The OB-GYN team at our program, of which residents are a key part, has the opportunity to care for women at all stages of life and provide well-woman care, often as the only physician a woman sees on a regular basis, as well as for pregnancy care, family planning, acute and chronic gynecologic problems, and menopausal care. We coordinate care for our patients with their primary care physicians and other specialists and act as consultants for primary care physicians who provide routine OB-GYN care to their patients. We aim to keep women healthy and happy throughout the stages of their lives, providing a continuity of care that very few specialties enjoy.
We are deeply committed to
- Providing outstanding training to our residents who graduate and provide care for women all across the country
- Providing the resources and guidance needed for our residents who pursue subspecialty training
- Promoting excellence in patient care and investigative research
- Providing care of the highest order to the women of our community
Outpatient Continuity Clinic
Throughout the 4 years of training, residents spend at least one half day per week or one full day every other week in their continuity clinic site, allowing them to establish continuity of care with a panel of patients. Each clinic site provides full clinical and clerical support for residents, electronic medical records, team meetings for quality improvement, integrated care with a group of nurse practitioners, dedicated attending preceptors, and didactic learning sessions on primary care and outpatient OB-GYN topics.
Each resident is assigned to one of two clinic sites: Community OB-GYN where residents have the opportunity to practice in a clinic allied with a busy midwifery practice in a community setting, or Women’s Health Practice the university-based clinic that is being developed as a medical home for the women of the Rochester area including on-site Internal Medicine & subspecialty preceptors and consultants.
Inpatient OB - University of Rochester Medical Center
Six weeks of every year is spent on inpatient obstetrics at the University of Rochester Medical Center (URMC) which incorporates a low-risk labor and delivery unit, triage, high-risk antepartum and postpartum unit, the high-risk labor unit, an ultrasound unit, and two dedicated obstetric operating rooms - all interconnecting on one floor. Our Level IV NICU is located on the same floor directly across from the labor & delivery units and a dedicated OB anesthesia team is assigned to the labor units 24 hours per day. Residents progress through increasing levels of responsibility starting with management of normal labor and ending as the resident chief overseeing all the units and resident team.
Inpatient GYN University of Rochester Medical Center
Six weeks of every year is spent on inpatient gynecology at URMC learning and developing surgical skills in a wide variety of surgical cases including advanced laparoscopy, robotics, pelvic floor reconstruction, and family planning surgical procedures. The majority of our GYN cases accessing the peritoneal cavity are performed laparoscopically or robotically providing our residents with ample opportunity for development as a minimally invasive surgeon. In 2010, URMC & HH were #1 in New York State in the use of robotics for GYN surgery. Weekly, residents are also assigned to the new URMC Sawgrass Ambulatory Surgical Center for outpatient GYN cases including laparoscopy, hysteroscopy, and hysteroscopic sterilization.
Inpatient OB-GYN - Highland Hospital
Six weeks each year is spent at our affiliated community hospital, Highland Hospital (HH). The resident team at HH includes OB-GYN residents, FM residents, and an OB Fellow with a FM background providing an integrative community experience. The OB-GYN R2 is assigned as “deck boss” where they learn to manage the OB service in a typically low-risk setting. OB-GYN residents interact with and serve as consultants for patients of the midwifery service as needed. The HH unit includes an ultrasound unit and a Level II special care nursery.
Residents gain subspecialty experience in GYN Oncology, Urogynecology, REI, Family Planning, Pelvic Pain, Vulvar Disorders, and Pediatric Gynecology throughout the 4 years of training in both inpatient and outpatient settings. Six weeks of the 1st, 3rd, and 4th years are spent on GYN-Oncology at HH where
inpatient medical and surgical care is provided in a dedicated women’s surgical unit. The GYN-Oncology service is the leading GYN robotics program for endometrial cancer in New York and one of the largest GYN-oncology services in the state.
Residents are offered 2 elective rotations, 4 weeks in 3rd year and again in 4th year, to pursue new learning opportunities or further develop skills already achieved. Each resident develops their elective in consultation with the program director and elective supervisor including scheduling and learning objectives to be achieved. Resident experiences have included: advanced ultrasound training, surgical rotations at affiliated hospitals, primary and OB-GYN care in developing countries (Nicaragua, Nepal, Uganda, and Haiti), quality assessment projects with systems development & testing, development of an educational program, surgical ICU, etc.
Resident Research Program
We have an unusually robust resident research program that is designed to initiate resident involvement in the development of a research project starting in their 1st year and helping them through all the steps and potential pitfalls of a research project to culminate in the 3rd year with presentation of their research to the department at the annual Resident Research Day. In addition to individual mentoring, we incorporate a research curriculum into our didactic sessions including statistics, study design, scientific writing, and literature interpretation. The majority of our residents present their research at national or international meetings and many graduate with publications to their name.
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.
Weekly Didactic Time
We have weekly protected didactic time on Thursday mornings for lectures, simulation & skills training, problem-based learning, and other educational activities. Residents are excused from clinical duties which are covered by attendings and midwives during these mornings. The curriculum is based on a core curriculum of basic topics derived from CREOG learning objectives with additional lectures based on
identified needs from faculty & resident reports and group performance on the annual CREOG exams. We encourage our faculty to be creative in their lecture styles and straightforward traditional lectures are no longer the norm - faculty and residents enjoy the more interactive style and one recent “lecture” included physical reenactment of radiation treatment of GYN cancers with residents acting out the roles of and effects on vagina, uterus, ovaries, and radiation beam under the direction of the participating audience!
We have added to our schedule weekly didactic time a 4th lecture that is run by the residents themselves which is proving very popular and a great way for residents to gain teaching skills.
Team STEPPS and OB-GYN 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 attendings, 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.
We encourage and require resident participation in the development and growth of our educational program. This provides an open forum to discuss what is working well and what isn’t and to brainstorm solutions together - both from program leadership and from the “troops on the ground”. At quarterly Resident Assembly, all resident meet during Thursday morning lecture time to discuss these issues as a large group and to let their representatives and program directors know of any ongoing issues. The 2 administrative chief residents are elected by their resident peers and their responsibilities include representing the residents at departmental and university meetings, making and monitoring the schedule, solving resident conflicts, and assisting the program directors with the running of the program. The input and participation of our residents is key to the maintenance of an outstanding program.
Other Program Highlights
- Robust Family Planning program with 2 dedicated attendings, including time at Planned Parenthood, and a department strongly committed to the provision of family planning services to the women of our community. All residents participate in family planning and advanced contraception clinics and participation in procedures is at the preference of the resident.
- eRecord used for all inpatient and outpatient documentation.
- Miner Online Library includes digital access to thousands of medical journals, including all the major OB-GYN journals, general OB-GYN and other medical specialty textbooks, and Up-To-Date (among other educational programs) from all clinical work sites.
- Medhub website is home to all curricula, learning objectives, educational materials, policies, etc. for the program and all rotations.