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Obstetrics & Gynecology at San Francisco

Academic Training in a Positive Learning Environment

Rotation Schedules and Electives

Rotations for 2012-2013 Academic Year

Interns through third year residents change rotations on the 1st of each month.

PGY 1, Intern Year:

  • 3 months Obstetrics
  • 2 months Gyn/Gyn-Onc
  • 2 months Night Float
  • 3 months Clinic
    • 1 month in-depth introduction
    • 1 month focused on REI and CPP
    • 1 month focused on U/S, PDC/genetics, Breast
  • 1 month Medicine Wards
  • 1 month ICU

PGY 2:

  • 2 months Obstetrics
  • 3 months Gyn/Gyn-Onc
  • 2 months Night Float
  • 3 months Clinic
    • 1 month focused Urogyn
    • 1 month focused on REI and CPP
    • 1 month focused on U/S, PDC/genetics
  • 1 month Path/OB, including Breast
  • 2 month Elective

PGY 3:

  • 2 months Obstetrics
  • 1 month Gyn/Gyn-Onc
  • 2 months Night Float
  • 1 month Clinic/OB- focus on ambulatory procedures, Breast
  • 1 month Urogynecology
  • 1 month REI
  • 3 months Kaiser Walnut Creek (benign gyn with L&D call)
  • 1 month Elective

PGY 4, Chief Year:

  • 3 months Obstetrics Chief
  • 3 months Gynecology Chief
  • 3 months Gyn-Onc Chief
  • 3 months Clinic Chief

Kaiser Walnut Creek: A benign gynecologic surgical rotation with L&D call.

Each clinic month in the first and second years has a specific focus in a particular sub-specialty to include REI, Urogyn, and Chronic Pelvic Pain.

Additionally, clinic months include an average of one half-day per week for research.

Call Schedule

call schedule Night Float: 5:30 PM – 7AM Monday-Friday,
7:30 PM – 7AM Sunday

Saturday Call: 7 AM – 7 AM (the only regularly scheduled 24-hour call for PHY 2-4; PGY 1's do 12 hour duty shifts on Saturday call)

Sunday Call: 7 AM- 9 PM (2 residents cover L&D/Gyn/ER)

In preparation for night float, interns will meet for short call at least 4 times with chief residents in order to review OB emergencies, antepartum admissions and other night float pearls.  PGY-1 residents will take call with senior resident until their first night float month.  PGY-2 residents will take call with a more senior resident for the first seven months of the year.  The PGY-2 residents will not be on-call together unless a specific exception is necessary due to unusual schedule requirements or until January when the PGY-2 can be the senior call resident.

When not on night float rotations, overnight call only occurs on Saturdays and within ACGME Duty Hour Guidelines.  There are some Friday 24-hour calls when covering for NF, always within ACGME Duty Hour Guidelines.

Chief year: No night float. Senior residents round on weekends.

FIRST YEAR

Obstetrics:  Interns perform vaginal deliveries, vacuum deliveries, cesarean sections and postpartum tubal ligations.  They learn to evaluate fetal wellbeing using internal and external fetal monitors, oxytocin stress tests, non-stress tests, biophysical profiles, and ultrasounds for growth.   They also become familiar with epidural and spinal anesthesia methods.  Interns join the other Labor & Delivery residents in making postpartum rounds each morning, and also actively co-manage patients admitted with antepartum complications. 

Gynecology:  Interns perform most minor procedures, such as dilation and curettage, laparoscopic tubal ligation and diagnostic laparoscopy. They also have the opportunity to scrub with other residents on more advanced surgical cases   First year residents learn to provide pre- and post-operative care for patients with both benign and malignant gynecologic conditions.  Interns carry the gynecology consult phone, allowing them to be the first to evaluate patients in the emergency room.

Outpatient clinic:  These three months provide an introduction to the outpatient practice of both generalists and sub-specialists.  Interns establish their own continuity clinic, with a focus on providing gynecologic care.  They also spend time in teen clinic, reproductive endocrinology and infertility clinics, urogynecology, pelvic pain, procedure clinics, and a special gynecology clinic devoted to breast cancer patients at UCSF. 

Medicine: Interns spend one month on internal medicine wards and one month in the intensive care unit.  These months provide valuable insight into managing complex patients, as well as giving interns the opportunity to build relationships with internal medicine staff and residents.

Night Float:  During these two months, interns truly master how to “run the board” on Labor & Delivery, as well as manage a busy triage.  By the end of intern year, most interns have done nearly 200 vaginal deliveries and 70 cesarean sections (both primary and repeat).

SECOND YEAR

Obstetrics: The second year residents run the labor and delivery floor under the supervision of the senior resident and the staff physician.  They perform more difficult cesarean sections and operative deliveries and manage more complicated antepartum patients.  They also share in the responsibility for teaching medical students.

Gynecology:  Second year residents learn to perform abdominal hysterectomies and myomectomies, operative laparoscopy, and diagnostic hysteroscopy and cystoscopy.  They develop more autonomy in evaluating ER patients, with the support of senior residents and staff.

Clinic:  Residents begin to see prenatal patients and also do a greater number of procedures in their continuity clinics.  They spend more time rotating through specialty clinics, including urogynecology, reproductive endocrinology, family planning, and chronic pelvic pain clinic. Residents have ample opportunity to further explore family planning at a special clinic at the Women’s Option clinic at UCSF Mt. Zion.

Elective: This month is an excellent opportunity to explore one’s special interests within Ob/Gyn. Residents have chosen to learn obstetrics and gynecology through travel to different countries, working in specialty clinics in San Francisco, or spending time at the Division of Research. Please see Elective section below.

Pathology/OB: Residents spend part of this rotation in half-days with the Pathology Department, where they review gynecological surgical specimens with the pathologist. Time is also spend with a specialized fetal and placental pathologist at Kaiser Oakland.  The remainder of the month is spent in various OB-GYN clinics and half-days on Labor & Delivery.

Night Float:  Second year residents care for the gynecology patients overnight and see all emergency room patients.  This provides them with the opportunity to perform urgent gynecologic surgeries if the need arises.  They also continue to play a key role in managing Labor and Delivery.

THIRD YEAR

Obstetrics: Residents care for increasingly complicated antepartum and laboring patients, and assume more teaching responsibilities for junior residents.  Residents also have the opportunity to perform cerclages and amniocenteses. rotation schedules

Gynecology: Three of the four months on gynecology are spent at the nearby Kaiser Permanente Medical Center in Walnut Creek.  This allows the resident to perform a large number of diverse gynecologic surgeries including vaginal, abdominal and laparoscopic hysterectomies, incontinence procedures including TVT and TOT, and prolapse procedures such as vaginal repairs, abdominal sacrocolpopexies and colpocleises.

Clinic: Senior residents continue to manage their continuity clinics while also attending specialty clinics, including reproductive endocrinology, urogynecology, adolescent gynecology, and colposcopy.

Elective: During the one-month elective period an effort is made to provide additional exposure to some aspect of interest in our specialty.  The elective may be spent in the outpatient department, at another Kaiser Permanente Medical Center, at a university with an approved residency program, or at an international site arranged by the resident. 

CHIEF (FOURTH) YEAR

During this unique year, fourth years assume the role of “chief” for 3-month blocks of time on the four services listed below.  They meet weekly with the program director to discuss the state of each service and focus on resident training, strategizing together about any problems that arise.  Chiefs also plan the resident retreat, a consistent highlight of the year.

Obstetrics:  Chiefs are responsible to the staff for all admitted antepartum, laboring, and postpartum patients; for teaching junior residents and medical students; and generally assuming responsibility for the service.  They attend Maternal Fetal Medicine clinic weekly.  In the operating room, they perform cerclages and amniocenteses and staff junior residents through cesarean sections with the supervision of staff physicians.

Gynecology:  Chiefs assume responsibility for all pre- and postoperative patients and other gynecology inpatients; for teaching junior residents and students; and for performing the most complicated gynecologic surgeries.  They organize a weekly preoperative conference, and are responsible for coordinating morning teaching.rotation schedules

Gynecologic Oncology: Chiefs work very closely with the busy gynecologic oncologists.  They assist to provide clinic preoperative care, operate on all gynecologic oncology patients and are responsible for the work-up and postoperative management of these patients.  They are also responsible for monthly presentations at tumor board.

Clinic:  Residents serve as administrative chief residents during the three months of the clinic rotation.  They organize daily teaching for the clinic and gynecology residents and schedule all resident and medical student clinics.  They can also function as staff for Teen Clinic and Gynecologic Urgent Care Clinic.

Electives

There are two months of electives in the curriculum in the PGY-2 and PGY-3 years. These months allow residents to pursue their academic/medical interests and/or meeting their self-identified learning needs within women’s health care. It is common for residents to create international electives or further pursue interests in sub-specialty areas. The electives, therefore, are arranged by the residents themselves.

Additionally PGY-2’s and 3’s may take advantage of the Kaiser Permanente Global Health Program. The mission of this program is to enable our clinical staff and residents to participate in medical care at various locations around the globe. The first affiliated program is in western Kenya - the Matibabu Foundation. The Matibabu Foundation provides medical care, training, and equipment to residents of Ugenya, Kenya, an extremely poor and disadvantaged area near Lake Victoria. This was founded in 2004 by Kaiser Permanente oncologist Gail Wagner and colleagues, and provides primary care services, pediatrics, women’s health, tropical medicine, and HIV/AIDS care to thousands of rural Kenyans.

There is potential funding for the third year elective that could include: air fare/lodging. If you are interested in going somewhere other than Matibabu - regional GME might still be able to provide limited funding. The requirements are that it needs to serve an underserved area, the program director must approve the rotation, the site needs to be approved by the Kaiser’s global health program (eg for safety/resources) and you will need to verify attending supervision (that they help you organize through their network). The funding can also be used for you to go to an underserved rural area in the US.

Over the past 6 years, residents have participated in the following elective experiences:

Year Grad
Resident
Ac Yr End
PGY 2 Elective
Ac Yr End
PGY 3 Elective
2014
m devoy
2012
UCSF Reproductive Infectious Disease
2013
 
 
c gamboa
2012
Costa Rica: Clinica Sanar Consultares
2013
 
 
b nguyen
2012
Matibabu Global Health
2013
 
 
c schroder
2012
Honduras: Clinica Esperanca
2013
 
2013
m evans
2011
Aventuras Languages and Mexico Birth Center
2012
PINCC (Nairobi) and Matibabu Kanya
 
e fukuchi
2011
Research/SRF experience
2012
 
 
j kubat
2011
UCSF Prenatal Diagnosis/Research
2012
Matibabu
 
j main
2011
Honduras: Roatan Mission
2012
Honduras Mission
2012
j wendt
2010
Peru Mission
2011
Doctors Medical Center: Modesto, CA
 
k pettit
2010
Matibabu Global Health
2011
UCSF HIV clinics and research
 
e deraleau
2010
Transgender rotation at Lyn-Martin
2011
Research focus
 
n rink
2010
Honduras Mission
2011
Research/San Rafael ObGyn
2011
r lamar
2009
Norway: Ob/Gyn
2010
Guatemala Mission
 
b todd
2009
Jordan: Ob/Gyn
2010
U/S at UCSF
 
c valentine
2009
medical spanish/Ultrasound KSFO
2010
Costa Rica Mission
 
a zewail
2009
Mexico: Casa Clinica de las Varas (Mar de Jade)
2010
Honduras Mission
2010
r gogia
2008
UCSF Prenatal Diagnosis
2009
research
 
s johnson
2008
Mexico Mission
2009
Guatemala Mission
 
k tam
2008
UCSF WOC/Research
2009
Taiwan: Urogyn
 
t wright
2008
Hayes Women's Community Clinic
2009
Portland: Urogyn
2009
e lantzman
2007
KSRF circumsision/Planned Parenthood
2008
Kenya Mission
 
j matchett
2007
medical spanish/research
2008
Mexico: Casa Clinica de las Varas (Mar de Jade)
 
m pravdin
2007
UCSF research
2008
Stanford REI
 
s tien
2007
Hayes Women's Community Free Clinic
2008
WCR-OR, Reserch UCSF

 

What our residents are saying:

"Having the opportunity for a one month elective offered me the experience of traveling to South America, where I was able to experience an entirely different culture and approach to practicing medicine."

Dr. Jacque Wendt
arranged her second year elective
in Peru

"Having a call free elective afforded me the opportunity to travel to rural Kenya and operate with local doctors. I taught Kenyan house officers on the wards and had a chance to demonstrate tangible skills I have acquired in residency. This elective opened my eyes to the opportunities doctors have to help influence the quality of healthcare around the globe and provided me with memories I will cherish forever."

Dr. Eric Lantzman
arranged his third year elective
working in a clinic in Kenya

"The Women's Community Clinic is the only free clinic for women in San Francisco. It provides basic health care including annual exams, paps and STD testing for women without health insurance. The clinic is unique in that it has a strong emphasis on informing patients through educational counselors. The clinic's greatest strength however is its volunteers. I felt my time at the Women's Community Clinic was an invaluable opportunity to broaden my exposure to a different patient population than that typically seen at Kaiser and to learn from a wealth of clinicians whose dedication to women's health is inspiring."

Dr. Tricia Wright
arranged her second year elective at the
Women’s Community Clinic in San Francisco

Rotations"Residency at KP allowed for me to travel to Jordan for a month during my second year. While I was there I worked at a refugee hospital and the Red Crescent hospital. Both locations had very little funding and had to do the best they could with limited resources. The people were warm, welcoming, and taught me how to be creative with what was available. It was an experience I will treasure for the rest of my life. I hope to be an international volunteer throughout my career."

Brie Todd