Gynecologic, Sexual, and Reproductive Health End of Rotation ™ Exam Blueprint & Topic List

The Gynecologic, Sexual, and Reproductive Health End of Rotation™ (EOR) exam is one of the PA Education Association’s objective, standardized evaluations and is intended to serve as one measure of the medical knowledge PA students gain during their supervised clinical practice experience. This article outlines the updated PAEA Gynecologic, Sexual, and Reproductive Health EOR Exam Blueprint, including its content and task areas, and presents the Exam Topic List. The specifications presented here reflect the updated Gynecologic, Sexual, and Reproductive Health Blueprint and Topic List published by PAEA as of July 2026. Updated Gynecologic, Sexual, and Reproductive Health exam versions based on these specifications were published July 2026; legacy "Women’s Health" examinations remain available through July 2027, so students should confirm which version their program is administering. Questions on an examination represent only a sample of the content that may be assessed and may not reflect every topic identified in the Topic List. Exam candidates and clinical coordinators are encouraged to review the original Blueprint, Topic List, and Core Tasks and Objectives through PAEA’s End of Rotation™ Blueprints and Topic Lists resource page at https://paeaonline.org/assessment/end-of-rotation/blueprints-and-topic-lists. ^[1]

AMBOSS is an independent entity with no affiliation to or endorsement by the PA Education Association (PAEA) or the PAEA End of Rotation™ examinations. The PAEA-derived portions of this article are based on the PAEA Gynecologic, Sexual, and Reproductive Health End of Rotation™ Exam Blueprint, Topic List, and Core Tasks and Objectives, which are created and owned by PAEA®. The gynecologic, sexual, and reproductive health-specific "Knowledge of" and "Skill in" descriptions, general study guidance, and organization of certain Professional Practice concepts were developed by AMBOSS and are not taken verbatim from the PAEA Core Tasks and Learning Objectives or from another source. AMBOSS does not claim ownership of material originating from PAEA. This article is provided at no cost to the public as an informational resource for PA students, educators, clinicians, and other healthcare professionals. It is not an official PAEA publication and does not contain actual PAEA examination questions. Use or reproduction of PAEA materials is subject to PAEA’s applicable terms and any required permissions. ^[2]

Content Categories

Task Categories

Each End of Rotation™ exam contains 120 multiple-choice questions, including 100 scored questions and 20 unscored pretest questions. The Blueprint percentages apply to the 100 scored questions. The updated Gynecologic, Sexual, and Reproductive Health Blueprint is organized by both content area and task area, and Professional Practice is one of its eight task areas.

General study approach

• Use the Blueprint percentages to set relative study priorities rather than to exclude lower-percentage categories.
  • Prenatal Care/Pregnancy and Uterine/Cervix together account for 32% of the scored questions, and the four largest content categories account for 52%; however, every listed category remains testable.
  • Diagnosis and Clinical Therapeutics together account for 36% of the scored questions, and adding History & Physical brings these three task areas to 51%, emphasizing the need to integrate focused assessment, diagnostic reasoning, and appropriate treatment.
• Gynecologic, Sexual, and Reproductive Health End of Rotation™ questions draw from adolescent and adult care and may be set in ambulatory, emergency department, inpatient, and perioperative settings. Preparation should include preventive and outpatient reproductive care as well as pregnancy, labor, postpartum, and other urgent gynecologic or obstetric presentations.
• End of Rotation™ questions use a one-best-answer clinical-vignette format intended to assess higher-order thinking. Study each condition through its risk factors and presentation, key distinguishing findings, appropriate diagnostic evaluation, first-line management, reproductive and pregnancy-related considerations, pharmacologic treatment, preventive needs, indications for urgent intervention or referral, and follow-up.

Content Categories

• Abortion
• Cervical insufficiency
• Cholestasis of pregnancy
• Eclampsia/HELLP
• Ectopic pregnancy
• Gestational diabetes
• Gestational trophoblastic disease
• Hyperemesis gravidarum
• Hypertensive disorders of pregnancy
• Multiple gestations
• Placenta attachment disorders (previa, accreta, increta, percreta)
• Pregnancy-induced hypertension
• Pregnancy physiology
• Prenatal management
• Rh incompatibility

• Abnormal uterine bleeding
• Amenorrhea
• Cervical dysplasia
• Cervical neoplasm
• Cervicitis
• Dysmenorrhea
• Endometrial neoplasm
• Endometriosis
• Leiomyoma
• Uterine neoplasm

• Assisted reproduction
• Barrier contraception
• Emergency contraception
• Hormonal contraception
• Infertility
• Non-hormonal contraception
• Pre-conception counseling
• Surgical contraception

• Differences of sexual development
• Dyspareunia
• Gender diverse care
• Human sexuality
• Menopause
• Perimenopause
• Physiology of menses
• Physiology of sexual development

• Breech presentation
• Fetal distress
• Labor dystocias
• Mechanisms of delivery
• Normal labor and delivery
• Post-term pregnancy
• Prelabor rupture of membranes
• Preterm labor
• Prolapsed umbilical cord

• Amniotic fluid embolism
• APGAR
• Endometritis
• Lactation
• Perineal laceration/episiotomy care
• Postpartum hemorrhage
• Postpartum physiology

• Breast abscess
• Breast adenoma
• Breast augmentation/reduction
• Breast neoplasm
• Fibrocystic breast disease
• Mastitis

• Atrophic vaginitis
• Bartholin gland cyst
• Lichen sclerosus
• Pelvic organ prolapse
• Urinary incontinence
• Vaginal/Vulvar neoplasm
• Vaginitis

• Postpartum anxiety
• Postpartum depression
• Postpartum psychosis
• Premenstrual dysphoric disorder
• Premenstrual syndrome
• Violence and abuse (intimate partner violence, sexual abuse, sexual assault)

• Bacterial vaginosis
• Candida
• Chancroid
• Chlamydia
• Gonorrhea
• Herpes simplex virus
• Human papillomavirus
• Pelvic inflammatory disease
• Syphilis
• Trichomoniasis

• Ovarian cysts
• Ovarian neoplasm
• Ovarian torsion
• Polycystic ovary syndrome

Task Categories

*AMBOSS editorial study guidance: The following gynecologic, sexual, and reproductive health-specific "Knowledge of" and "Skill in" descriptions were developed by AMBOSS and are not taken verbatim from the PAEA Core Tasks and Learning Objectives or from another source.

• Knowledge of:
  • Components and techniques of comprehensive, focused, and problem-based gynecologic, obstetric, sexual, reproductive, and breast histories and physical examinations
  • Menstrual history, including age at menarche, cycle frequency and duration, bleeding pattern, dysmenorrhea, and date of the last menstrual period
  • Obstetric history, including prior pregnancies, pregnancy outcomes, complications, mode of delivery, postpartum complications, and lactation history
  • Pregnancy history, including gestational dating, prenatal care, fetal movement, vaginal bleeding, fluid loss, contractions, maternal symptoms, and pregnancy-related risk factors
  • Sexual history, contraceptive use, reproductive goals, fertility history, sexually transmitted infection history, and cervical and breast screening history
  • Medical, surgical, medication, allergy, family, genetic, psychiatric, substance-use, and social histories relevant to reproductive health
  • Risk factors and historical features associated with ectopic pregnancy, hypertensive disorders of pregnancy, pregnancy loss, preterm labor, placental disorders, malignancy, infertility, and other important reproductive conditions
  • Historical features concerning for intimate partner violence, sexual abuse, sexual assault, reproductive coercion, or other threats to patient safety
• Skill in:
  • Conducting sensitive gynecologic, obstetric, sexual, and reproductive histories using a patient-centered, trauma-informed, and culturally responsive approach
  • Determining gestational age and estimated date of delivery from menstrual history and available clinical information
  • Performing appropriate abdominal, breast, pelvic, speculum, bimanual, and external genital examinations
  • Assessing maternal vital signs, fetal status, uterine size, contractions, vaginal bleeding, fluid loss, and other findings relevant to pregnancy and labor
  • Identifying examination findings associated with acute pelvic or abdominal pathology, pregnancy complications, infection, malignancy, and obstetric emergencies
  • Obtaining confidential sexual and reproductive history when appropriate while explaining the limits of confidentiality
  • Screening for intimate partner violence, sexual violence, abuse, coercion, depression, anxiety, and other psychosocial concerns
  • Recognizing findings that require urgent stabilization, obstetric or gynecologic consultation, emergency evaluation, or hospital-level care

• Knowledge of:
  • Patient- and family-centered education related to gynecologic, obstetric, breast, sexual-health, and reproductive diagnostic studies
  • Indications, limitations, risks, contraindications, techniques, and potential complications of commonly used diagnostic studies
  • Selection of initial and subsequent testing based on clinical presentation, pregnancy status, age, risk factors, cost, probable yield, invasiveness, and effect on management
  • Indications and interpretation of pregnancy testing, prenatal laboratory studies, blood type and Rh testing, sexually transmitted infection testing, vaginal testing, urinalysis, cultures, hematologic studies, metabolic studies, and reproductive hormone testing
  • Indications for cervical cancer screening, human papillomavirus testing, colposcopy, cervical or endometrial sampling, and other evaluation of abnormal uterine or cervical findings
  • Indications for pelvic ultrasonography, obstetric ultrasonography, fetal assessment, mammography, breast ultrasonography, and other appropriate imaging
  • Diagnostic evaluation of infertility, abnormal uterine bleeding, amenorrhea, pelvic pain, adnexal masses, pregnancy complications, and breast abnormalities
  • Pregnancy-specific considerations involving ionizing radiation, contrast, medication exposure, invasive testing, and interpretation of physiologic laboratory changes
• Skill in:
  • Selecting appropriate initial and subsequent laboratory, diagnostic, imaging, and screening studies
  • Collecting cervical, vaginal, urine, blood, and other specimens using appropriate technique
  • Reviewing and interpreting pregnancy tests, prenatal laboratories, microbiologic testing, cervical screening results, hormone studies, imaging, and fetal assessments in clinical context
  • Interpreting diagnostic findings in relation to menstrual cycle phase, pregnancy, postpartum physiology, menopause, and other reproductive states
  • Recognizing results suggestive of ectopic pregnancy, pregnancy loss, severe hypertensive disease, fetal compromise, infection, malignancy, torsion, hemorrhage, or other urgent conditions
  • Determining when additional testing, serial evaluation, biopsy, specialty consultation, or emergency assessment is required
  • Avoiding unnecessary testing when results are unlikely to alter management
  • Communicating the indication, limitations, preparation, risks, results, and follow-up implications of testing to patients and caregivers

• Knowledge of:
  • Significance of the history, physical examination, pregnancy status, laboratory studies, imaging, and other diagnostic findings as they relate to the differential diagnosis
  • Typical and atypical presentations, epidemiology, risk factors, natural history, and complications of common gynecologic, obstetric, breast, sexual-health, and reproductive conditions
  • Normal menstrual, sexual-development, pregnancy, labor, postpartum, lactational, perimenopausal, and menopausal physiology
  • Distinguishing features of pregnancy-related complications, including ectopic pregnancy, pregnancy loss, hypertensive disorders, placental disorders, preterm labor, fetal distress, and postpartum complications
  • Causes of abnormal uterine bleeding, amenorrhea, dysmenorrhea, pelvic pain, dyspareunia, vaginal symptoms, infertility, breast complaints, and adnexal masses
  • Features distinguishing benign, infectious, inflammatory, hormonal, structural, psychiatric, and neoplastic reproductive conditions
  • Effects of age, pregnancy, postpartum status, medications, contraception, fertility treatment, comorbidities, sexual history, and psychosocial factors on clinical presentation
• Skill in:
  • Formulating an appropriately prioritized differential diagnosis based on the available clinical information
  • Selecting the most likely diagnosis based on history, examination findings, pregnancy status, laboratory studies, imaging, and other diagnostic data
  • Distinguishing normal physiologic changes from pathologic findings during menstruation, pregnancy, postpartum recovery, lactation, perimenopause, and menopause
  • Recognizing time-sensitive conditions including ectopic pregnancy, ovarian torsion, eclampsia, severe obstetric hemorrhage, fetal distress, prolapsed umbilical cord, and postpartum emergencies
  • Distinguishing common causes of vaginal discharge, pelvic pain, abnormal uterine bleeding, amenorrhea, breast symptoms, and infertility
  • Identifying concurrent medical, psychiatric, infectious, and reproductive diagnoses that may influence management
  • Revising the differential diagnosis when symptoms evolve, treatment fails, or new diagnostic information becomes available
  • Recognizing when diagnostic uncertainty requires observation, urgent evaluation, specialty consultation, operative management, or longitudinal reassessment

• Knowledge of:
  • Age- and risk-appropriate preventive care, screening, counseling, and health-promotion recommendations relevant to gynecologic, sexual, and reproductive health
  • Cervical cancer screening, human papillomavirus prevention, breast cancer screening, and evaluation of individual cancer risk
  • Contraceptive counseling, reproductive life planning, pre-conception counseling, and prevention of unintended pregnancy
  • Prenatal preventive care, recommended screening during pregnancy, maternal immunization, nutrition, physical activity, and avoidance of harmful exposures
  • Sexually transmitted infection prevention, screening, partner considerations, and risk-reduction counseling
  • Health maintenance during perimenopause and menopause, including bone health, cardiovascular risk, sexual health, and symptom counseling
  • Prevention and recognition of intimate partner violence, sexual abuse, sexual assault, reproductive coercion, and other threats to safety
  • Effects of health literacy, culture, religion, gender identity, sexual orientation, finances, transportation, insurance, housing, and access to reproductive care
• Skill in:
  • Identifying preventive services and screening studies that are due based on age, reproductive status, pregnancy, sexual history, family history, and other risk factors
  • Providing patient-centered contraceptive counseling that incorporates effectiveness, risks, benefits, preferences, reproductive goals, and contraindications
  • Providing pre-conception counseling regarding health optimization, medications, nutrition, folate, immunization, substance use, genetic risk, and chronic disease
  • Counseling patients regarding cervical and breast cancer screening and appropriate follow-up of abnormal results
  • Providing sexually transmitted infection prevention, safer-sex, vaccination, and risk-reduction counseling
  • Providing preventive counseling during pregnancy, postpartum recovery, lactation, perimenopause, and menopause
  • Screening sensitively for intimate partner violence, sexual violence, reproductive coercion, depression, anxiety, and other psychosocial risks
  • Identifying barriers to reproductive and preventive care and coordinating appropriate medical, social, and community resources

• Knowledge of:
  • Indications, contraindications, risks, benefits, complications, techniques, and aftercare associated with common gynecologic, obstetric, reproductive, and breast interventions
  • Principles of stabilization and urgent management for ectopic pregnancy, severe hypertensive disorders of pregnancy, obstetric hemorrhage, fetal distress, prolapsed umbilical cord, ovarian torsion, and other acute reproductive emergencies
  • Indications for office-based gynecologic procedures, cervical or endometrial sampling, colposcopic evaluation, treatment of Bartholin gland disease, and contraceptive device procedures
  • Principles of management of pregnancy loss, abnormal uterine bleeding, pelvic organ prolapse, urinary incontinence, breast disease, and adnexal pathology
  • Principles of normal labor, fetal surveillance, management of labor abnormalities, delivery, perineal laceration or episiotomy care, and postpartum monitoring
  • Nonpharmacologic interventions for fertility management, pelvic-floor disorders, menopausal symptoms, sexual dysfunction, lactation difficulties, and behavioral health concerns
  • Criteria for consultation, referral, emergency transfer, hospitalization, operative intervention, or higher-level obstetric care
  • Postprocedural monitoring, discharge planning, safety-net instructions, and follow-up after gynecologic and obstetric interventions
• Skill in:
  • Prioritizing interventions based on maternal stability, fetal status, pregnancy stage, severity of illness, and risk of deterioration
  • Initiating appropriate stabilization and urgent consultation for gynecologic and obstetric emergencies
  • Selecting appropriate office-based, procedural, surgical, or nonpharmacologic interventions consistent with the working diagnosis
  • Obtaining informed consent and explaining expected benefits, risks, alternatives, and postprocedure care
  • Performing or assisting with appropriate gynecologic and reproductive procedures within the PA’s training and assigned role
  • Assessing labor progression, maternal status, and fetal status and recognizing findings that require escalation
  • Evaluating response to clinical interventions and recognizing complications or treatment failure
  • Coordinating obstetric, gynecologic, reproductive-endocrinology, oncology, pelvic-floor, breast, behavioral-health, and other appropriate referrals
  • Providing clear discharge instructions, warning signs, return precautions, and follow-up plans

• Knowledge of:
  • Indications for use
  • Contraindications and precautions
  • Mechanisms of action
  • Dosing and routes of administration
  • Pharmacokinetics and pharmacodynamics
  • Pharmacologic methods of contraception, including emergency contraception, and patient-specific factors affecting method selection
  • Pharmacologic treatment of sexually transmitted infections, vaginitis, pelvic inflammatory disease, mastitis, endometritis, and other infections
  • Medication management of nausea and vomiting of pregnancy, hypertensive disorders of pregnancy, gestational diabetes, preterm labor, and other pregnancy-related conditions
  • Medications used during labor, delivery, and postpartum care, including therapies for hemorrhage, hypertension, pain, and lactation-related conditions
  • Pharmacologic treatment of abnormal uterine bleeding, dysmenorrhea, endometriosis, polycystic ovary syndrome, menopausal symptoms, and other common reproductive disorders
  • Principles of fertility pharmacotherapy and medication use in assisted reproduction
  • Pregnancy- and lactation-specific medication safety, including teratogenicity, fetal effects, placental transfer, and medication passage into breast milk
  • Drug interactions, adverse effects, contraindications, and monitoring requirements associated with hormonal and other reproductive-health therapies
• Skill in:
  • Selecting appropriate pharmacologic therapy based on diagnosis, pregnancy status, gestational age, lactation, comorbidities, contraindications, reproductive goals, and patient preferences
  • Selecting and prescribing an appropriate contraceptive method and recognizing when a particular method is contraindicated
  • Selecting appropriate antimicrobial therapy for sexually transmitted and other reproductive tract infections
  • Selecting pregnancy-compatible and lactation-compatible medications when treatment is required
  • Initiating and modifying pharmacologic treatment for common pregnancy, gynecologic, reproductive, and menopausal conditions
  • Recognizing medications requiring modification, discontinuation, substitution, or additional monitoring during pregnancy or lactation
  • Monitoring therapeutic response through symptoms, examination findings, laboratory studies, blood pressure, glucose measurements, fetal assessment, or other appropriate measures
  • Recognizing adverse effects, drug interactions, medication toxicity, treatment failure, and treatment-emergent pregnancy complications
  • Counseling patients regarding medication purpose, administration, expected benefits, adverse effects, interactions, reproductive implications, pregnancy or lactation safety, and adherence

• Knowledge of:
  • Associations among gynecologic, obstetric, sexual, and reproductive conditions and complications identified through the application of scientific concepts
  • Reproductive anatomy, embryology, genetics, and congenital development
  • Physiology of sexual development, puberty, the menstrual cycle, ovulation, fertilization, implantation, and menopause
  • Reproductive endocrinology, including hypothalamic, pituitary, ovarian, placental, and end-organ hormonal regulation
  • Normal maternal physiologic changes during pregnancy and postpartum recovery
  • Placental development, placental function, maternal-fetal exchange, and mechanisms underlying placental disorders
  • Physiology and mechanisms of labor, cervical change, delivery, postpartum uterine involution, and lactation
  • Pathophysiology of hypertensive disorders of pregnancy, gestational diabetes, abnormal uterine bleeding, endometriosis, infertility, polycystic ovary syndrome, and other reproductive conditions
  • Microbiology and immunology relevant to sexually transmitted infections, vaginitis, pelvic inflammatory disease, pregnancy, and perinatal infection
  • Pharmacologic principles relevant to contraception, fertility treatment, pregnancy, labor, postpartum care, lactation, and menopause
  • Public-health principles relevant to reproductive health, maternal morbidity, sexually transmitted infections, intimate partner violence, access to contraception, and disparities in pregnancy outcomes
• Skill in:
  • Applying reproductive anatomy and physiology to diagnosis and management
  • Relating menstrual and reproductive endocrinology to amenorrhea, abnormal uterine bleeding, infertility, polycystic ovary syndrome, and menopausal symptoms
  • Applying pregnancy and placental physiology to prenatal assessment and recognition of pregnancy complications
  • Relating maternal physiologic changes to expected and abnormal laboratory, cardiovascular, metabolic, and clinical findings during pregnancy
  • Applying the physiology of labor, delivery, postpartum recovery, and lactation to clinical assessment and management
  • Applying microbiologic and immunologic principles to prevention, diagnosis, and treatment of reproductive tract and sexually transmitted infections
  • Applying pharmacokinetic and pharmacodynamic principles to medication selection during pregnancy, lactation, contraception, fertility treatment, and menopause
  • Incorporating evidence-based medicine and current reproductive-health guidance into clinical decision-making

Legal/medical ethics

• Knowledge of:
  • Informed consent and refusal for pelvic and breast examinations, contraception, fertility treatment, prenatal care, procedures, pregnancy-related treatment, and other reproductive interventions
  • Reproductive autonomy and ethical principles related to contraception, pregnancy, pregnancy loss, fertility treatment, sterilization, and other reproductive decisions
  • Decision-making capacity and identification of an appropriate surrogate decision-maker
  • Confidentiality and privacy considerations involving adolescents, sexual history, gender identity, reproductive care, pregnancy, sexually transmitted infections, and electronic communication
  • Ethical and legal considerations related to intimate partner violence, sexual abuse, sexual assault, reproductive coercion, trafficking, and applicable reporting requirements
  • Advance directives, code status, including do-not-resuscitate and do-not-intubate orders, medical power of attorney, organ donation, and goals-of-care decisions when applicable
  • Patient rights, cultural and religious beliefs, gender identity, sexual orientation, health disparities, and legal or policy issues affecting access to gynecologic, sexual, and reproductive health care
• Skill in:
  • Obtaining informed, voluntary consent for sensitive examinations, procedures, and treatment
  • Supporting reproductive decision-making through accurate counseling and respect for patient autonomy
  • Maintaining confidentiality while recognizing applicable circumstances requiring disclosure or mandated reporting
  • Providing trauma-informed care to patients affected by sexual violence, intimate partner violence, abuse, or reproductive coercion
  • Communicating with legally authorized representatives when a patient lacks decision-making capacity
  • Recognizing and escalating complex ethical or legal concerns to the supervising physician, ethics service, risk management, legal counsel, or other appropriate resource

Medical informatics

• Knowledge of:
  • Accurate and complete documentation of menstrual, obstetric, gynecologic, sexual, reproductive, pregnancy, labor, postpartum, and breast care
  • Documentation requirements related to informed consent, pregnancy dating, fetal assessment, procedures, contraception, screening, violence or abuse, and transitions of care
  • Electronic health records, prenatal records, immunization and screening systems, clinical decision-support tools, patient portals, telemedicine, and evidence-based reproductive-health resources
  • Privacy risks involving sexual-health information, pregnancy-related care, adolescent care, gender-related care, and patient portal access
• Skill in:
  • Documenting clinical reasoning, pregnancy status, reproductive goals, examination findings, counseling, procedures, treatment, and follow-up accurately and promptly
  • Using health information systems to review prior pregnancies, contraceptive use, medications, cervical and breast screening, laboratory results, imaging, and relevant medical history
  • Tracking abnormal screening results, diagnostic studies, pathology, referrals, pregnancy-related testing, and other follow-up needs until appropriate action is completed
  • Protecting sensitive reproductive, sexual, and pregnancy-related information when using electronic health information systems and communication tools

Patient care and communication (individual patients)

• Knowledge of:
  • Affordable, effective, and patient-specific gynecologic, sexual, reproductive, obstetric, postpartum, and breast care
  • Communication and care preferences of diverse patients and families
  • Effects of health literacy, language, disability, culture, religion, gender identity, sexual orientation, finances, housing, transportation, insurance, and social support on reproductive-health decisions and outcomes
  • Trauma-informed, culturally responsive, inclusive, and nonjudgmental communication principles for sensitive reproductive and sexual-health encounters
  • Communication strategies for pregnancy complications, infertility, pregnancy loss, sexual dysfunction, cancer, violence, sexual assault, and other emotionally difficult conditions
• Skill in:
  • Establishing rapport and maintaining patient dignity during sensitive histories and examinations
  • Communicating with empathy, cultural humility, inclusive language, and respect for individual reproductive goals and preferences
  • Using qualified interpreters and accessible communication methods when appropriate
  • Explaining diagnoses, diagnostic uncertainty, reproductive options, procedures, medications, risks, benefits, and follow-up in understandable language
  • Engaging patients in shared decision-making regarding contraception, fertility, pregnancy, treatment, and preventive care
  • Communicating sensitively regarding pregnancy loss, infertility, serious maternal or fetal complications, malignancy, and sexual violence
  • Identifying barriers to care and coordinating realistic medical, social, behavioral-health, and community resources

PA role in professional practice

• Knowledge of:
  • Professional and clinical limitations, scope of practice, credentialing, privileging, supervision, and collaboration requirements
  • Responsibilities of the PA in preventive reproductive care, prenatal and postpartum care, acute gynecologic care, labor and delivery support, procedures, and transitions of care
  • Roles and responsibilities of obstetricians, gynecologists, maternal-fetal medicine specialists, reproductive endocrinologists, midwives, nurses, pharmacists, lactation specialists, behavioral-health clinicians, social workers, and other members of the interprofessional team
  • Professional boundaries, conflicts of interest, clinician impairment, ethical conduct, and effects of implicit bias on reproductive and obstetric care
• Skill in:
  • Recognizing personal limitations and seeking supervision, consultation, referral, or transfer of care appropriately
  • Communicating effectively during obstetric and gynecologic consultations, referrals, handoffs, multidisciplinary discussions, and transitions of care
  • Collaborating effectively with obstetric, gynecologic, surgical, nursing, behavioral-health, social-service, and other interprofessional teams
  • Maintaining professional behavior and appropriate boundaries during sensitive, stressful, emergent, or emotionally difficult encounters

Professional development

• Knowledge of:
  • Continuing medical education resources relevant to gynecology, obstetrics, contraception, fertility, sexual health, breast care, and reproductive medicine
  • Evidence-based guidelines, quality standards, screening recommendations, and evolving reproductive-health practices
  • Principles of lifelong learning, self-assessment, feedback, clinician well-being, and maintenance of professional competence
• Skill in:
  • Critically evaluating gynecologic, obstetric, and reproductive-health literature and applying evidence-based recommendations appropriately
  • Identifying and interpreting information from reliable reproductive-health and obstetric resources
  • Recognizing personal knowledge or skill gaps and pursuing appropriate education, supervision, simulation, feedback, or additional training
  • Participating in quality-improvement, morbidity review, maternal-safety, preventive-care, and patient-safety activities

Public health (population/society)

• Knowledge of:
  • Population-level principles of contraception access, pre-conception health, maternal health, sexually transmitted infection prevention, cancer screening, and reproductive-health promotion
  • Maternal morbidity and mortality, pregnancy-outcome disparities, and social determinants affecting reproductive health
  • Population-level prevention of sexually transmitted infections, unintended pregnancy, intimate partner violence, sexual violence, and reproductive coercion
  • Community resources addressing prenatal care, contraception, fertility, sexual assault, domestic violence, behavioral health, housing, transportation, and other reproductive-health needs
  • Applicable public-health and reporting requirements involving communicable infections, abuse, assault, and other threats to patient safety
• Skill in:
  • Recognizing reportable infections and following applicable public-health and reporting requirements
  • Counseling patients regarding contraception, infection prevention, cancer screening, pregnancy health, and other reproductive-health risk reduction
  • Identifying individuals and populations affected by disparities in access to reproductive, prenatal, obstetric, postpartum, and sexual-health care
  • Connecting patients with appropriate medical, behavioral-health, social-service, violence-prevention, and community resources
  • Incorporating population-level risks, disparities, and social determinants into individualized reproductive-health care plans

Risk management

• Knowledge of:
  • Accountability, standards of care, and appropriate resource utilization in gynecologic, obstetric, sexual, and reproductive health practice
  • Common causes of preventable harm involving missed ectopic pregnancy, delayed recognition of hypertensive disease, obstetric hemorrhage, fetal compromise, medication error, missed screening results, and inadequate follow-up
  • Patient-safety measures involving patient identification, pregnancy-status verification, allergy review, medication reconciliation, informed consent, procedural time-outs, infection prevention, and the Universal Protocol when applicable
  • Importance of timely reassessment during pregnancy complications, labor, postpartum care, acute pelvic pain, hemorrhage, and other evolving conditions
  • Requirements for reporting adverse events, near misses, safety concerns, occupational exposures, and other reportable incidents
• Skill in:
  • Verifying patient identity, pregnancy status, allergies, medications, procedure, consent, and operative or procedural site when applicable
  • Recognizing and escalating abnormal maternal vital signs, fetal findings, bleeding, severe pain, neurologic symptoms, or other evidence of clinical deterioration
  • Tracking screening tests, prenatal studies, imaging, pathology, referrals, and abnormal results to prevent loss to follow-up
  • Providing explicit return precautions and safety-net instructions for uncertain or potentially evolving gynecologic and obstetric conditions
  • Providing safe handoffs that communicate pregnancy status and gestational age when applicable, diagnosis, maternal and fetal status, treatments, completed and pending studies, and contingency plans
  • Recognizing, documenting, reporting, and responding appropriately to adverse events and near misses
  • Escalating concerns when patient safety, clinician impairment, staffing, equipment function, or standards of care are compromised

AMBOSS is an independent entity with no affiliation to or endorsement by the PA Education Association (PAEA) or the PAEA End of Rotation™ examinations. The PAEA-derived portions of this article are based on the publicly available PAEA Gynecologic, Sexual, and Reproductive Health End of Rotation™ Exam Blueprint, Topic List, and Core Tasks and Objectives, which are solely created and owned by PAEA®. The gynecologic, sexual, and reproductive health-specific "Knowledge of" and "Skill in" descriptions, general study guidance, and organization of certain Professional Practice concepts were developed by AMBOSS and are not taken verbatim from the PAEA Core Tasks and Learning Objectives or from another source. AMBOSS does not claim ownership of material originating from PAEA. This article is provided at no cost to the public as an informational resource for PA students, educators, clinicians, and other healthcare professionals. It is not an official PAEA publication and does not contain actual PAEA examination questions. Questions on an examination represent only a sample of the content that may be assessed, and the Topic List is not a comprehensive list of all possible examination topics. Use or reproduction of PAEA materials is subject to PAEA’s applicable terms and any required permissions. ^[2]