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Obstetrics and Gynecology Training

First-Year Training

First-year training consists of:

  • Obstetrics — 6 months
  • Gynecology — 2 months
  • Emergency Medicine — 1 month
  • Neonatal Intensive Care Unit — 1 month
  • Internal Medicine Outpatient Clinic — 1 month
  • Medical Intensive Care Unit — 1 month

The obstetrics rotations include two months (nonconsecutive) of weekday, nights-only rotations. The large volume of normal and abnormal cases cared for by our obstetrics service provides excellent training opportunities for the residents. They are taught the importance of proper medical histories and physical examinations of patients in labor and are responsible for the prompt evaluation of new admissions to the delivery suite. They also follow the progress of patients in labor and learn to deliver uncomplicated cases under supervision. They assist the attending staff or senior resident in the management and delivery of complicated cases. Toward the middle of the first year of residency, as they gain experience, residents perform cesarean sections under supervision. With the full-time medical staff, daily postpartum rounds are made on all non-private patients.

Residents are assigned to their own Continuity-of-Care obstetric clinic one-half day per week, where they are supervised by full-time faculty. They learn to take histories, risk assess, and examine new cases. They follow the progress of patients prenatally and are taught the management of complications before delivery.

Residents and faculty present cases at the regularly scheduled Morning Report. Residents are expected to review the current literature about the case they are presenting. Residents also present one seminar each year on assigned topics.

While on the Gynecology service, first-year residents learn to obtain a complete history and perform a physical examination. Every attempt is made to have the same resident scrub with the case they have worked up. In the operating room, they assist in major gynecologic surgery, and perform D&Cs, laparoscopies and minor cases under the supervision of the full-time and attending medical staff. Residents have their own continuity-of-care GYN clinic separate from their OB Clinic.

Daily rounds are carried out by the full-time faculty on all gynecology patients on the clinic service including consultations.

The first-year resident rotates through the Neonatal Intensive Care Unit under the supervision of board-certified neonatologists for one month to learn the principles of and to perform neonatal resuscitation. Also, one month is spent in the Emergency Room under the supervision of full-time ER faculty to learn principles of acute medical care as part of an ambulatory experience. One month in the Outpatient Internal Medicine Clinic and one month in the MICU are provided.

Intensive OB ultrasound training begins in the first year during OB rotations twice weekly with Dr. Zalenski. Gynecologic ultrasound training is also a vital component of the formal ultrasound training program.

Second-Year Training

Second-year training consists of:

  • Obstetrics — 4 months
  • Gynecology — 6 months
  • Internal Medicine Outpatient Clinic — 1 month
  • Internal Medicine (private office) — 1 month

Second year residents participate in an area wide organized oral board preparation exam.

The obstetrics experience includes of two months of OB weekday, nights-only rotations. On the Obstetric service, second-year residents are in charge in the absence of a more senior resident. They are expected to scrub and perform cesarean sections under the direction of the medical staff. As their ability improves, they are given greater responsibility and are permitted to perform instrumental deliveries under the direct supervision of the medical staff. Most of the cesarean sections on private as well as clinic service are done by first and second-year residents. With the full-time medical staff and other residents, they make daily rounds on their assigned patients and all complicated cases. They assume increasing responsibility in the high risk clinic.

One month of ambulatory Internal Medicine is also included in a private internist’s office along with another month in the Internal Medicine Outpatient Clinic.

Third-Year Training

Third-year training consists of:

  • Obstetrics — 1 months
  • Reproductive Genetics — 1 month
  • Gynecology — 1 months
  • Gynecologic Oncology — 2 months
  • GYN Urology — 1 month
  • Reproductive Endocrinology — 2 months
  • Maternal-Fetal Medicine — 2 months
  • Internal Medicine Outpatient Clinic — 2 months

Third-year residents participate in the OHEP oral board preparation exams.

Fourth-Year Training

Fourth-year training consists of:

  • Obstetrics — 4 months
  • Maternal-Fetal Medicine — 2 months
  • Gynecology — 4 months
  • Gynecologic Oncology — 2 months

Senior residents, are responsible for their service at all times, under the guidance of the full-time physician. They assume direct responsibility for all clinic, staff, private and maternal transfer patients admitted to the service and assign responsibilities to their junior residents. They are responsible for coordinating the instruction of all residents and medical students on their service. The teaching of the junior and senior medical students is the direct responsibility of the fourth-year resident. For four months, they serve as the chief resident administratively and are responsible to the chief of the department for the overall care of all OB/GYN patients.

Senior GYN residents perform a large number of major GYN surgical procedures under the supervision of the staff instructors. They directly supervise and teach the students and junior residents, including management of GYN Emergency Room care. They answer all GYN consultations on clinic and staff patients in other departments of the hospital. They are responsible for the selection of cases and topics for the regular morbidity/mortality conferences teaching sessions. They attend the weekly Breast Disease Teaching session with a General Surgeon.

Senior OB residents function as consultants to all resident staff and medical students. All assignments for work-ups, cesarean sections and rounds are made by the senior OB resident. The senior resident is responsible for complete care of all high-risk pregnancies. They attend the Perinatal Mortality Committee, Quality Assurance Committee Women’s Health Improvement Council, Department Education Committee, Graduate Medical Education Committee, and the weekly NICU Conference. Fourth-year residents participate in the OHEP mock oral board preparation exams.

Medical Students

Wayne State University sends medical students to the OB/GYN service. Their activity is closely supervised by the full-time medical staff. Residents are expected to be actively involved with student teaching. Their history and physical examinations are reviewed and corrected by the most senior resident in the division. All students meet regularly with the full-time faculty for clinical discussions.

Teaching Sessions

Departmental Conferences

  • OB/GYN Grand Rounds
  • High-Risk OB Conference and Rounds
  • Reproductive Endocrine Conference
  • Gynecologic Oncology Conference
  • OB/GYN Seminar
  • Pathology Slide Conference
  • Perinatal Mortality (OB Chief Resident)
  • Morning Report
  • Benign GYN and OB Teaching Rounds
  • Journal Review
  • Office Medicine Conference
  • OB/Pediatric Conference
  • NICU Admission Conference
  • Breast Disease Teaching Session
  • Genetics Teaching Session
  • Ultrasound Teaching Sessions
  • Geriatrics Curriculum
  • Resident Counseling Lectures
  • Monthly Textbook Exam
  • QA Committee (seniors only)
  • Morbidity/Mortality Conference
  • GYN Tumor Board
  • Departmental Meeting Guest Lecture
  • Hospital Basic Science Conference
  • OB-GYN Basic Science conference

Resident Call Schedule

The approximate number of annual in-house calls for each PGY level is as follows:

  • PGY-1 — 70 calls (includes night rotations)
  • PGY-2 — 70 calls (includes night rotations)
  • PGY-3 — 60 calls (includes night rotations)
  • PGY-4 — 15 calls

Night rotations are an integral part of the call schedule during the first three years of residency due to the imposition of the ACGME work rules. In-house moonlighting is provided on an extremely limited basis coincident with the ACGME work rules. Home call has now been instituted.

Weekly Clinics

Continuity-of-Care OB Clinics (3)

High-Risk Clinic (2)

Continuity-of-Care GYN Clinics (3)

Colposcopy Clinic (bi-weekly)

Evaluation of Residents

Resident performance throughout the training program is assessed by competency-based evaluations. The national CREOG examination is given every year. Mock oral board exams are given annually to PGY-2's, PGY-3's, and PGY-4's. Residents are also evaluated every three months by the Education Committee of the OB/GYN Department. The full-time faculty carries out monthly written evaluations of each resident.

Evaluation of Faculty

Faculty are evaluated semi-annually by the residents in an anonymous fashion. Outgoing senior residents assess the program in writing annually with the Director of Medical Education.

Faculty-Resident Interaction

The full-time faculty and the residents meet quarterly for the purpose of engaging in a dialogue to bring about changes of mutual benefit in the program. Informality is encouraged.

For more information or an application you can write to the following address,
call (313) 343-3875, or e-mail Kim Mahoney.

Medical Education Department
St. John Hospital and Medical Center
22101 Moross Road
Detroit, Michigan 48236

or:

Go to to www.apgo.org and the directory of residency programs by clicking on Get Information, and then click on Residency Directory. Enter the user name as “directory” and the password as “stjohn123”. (You will also find past resident case experiences).


 

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