GrandRapidsMedicalEducation

Curriculum

First year
6 months of obstetrics
2 months of primary care (FM, MICU, EM)
1 month of Oncology/Critical Care
1 month of Maternal Fetal Medicine/OB Ultrasound
1 month of Urogynecology
1 month Surgical-Float

Second year
6 weeks of elective or Gyn
9 weeks of gynecology
15 weeks of obstetrics
12 weeks of nightfloat
6 weeks MFM

Third year
6 weeks of night float
6 weeks obstetrics
6 weeks of Maternal Fetal Medicine
6 weeks of Oncology
6 weeks of REI
6 weeks UroGynecology
12 weeks of Gynecology

Fourth year
6 weeks of obstetrics chief
6 weeks of gynecologic oncology
6 weeks of urogyn
6 weeks of ambulatory
12 weeks of administrative chief
12 weeks of gynecology

Call System/Vacation/Conference Time
During most rotations, 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). 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 7:00 am until 7:00 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.

The main call system at Spectrum Health Butterworth is a night float system also. Most days post call you will be allowed to leave after rounding at 7:00 am.

OBG-1
Call per service:
6 weeks nights
Emergency Medicine shift work
Family Medicine q 3-4
Onc 2 weekends
MFM 2 weekends
MICU 1 week night float & 1-2 weekend shifts
Vacation: 3 weeks
Meeting: None (may use weekend time or vacation time to go to short conferences)

OBG-2
Call per service:
OB 3 weekends/block 
Gynecology 3 weekends/block
MFM 3 weekends/block
Oncology 3 weekends/block
Nights: 12 weeks
Vacation: 3 weeks
Meeting: 1 week

OBG-3
Call per service:
Oncology 2-3 weekends/Block and home call
OB 2-3weekends/block
MFM 3 weekends/block
Gynecology 2-3 weekends/block
REI-2-3 weekends/Block
UroGynecology 2-3 weekends/Block 
Nights 6 weeks
Vacation: 3 weeks
Meeting: 1 week

OBG-4
Call per service:
Oncology 2-3 weekends/Block and home call
UroGynecology 2-3 weekends/Block
Gynecology 2-3 weekends/Block
OB 2-3 weekends/Block
Ambulatory 2-3 weekends/Block
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, Benign Gyn, Gyn Tumor Conf, Gyn M&M, Perinatal Conference, Perinatal M&M, Primary Care Conference, Reproductive Endocrinology Conference, UroGynecology and the Visiting Professor Program. Other conferences include: Morning report, Journal Club, Fetal Anomaly Board, 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 Resident Research Day. Certificates and awards are handed out to recognize each resident's efforts. The residents are encouraged to further present their work at regional and national meetings.

Resident research is supported by the institution and in April residents present at a city wide Research Day. 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.

Grand Rapids Medical Education Partners houses a Research Office, led by Dr. Alan Davis, PhD. Residents may be involved in multi-institutional studies with Vand Andel Research Institute, 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. The resident's research projects are monitored semi-annually by the Program Director and monthly 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 throughout their training.

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 direct supervision of an 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 hospital 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 several times per week for a half day. All residents on the MFM service 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 during the 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.
• 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 48
Vaginal hysterectomy 42
Incontinence Surgery 218
Operative Laparotomy 53
Vaginal Ultrasound 165
Operative Laparoscopy 132
Hysteroscopy 100
Surgery for Invasive Cancer 66
LAVH 55
LASH 38

Typical Four Year Experience in Obstetrics:
Spontaneous delivery 375
Forceps 15
Vacuum Delivery 20
Cesarean delivery 381
Breech delivery 11
Multifetal delivery 25
Amniocentesis 12

Research

The Annual GRMEP Research Day will be held on April 18, 2012 at the DeVos Place, Grand Rapids, MI.

The Annual Junior Fellow Research Day will be held on May 23, 2012 at The James B. Henry Center in Lansing, Michigan.

Click here for GUIDELINES FOR THE PREPARATION AND PRESENTATION OF RESIDENT/FELLOW PAPERS (PDF attached)