• Be aware of the pathologies that can affect the pelvic floor and how to identify them
• Understand how trauma can affect the pelvic floor muscles

4. Development of the Reproductive System

• Understand the progression of development of the reproductive tracts and gonads (the testes and ovaries)
• Understand the hormonal control of these developmental mechanisms
• Be aware of the gubernaculum (a fibrous cord attached to the developing gonad), its function and descent and the potential complications related to this
• Be aware of potential issues with the development of the genitalia and how such problems present in the newborn or adult

5. Puberty

• Understand the difference between primary and secondary sexual characteristics and when they develop
• Understand the age ranges at which males and females undergo puberty-related changes
• Identify the different sexual characteristics that develop in both females and males during puberty
• Be aware of the basics of hormone release and actions during puberty

6. The Menstrual Cycle and Menstrual Abnormalities

• Understand the role of the hypothalamic-pituitary-ovarian (HPO) axis in menstruation
• Understand and recall the cycles of menstruation
• Be aware of and understand the causes of various menstrual abnormalities
• Be aware of investigations that can be done for various menstrual abnormalities and be able to apply your knowledge of pathophysiology (how disease changes normal function) to identifying causes for these abnormalities

7. Gametogenesis

• Understand why gametogenesis (the making of sperm and egg cells) is required and the various stages involved in the production of a functional gamete in both males and females

• The sexual response cycle and the autonomic basis of erection, emission (semen moving into the urethra) and ejaculation
• Causes, investigation and principles of treatment of male and female infertility
• Mechanism, effectiveness and contraindications of the major contraceptive methods
• Emergency contraception options including the copper intrauterine device (IUD, or 'coil') as the most effective

9. Physiology of the Mother

• Understand the endocrine, cardiovascular, renal, respiratory, musculoskeletal, gastrointestinal and immune changes the mother's body undergoes during pregnancy

10. Diseases of the Mother in Pregnancy

• Understand the pathologies that can begin during pregnancy, and the symptoms, pathophysiology and basic management of each

• The fetal circulation: the ductus venosus (a vessel that lets blood from the placenta partly bypass the liver), the foramen ovale (the opening between the right and left atria), the ductus arteriosus (a vessel linking the pulmonary artery to the aorta) and the streaming pattern (how oxygen-rich and oxygen-poor blood stay largely separate)
• Fetal haemoglobin and the leftward shift of the oxygen dissociation curve (fetal haemoglobin holds oxygen more tightly than adult haemoglobin)
• Lung development, surfactant production and the role of antenatal corticosteroids (steroids given to the mother before birth)
• Renal, gastrointestinal, endocrine and immune physiology of the fetus, and the integrated transition at birth

12. The Placenta

• Understand the process of implantation of the embryo
• Understand the stages and components of the formation of the placenta
• Understand and be aware of the issues that can arise with regards to implantation of the placenta
• Understand the endocrine links and control of the placenta
• Understand the basics of how immunoglobulins (antibodies) pass from the mother to the fetus across the placenta
• Understand the concept of teratogenic substances (substances that can harm a developing embryo or fetus)

13. Labour and Delivery

• Be aware of the stages of labour
• Be able to describe and understand the hormonal and physiological changes that occur at each stage of labour
• Understand the basics of induction of labour (starting labour artificially)
• Understand the basics of managing problems in labour, such as bleeding and delay (slow progress)

14. The Postpartum Period

• Understand the complications faced by the mother immediately after birth (postpartum), in the short term and in the long term
• Understand how mental health problems can affect the mother after birth and the complications that can follow

15. Infections of the Reproductive Tract

• Understand the various sexually transmitted infections (STIs), their symptoms, prevalence and basic management
• Understand the principle of contact tracing (partner notification: telling a patient's sexual partners so that they can be tested and treated)
• Understand the various non-sexually transmitted infections that can affect the genital tract and their symptoms and basic management
• Identify that vaginal discharge may be a symptom of disease, but also can be a normal physiological process

16. Pelvic Inflammatory Disease

• Understand the pathophysiology and causes of pelvic inflammatory disease (PID)
• Understand the links between sexually transmitted infections and PID
• Understand the complications of PID

17. The Menopause

• Understand that the menopause is a natural part of reproductive life in women
• Identify the stages of the menopause
• Identify the symptoms associated with each stage
• Be aware of the pharmacological and non-pharmacological treatments for dealing with these symptoms
• Be aware of the pathologies associated with premature menopause (premature ovarian insufficiency, POI: loss of ovarian function before the age of 40)

18. Malignancies of the Reproductive Tract

• Be aware of the various malignancies that can affect the reproductive organs
• Understand the basic presentation, types, tumour markers (substances in the blood that can point to a cancer) and progression of ovarian cancer
• Understand the basic presentation, types and progression of endometrial cancer (cancer of the lining of the uterus)
• Understand the basic presentation, types and progression of cervical cancer
• Understand the basics of the screening programme for cervical cancer in the UK and its links with the human papillomavirus (HPV)
• Be aware of vulval cancer (cancer of the vulva, the external female genitalia), its associations and basic management

19. Introduction to the Breast

• Understand the basic function of the breasts
• Understand the basic signs and symptoms of breast disease
• Understand the basics of breast imaging

20. Benign Conditions of the Breast

• Understand the different benign conditions that can affect the breast
• Be aware of how these conditions may be managed and identified

21. Malignant Conditions of the Breast

• Understand how common breast cancer is and what impact it has on the population
• Be aware of key symptoms and signs that could indicate a potential breast cancer
• Understand the basics of the breast cancer screening programme and triple assessment (breast examination, imaging and biopsy)
• Understand the different types of breast cancer
• Have a basic understanding of breast cancer treatment