Clinical Rotations

The PGY-1 Experience

The first year of the OBGYN Residency Program is divided into a pair of two-month blocks each of Obstetrics, Gynecology, and Ambulatory Care. The goal of the PGY-1 experience is to develop the basic skills and clinical acumen required for general OB/GYN under the close supervision and tutelage of the full-time faculty. PGY-1 residents are assigned weekend call, but no weekday night float or night call.

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Obstetrics
The PGY-1 experience is primarily a laborist experience, committed to developing expertise in all areas of inpatient obstetrics. The resident learns the management of normal and abnormal labor, inpatient antepartum and postpartum care, OB triage, management of obstetric emergencies, performance of spontaneous and operative deliveries, and performance of Cesarean sections.

Ambulatory OB/GYN
The two-month PGY-1 ambulatory OB/GYN experience is focused primarily on outpatient prenatal care, gynecology referral evaluation and management, and outpatient procedures under the direct supervision of the clinic faculty attending staff. The primary site for this rotation is the on-campus UT OB/GYN clinic. A resident who evaluates and performs the preoperative evaluation of a patient who subsequently undergoes an operative procedure will be invited to take time away from the clinic to assist or perform the surgery and provide the patient’s postoperative care, providing global care for the patient.

Gynecology
This experience is divided into a two-month rotation and two one-month rotations. The PGY-1 serves as primary surgeon on a variety of major and minor cases with full time and select private faculty at Saint Thomas Midtown, gaining surgical experience as is appropriate for his/her skill level.

Obstetric Ultrasound
During this one month rotation the resident develops the skill to confidently perform level II transabdominal ultrasound on obstetric patients, including biometry and biophysical profiles under the tutelage of subspecialty Maternal Fetal Medicine ultrasonographers.

​​Emergency Department
The PGY-1 resident spends one month evaluating and treating general medical and surgical patients in the Emergency Department under the supervision of the ED attending staff.

Continuity Clinic

In accordance with ACGME requirements, each resident will staff her/his own continuity clinic one half-day per week. Attendance at the clinic will take priority over all other academic and clinical duties. During the PGY-1 year the resident establishes a panel of patients for whom she/he will provide continuous care extending over the subsequent four years. It is expected that the panel is primarily composed of patients needing well-woman continuous follow up and new OB patients whom the resident may follow throughout their prenatal course, delivery and postpartum care.

The PGY-2 Experience

During the second year of the OBGYN program the resident’s experience begins to extend to the subspecialties as well as Breast Health and Intensive Care disciplines.

Night Float
The PGY-2 resident spends two one-month rotations on night float, covering the obstetrics service at Saint Thomas Midtown Hospital under the supervision of the obstetric hospitalists.

SICU
The PGY-2 resident spends one month in the SICU, evaluating and treating patients under the supervision of the attending staff.

Gynecology
The PGY-2 resident on gynecology will continue to develop more advanced surgical skills, focusing on laparoscopic procedures and vaginal surgery. Robotic techniques and experience will also be introduced.

Inpatient Maternal Fetal Medicine
Two months are spent in an immersion experience on the Maternal Fetal Medicine inpatient  service to develop competence in the management of complicated pregnancies as consultants to general private obstetricians.

Reproductive Endocrinology and Infertility
During this two month immersion rotation in the office of the Nashville Fertility Center, the resident works closely with the faculty in the outpatient setting and develops competence in the performance of transvaginal gynecologic ultrasound.

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​Breast Health
This one- month rotation is dedicated to the evaluation and treatment of breast health issues, including invasive cancer. The resident will spend two weeks concentrating on the interpretation of breast imaging modalities, including mammography, ultrasound, and biopsies at the STM Center for Breast Health. Another two weeks will be spent working with Dr. Eduardo Dias evaluating and treating patients with breast cancer in the STM Breast Surgery Center and assisting on breast cancer surgery.

The PGY-3 Experience

During the third year residents will continue to develop competence in inpatient obstetrics and Maternal Fetal Medicine and obtain unique knowledge and expertise in the subspecialties of Gynecologic Oncology and FPMRS. The 2018-19 PGY-3 residents will experience some in-house call within the parameters of the ACGME duty hour restrictions.

Night Float
The PGY-3 resident spends two one-month rotations on night float, covering the obstetrics service at Saint Thomas Midtown Hospital under the supervision of the obstetric hospitalists.

Gynecology​
The PGY-3 resident on gynecology continues to develop more advanced surgical skills while focusing on open procedures, advanced minimally invasive surgery, robotic surgery and vaginal surgery.

Gynecologic Oncology

The PGY-3 spends a two-month rotation and a one month rotation (a total of three months) on the gynecologic oncology service to develop more advanced surgical skills, gain knowledge and clinical judgment in the management of gynecologic malignancies, and establish competence in robotic surgery.

Outpatient Maternal Fetal Medicine

The PGY-3 resident spends one month in the private office of the Maternal Fetal Medicine subspecialists to experience the evaluation and management of high-risk pregnancies and genetic counseling as performed by consultants.

Minimally Invasive Surgery/Female Pelvic Medicine and Reconstructive Surgery

This rotation is a two-month immersion rotation concentrating on the outpatient evaluation and operative therapy for urologic and pelvic support problems under the direct supervision of the FPMRS faculty.

Elective

One month during the third year is set aside for the resident to self-direct her/his experience. Each resident might choose to complete his/her research project, participate in an international experience or a rotation in another institution as a prelude to fellowship, or design an approved experience within the program to further develop her/his fund of knowledge or surgical experience.

The PGY-4 Chief Experience

The essence of the Chief year in the OBGYN program is the establishment of competence in all aspects of general obstetrics and gynecology in preparation for independent practice. Four months are spent on each of the major services. ​

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Obstetrics
The Chief Resident on obstetrics coordinates the operation of the inpatient obstetrics service and serves as teacher and mentor to the other house staff and students assigned to the service. The Chief has the privilege of supervising the most difficult cases and performing the most unique procedures while working closely with the core generalist and Maternal Fetal Medicine faculty.​

Gynecology

The Chief Resident on gynecology supervises all junior residents on the gynecology service. The Chief is expected to serve as a mentor and teacher to other residents and medical students while assuming the role of teaching assistant on operative cases. During one month of the rotation the PGY-4 also serves as gynecologic oncology Chief to maintain competence in robotic surgery.

Ambulatory OB/GYN
The Clinic Chief is responsible for providing the highest level of care within the UT/STMP OB/GYN Center to serve as a teacher and mentor to other residents and students. On this rotation the Chief hones her/his skills in ambulatory care and outpatient procedures in preparation for practice. The Clinic Chief is supported and mentored by the on-site clinic faculty member. Two weeks of this rotation is spent at Planned Parenthood performing family planning and counseling as well as medical and surgical abortions. In accordance with ACGME policy, residents who have a religious or moral objection may opt-out, and will not be required to participate in training or performing induced abortions.


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