Rotations are divided into 4 week blocks. Residents complete 12 rotations each year. The remaining 4 weeks are divided into an abbreviated 2 week holiday block in late December/early January and another abbreviated 2 week block in late June to allow transitions into higher levels of responsibility and orientation of the new PGY1 class.
Schedule
- Obstetrics - 3 blocks
- Benign Gynecology – 2 blocks
- Night float - 2 blocks
- Gyn Oncology- 1 block
- Community Medicine* - 1 block
- Emergency Medicine - 1 block
- Ultrasound - 1 block
- Surgical ICU - 1 block
The internship year is focused on learning the essentials of both Obstetrics and Gynecology. Obstetric blocks focus on basic labor triage and low risk obstetrics. Gynecology and Gyn Oncology months are focused on floor work, admissions, and minor surgical procedures. PGY1s spend a block learning and developing competence in Ultrasonography – both Obstetric and Gynecologic, crucial skills to working on labor and delivery. PGY1s also rotate for one block in the ED to learn basic principles of emergency medicine. PGY1 residents spend one block in the Intensive Care Unit - which prepares them to take care of medically complicated women whom they will later encounter in both oncology and Maternal-Fetal Medicine.
*During this self-directed ambulatory rotation, residents are encouraged to explore community connections to the greater Portland community, including many clinics that have referral connections to the Resident Continuity Clinic including but not limited to Greater Portland Health (a FQHC), The Portland STD Clinic, and the Preble Street Initiative. They will also have the opportunity to complete administrative work that is foundational to scholarly activity such as Quality Improvement Projects and Resident Research.
- Obstetrics - 3 blocks
- Gyn Oncology - 3 blocks
- Benign Gynecology - 1 blocks
- Family Planning – 1 block
- Night float - 1 block
- Flex - 1 block
- Ambulatory Medicine - 1 block
- Repro/Endo - 1 block
The PGY2 year is structured to build on the skills acquired in the PGY1 year and to increase responsibility. The 3 months on OB are focused on learning C-sections and the management of low-risk MFM patients. The PGY2 resident on Gyn Oncology will perform a number of surgeries – minor, laparoscopic, and an introduction to robotics, as well as performing medical admissions, and ER consultation. The PGY2 rotations on Benign Gynecology will include one block focused on Family planning including exposure to Planned Parenthood as well as internal services. The experience also includes exposure to specialty clinics in Pediatric and Adolescent Gynecology as well as a clinic in Vulvology. The ambulatory month allows the PGY2 resident the opportunity to explore community based, non-academic OBGYN practices as well as other ambulatory clinics including cancer genetics, peri-natal genetics, and the breast clinic.
- MFM - 3 blocks
- Gyn Oncology - 3 blocks
- Night float - 2 blocks
- Elective - 1 block
- Repro/Endo - 1 block
- Benign Gynecology - 1 block
- Flex - 1 block
The PGY3 residents spend 3 months on the Maternal-Fetal-Medicine service where they provide inpatient antepartum care, focused on complex/high risk obstetric issues. They also spend 3 months on the Gyn Oncology service where they gain the bulk of their surgical experience, including developing competence in robotic surgery. There is a 1 month exposure to Benign Gynecology in an introductory senior role which includes a mix of inpatient surgery, ER coverage, and ambulatory experience. The PGY3 resident will also spend one month on Reproductive Endocrinology. The elective month is explained under Electives & International Opportunities.
- Obstetrics - 3 blocks
- Gyn Oncology - 3 blocks
- Benign Gynecology – 2 blocks
- Urogynecology - 1 block
- Ambulatory rotation – 1 block
- Flex – 1 block
- Night float - 1 block
The PGY4 schedule is structured to allow the OB chief resident to manage the labor and delivery board, refining complex OB skills and supervising and leading a team of up to six residents, including off-service residents from Family Medicine and the Emergency Department. The GYN Oncology chief manages a very busy oncology service with three residents and 2 APPs. The Benign GYN chief coordinates with the Urogyn resident. Together they perform ambulatory gynecology surgery and provide inpatient consultation for gynecologic issues. The Urogyn resident spends ambulatory time in addition to the surgical experience. The Ambulatory Clinic rotation affords Chief Residents elective time in their last year to focus on ambulatory experiences that are most useful for their unique needs. Our chief residents also get structured experience learning to precept junior residents in the continuity clinic and in the operating room.
In addition to these rotations some rotations repeat across years.
- The Night Float team includes a two person team at all time – during the early part of the year, consisting of a PGY4 and a PGY2, and during the latter part of the year a PGY3 and a PGY1. They primarily focus on obstetrics and ER consultation as well as managing the inpatient needs of all benign and oncology gynecology patients. Occasional surgical emergent surgeries may arise.
- This team is supported by the Short Call resident as well as a back-up resident for busier surges in clinical activity. The Short Call resident begins their shift at noon and is expected to be in the hospital until 10PM. During regular hours they flex to the service most in need (for example to cover a vacation absence). They are essential to helping day teams leave in a timely fashion and help the night team “tuck in” the services during the busy 4-8PM window. The Short Call person is “at risk” until 2 AM but may leave at 10PM if they are not needed. A back up resident system is in place to bridge 2 AM onward.
- Reproductive Endocrinology and Research have been combined in response to resident feedback. For one, there is great synergy as both experiences are directed by Dr Daniel Spratt. By combining them it allows flexibility for the resident to build their resident research project over the years in incremental fashion with guidance. The REI education can also then be built and supplemented in response to clinical demand allowing for greater levels of graduated responsibility than were possible in a concentrated month. Residents are exposed to an academic endocrinology practice as well as a private infertility practice with attention on assisted reproductive technology.