Overview of Rotations
PGY 3 & 4
Optional elective time can be taken out of gynecology. Past residents have done global health rotations in Ghana and Uganda! Other electives may include away rotations in a desired sub-specialty.
Residents manage all aspects of obstetrical care including antepartum, intrapartum and postpartum evaluation and management. There is in-house faculty available 24 hours a day in charge of supervision. Residents attend all vaginal and cesarean deliveries while on the floor. Residents also play a role in teaching medical students on the rotation the aspects of normal obstetric care.
Residents cover all inpatient/outpatient surgeries, including preoperative evaluation and postoperative care. The extent of involvement by residents during surgery is determined by the complexity of the case and the resident's skill level. The setting of the program allows for a large volume and variety of cases. By their 4th year, residents are expected to be dexterous in performing minimally invasive laparoscopic surgery, and complex robotic cases. Residents on the GYN rotation also attend inpatient and ER consults, effectively learning how to manage routine GYN emergencies, under faculty supervision.
The Reproductive Endocrinology rotation is carried out at SIUs Fertility Center, where residents actively engage in the management of the infertile couple. Residents are exposed to the entire spectrum of the field: from minimally invasive fertility surgery, to cutting edge artificial reproductive technologies. Residents assist with workup of the infertile couple as well as follow-up and management of patients undergoing IVF cycles. There is also exposure to SIUs state of the art embryology lab for embryo culture and selection, PGD/PGS, etc. During this rotation, residents further strengthen their gyne-ultrasound skills.
Maternal Fetal Medicine
Under the direction of the faculty in this division, residents manage antepartum and intrapartum patients, both inpatient and outpatient for high-risk patients. Ultrasound skills are sharpened with particular emphasis in pregnancy dating, anomaly investigation, biophysical profile, amniotic fluid assessment, and amniocentesis. Clinical training in genetics occurs during this rotation. As a level III referral center for obstetrics and pediatrics, there is a vast diversity and volume of maternal-fetal medicine patients that residents see.
Formal ultrasound training in obstetrics and gynecology is obtained during the first year of residency under the direction of the MFM faculty, and the certified sonographers. Basic training in physics, machine operation, scanning technique, image optimization, measuring structures, and interpretation are provided during this time. Further training and refining of skills occurs throughout residency on the wards and clinics with emphasis on specific obstetrical skills being provided during MFM rotations.
The genetics curriculum is taught in conjunction with the Division of Genetics, Department of Pediatrics, and the Maternal Fetal Medicine Division. A faculty member who is board certified in Genetics provides the primary lectures. The management and application of genetics in the clinical situation is taught during the MFM rotation and within the resident continuity clinics. Residents manage patients and provide routine genetic counseling within their resident obstetric continuity clinics.
Research is encouraged throughout the 4 years of residency. During this time, research projects are to be designed, data is to be gathered and analyzed, and papers written under the direction of the faculty. The Director of Research and Program Director must approve all resident projects prior to initiation to ensure appropriate design and feasibility of the project. The research division assists each resident with preparation of Internal Review Board applications. All PG-3 and PG-4 residents must present a paper on original research (no case studies or previously published papers) at the SIU Research Symposium at the end of the year.
Each 2nd, 3rd, and 4th year resident conducts a ob/gyn continuity clinic one-half day per week. There is ongoing random assignment of patients to these clinics from the emergency room, hospital discharge, individual requests, etc. Care of continuity clinic patients takes preference over all other activities. The residents are responsible for all patient management decisions, both inpatient and outpatient for patients seen in their clinics. An important fraction of resident surgical cases come from their continuity clinic. Faculty is present in these clinics for supervision.
These half-day continuity clinics are conducted by the PG 1 residents and they provide care for obstetric patients only. The residents are the primary caregivers supervised by attending physicians. These clinics provide health status assessment, diagnosis and dating of pregnancy, initial evaluation, and all prenatal care. Case managers, dieticians and other necessary support staff are present in these clinics for consultation.
During this rotation residents attend clinic 4 days a week, and see a mixture of gyne and high-risk ob patients. Every Thursday, ambulatory clinic residents perform colposcopic evaluation of patients for cervical dysplasia under the supervision of a Gynecologic Oncologist.