Curriculum/Rotations

First year
5 months of obstetrics
4 months of primary care (FP, Med, ER)
1 month of Oncology/Critical Care
1 month of Maternal Fetal Medicine/OB Ultrasound
1 month of Geriatrics/Triage

Second year
6 weeks of REI
12 weeks of gynecology
30 weeks of obstetrics

Third year
6 weeks of night float
6 weeks of Maternal Fetal Medicine
6 weeks of Oncology
6 weeks of REI
24 weeks of Gynecology

Fourth year
6 weeks of gynecology chief
6 weeks of obstetrics chief
6 weeks of gynecologic oncology
6 weeks of urogyn
6 weeks of ambulatory/geriatrics
6 weeks of floating Gynecology
12 weeks of administrative chief

Call System/Vacation/Conference Time
During each rotation, you will be expected to take call. The frequency and duration of the call depend on which rotation you are on and at which hospital you are working. While on an OB/Gyn service month, you will be expected to take call every 3-5 days depending on your residency level. You will also be expected to work two weekends out of each month, which means you will be off an average of two weekends each month!

While working at Saint Mary's hospital, you will have weekend call. Saint Mary's call system includes a night float person who covers labor and delivery, postpartum, gynecology, and ER from 7:00 pm until 7:00 am the next morning (with a few exceptions). Interns on Family Practice rotations take short call at Saint Mary's from 5:00 pm until 9:00 pm on the weekdays and also have weekend calls at Spectrum Health Butterworth Campus. Weekend call is either a Friday/Sunday or a Saturday call. If you are assigned a Friday/Sunday, you will work from 5:00 pm Friday night until 7:00 am Saturday morning. On Sunday, you will work from 8:00 am until 11:00 pm at which time the night person takes over. If your call is a Saturday, you will work 7:00 am Saturday until 7:00 am Sunday. When you are on call at Saint Mary's, you are responsible for labor and delivery, postpartum, gynecology, and ER calls. There is a back-up resident who is on pager call at home seven days per week and that would be a PG2, PG3 or PG4. A chief is always available by phone and in person as need be.

The main call system at Spectrum Health Butterworth is the traditional 24-hour call, however there is a night float system at this campus also. Most days post call you will be allowed to leave after rounding at 8:30 am.

OBG-1
Call per service:
OB q 3-4
Emergency Dept. shift work
Family Practice q 3-4
Onc q 3-4
MFM 1 call
Medicine q 6
Vacation: 3 weeks
Meeting: None (may use weekend time or vacation time to go to short conferences)

OBG-2
Call per service:
OB every other weekend, 2 week nights/6 weeks on gyn call
Gyn q 6-7
REI q 3 of 6 weekends
Vacation: 3 weeks
Meeting: 1 week
Nights: 11 hr shifts

OBG-3
Call per service:
OB 2 ob nights/year
Gyn q 7
REI q 7
Oncology q 2 (home call - every weeknight, every other weekend)
Nights 12 hr shifts
Vacation: 3 weeks
Meeting: 1 week

OBG-4
Call per service:
OB q 4 (home call)
Gyn q 4 (home call)
Oncology home call every night and every other weekend
Uro/Geriatrics q 4 (home call)
Vacation: 3 weeks
Meeting: 1 week

Library
There is a complete medical library in each hospital, with Internet access. Each hospital has an OB resident lounge with a computer and private library. Educational Conferences
Wednesday morning is protected time for educational conferences, which include didactic lectures, Grand Rounds, Gyn Tumor Conf, Perinatal Conference, Perinatal M&M, Primary Care Conference, Reproductive Endocrinology Conference, and the Visiting Professor Program. Other conferences include: Morning report, Journal Club, Fetal Anomaly Board, Reading Club, Benign Gyn, and High Risk Ob Conference.

Research
A resident research project is required to graduate from the program. Each resident is obliged to present their project in December of their fourth year at the City Wide Resident Research Day. Certificates and awards are handed out at that time to recognize their efforts. The residents are encouraged to further present their work at regional and national meetings.

Resident research is supported by the institution and the department. Financial support from available funds can be requested from the Research and Institutional Review Board. The department also has pledged financial support to resident projects.

The Medical Education & Research Center houses a Research Office, led by Dr. Alan Davis, PhD. Residents are also involved in multi-institutional studies via our affiliation with Michigan State University and the University of Michigan.

Guidelines and timetables are made available to the residents to help them complete their projects in a timely fashion. These are distributed to all residents. The resident's research projects are monitored semi-annually by the Program Director at the feedback sessions.

Clinics
Continuity of care is emphasized very early in the training program. Starting in the first year, each resident is assigned to a clinic session. This introductory experience teaches the residents the basics of ambulatory care and clinic protocols. Most of the patients assigned in the first year are annual gynecologic exam and obstetric patients.

In the second year, obstetrics is emphasized and the majority of the clinic patients for this year are obstetric. In this year, the residents will also see some minor gynecologic problems. The resident also serves as the primary care provider for his/her patients. The resident has the opportunity to then follow these patients for a period of three to four years.

As the residents advance to the third and fourth years, more complicated patients are scheduled for them. When they are in the forth year, they should be seeing the most difficult problems and should be providing the most advance care, including major surgical procedures. All residents are under the direct supervision of the attending faculty.

To maintain continuity with their patients, the residents keep their weekly clinic in the same hospital for their entire residency, even though they rotate to the other hospitals for clinical assignments.

The clinic population primarily receives medical assistance, however, there are some commercial insurance patients. The clinic patients at Spectrum Butterworth are from urban and rural areas. The Saint Mary's clinic patients primarily come from the inner city. There is a high percentage of minority groups in the clinic population.

The resident clinics at Spectrum Health Butterworth care for the high risk patient. The patients that attend the high risk clinic have pregnancies complicated by various processes. Such pregnancies may be complicated by asthma, diabetes (insulin dependant, gestational), hemoglobinopathies, hypertension, drug dependency, previous IUGR infants, multiple gestations, and many other factors. The high risk clinic meets once a week. All available residents are required to meet at the weekly conference for the high risk patients and then help see the patients that are present each week. Management strategies for each patient are discussed in the conference before each clinic session with the Maternal Fetal Medicine subspecialist. At Spectrum Butterworth, the fourth year resident reviews the patient's chart and makes management decisions with the Maternal Fetal Medicine physicians.

General Program Goals

• To prepare each resident for the next phase in their career, be it subspecialty training or private practice.
• To develop in each resident the professional capabilities and attitudes to provide quality medical and surgical care for the female patient, from adolescence through menopause. Specific Program Goals
• To instill in each resident the special medical knowledge of our field, and to prepare each resident for the American Board of Obstetrics and Gynecology certifying exam.
• To teach each resident the appropriate traditional and innovative surgical skills of our specialty.
• To assist each resident in completing and presenting one scientific project.
• To develop sound clinical judgment in each resident.
• To foster strong interpersonal skills and to establish commitment to wellness for all female members of our society.

Typical Four Year Experience in Gynecology:
Total abdominal hysterectomy 85
Vaginal hysterectomy 88
Incontinence Surgery 130
Laparotomy/Surgery for invasive cancer 42
Vaginal Ultrasound 256
Operative Laparoscopy 141
Hysteroscopy 139

Typical Four Year Experience in Obstetrics:
Spontaneous delivery 388
Forceps 20
Cesarean delivery 408
Breech delivery 3
Multifetal delivery 12
Amniocentesis 10

*Statistics averaged from 2006-2007 graduates