Clinical Rotations

The PGY-1 Resident 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. During the second six months, the resident experiences two additional months in surgical gynecology and inpatient obstetrics as well as one-month rotations in emergency medicine and obstetric ultrasound. The goal of the PGY1 experience is to develop the basic skills and clinical acumen required for general OB/GYN while under the close supervision and tutelage of the senior residents and full-time faculty. PGY-1 residents are assigned to 24-hour call, in-house every third Saturday.

Obstetrics
The PGY-1 experience is primarily an OB hospitalist experience, committed to developing expertise in all aspects 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, well-woman care, contraception, 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.

Gynecology
The PGY-1 resident serves as primary surgeon on a variety of major and minor cases with full time and select private faculty to gain surgical experience as is appropriate for her/his skill level. Minimally invasive and robotic techniques are introduced.

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 each week. Attendance at the clinic will take priority over all other academic and clinical duties except protected conference time. 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 Resident 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, during which the resident covers the obstetrics service at Ascension Saint Thomas Hospital Midtown (ASTHM) under the supervision of the obstetric hospitalists.

SICU
The PGY-2 resident spends one month on the SICU rotation evaluating and managing critical care patients under the supervision of the attending staff.

Gynecology
The PGY-2 resident on gynecology continues to develop more advanced surgical skills and focuses on laparoscopic procedures and vaginal surgery. Minimally invasive laparoscopic and robotic techniques and experience are developed.

Maternal Fetal Medicine
One month (each) is spent with the maternal fetal medicine faculty in the outpatient and inpatient settings. The resident develops a fund of knowledge of high risk obstetric care as well as competency in the management of complicated pregnancies as a consultant to private general 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. The resident develops an understanding of infertility management, including assisted reproduction technologies, and competence in the performance of transvaginal gynecologic ultrasound.

Breast Health
This one-month rotation is dedicated to the evaluation and treatment of breast health issues. The resident spends two weeks concentrating on interpretation of breast imaging modalities, which include mammography, ultrasound and biopsies at the Ascension Saint Thomas Center for Breast Health. The remaining two weeks are spent working with Dr. Eduardo Dias in evaluating and treating patients with breast cancer in the ASTHM Breast Surgery Center and assisting with breast cancer surgery.

Female Pelvic Medicine and Reconstructive Surgery
This rotation is a two month experience in both outpatient and inpatient evaluation and operative therapy for urologic and pelvic support problems under the direct supervision of the FPMRS faculty.

The PGY-3 Resident Experience

During the third year the resident continues to develop competence in inpatient obstetrics and maternal fetal medicine. The resident also obtains unique knowledge and expertise in gynecologic oncology while establishing expertise in robotic surgery.

Night Float
The resident spends two one-month rotations on night float and covers the obstetrics service at ASTHM under the supervision of the obstetric hospitalists.

Gynecology
The 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 resident 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 open and robotic surgery.

Elective
Upon request and approval, one of the months of gynecology may be used to perform a research project, participate in an international experience, or experience a rotation in another institution as a prelude to a fellowship.

Maternal Fetal Medicine
One month is spent with the maternal fetal medicine faculty in the inpatient setting. The resident further develops her/his fund of knowledge of high risk obstetric care as well as competency in the management of complicated pregnancies as a consultant to private general obstetricians.

The PGY-4 Chief Experience

The essence of the PGY-4 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. In accordance with ACGME requirements, the Chief resident is expected to practice with minimal supervision and serve as a teacher to medical students and other residents.

Obstetrics
The Chief resident on obstetrics coordinates the operation of the inpatient obstetrics service and serves as teacher and mentor to the other residents and medical students assigned to the service. The Chief has the privilege of supervising the most difficult cases and performing unique procedures while working closely with the core obstetricians and attendings.

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 the gynecologic oncology resident to maintain competence in more difficult open and robotic surgery.

Ambulatory OB/GYN
The Clinic Chief is responsible for providing the highest level of care within the UT OB/GYN Center and 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.