While you are in residency training, everything you see, hear, and feel (and sometimes smell and taste!) is part of your education. In order to maximize your learning we try to stimulate all the senses by incorporating a variety of teaching modalities including lectures, group activities, clinical and sign-out rounds, problem-based learning, peer-to-peer teaching, simulation, multi specialty conferences, tissue labs, and skills training.
The curriculum is designed to help our residents progress successfully through the milestones of each core competency of residency training:
Practice-based Learning and Improvement
Interpersonal and Communication Skills
Thursday Lecture Time
Every Thursday from 8:45 a.m. to 12 noon residents are excused from clinical duties to attend resident lectures and educational activities. During this time clinical activities are covered by attendings and midwives. We typically have 3 lectures or educational sessions of 45 minutes each dedicated to a topic from the core curriculum - occasionally session will be combined to allow for a longer activity or discussion. The final 45 minutes, known as “4th lecture” is peer-to-peer teaching organized and presented by the residents for their fellow residents. The core educational curriculum is derived from CREOG learning objectives and augmented to cover additional topics suggested by faculty and residents based on identified need, group CREOG performance, and special interest. Additional sessions held on Thursdays include skills labs, simulation, resident assembly, the mindfulness series, journal club, etc.
Weekly departmental grand rounds are held throughout the fall, winter, and spring. A variety of educational, research, and quality assessment topics are presented by guest speakers and university faculty. Many of our grand rounds presentations are routed live to Highland Hospital and other affiliated institutions and recorded for viewing on the URMC website. Once per month, Morbidity & Mortality Conference is presented by the residents with PGY-4s presenting and discussing interesting or complicated cases from the OB, GYN, and Ambulatory services. Quarterly, city-wide or special grand rounds are held at which a special guest lecturer speaks to a gathering of OB-GYNs from the Rochester area. In the summer months, residents are invited to give departmental grand rounds on a topic of their choice with the mentorship of a faculty member - topics have included bladder injury at the time of cesarean section, evidence-based evaluation & treatment of bacterial vaginosis, and review of misoprostol for labor induction.
Team STEPPS & Skills Simulation
Residents participate in a variety of simulation activities including Team STEPPS, a teamwork system designed for health care professionals- residents learn teamwork skills in a variety of OB-GYN scenarios also attended by OB-GYN attending, nurses, NICU and Anesthesia personnel. Spontaneous OB simulations are held on Labor & Delivery including shoulder dystocia, postpartum hemorrhage, and the always popular breech delivery in triage. Formal resident OB & GYN skills development and evaluation sessions are held several times per year, with pre-testing in August and post-testing in June for monitoring of group and individual progress.
Journal Club is held quarterly during Thursday lecture time as a group learning activity. Articles are chosen by the faculty preceptor to cover a specific type of research or a specific topic in OB-GYN and all residents read the articles and participate in the presentation. The preceptor acts as a guide for the resident groups as they assess the research goals, methods, data analysis, conclusions, and clinical application. Using this format has led to a more stimulating and productive discussion and increased resident (and faculty) satisfaction with journal club.
Mindful practice refers to our ability to be aware, in the moment, on purpose, with the goal of providing better care to patients and to take better care of ourselves. Being mindful is at the core of clinical competence. The purpose of this program is to improve quality of care and physician well-being by helping residents to be more mindful during daily clinical practice,including:
Being responsive rather than reactive
Noticing things about oneself and situations even though they might be unpleasant
Acting with awareness and intention (not being on “automatic pilot”) Focusing on experience, not the labels or judgments we apply to them (e.g. understanding patients and their problems rather than just categorizing or judging them)
Sessions include meditation, narrative and appreciative inquiry exercises. Session themes include: noticing, being with suffering, professionalism, how doctors think, time, self-care and burnout, responding to errors, mindful communication, balance, death and dying, conflict, teams and partnerships, and working with electronic media.
Miner Digital Library
Miner Library, the University of Rochester medical library located at the University of Rochester Medical Center, provides robust electronic resources for the medical community. Residents have full access to these resources, which include:
Pub Med Medline
Up To Date
And many others!
Residents also have free access to bibliographic software including RefWorks and EndNote. Training for these and other resources is available in online tutorials or live sessions with library reference staff.
Will I Learn to Teach?
Being the teacher is often the best way to assess your own knowledge and understanding. Teaching as an OB-GYN resident takes many forms - reviewing the reasoning behind a treatment plan during sign-out rounds, showing a student how to interpret a fetal monitoring strip, giving a “4th lecture” to your peers or presenting your research project at Resident Research Day. Sometimes the hardest part is recognizing that you are teaching or being taught! While most residents are more natural teachers than they think, we do have group sessions on teaching and giving feedback during lecture times and we provide opportunities for our residents to practice “formal teaching” such as lectures, grand rounds, peer-to-peer teaching, etc. We expect our faculty to act as role models for teaching on the fly during clinical care so that our residents learn to offer those small moments of teaching that are so valuable to those following in their footsteps. Residents also practice giving constructive feedback, a crucial part of being an effective teacher, through completion of evaluations of faculty, peers, and students as well as through direct feedback during supervision of junior residents and students.
Will I Learn to Lead?
An inevitable part of being a resident progressing through the ranks is being a leader - for your team, for the service, and for your patients and their families. What is important is making sure you are a good leader and you learn to recognize your preferred interaction and coping strategies and those of your colleagues so you can foster the most effective and positive team possible. To that end, we utilize the mindfulness curriculum to help explore these areas and initiate discussions of good teamwork and leadership. Before becoming a chief resident, residents attend a leadership seminar including personality type testing and case scenario discussions designed to help PGY 4s use their strengths to the benefit of the team and work well with peers who have different approaches & coping mechanisms.