The Obstetrics and Gynecology Residency Program

Eugene A. Scioscia, Jr., M.D., Program Director

Mohan K. Paranjpe, M.D., Director of Ambulatory Clinic, Assistant Director of Ob/Gyn Residency Education

              Length of program:    4 years

              Number of position(s): 8 (2 at each level)

The four-year Obstetrics and Gynecology Residency Program is fully accredited and designed to pre-pare residents for an academic career, private practice or subspecialty training within the discipline.

Full-time faculty in the department include the department chairman, residency program director, gynecologic oncologists, reproductive endocrinologists, genetic counselors, maternal-fetal medicine specialists and generalists in obstetrics and gynecology. Clinical faculty is extensively involved in the teaching program.

Two residency positions are available at each of the four years. The residency staff is divided into two teams: one is assigned to the obstetrics service and the other to the gynecology service. Residents in the department also rotate through the breast service, endocrinology, pathology, ultrasonography, geriatric and outpatient medicine. Residents are trained in breast disease evaluation and management as well as each of the additional areas as outlined in the Council on Resident Education in Obstetrics and Gynecology guidelines. Education encompasses practice management and medical ethics.

Residents care for patients in both clinic and private-practice settings; in the former, residents assume primary responsibility for patients while members of the attending staff remain immediately available at all times. Physicians in the hospital-based obstetrics and gynecology services treat on average more than 10,000 clinic patients and 12,000 private patients annually.

Clinical Services

Urogynecology Service

In conjunction with Allegheny General Hospital’s Division of Urology, faculty members in the Department of Obstetrics and Gynecology are regularly involved in the evaluation and management of patients who experience urogynecological problems.

Multichannel urodynamic equipment facilitates the differential diagnosis; treatment may involve urogynecologic surgery, medications and/or behavior modification. In PGY-3 and 4, residents receive training in urogynecologic evaluation and management.

Gynecologic Oncology

With board-certified gynecologic oncologists on staff, the department offers a wide array of major surgical services to patients with gynecologic malignancies. In the past year, more than 200 advanced radical surgical procedures were performed. Residents regularly participate in evaluating and treating patients with gynecologic cancer particularly during PGY-3.

Allegheny General Hospital offers comprehensive diagnostic and treatment services for patients with gynecological malignancies. A multidisciplinary approach to the treatment of patients includes the active participation of physicians in the departments of Radiation Oncology and Pathology and Lab-oratory Medicine and the Division of Medical Oncology. The Division of Gynecologic Oncology actively participates in the cooperative clinical trials of several national multi-institutional groups. In addition, the Division of Gynecologic Oncology sponsors clinical research at an institutional level, treating patients with gynecologic cancer.

Reproductive Endocrinology and Infertility (The Jones Institute)

During PGY-2 and 3, residents rotate through the Division of Reproductive Endocrinology and Infertility, where they are involved in the evaluation and treatment of male and female infertility, management of pelvic endometriosis, use of menopausal estrogen-replacement therapies and treatment for other endocrine disorders.

The division is now affiliated with the internationally recognized Jones Institute. The faculty consists of two faculty members who work on the AGH campus. Residents participate in managing patients who are being treated with advanced reproductive technologies such as IVF, GIFT, frozen-embryo transfer and intracytoplasmic sperm injection. This also includes the recent introduction of a potential donor egg program. 

Residents are actively involved in procedures for treating infertility, including operative laparoscopy and hysteroscopy, tubal reconstruction and tubal reanastomosis. Residents also are introduced to conservative and radical treatments for infertility-related disorders such as endometriosis.

Research

The division is very active in research. Residents are encouraged to complete two research projects during their four years. Current projects include, vegetative state, gastric bypass, and monochorionic/dichorionic twins; tracking anomalies. Most recently we have become one of the designated centers to provide first trimester screening with Nuchal Translucency Testing in combination with Papp-A and free beta screening.

Cytogenetics

The department, in collaboration with Allegheny General Hospital’s Center for Medical Genetics, offers genetic testing and counseling to individuals with family histories of stillbirth(s), genetic anomalies such as Down syndrome and mental retardation. Also, genetic testing is performed on couples over 35 or those who have encountered habitual miscarriage, abnormal ultra-sound findings and abnormal maternal serum alpha-fetoprotein.  Most recently we have become one of the designated centers to provide first trimester screening with Nuchal Translucency Testing in the first trimester in combination with Papp-A free beta screening.

Allegheny General Hospital’s Cytogenetics Laboratory conducts more than 1,200 evaluations per year. The Cytogenetics Laboratory performs chromosomal analysis on blood, amniotic fluid, chorionic villi, bone marrow and other tissues. Staffed by Cytogenetics Specialists, the laboratory is equipped with a video-image analyzer that displays chromosomes, enabling Cytogeneticists to process them more quickly than with conventional photographic techniques. The Cytogenetics Laboratory also includes counseling and the evaluation for patients where oncology issues may be of concern including testing and counseling for BRCA positive patients. 

The Allegheny General Hospital Center for Medical Genetics also provides a full range of genetic counseling and cytogenetic cancer services as well as DNA studies for metabolic errors or paternity determination.

Maternal-Fetal Medicine

The Maternal-Fetal Medicine Program at Allegheny General Hospital receives a large number of referrals from health-care professionals throughout the tri-state area. Through this program, the department staff cares for an extensive number of high-risk patients. The department averages approximately 20-23 perinatal transports per month.

Physicians are regularly involved in the prenatal diagnosis and obstetrical management of various major congenital anomalies. Allegheny General Hospital’s Department of Pediatrics oversees the sophisticated Neonatal Intensive Care Unit, a certified Level III facility that can care for the most critical cases - particularly those infants who require ventilatory care. Complementing the services provided by the Maternal-Fetal Medicine Program, the unit is staffed by full-time neonatologists. All levels of neonatal support, excluding extracorporeal membrane oxygenation (ECMO), are available.

Endoscopic Surgery

An integral part of resident education includes laparoscopic and endoscopic surgery. This includes a combination of both laparoscopic diagnostic and therapeutic procedures as well as hysteroscopic, diagnostic and therapeutic procedures. Most recently we have added to our acumen the laparoscopically assisted vaginal hysterectomy and laparoscopic supracervical hysterectomy and the hysteroscopic placement of ESSURE tubal occlusion devices along with multiple procedures for endometrial ablation and endometrial resection. 

Ultrasonography

Open five days per week, the department’s Ultrasonography Laboratory offers a wide array of diagnostic services, including traditional ultrasonography, transvaginal studies, 3D sonograms and first trimester screening. In addition, the department is now currently linked to provide images at any computer access point.

The department is equipped with four ultrasound units, as well as portable real-time ultrasound for use in labor and delivery, the operating room or on the nursing units. Laboratory staff members perform about 30 studies per day. Services are used to diagnose fetal abnormalities such as neural tube defects, ovarian cysts, molar and ectopic pregnancies, leiomyoma evaluation, intrauterine growth retardation, pelvic masses and multiple gestations. The Ultrasound Laboratory staff also assists physicians with amniocentesis and cordocentesis.

Women’s Preventative Health Center (Menopause Center)

This resource focuses on risk assessment; patient education and research related to menopause fulfilling a niche in patient care for women beyond the reproductive years.

An intense educational experience, including virtually all aspects of the discipline of obstetrics and gynecology, is provided for the residents. Excellent preparation for a career focused on either academic medicine or private practice reflects the mission, goals and objectives of the Department of Obstetrics and Gynecology.

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