Obstetrics and Gynecology Residency Program
Mitchell P. Dombrowski, MD
Minu Kashef, MD
Advanced GYN Surgery Benign Gynecology
Michael Prysak, PhD, MD
Cassie Laasch, MD
Associate Program Director
Shyla R. Vengalil, MD
Director, Maternal-Fetal Medicine
Vice-Chief of Obstetrics
Deborah Wright, MD
Brian Mason, MD
Director of Research
Anne M. Schneider, MD
Medical Student Director
Nathan V. Wagstaff, MD
Robert Morris, MD
Carol Kowalczyk, MD
Assistant Program Director Reproductive Endocrinology/Infertility
Shiva Maralani, MD
David Zalenski, MD
Karen Hagglund, MS
The four-year residency program in Obstetrics and Gynecology is fully approved for 16 residents. Heavy emphasis is placed on clinical training. All patients are available for teaching purposes. The resident's continuity-of-care clinic features a brand new facility. All outpatient clinics are supervised by the full-time faculty. Residents are responsible for the total care of the non-private patients under the supervision of the full-time staff. Coupled with subspecialty training in Obstetrics and Gynecology, residents receive additional experience and responsibility in those other branches of medicine that are important to round out their education. A six-month ambulatory primary care experience is provided. During each year, residents are responsible for instructing the junior and senior medical students assigned to the department. The program is fully approved by the American Board of Obstetrics and Gynecology. The program is affiliated with Wayne State University School of Medicine, and a third and fourth year medical students rotate on our services. St. John is a tertiary care hospital located on the border of Grosse Pointe and the city of Detroit. The hospital is on sound financial footing and continues to grow and expand with over 600 beds and consistent 95% bed occupancy. The St. John Providence Health System is part of Ascension Health System, the largest Catholic hopsital system in the nation. Other residency programs exist at St. John Hospital and include family practice, internal medicine, general surgery, pediatric, emergency medicine, and the transitional year. Medicine sub-specialty fellowships include cardiology, nephrology, and infectious disease.
The patient profile in obstetrics is 75% private and 25% clinic, staff, and maternal transfers. Our clinic patients receive their care on-site in our supervised clinics. Our program features a very large number of major gynecologic surgeries. Our attending physicians are committed to resident education and are always extremely generous in allowing residents to be the primary surgeons in major cases.
In 2002, the program received approval to increase from 3 to 4 residents per year. Meticulous attention is devoted toward achieving the educational goals of the program. The high gynecologic surgery volume per resident ensures very meaningful clinical experience, which few programs can match. Throughout their training, funds are available for residents' attendance at local and national meetings and postgraduate courses. ACOG Junior Fellow status is required in the first year. A textbook stipend is provided.
The OB/GYN Residency Program is under the direction of Dr. Prysak, a member of the clinical faculty at Wayne State University School of Medicine. Drs. Laasch and Kowalczyk are the Associate Residency Directors. Dr. Dombrowski is Chief of the Department and is a tenured professor at Wayne State University School of Medicine. This experienced team, is responsible for carrying out the details of the education program. All department members are board-certified or board-eligible. An attending physician is physically present in the hospital at all times for consultation and resident supervision, even on nights, weekends and holidays.
Facilities at St. John Hospital are excellent. The Birthing Suite is spacious and attractive and was opened in 1996 with renovations in 1998. We have 31 LDRPs, the largest unit of its kind in the State. The resident Clinic, which is contiguous with the hospital, was completed in 2003. The library facilities at St. John Hospital are outstanding both from the standpoint of services provided (literature searches, current journals and textbooks, audiovisuals) and a preservation of materials.
Dr. Morris is a board certified gynecologic oncologist located at St. John Hospital and Medical Center directs training in the subspecialty of gynecologic oncology. Surgical anatomy and the principles of surgery are taught with hands-on experience in the operating room. Radical surgical resections and management of acutely ill patients are among the responsibilities of the senior-level resident assigned to the oncology service. In addition to tumor board and formal didactic sessions, cancer screening and surveillance as well as management of chemotherapy are taught in the oncology outpatient office. As a faculty member of the Wayne State University School of Medicine, research opportunities and participation in multicenter clinical trials will be available to the residents. The oncology rotation objectives for third and fourth year residents include surgical training, basic principles of oncologic surgery and chemotherapy, management of acutely ill patients, and mentorship for those who are interested in post-residency subspecialty training.
Reproductive Endocrinology and Infertility is directed by Drs. Kashef and Kowalczyk. Dr. Kashef is vastly experienced in pelviscopy including laser techniques. He and other attendings have performed an extensive series of pelviscopic surgeries including hysterectomies, as well as management of ectopic pregnancies and other pelvic conditions. It is also important to note that part of the REI rotation is through Dr. Kowalczyk's private office, which features in-vitro fertilization facilities.
The division of Maternal-Fetal medicine has four full-time faculty mmembers who manage an increasing number of high-risk pregnancies including preterm labor, PPROM, medical complicaitons of pregnancy, multiple gestations, and fetal anomalies. The number of maternal transfers has been increasing in the past academic year. These maternal transfer patients are referred from institutions in the perinatal network of eastern Wayne and Macomb Counties including Bon Secours Hospital, Riverview Hospital, Macomb Hospital Center, Mt. Clemens General Hospital, and River District Hospital and several other institutions. St. John Hospital has a state-of-the-art tertiary care NICU. Our new ultrasound unit features 3D and 4D imaging capability. Obstetric and gynecologic ultrasound experience is emphasized with over 1,000 exams perforemd annulally by the resident, most supervised by Dr. Zalenski or our perinatologists.
Genetic counseling is offered by our maternal-fetal medicine subspecialist. There is an active referral system for this service which also includes amniocentesis, cordocentesis, and CVS, if indicated. A PhD cytogeneticist is part of the laboratory support for this service. An offsite genetics rotation is part of the curriculum.
Our department has increased its emphasis on research. St. John Hospital has become an NIH Research site for Obstetrics and Gynecology. Our academic output for year 2000 academic year has surpassed most community and even most university-based OB/GYN programs. Since 2000, our faculty has published approximately one paper, Chapter, or abstract per month. Dr. Dombrowski is the co-editor of the textbooks, Practical Strategies in Obstetrics and Gynecology, Saunders Inc. 2000 and Contemporary Therapy in Obstetrics and Gynecology, Saunders Inc. 2002. Each resident will be required to complete one research project before the end of his or her training program. In order to support the research and education of our Department, we are currently raising funds to establish an endowed Chair in Women’s Health at St. John Hospital and Medical Center. Our vision is to develop a “hybrid” residency program that will combine the gynecologic surgical excellence of community programs with academic and research excellence traditionally limited to major university-based programs.
Our residents are encouraged to seek subspecialty training. Of the three residents graduating in 2003, one entered a Fellowship in Maternal Fetal Medicine, another declined an offier by the NIH to conduct research in order to join our faculty.