Overview
The overall educational objectives of the program of Obstetrics and Gynecology at Exempla Saint Joseph Hospital are based on Educational Objectives: Core Curriculum in Obstetrics and Gynecology as published by the Council on Resident Education in Obstetrics and Gynecology. This format is reviewed with each new edition, and continues to allow for the training of physicians in the primary and preventive care of women, pregnancy, and the female reproductive system. The educational objectives strive to accomplish the following for graduating residents:
- To be able to practice the full range of obstetrics and gynecology in a recognized physician-patient relationship.
- To successfully complete the certifying examinations of the American Board of Obstetrics and Gynecology.
- To serve as a consultant in obstetrics and gynecology to other physicians and health care providers.
- To enter advanced training in the subspecialties of obstetrics and gynecology as talents and aspirations dictate.
- To establish lifelong habits of scholarship and intellectual curiosity.
- To recognize the special and unique role of the obstetrician/gynecologist in their promotion of health and well-being for women and their unborn children.
- To obtain and demonstrate competencies in patient care, medical knowledge, practice based learning, interpersonal and communication skills, professionalism, and systems based practice.
We expect our physicians to be able to evaluate the general health care needs of women, and deviations from normal in women, so that they can appropriately refer to other specialists. Additionally, we expect the educational program to result in our physicians realizing their capabilities within the specialty and to recognize the need to refer patients within our specialty. Finally, we strive for compliance with all aspects of the RRC Requirements.
All patients admitted to the service are considered "teaching patients," and house staff members participate in their complete management and care. House staff participation in the care of patients is consistent with the demonstrated experience, ability and comprehension of the resident. Progressive responsibility is the expected norm with culmination in the chief year.
The hospital provides an in-house clinic for patients without insurance or other means of full payment, and local county clinics regularly refer patients to Exempla Saint Joseph for care. This enables the residents to have both obstetrical and gynecologic continuity clinics throughout their four years of training. Residents follow their own patients and are involved in their patient's deliveries and gynecologic procedures. There is faculty supervision in the clinic at all times and in-house coverage 24 hours a day. There is a large Hispanic population among our uninsured patients. Proficiency in Spanish is definitely an asset, but not a requirement.
In keeping with traditional Catholic teaching and respects to ethical and religious directives, training in family planning is conducted outside of Exempla Saint Joseph Hospital, through participation in local family planning clinics as well as private physician offices under the guidance of department and volunteer faculty.
Intern Year
First-year residents (aka. "interns") can count on a full obstetrical experience, including a rotation on the high-risk OB service. While spending a rotation block on the Family Medicine Service, interns will begin developing their primary medicine skills. One block has been dedicated to addressing clinical applications of ultrasound. In addition, the first year resident will gain ambulatory clinic experience developing triage skills on both OB and GYN patients, while also having the opportunity to develop their GYN surgical skills.
Second & Third Year
Second and third year residents enjoy increasing responsibility in obstetrics and gynecology cases as well as in the sub-specialty services of urogynecology, reproductive endocrinology and infertility, and gynecologic oncology. Second year residents also have an elective block as part of their year while third year residents are scheduled a dedicated research block and sub-specialty elective block rotation.
Fourth Year
Fourth year residents share the responsibilities of "OB and GYN Chief", taking turns overseeing their entire respective services. They also have an elective rotation where they can pursue additional areas of academic interest.
Rotations
Here is an example of our OB/GYN 2009/2010 rotations:
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Rotations
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PGYI
(Post Graduate Year I)
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PGYII
(Post Graduate Year II)
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PGYIII
(Post Graduate Year III)
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PGYIV
(Post Graduate Year IV)
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Ambulatory Clinic
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2 blocks
(10 weeks)
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Antepartum/High Risk Obstetrics
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1 block
(5 weeks)
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1 block
(5 weeks)
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Clinic Chief
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2 blocks
(12 weeks)
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Elective
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1 block
(5 weeks)
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1 block
(6 weeks)
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Family Medicine
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1 block
(5 weeks)
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Gynecology
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1 block
(5 weeks)
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3 blocks
(15 weeks)
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3 blocks
(15 weeks)
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Gynecologic Oncology
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3 blocks
(15 weeks)
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Gynecology Service Chief
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4 blocks
(24 weeks)
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Labor & Delivery (Days)
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2 blocks
(10 weeks)
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2 blocks
(10 weeks)
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Labor & Delivery (Nights)
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2 blocks
(10 weeks)
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2 blocks
(10 weeks)
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Obstetrical Service Chief
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1 block
(5 weeks)
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1 block
(6 weeks)
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Reproductive Medicine & Endocrinology
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1 block
(5 weeks)
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Research
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1 block
(5 weeks)
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Sub-Specialty Elective
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1 block
(5 weeks)
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Ultrasound
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1 block
(5 weeks)
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Urogynecology
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1 block
(5 weeks)
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Didactics and Conferences
Each week, at least four to five hours are devoted to academic sessions that are conducted by the department faculty, volunteer faculty from the private sector, Kaiser Permanente, and the University of Colorado. Lectures are provided from general OB/GYN practitioners as well as sub-specialists within the field of OB/GYN. To further compliment opportunities to learn, guest lecturers may include faculty from the Department's of Pathology, Family Medicine, Internal Medicine, General Surgery, and Anesthesia. Residents also participate actively, providing lectures and organizing Morbidity and Mortality Conferences and Journal Club. Residents are also encouraged to attend lectures provided by the Colorado Section of ACOG (American College of Obstetrics and Gynecology).
In addition, up to ten small group "rounds" take place each weekday morning, divided equally between disciplnes of obstetrics and gynecology with each lasting approximately 30 minutes. These rounds allow a more focused discussion and analysis of cases admitted overnight and provides another opportunity to learn via "mini-lectures" and evidence-based discussions of the literature.
Electives
Recognizing the importance of extracurricular educational opportunities, the department offers electives during both Post Graduate Year II and Post Graduate Year IV. In the past, residents have taken this opportunity to travel abroad to perform international humanitarian OB/GYN work in both Tanzania and Ecuador, just to name a few. Traveling abroad is limited to the PGY IV Elective. Other residents have taken the opportunity to stay more local and shore up their fund of knowledge and familiarity in private practice and community-based care.
Residents are asked to submit to the faculty for approval a list of educational objectives to be gained by the elective experience as well as point-of-contact information of an official at the institution or practice overseeing the resident's experience and performance in advance of at least four months (i.e. 120 days).
The "Sub-Specialty" Elective during the PGY III year provides the resident an additional block to futher their education in either maternal fetal medicine, gynecologic oncology, reproductive endocrinology & infertility, or urogynecology.
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