Curriculum overview (each block is 3-4 weeks in length)
PGY 1
- OB – 2 blocks
- Gyn – 2 blocks
- Night Float – 2 blocks
- Gyn Oncology – 2 blocks
- High Risk OB Clinic – 2 blocks
- OB Surgery – 1 block
- Triage and Peds/Adolescent Gynecology – 2 blocks
- Postpartum – 1 block
PGY 2
- OB – 2 blocks
- Gyn – 2 blocks
- Night Float – 2 blocks
- Gyn Oncology – 2 blocks
- High Risk OB Clinic – 2 blocks
- OB Surgery – 1 block
- Elective (internal) – 1 block
- Triage (days) – 1 block
- Clinic (Pediatric Adolescent Gynecology/Gynecology/Ultrasound – 1
PGY 3
- OB – 2 blocks
- Gyn – 2 blocks
- Night Float – 2 blocks
- Gyn Oncology – 2 blocks
- High Risk OB Clinic – 2 blocks
- Elective – 1 block
- Urogynecology – 2 blocks
- Reproductive Endocrinology and Infertility – 1 block
PGY 4
- OB – 2 blocks
- Gyn – 2 blocks
- Night Float – 2 blocks
- Gyn Oncology – 2 blocks
- High Risk OB Clinic / OB surgery– 2 blocks
- Minimally Invasive Surgery – 2 blocks
- Clinic – Gynecology/Ultrasound – 1 block
- Reproductive Endocrinology and Infertility – 1 block
High Risk Obstetrics
The obstetrics blocks will provide education on the various aspects of inpatient care for the pregnant and immediately postpartum patient. Residents are involved with cases with gradual increases in the levels of autonomy through the course of the academic year. On labor and delivery, residents learn to interpret fetal heart tracings, perform vaginal deliveries, operative deliveries, and Cesarean sections. Our program has resident involvement in surgical cases early and often, refining skills in repairs after vaginal delivery, as well as in the operating room with Cesarean sections. Residents will function as the primary surgeon typically in the latter half of their first year. Residents also provide coverage for the antepartum unit. Here they learn to manage complications of pregnancy (including preterm labor, pre-eclampsia, multifetal gestations, PPROM, etc.). They provide care for both resident and private patients in order to maximize educational opportunities. Lastly, residents provide postpartum care for patients following delivery.
Gynecology Oncology
The gynecology blocks educate residents on inpatient/outpatient management of gyn issues. The majority of these rotations involve time in the operating room to develop surgical skills. There is a gradual increase in the complexity of cases year to year. Residents operate with the faculty of our program as well as with private OB/GYNs from the community to maximize surgical experience. Orlando Health Winnie Palmer Hospital has been designated as a Center of Excellence for Minimally Invasive Gynecology Surgery. Our residents receive education on the various routes from gyn surgery (open, laparoscopic, robotic, and vaginal). Residents typically graduate with a high number of cases under their belt (usually at 70-90th percentile compared to cases done by residents across the nation). They also provide inpatient consultation when requested by other medical specialties.
High Risk Obstetrics
Residents on this service participate in providing antepartum outpatient care to women with high risk conditions. These patients have various conditions/comorbidities complicating pregnancy. Residents, under the supervision of Maternal Fetal Medicine faculty, help to manage these conditions to provide optimal care to both mother and baby.
Gynecology Oncology
This rotation focuses on gyn cancers that occur in the female pelvis. Residents participate both in the outpatient and inpatient care of these complex patients, from initial evaluation in the office, to surgical management in the operating room, and postoperative care. Residents also participate in a multidisciplinary tumor board. They are educated about all aspects of treatment of gynecologic cancer from surgical to medical management, with chemotherapy and/or radiation. Although this is one of the more demanding rotations, due to complexity of the cases, it is also one of the most rewarding and educational for residents. They perform very difficult and challenging surgeries under the guidance of gynecology oncology attending physicians.
Obstetric Surgery
This rotation is designed to build resident's surgical skills. The majority of cases are cesarean sections and the role of the resident is to develop and refine their surgical skills by functioning as the primary surgeon in these cases. Residents start doing Cesarean sections in the latter half of their intern year. There is gradual progression to more complex cases over time as they demonstrate increased proficiency, skills, and knowledge.
Triage
This rotation involves time in our triage/Women’s ED unit. Residents, along with nurse practitioners and attending physicians, evaluate and treat every patient that walks in through the doors of Winnie Palmer Hospital. This involves management of early pregnancy issues (ectopic pregnancy, miscarriage, hyperemesis), to full term labor checks. Residents will experience a multitude of clinical scenarios in this unit, going from simple, routine pregnancy concerns in one room, to emergent, life threatening conditions in the next room. Residents evaluate and manage primary care issues, along with obstetrical/gyn issues while in triage. Residents also learn/perform ultrasounds while on this rotation. Residents develop clinical skills, efficiency, and time management on this rotation. It also helps them learn about making decisions quickly with rapidly changing clinical scenarios.
Pediatric and Adolescent Gynecology
Residents on this rotation learn about the evaluation, diagnosis, and treatment of gynecologic disorders in the pediatric/adolescent population. They are involved in the outpatient, inpatient and surgical care of this special population.
Urogynecology
This rotation educates residents on disorders of the female pelvis involving the bladder, and pelvic support/pelvic reconstruction. Residents participate in outpatient evaluation, diagnosis and development of a treatment plan. They are also involved in the surgical cases to correct these disorders (for both bladder issues and/or pelvic support).
Reproductive Endocrinology and Infertility
This rotation educates residents on the causes and treatment options for infertility. Abdominal and vaginal ultrasound are key in this subspecialty and as such, residents enhance their sonography skills on this rotation. In addition, they learn about endocrinology disorders that affect female patients.
Minimally Invasive Surgery (MIS)
This rotation focuses in developing and refining surgical skills for laparoscopic and robotic gyn surgery. Residents spend some time in the office with MIS faculty. However, the majority of the time is in the operating room, where they learn and then develop proficiency in surgical techniques. Orlando Health Winnie Palmer Hospital has one of the highest rates in the US (greater than 80%) for hysterectomy performed by minimally invasive surgical techniques. Furthermore, Orlando Health Winnie Palmer has been designated as a Center of Excellence for Minimally Invasive Gynecology Surgery.
Elective
This block is designed to allow residents to explore aspects of OB/GYN for which they have a passion. Residents can do away rotations at other institutions (possibly to explore as a site for fellowship). During PGY-2 year, residents can do an internal elective to get early exposure to subspecialties. PGY-3 residents that participate in the Global Health Track may use this time for a rotation at a partner hospital in Kenya, where they will participate in training Kenyan OB/GYN physicians. Finally, this time can also be used to work on scholarly activity/research projects.
Clinic
This block allows for more ambulatory exposure to general obstetrics and gynecology. Residents rotate through various clinics, such as ultrasound with maternal-fetal medicine, gynecology/preventive care and pediatric gynecology. This block allows operating time for surgeries on continuity clinic patients and research time.
