All core rotations last four weeks. Below is a description of core rotations and experience in each over four years (number of rotations and PGY levels).
Labor and Delivery
Experience: 8 rotations (PGY-1 x 2, PGY-2 x 2, PGY-3 x 2, PGY-4 x 2)
Description: A team of four residents (one of each PGY level) rounds on postpartum patients prior to 7am signout. During the day, they manage the L&D unit (low and high-risk patients), perform obstetric cases (cesarean deliveries, external cephalic versions), and see patients in OB triage until evening signout at 5pm. The team also includes a nurse practitioner who helps see postpartum patients and a certified nurse midwife who sees triage patients and supervises PGY-1 and -2 residents in vaginal deliveries.
Night Float
Experience: 8 rotations (PGY-1 x 2, PGY-2 x 2, PGY-3 x 2, PGY-4 x 2)
Description: A team of four residents (one of each PGY level) manages all inpatient services from 5pm until 7am. The PGY-1 is responsible for L&D, OB triage, and the postpartum unit. The PGY-2 is responsible for all gynecologic services, ED consults, and GYN surgeries. The PGY-3 is responsible for the MFM service. The PGY-4 supervises the entire resident team and acts as teaching assistant on all surgical cases.
Gynecology
Experience: 8 rotations (PGY-1 x 2, PGY-2 x 2, PGY-3 x 2, PGY-4 x 2)
Description: A team of four residents (one of each PGY level) performs the full spectrum of gynecologic operative cases and operate 4-5 days each week. They operate with both core faculty physicians and community physicians. The team manages the inpatient benign gynecology service, including admissions, postoperative care, and inpatient and emergency department consultations. In addition, the GYN team sees patients in our perioperative clinic and presents all upcoming cases for discussion at a weekly perioperative conference. This team also staffs an outpatient procedure clinic that includes office hysteroscopy, manual vacuum aspirations, SIS, HSG, and ultrasound-assisted procedures.
Maternal-Fetal Medicine
Experience: 4 rotations (PGY-1 x 2, PGY-2, PGY-3)
Description: A team of two residents rounds with the MFM attending and fellow on our busy and complex high risk service. The average census is 18 patients between the antepartum unit, L&D, and the intensive care unit. We see a large variety of maternal and fetal pathology and serve a large catchment area with the most advanced level of specialty care in the area in our Level III NICU. This team also performs operative cases on service patients including cesarean delivery, cervical cerclage, and PUBS.
Ultrasound
Experience: 2 rotations (PGY-1, PGY-4)
Description: In the first of two dedicated ultrasound months, interns learn all the key components of obstetric ultrasound, including first trimester dating, second trimester anatomy ultrasound, performing fetal biometry, and antenatal surveillance with biophysical profile. In the second rotation, chief residents tailor their experience to include a mix of obstetric and gynecologic ultrasound that will most benefit them in their post-graduation fellowship or practice.
Obstetric Clinic
Experience: 6 rotations (PGY-1 x 2, PGY-2 x 2, PGY-3, PGY-4)
Description: A team of three residents sees patients in our High Risk Obstetrics Clinic. They are directly supervised by an MFM faculty member. The broad range of pathology includes patients with diabetes, hypertensive disorders, fetal anomalies, adult congenital heart disease, multifetal gestation, and many other comorbidities. The large volume of low-risk obstetric patients at the OBGYN Center are cared for by our skilled nurse practitioners and nurse midwives.
Gynecologic Oncology
Experience: 5 rotations (PGY-1, PGY-2, PGY-3, PGY4 x 2)
Description: A team of two or three residents operates with our three busy GYN Oncologists and manages the inpatient Gynecologic Oncology service. This includes admissions, care of postoperative patients, and consultations. Residents usually operate 4 days each week. This is an excellent opportunity for experience in robotic and abdominal hysterectomies and management of medically complex and critically ill patients.
Reproductive Endocrinology and Infertility
Experience: 2 rotations (PGY-2, PGY-3)
Description: One resident works directly with our five REI faculty members seeing patients in their office and performing cases in the operating room. Cases include advanced hysteroscopy, diagnostic and complex operative laparoscopy, myomectomy, and hysterectomy. Residents gain excellent experience with transvaginal GYN ultrasound during this rotation, and they also spend time in the ART lab. Residents participate in the weekly IVF conference, including clinical and didactic discussions.
Female Pelvic Medicine and Reconstructive Surgery (Urogynecology)
Experience: 2 rotations (PGY-2, PGY-4)
Description: One resident operates with our two FPMRS faculty members and sees patients in the office with them. This rotation provides immersive experience in vaginal surgery, including vaginal hysterectomy, incontinence procedures, repair of pelvic organ prolapse, and colpocleiesis. Outpatient, residents become familiar with the full range of evaluation and treatment procedures, including simple cystometrics, urodynamic testing, cystoscopy, and pessary use.
Pediatric and Adolescent Gynecology
Experience: 1 rotation (PGY-3)
Description: One resident works with our two PAG physicians and two NPs in the outpatient office, operating room, and inpatient for consultations. The clinical focus includes learning the normal menstrual cycle and managing abnormalities including absent, frequent, infrequent, heavy, or irregular menses. Residents also obtain in-depth knowledge of contraception, sexually-transmitted infections, and bleeding disorders.
Research
Experience: 1 rotation (PGY-3)
Description: While residents have been working on their research project longitudinally from the first month of residency, they have a dedicated month for manuscript writing and revision and preparing for their oral presentation of the project at the annual C.M. Easley Research Symposium.
Family Planning/Selective
Experience: 1 rotation (PGY-4)
Description: Residents may opt in/out of a four-week rotation in family planning. This includes training in provision of medical and surgical pregnancy termination, experience in comprehensive contraceptive counseling, and outpatient treatment of spontaneous abortions. For those who opt out, this selective may be tailored to the individual desires of the resident. Other experiences include a substance use disorder elective, international mission work, GYN operative experience, outpatient gynecology or general OBGYN, and time for board exam preparation and study.
Longitudinal experiences:
- GYN Continuity Clinic
Experience: one half day weekly on most rotations
Description: Residents see the full spectrum of gynecologic conditions appropriate to their PGY level. First year residents focus on providing routine GYN and primary care, contraception, and STI services. Upper-level residents see more complex conditions, including infertility, pelvic pain, abnormal uterine bleeding, and pelvic organ prolapse.
- Centering Pregnancy Clinic
Experience: Intern Year
Description: Centering Pregnancy is a nationally-recognized program of group prenatal care. First year residents are each assigned a group that they follow through the year. The groups are assigned such that patients’ EDD falls during the resident’s L&D and night float rotations so the resident is able to deliver their Centering Pregnancy patients for optimal continuity on care.
- Colposcopy Clinic
Experience: 4-6 sessions each year
Description: Two residents perform colposcopic examinations and LEEP procedures in the outpatient OBGYN Center with one GYN faculty member.
- Vulvar Medicine Clinic
Experience: 4 sessions during the PAG rotation
Description: Residents see patients with one of our vulvar medicine specialists in their outpatient office, gaining exposure to a wide variety of common and rare vulvovaginal conditions (dermatoses, vaginitis, pain syndromes, etc.)
Additional clinical experience:
Core rotations cover 11 months of the year. The final four-week block (June of each year) is broken into two-week blocks of extra experience in the core rotations. This allows us to give extra experience as needed or allows residents to make up for rotations missed for parental or other leave. Additional selective months may be granted in the third or fourth year to allow for exceptional clinical experience.
Boards Study and Preparation:
All chief residents conclude their clinical rotations and call mid-June and have two weeks of time dedicated to boards preparation.