Obstetrics and Gynecology Residency Program
Mitchell P. Dombrowski, MD
Minu Kashef, MD
Advanced GYN Surgery
Michael Prysak, Ph.D., MD
Cassie Laasch, MD
Associate Program Director
Shyla R. Vengalil, MD
Director, Maternal-Fetal Medicine
Vice Chief of Obstetrics
Debra Wright, M.D.
Brian A. Mason, MD
Director of Research
Nathan V. Wagstaff, MD
Anne M. Schneider, MD
Medical Student Director
Robert Morris, MD
Leigh Solomon, MD
Carol Kowalczyk, MD
Assistant Program Director
Shiva Maralani, MD
David Zalenski, MD
Karen Hagglund, MS
St. John Hospital and Medical Center is a 776-bed hospital located on the border of Grosse Pointe and the city of Detroit. St. John is a Level II trauma center, with a 10-bed surgical intensive care unit, a 10-bed medical intensive care unit, and a 10-bed coronary care unit. The St. John Providence Children’s Hospital has a Level III 35-bed neonatal intensive care unit (one of the first Neonatal ICUs established in Michigan), and an eight-bed pediatric intensive care unit. St. John also features a 30-bed cardiac surgery step-down unit, cardiac catheterization laboratories, nuclear cardiology and a complete non-invasive cardiology laboratory. The OB/GYN department serves as the major perinatology resource for our service area. St. John Providence Health System is a part of Ascension Health, the largest Catholic hospital system in the Nation.
St. John Hospital and Medical Center is the first hospital in Detroit to earn “Baby Friendly” accreditation through the prestigious Baby-Friendly USA, Inc. This accrediting body for the Baby-Friendly Hospital Initiative (BFHI) in the United States recognizes hospitals and birthing centers that offer an optimal level of care for infant feeding and mother/baby bonding.
St. John Hospital and Medical Center has state of the art facilities. The Birthing Center is spacious and attractive with 31 LDRPs, to include holistic birthing suites, plus 20 post-partum and 17 high risk rooms. It is a large unit with 3,200 deliveries annually. The patient profile in obstetrics is 70% private and 30% clinic, staff, and maternal transfers.
St. John Hospital and the Department of OB/GYN place significant emphasis on patient safety objectives. PGY1 residents attend a training session focusing on Communication for Patient Safety within the first month of residency. All associates who work on the Birthing Center receive this training also. St. John Hospital participated in the AHRQ grant from 2009-2013. This grant focused on education, simulation exercises and disclosure training in order to improve patient safety on Labor and Delivery. Educational activities related to the grant continue. Residents participate in simulation exercises using the Noelle Obstetric Simulator. St. John Hospital has a Safety Committee, a SAFER system for reporting safety concerns, and many individual departmental initiatives related to patient safety.
The OB/GYN Residency Program is accredited through the Accreditation Council for Graduate Medical Education as a four year program accepting four residents per year. 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.
During each year, the residents are responsible for instructing the junior and senior medical students assigned to the department. The program is affiliated with Wayne State University School of Medicine and St. George University School of Medicine, and their third and fourth year medical students rotate on our services.
As part of the Educational Curriculum, residents have protected time slots and participate in the following departmental conferences/lectures:
- OB/GYN Grand Rounds
- High-Risk OB Conference and Rounds
- OB-GYN Resident Seminar
- Pathology Conference
- Morning and Evening Report
- Benign GYN and OB Teaching Rounds
- Journal Review
- Office Medicine Conference
- NICU Admission Conference
- Ultrasound Teaching Sessions
- Resident Counseling Lectures
- Monthly Textbook Exam
- QA Committee (Chief Resident)
- Morbidity/Mortality Conference
- GYN Tumor Board
- Departmental Meeting Guest Lecture
- OB-GYN Basic Science Conference
The large volume of normal and abnormal cases cared for by our obstetrics service provides excellent training opportunities for the residents. All patients (staff, clinic and private) are managed by the residents. For PGY1 residents, we encourage early hands-on experience with deliveries and first-assisting during cesarean deliveries. PGY1 residents are actively involved in the management of laboring patients and evaluation of triage patients. PGY2 and PGY3 residents assume greater responsibilities with regard to running the service, taking care of high-risk patients and performing procedures including operative deliveries. PGY4 residents serve as chiefs of the Obstetric service throughout the year and manage the care of high-risk patients. All residents are assigned to a continuity of care OB clinic once per week. Two high-risk clinics per week are also covered by the OB team.
Residents on the GYN service cover all cases in the operating room, see consults for patients in the ER and on the floor, and manage all postoperative patients and inpatients admitted with gynecologic problems. The GYN service cares for a wide variety of both routine and complicated cases. PGY1 residents perform D&C’s, laparoscopies and minor cases with supervision and assist on major gynecologic surgeries. PGY2 residents perform abdominal hysterectomies, laparotomies and operative laparoscopies and assist on vaginal surgeries, robotic surgeries and oncology cases. PGY3 and PGY4 residents perform laparoscopic hysterectomies, vaginal hysterectomies and robotic and oncology surgeries. All residents are assigned to a continuity of care GYN clinic once per week. Colposcopy is taught in the continuity of care GYN clinics as well as through the oncology service.
Residents participate on the Oncology service starting as PGY2’s. As PGY3’s and PGY4’s, residents serve as chief of the oncology service. Two board-certified gynecologic oncologists are based at St. John Hospital, each having one full OR day and one office day each week. The GYN Oncologists are faculty members at Wayne State University and therefore, research opportunities and participation in multi-center clinical trials are available to the residents. Residents also work closely with GYN-ONC fellows from Wayne State University who rotate at our hospital. 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. Residents participate in daily rounds on hospitalized oncology patients, attend weekly preoperative conference, monthly tumor board meetings and assist in all surgeries.
Residents are assigned to formal REI rotations as PGY3’s. Residents spend two months in a private Reproductive Endocrinology office which features in-vitro fertilization facilities. This office experience provides exposure to evaluation and treatment of patients presenting with infertility as well as a variety of other endocrinologic disorders. Residents observe and participate in procedures such as hysterosalpingograms and sonohysterography during this rotation. Considerable vaginal ultrasound experience is gained during this month.