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. Each resident will spend ½ day per week in his/her Continuity Clinic on campus. 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. No night call or night float will be assigned to the 2016-2017 PGY-1 class.

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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 will learn the management of normal and abnormal labor, inpatient antepartum and postpartum care, OB triage, management of obstetric emergencies, and performance of spontaneous and operative deliveries as well as 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 attending. 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 two two-month rotations. In 2016-7 the PGY-1 will operate with the full time and select  private faculty at Saint Thomas Midtown, gaining surgical experience as is appropriate for his/her skill level. We expect the development of surgical skills to be accelerated in the first class due to the large number of cases available for training.
Primary Care Medicine
The PGY-1 resident will spend one month assisting in the office practice of a member of the volunteer faculty in Internal Medicine. The resident is expected to learn the basics of general primary care and understand the management of common primary care problems such as age-appropriate health screening, hypertension, lipid disorders, thyroid disease, and diabetes.
​Emergency Department
The PGY-1 resident will spend one month evaluating and treating patients in the Emergency Department under the supervision of the ED attending staff.

Continuity Clinic

In accordance with ACGME requirements, each OB/GYN Program resident will staff his/her 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 will establish a panel of patients for whom he/she will provide continuous care extending over the subsequent four years. It is expected that the panel will be 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 Emergency and Intensive Care disciplines.

Night Float
During the first half of the 2017-8 year the PGY-2 residents will spend two one-month rotations on night float, covering the obstetrics service and gynecology admissions from the Emergency Department at Saint Thomas Midtown Hospital only. The OB hospitalists will provide on-site supervision.
SICU
The PGY-2 resident will spend 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 open procedures, advanced minimally invasive surgery and vaginal surgery. Robotic techniques and experience will also be introduced.
Maternal Fetal Medicine
Two months are spent in an immersion experience on the Maternal Fetal Medicine inpatient and outpatient services, developing competence in the management of complicated pregnancies and the performance of OB ultrasound.
Reproductive Endocrinology and Infertility
This is a two month immersion rotation in the office of the Nashville Fertility Center, working closely with the faculty, and participating in infertility surgery.
Pregnancy Termination and Breast Imaging
This is a one month rotation divided between the provision of pregnancy termination procedures at a local clinic and participating in the interpretation of breast imaging, including mammography, ultrasound, and biopsies at the STM Center for Breast Health. 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.

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.

Gynecologic Oncology
The PGY-3 will spend a total of four months, in two month blocks, on the Gynecologic Oncology service in the ambulatory setting and in the operating room, developing more advanced surgical skills, learning robotic techniques, and gaining knowledge and clinical judgment in the management of gynecologic malignancies.
Inpatient Obstetrics
The PGY-3 on Obstetrics will spend two two-month rotations as the primary obstetrician in labor and delivery, coordinating the care of all patients managed by the resident staff with the assistance and supervision of the faculty laborist.
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
Two months during the third year are set aside for the resident to self-direct his/her 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 his/her fund of knowledge or surgical experience.

The PGY-4 Chief Experience

The 2019-2020 PGY-4 residents and the PGY-3 residents in the OBGYN Residency Program will rotate night call every fourth to sixth night, depending on the time of year and vacations. The PGY-4 residents will not be assigned home call. The essence of the Chief year in the OBGYN program is full supervision of and responsibility for a service. Four months, in two-month blocks are spent on each of the major services.

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Obstetrics
The Chief Resident on Obstetrics will coordinate the operation of the inpatient Obstetrics service and serve as teacher and mentor to the other house staff and students assigned to the service. The Chief will have the privilege of supervising the most difficult cases and performing the most unique procedures, working closely with the laborist and Maternal Fetal Medicine staff.
Gynecology
The Chief Resident on gynecology will distribute case assignments at  STM and will perform the most interesting and difficult cases, including those on the REI, MIS/FPMRS and Gynecologic Oncology services. The Chief will be expected to serve as a mentor and teacher to other residents and medical students.
Ambulatory OB/GYN
The Clinic Chief will be responsible for providing the highest level of care within the UT/STMP OB/GYN Center and serve as a teacher and mentor to other residents and students. On this rotation the Chief will hone his/her skills in ambulatory care and outpatient procedures in preparation for practice. The Clinic Chief will be supported and mentored by the on-site clinic faculty member.


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