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Obstetrics & Gynecology Residency: Curriculum

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Curriculum Overview

The Dell Medical School Obstetrics and Gynecology Residency curriculum provides a comprehensive academic framework from which residents explore general and subspecialty topics.  Integrating the teaching philosophy of the medical school, our residents engage in both traditional and non-traditional learning activities using a variety of instructional formats to optimize their professional development regardless of their ultimate career path. The structured inquiry-based didactic program provides residents with flexibility to individualize learning activities commensurate with their level of training. Clinical training provides residents with progressive levels of responsibility for clinical management in the provision of patient-centered care.  Residents develop their leadership and teamwork skills while synthesizing their expanding knowledge and experience that is necessary to create and direct increasingly complex treatment plans for their patients.

Didactic Program

Our formal didactic series includes the lecture-based Community Education Series, quality improvement conferences, large and small group discussions, simulation and skills workshops, and self-directed learning:

Community Education Series: Designed as a series of interactive lecture-based sessions by the Department of Women’s Health, the Community Education Series invites visiting and local faculty to present the latest evidence-based medical information and techniques relevant to current and future clinical practice in an all-inclusive, interprofessional learning environment.

Patient Safety Conference: This monthly quality review of the gynecology and obstetrics services was developed as a forum for interprofessional discussion focusing on patient safety, systems performance, and quality improvement.

Journal Club: Each month, Journal Club engages residents, medical students, and faculty as they critique selected articles in small-group discussion and debate-style formats.

Pre-op Conference: Designed to develop clinical reasoning skills and optimize patient outcomes, this resident-led weekly conference focuses on surgical planning and fosters inquiry and dialogue for upcoming operative procedures.

Simulation/Surgical Skills: Taught in the classroom environment and via in situ drills, monthly simulation activities focus on emergent care, rare events, fostering communication, and working within interdisciplinary teams.  Surgical skills are enhanced through training in open and minimally-invasive procedures, as well as robotic surgery.  A combination of low and high fidelity equipment is used to train both surgical and procedural skills, including ultrasound.

Wellness: Three times a month, residents participate in our wellness curriculum.  This humanistic approach to learning focuses on creating self-sustained physical and psychological wellbeing for continued resilience throughout training and into practice.

Resident “Lecture” Series:  Presented in an interactive environment, these weekly learning sessions expand the residents’ knowledge base in all topics across the spectrum of Obstetrics and Gynecology and subspecialties. Knowledge retention is increased by presenting traditionally lecture-based topics using a variety of active instructional methods including flipped classroom, small-group discussions, problem-based scenarios or case vignettes.

Self-directed Learning: Residents are provided protected time each week to engage in individualized, autonomous learning. Examples of activities residents may use this time for include upcoming didactic preparation, research studies or quality improvement projects, mentorship sessions, reflective writing and self-assessment exercises, presentation of medical student lectures, surgical skills practice, completion of asynchronous learning modules, or preparation for in-service or board examinations.

In addition to our weekly series, our fifth Thursday conferences convene periodically throughout the academic year to cover special topics and include: Educator Development, inclusive of residents-as-teachers and faculty development; Team Building and Leadership; Resident Town Halls; and Humanities in Medicine.

curriculum-gme

Clinical Training

The academic year is divided into 10 blocks of five weeks each. The final two weeks are designated “flex” weeks, allowing residents to supplement their experience as needed based upon the quantity and quality of their unique experiences.

New residents matriculate with a paid program orientation in late June just prior to beginning their first block in July. Advancing residents simultaneously transition to new leadership and clinical roles, while graduating PGY-4 residents dedicate this time to prepare for their written Board examination.

Post Graduate Year 1 (PGY-1)

  • 2 blocks: Obstetrics
  • 2 blocks: Gynecology
  • 2 blocks: Gynecology Clinics
  • 1 block: Family Planning Clinics
  • 1 block: Reproductive Endocrinology and Infertility
  • 1 block: Private Office
  • 1 block: Surgical ICU

Post Graduate Year 2 (PGY-2)

  • 2 blocks: Obstetrics
  • 2 blocks: Gynecology
  • 2 blocks: Night Float
  • 2 blocks: Gynecologic Oncology
  • 1 block: Reproductive Endocrinology and Infertility
  • 1 block: Family Planning Clinics

Post Graduate Year 3 (PGY-3)

  • 2 blocks: Obstetrics
  • 2 blocks: Maternal-Fetal Medicine
  • 2 blocks: Float
  • 2 blocks: Gynecology
  • 2 blocks: Gynecologic Oncology

Post Graduate Year 4 (PGY-4)

  • 3 blocks: Obstetrics
  • 3 blocks: Gynecology
  • 2 blocks: Night Float
  • 2 blocks: Urogynecology

PGY-1

Obstetrics: Residents are introduced to Labor and Delivery at Seton Medical Center Austin (SMCA), where they focus on normal obstetrics in a busy teriary care setting. This rotation builds a solid foundation for the development of complex obstetrical skills through participation in obstetrical triage, intrapartum mangement, vaginal and primary cesarean deliveries, and postpartum care.

Gynecology: Residents on the Gynecology Service at Brackenridge Hospital (UMCB) are introduced to basic inpatient gynecologic care in a major urban hospital. This rotation focuses on building foundational operative skills, management of post-surgical care, and exposure to the Emergency Department under the supervision of senior residents and faculty.

Gynecology Clinics: Interns in the gynecology clinic are introduced to a broad spectrum of outpatient experiences. They are exposed to basic well-woman and routine prenatal care, management of abnormal cervical cytology, gynecologic ultrasound, and outpatient surgical sterilization. Care of their patients is provided in our three Regional Care Clinics: North Central, East Austin, and Southeast Health and Wellness.

Family Planning Clinic: Residents on the family planning clinic rotation also participate in a wide array of outpatient experiences, which include routine gynecologic and obstetrical care, colposcopy/LEEP, and first and second trimester pregnancy termination. Patient care is provided in our three Regional Care Clinics and at Planned Parenthood of Greater Texas.

Reproductive Endocrinology and Infertility: The REI rotation introduces residents to the basic evaluation and management of infertility, ovulation induction, and various assisted-reproduction techniques.  Located at Reproductive Medicine Associates of Austin, residents refine their understanding of transvaginal ultrasonography and learn about the medical and surgical management of infertility.

Private Office: Residents rotate with two different private practices during this outpatient experience: University Physicians Group and Women's Partners in Health. Residents are exposed a variety of practice patterns of individual physicians and actively participate in basic obstetric and gynecologic procedures.

Surgical Intensive Care Unit: Residents care for critically ill patients in the SICU at UMCB. Residents build their knowledge of critical care medicine which will prepare them to take care of acutely ill gynecologic and obstetrical patients throughout their careers.

PGY-2

Obstetrics: Second-year residents return to Labor and Delivery at SMCA to focus on managing abnormal labor, performing operative vaginal and repeat cesarean deliveries, and caring for more complicated patients during the postpartum period. PGY-2 residents are also introduced to inpatient management of high-risk obstetrical patients.

Gynecology: Residents develop more complex surgical skills during their 2nd year gynecology rotation. Procedures performed include operative hysteroscopy, straight-stick laparoscopy, robotic surgery, and basic laparotomy. Each second year resident participates in backup gynecology pager call one evening per week, during which they manage ER consults and inpatient issues under the guidance of an attending physician.

Night Float: Based at SMCA, residents gain further exposure to obstetrics. Experiences include the management of medically-complicated pregnancies, admission of antepartum patients, and supervision of Family Medicine and Emergency Medicine interns.

Gynecologic Oncology: PGY-2 Gyn Onc residents participate in the initial evaluation of women with gynecologic malignancies, as well as medical, surgical, and radiation therapy. They manage oncologic care in both the inpatient and ambulatory settings, and are introduced to palliative care. These residents will take backup gyn onc pager call one night per week, during which they manage emerging inpatient issues under the guidance of an attending physician.

Reproductive Endocrinology and Infertility: The 2nd year REI rotation introduces residents to more complicated concepts in reproductive infertility as well as endocrinology. Residents perform transvaginal ultrasonography and participate in patient care planning.  Each week, this resident is responsible for presentations to the fertility center staff.

Family Planning Clinics: Residents on the Family Planning Clinic rotation train in a variety of broad-based outpatient experiences, which includes routine gynecologic and obstetrical care, colposcopy/LEEP, and pregnancy termination. Patient care continues in our three Regional Care Clinics in addition to Planned Parenthood of Greater Texas.

PGY-3

Obstetrics Float: Residents on this rotation care for obstetrical patients at both SMCA and St. David’s Medical Center. An integral experience on this rotation includes postpartum and interval tubal ligation, which are performed at St. David’s.

Maternal-Fetal Medicine: The MFM rotation includes management of the inpatient antepartum service at SMCA and outpatient experiences at the Community Care high-risk obstetrical clinic. Residents participate in obstetric ultrasonography within the Seton Antenatal Testing Unit and are responsible for the teaching and supervision of junior residents and medical students who care for antepartum patients.

Night Float: This SMCA-based rotation includes further exposure to obstetrics, such as the management of medically-complicated pregnancies, admission of antepartum patients, and the supervision of Family Medicine and Emergency Medicine interns.

Gynecology: This rotation exposes residents to advanced gynecologic surgery in private community-based hospitals and surgical centers. The resident has the opportunity to participate in the surgical and postoperative care of patients under the supervision of multiple UT affiliate faculty physicians, allowing for exposure to a variety of advanced surgical techniques. Night-call responsibility for this rotation includes 1-2 days per week of backup gynecology pager coverage at UMCB for emergency consults and surgeries.

Gynecologic Oncology: The third-year reisdent on this service is responsible for the management of all patients on the gynecologic oncology service.  This includes their initial evaluation, medical, surgical, and radiation therapy, as well as their outpatient and end-of-life care. This resident is responsible for backup gyn onc pager call four days per week, during which they manage emerging inpatient issues under the supervision of an attending physician.

PGY-4

Obstetrics: Obstetrical training culminates during this rotation. The chief resident assigned to this rotation supervises all students and residents assigned to the healthcare team.  The chief is also responsible for overseeing all triage, labor, antepartum, and postpartum patients at SMCA.

Gynecology: This rotation serves as the culmination of training in gynecology. The chief resident assigned to this rotation will perform and act as a teaching assistant in complicated surgical procedures including vaginal surgery. They are responsibile for all gynecologic patients admitted to UMCB, and supervise the student/resident team assigned to this service. Outpatient experiences include continuity clinic and preoperative clinic. Night-call responsibility during this block includes 1-2 days per week of pager coverage at UMCB for emergency consults and surgeries.

Night Float: This rotation provides night coverage for the obstetrical service at SMCA. The PGY-4 assigned to this service is responsible for supervising all students and residents assigned to their team.  They are also primarily responsible for admitting new patients to these services.

Urogynecology: Residents advance their skills in the evaluation and treatment of pelvic floor disorders on this PGY-4 rotation. The resident is responsible for the clinical and surgical management of urinary and fecal incontinence and pelvic organ prolapse. They will enhance their leadership skills as they manage the CommUnity Care urogynecology clinic and the inpatient urogynecology surgical service. In addition, they will hone their skills in vaginal surgery.