Overview of the Program
The educational objective of the residency in Obstetrics and Gynecology is to provide a clinical program and a formal didactic curriculum that follows the Educational Objectives: Core Curriculum in Obstetrics and Gynecology, (CREOG) and insures the development of the requisite knowledge, skills and attitudes for independent practice.
The residency training takes place on the campuses of the North Shore University Hospital and LIJMC with experience at Huntington Hospital designed to supplement the surgical training at the core sites.
The schedule of clinical activities is organized around regular blocks of time, with residents rotating through both core and subspecialty clinical areas. Compliance with duty hour regulations is facilitated by a night float system.
In the intern year (PGY-1), a broad experience in obstetrics, gynecology and neonatology provides the foundation for the first year of training. Rotations in the Medical Out-Patient Department, the Emergency Department and the SICU enhance the residents' primary and critical care skills. As a junior resident (PGY-2), involvement in the full spectrum of obstetric and gynecologic cases fosters the ongoing development of clinical expertise. This growth is supported by rotations in gynecologic oncology, sonography, colposcopy, pathology, and experience in the Breast Clinic. The first two years of training are also characterized by an abundant ambulatory surgery schedule and increasing responsibility during in-patient procedures.
Senior residents (PGY-3) take on greater responsibility on the various obstetric and gynecologic services, both managing more complex clinical problems and supporting the more junior residents (under the supervision of service attendings), including maternal fetal medicine, reproductive endocrinology and infertility, and urogynecology.
Chief residents (PGY-4) function in leadership roles in obstetrics, gynecologic, urogynecologic and oncology services. A rotation as the Chief Resident in the Out-Patient Clinic serves as the culmination of the continuity experience in ambulatory medicine and as an additional step toward the transition to general practice or further training. It is also during the PGY-4 that the resident presents the results of their research and experience, that is the highlight of our academic series. At the completion of training, graduates take the written examination of the American Board of Obstetrics and Gynecology certification process.
- Mentoring program — Each resident is assigned a faculty mentor with whom they meet on a regular basis. Mentors serve as advisors, counselors and support personnel. They facilitate the transition to residency and guide their charges throughout the program.
- Attending supervision is part of all clinical care provided by the resident staff. An in-house attending is present at all times, with both full-time and voluntary attending physicians sharing this responsibility. An atmosphere of support and guidance is our goal and we succeed.
- The program remains in strict compliance with the ACGME regulations and the New York State rules regarding work hours. Residents maintain a daily log of their duty shifts, and the program director reviews these regularly, submitting reports to the institution's GME Committee quarterly. A night float system is in place to assist with duty hour compliance. The night float team consists of an intern, a junior resident and a senior resident. They work from Sunday through Friday evenings with the other residents covering the remaining shifts. Chief Residents participate in the Night Float System at both LIJMC and NSUH.
- Both North Shore University Hospital and Long Island Jewish Medical Center have very busy obstetrical services, drawing patients from throughout the Metropolitan area, and serving as a Regional Perinatal Center. The High-Risk Obstetrical Program, under the supervision of the Division of Maternal-Fetal Medicine (MFM), has multiple weekly clinic sessions. The Antepartum Testing Unit conducts the full range of perinatal assessments with participation by the residents in early pregnancy ultrasound, Level I and Level II sonography, fetal monitoring, amniocentesis and other obstetric interventions. The residents are also part of our Diabetes in Pregnancy and HIV in Pregnancy programs.
- Seven gynecological oncologists between the two sites perform a large number of major cases annually as well as a large number of ambulatory procedures, including both laser and electrosurgical treatments. Residents are involved in all of these cases, fine-tuning their skills in complex dissections, advanced laparoscopy and critical care..
- There are seven full-time members of the Division of Human Reproduction, who provide a comprehensive lecture series, reviewing reproductive endocrinology and infertility (REI). The residents' experience during the REI rotation includes ambulatory evaluations, sonography and hysterosalpingography, ambulatory and in-patient surgical procedures, (including operative hysteroscopy, operative laparoscopy, and intraperitoneal laser). The residents also learn about the laboratory assessment of endocrinopathies and infertility, as well as the management of sexual dysfunction with a full-time staff member who has special expertise in this area.
- Three fellowship-trained specialists in Urogynecology and Pelvic Reconstructive Surgery oversee one of the busiest services in the region.They provide instruction and supervision for urodynamic testing, non-surgical management of incontinence and genital relaxation, as well as a variety of transvaginal and transabdominal reconstructive procedures. The experience gained by performing complex dissections complements the skills fostered on the other services.
- With a full-time and voluntary generalist staff of more than two hundred physicians, residents are ensured an opportunity to work with and learn from many attending physicians. This allows our residents to see a great variety of approaches to clinical management. Many members of our staff have considerable expertise in advanced obstetric and gynecologic techniques, providing a diverse and comprehensive training experience.
- The residents conduct their continuity and other clinic sessions, either in an out-patient facility, which is located in a professional office building on Northern Boulevard several minutes from the hospital and surrounded by buildings which house most of the medical staff members' offices, or within the ambulatory care unit within the hospital. This creates a setting and environment where our resident staff can attend to their patients in a manner similar to what they will experience in practice. The full range of out-patient ancillary services are available, including a laboratory, colposcopes, ultrasound units and support staff such as nutritionists, lactation consultants and social workers. The Physician-in-Charge of the Ambulatory OB/GYN Clinic is present to supervise patient sessions.
- A team of allied health professionals are a vital part of our Department. They work seamlessly with our resident and attending staff to enhance the residents' opportunities for learning and optimize our patients' care. They also assist in the coverage of certain basic, routine issues during transition times in the residents' schedule and during conference times.
- Didactic Program — A comprehensive curriculum is in place based upon CREOG guidelines, covering all aspects of general OB/GYN, sub-specialty care and primary/preventive medicine. Chapter reviews from major OB and GYN texts, journal clubs, M&M reviews, Tumor Boards, and a variety of other conferences provide a foundation upon which independent study can build. Guidelines have been established to assist in the development of a self-study routine that will continue throughout the residents' career.
- Our residents have weekly sessions a the Patient Safety Institute, our Health System’s high fidelity simulation facility that is a core component of the Center for Learning and Innovation. The Bioskills Laboratory, the System’s cadaver dissection facility, is also used for surgical skill development.
- Ultrasound is a core part of clinical practice. Residents rotate through the Department's Ultrasound Unit on both campuses, as well as with ambulatory radiologists. Sonography equipment is also available for use on the Labor & Delivery Suite, in the Division of Human Reproduction's office and in the Ambulatory Clinic, providing an opportunity for residents to incorporate sonography into their evaluation of continuity clinic patients.
- Breast Education — Our residents have a multi-disciplinary approach to supervised learning in Breast Health. In addition to the exposure to breast evaluation on the OB/GYN services and Medical Clinics, our residents rotate through the Breast Clinic, further enhancing their skills in the triage and management of breast complaints under the supervision of faculty from the Department of Surgery.
- Committees — Residents participate in hospital-wide committees, such as the Resident and Fellow Forum, the Program Evaluation Committee and the Clinical Competency Committee.
- Research — Residents are required to complete a project under the supervision of a faculty mentor and present their work at the annual Research Lectureship. This serves as the accumulation of a progressive education in critical thinking and analysis. Our residents are frequent presenters at regional meetings (e.g. New York Obstetrical Society, ACOG District II, Nassau OB/GYN Society). Their projects have also been highlighted at national conferences, most recently the annual meetings of the American College of Obstetricians and Gynecologists, the American Society of Reproductive Medicine, and recently an international conference in Prague.
Rose and Wilfred P. Cohen Lectureship in Obstetrics and Gynecology/Resident Research Day
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