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Education

Residency Training Structure

The overall philosophy of our Obstetrics and Gynecology Residency Training Program is to create an environment that provides formal instruction and constructive evaluation as well as increasing levels of experience and responsibility from the earliest levels of training onward. All patients - whether service or private, including patients seen in the outpatient department, admissions, surgeries, and deliveries - are available for resident education. In addition, the department strives to create an environment of research and scholarly activity that optimizes the academic efforts of all members of the department and encourages a life-long commitment to the pursuit of knowledge.

Our organization serves a culturally diverse population from western Pennsylvania, Ohio and West Virginia. More than 10,000 outpatients are treated in the department each year and about 4000 ultrasounds are performed annually. 

More than 4200 women give birth in our hospitals annually, and more than 40% of births at West Penn Hospital involve high-risk patients. West Penn Hospital receives more than 600 maternal and neonatal transports each year.

In addition to the many educational and clinical opportunities available within the department itself, our residents obtain additional educational experiences from rotations outside the department. These include rotations in the outpatient internal medicine clinics, Family Medicine, the Emergency Department, and Anesthesia.

In addition, residents are given one month of elective time where they may schedule an in-house or off-site rotation to complement their educational experience.

Beginning in the first year of training, residents attend a half-day continuity clinic session each week in the outpatient clinics. These sessions consist of two to three residents and a supervising faculty attending. Attendings do not have other responsibilities or see other patients while supervising residents. Each resident follows his or her complement of patients under the supervision of a faculty attending. As residents advance in their training, the number of patients they oversee will increase.

In addition to the continuity clinic sessions, residents will rotate through departmental specialty clinics, including high-risk obstetrics, urogynecology, oncology and reproductive endocrinology and infertility.

The outpatient clinics are located in a large, renovated space equipped with a procedure room, 6 examination rooms, 2 consultation rooms, and a conference space with library and computers. Procedures performed include colposcopy, LEEP, cryotherapy, endometrial sampling, complex cystometrics, cystoscopy, and office hysteroscopy. A mobile ultrasound with abdominal and endovaginal probes is available for use in each evaluation room.

The department employs a night float system to comply with the ACGME duty-hour requirements. This improves the educational experience of residents while rotating on the various clinical rotations and services. Night float is scheduled with three residents on a team (PGY-1 to PGY-3).


PGY-1 (First-Year Residents)

First-year (PGY-1) resident rotations include the following:

  • Gynecology – 2 months
  • Obstetrics nights – 2 months
  • Obstetrics days – 2 month
  • Emergency Department – 1 month
  • Internal Medicine – 1 month
  • Family Medicine – 1 month
  • Triage – 1 month

The fundamentals of diagnosis, work-up, management, anatomy, and physiology as well as appropriate consultation are emphasized. The first-year resident actively participates in each service performing vaginal deliveries, cesarean sections, ultrasounds, and minor gynecology procedures such as D&C, hysteroscopy, biopsy, polypectomy, laparoscopy, cerclage and marsupialization.

First-year residents participate in and perform these procedures under resident and attending physician supervision from the first day of training. In addition, residents will start to see their own panel of patients in the ambulatory care center under the direction and supervision of the attendings. During off-service rotations (Internal Medicine, Emergency Department, etc.), residents function as active members of the respective team, evaluating and managing outpatient medical conditions.


PGY-2 (Second-Year Residents)

Second-year residents expand upon their knowledge and proficiency in the diagnosis and management of obstetrical and gynecological problems. At this level, there is greater participation in both the basic and more advanced gynecologic procedures including hysteroscopic myomectomy, endometrial ablation, operative laparoscopy, and minor laparotomies. In addition, there is greater participation in basic and advanced obstetrical procedures including vacuum deliveries and difficult cesarean sections.

Second-year resident rotations include the following:

  • Gynecology – 2 months
  • Obstetrics days – 2 months
  • Obstetrics nights – 2 months
  • Gynecologic Oncology – 2 months
  • Triage – 1 month
  • Reproductive Endocrinology and Infertility / Anesthesia / Outpatient Internal Medicine – 1 month

PGY-3 (Third-Year Residents)

Third-year residents have more responsibility for the management of obstetrical and gynecological patients and expand on their experiences from previous years with greater participation in more difficult cases and greater responsibility in managing and supervising the junior residents of the team.

Third-year resident rotations include the following:

  • Gynecology – 2 months
  • Forbes Regional Hospital Gynecology – 1 month
  • Allegheny General Hospital Clinic – 1 month
  • Obstetrics days – 2 months
  • Obstetrics nights – 2 months
  • Genetics / Maternal-Fetal Medicine– 1 month
  • Patient Safety/ Quality Improvement and Research – 1 month

Each third-year resident is required to complete a research project to be presented on Resident Research Day. Faculty members assist in the selection, design, and interpretation of research project topics. After collection of the data, results are interpreted and compared with the study hypothesis. Past projects have been presented at national meetings and published in peer reviewed journals.


PGY-4 (Fourth-Year Residents)

During the fourth year, residents will continue to enhance their diagnostic and management skills while assuming responsibility as chief resident. During this year, residents will acquire the knowledge and skills necessary to function as attending obstetricians/gynecologists without direct supervision and to pass the oral and written OB/GYN Board examinations. As chief residents, fourth-year residents assume greater responsibility in supervising and teaching the junior members of the team and students. It is not uncommon for the chief resident to function as first assistant while taking the junior members through surgical procedures.

Fourth-year resident rotations include the following:

  • Gynecology – 2 months
  • Obstetrics days – 2 months
  • Oncology – 2 months
  • Breast/ Reproductive Endocrinology and Infertility – 1 month
  • Allegheny General Hospital Clinic – 1 month
  • Forbes Regional Hospital Gynecology – 1 month
  • Elective – 1 month

 

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