Curriculum overview (each block is 3-4 weeks in length)
PGY 1
- OB (Labor and Delivery) – 2 blocks
- Benign Gynecology – 2 blocks
- Night Float– 2 blocks
- Gynecologic Oncology – 2 blocks
- High Risk OB Clinic – 2 blocks
- OB Surgery – 1 block
- Community- 1 block
- Triage– 2 blocks
- Postpartum – 2 blocks
PGY 2
- OB (Antepartum) – 2 blocks
- Benign Gynecology – 2 blocks
- Urogynecology- 1 block
- Night Float – 2 blocks
- Gynecologic Oncology – 2 blocks
- High Risk OB Clinic – 2 blocks
- OB Surgery – 2 blocks
- Triage – 1 block
- Clinic/Ultrasound – 2 blocks
PGY 3
- OB (Labor and Delivery) – 2 blocks
- Benign Gynecology – 2 blocks
- Urogynecology- 2 blocks
- Night Float – 2 blocks
- Gyn Oncology – 2 blocks
- High Risk OB Clinic – 2 blocks
- Elective – 1 block
- Reproductive Endocrinology and Infertility – 1 block
PGY 4
- OB (Antepartum) – 2 blocks
- Benign Gynecology – 2 blocks
- Minimally Invasive Gynecologic Surgery - 2 blocks
- Night Float – 2 blocks
- Gynecologic Oncology – 2 blocks
- High Risk OB Clinic - 2 blocks
- Clinic – 1 block
- “Jeopardy”/ Float – 1 block
Labor and Delivery
Postpartum
On Labor and delivery, residents learn to manage normal labor and delivery, including spontaneous labor, labor induction, and pain management. Residents learn to perform vaginal deliveries, operative deliveries, and Cesarean sections. They also refine their skills in laceration repairs after vaginal delivery. Residents learn to assess fetal well-being during labor and interpret and manage fetal heart tracings. In addition, residents oversee intrapartum management of out high risk patients with conditions such as Preeclampsia, Eclampsia, Diabetes, HELLP Syndrome, Residents learn to respond to obstetric emergencies intrapartum and postpartum, including but not limited to hypertensive emergency, seizure, hemorrhage, sepsis.
Residents also provide comprehensive care for all of the postpartum patients throughout their hospital stay.
OB Surgery
Our program emphasizes early and frequent involvement in procedures and surgery. On the OB Surgery rotation, residents will initially assist with- and then function as primary surgeon for-both scheduled and unscheduled/ urgent or emergent Cesarean Sections. Because of our significant OB volume, there is a dedicated resident performing just Cesarean deliveries and not managing labor patients. The OB Surgery resident is also responsible for presenting Complex Surgical patients’ cases at our monthly Placenta Accreta and Complex OB Surgery Conference. The PGY4 residents, when in the OB Surgery role, perform the most complex Cesarean Sections including our Placenta Accreta Spectrum (PAS) cases and Cesarean hysterectomies as part of our renowned multidisciplinary PAS team.
Antepartum
A team of 2 residents (PGY2 and PGY4), under the close supervision of a Maternal Fetal Medicine specialist, provide coverage for the inpatient antepartum unit- often caring for between 20-40 patients on the service. Residents learn inpatient management of complications of pregnancy including preterm labor, pre-eclampsia, multifetal gestations, fetal anomalies, PPROM, and complex cardiac/ metabolic conditions in pregnancy. This team also takes care of patients who have undergone fetal surgery. The resident team works closely with multiple consulted medical teams as indicated as well as with our Critical Care team to care for all patients admitted to our Women’s ICU.
Benign Gynecology
On this rotation, residents learn both medical and surgical management of benign gynecologic conditions. Residents manage patients undergoing outpatient surgery as well as manage the inpatient gynecology service. This rotation includes time in the operating room to develop surgical skills; there is a gradual increase in the complexity of cases in which residents are involved from year to year. Residents operate with our academic generalist faculty as well as occasionally 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 of gynecologic surgery (open, laparoscopic, robotic, and vaginal). Residents typically graduate with a high number of cases logged (usually at 70-90th percentile compared to cases done by residents across the nation). This team of residents also provides inpatient consults to other teams at Orlando Regional Medical Center and Arnold Palmer Hospital for Children.
High Risk Obstetric Clinic
Residents on this service participate in providing outpatient prenatal care to women with high-risk conditions under the supervision of our Maternal Fetal Medicine (MFM) faculty, striving to provide optimal care to both mother and baby. Due to the complexity of our patient population, our High Risk OB clinic works closely with our Fetal Care Center, Genetics department and Complex Cardiac/ OB clinic- all overseen by our MFM group.
Gynecology Oncology
This rotation focuses on gynecologic cancers. Residents participate both in the outpatient and inpatient care of these complex patients, from initial evaluation in the office, to surgical management, postoperative care and inpatient management of medical and surgical complications. Residents also participate in a multidisciplinary tumor board and learn about all aspects of treatment of gynecologic cancer including chemotherapy and 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 as they are involved in complex medical cases and surgeries under the guidance of gynecology oncology attending physicians.
Triage
This rotation involves time in our dedicated 20-bed Triage/ Women’s Emergency Department. 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, ranging from simple, routine pregnancy concerns to emergent, life-threatening condition. Residents also learn to perform bedside ultrasounds while on this rotation. Residents develop clinical skills, efficiency, and time management on this rotation, honing their assessment and decision-making skills in rapidly changing clinical scenarios.
Urogynecology
Residents rotate through Urogynecology clinic to learn outpatient evaluation, diagnosis and development of a treatment plan for common urogynecology conditions such as prolapse and incontinence. They are also involved in the surgical cases to correct these disorders (for both bladder issues and/or pelvic support). Our urogynecology department has grown substantially in recent years and thus urogynecology surgery volume is robust and provides an excellent learning opportunity for our residents.
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 endocrinologic disorders that affect female patients. This rotation includes time in clinic, performing procedures and participating in surgery.
Minimally Invasive Surgery (MIS)
This rotation focuses on developing and refining surgical skills for laparoscopic and robotic gynecologic surgery. Residents spend some time in the office with MIS faculty and the majority of time is spent in the operating room, where they learn and 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), or can do an internal or local elective to get early exposure to subspecialties. Finally, this time can also be used to work on scholarly activity/research projects.
Community
Residents are exposed to other medical specialties and groups that work within our hospital, such as neonatology, nursing, lactation consulting and social work. This allows the residents to develop a more well-rounded understanding of the total care our patients and their families require throughout their pregnancy, delivery, surgery or hospital admission.
Clinic/ Ultrasound
This block allows for more ambulatory exposure to general obstetrics and gynecology. Residents rotate through clinics with community generalist OBGYNs and subspecialists in MIGS. Residents also spend time with our skilled ultrasonographers in both OB and gynecology settings.
