Rotation Objective: To provide a setting where upper level residents can experience ambulatory OBGYN in a private practice setting with direct supervision of attending faculty from Division of Women’s Reproductive Health.

Supported by the Division of Women’s Reproductive Heathcare (WRH), the resident has his/her own daily schedule of patients. This rotation allows the resident to experience and see unique office situations such as in office procedures and specific counseling is emphasized throughout their rotation. Additionally residents are responsible for learning proper coding, documentation, and lab follow up. On days where seeing patients at the WIC, they are additionally responsible for aiding faculty with postpartum rounding.

 GYN Ambulatory
The service consists of two teams, UAB Gold and UAB Green, with resident division as follows: PGY1/PGY4 and PGY2/PGY3.  The individual teams switch services at a predetermined time in the middle of the rotation so that adequate exposure to each service is achieved.  There is also a PGY-1 clinic intern who covers the outpatient clinic.  Residents on the oncology service are expected to attend Tumor Board on Mondays at 1630 and didactics at 0645 on Tuesdays.

UAB Gold: Drs. Bevis, Alvarez, Huh
UAB Green: Drs. Straughn, Leath, Arend

PGY 1/4 Team
PGY1: The intern's primary responsibility is to manage the floor patients.  He/she will perform appropriate major and minor cases in the OR if available.  He/she is 1st call to see all oncology patients on the floor and admits.  He/she is expected to frequently check in with the PGY 4 in the OR for floor duties. This intern attends colposcopy clinic on Friday morning.
PGY4: This resident has ultimate responsibility for his/her inpatient service and should communicate with the fellow on a regular basis regarding patient care. He/she should see all ICU patients on his/her service. He/she will perform most of the major oncology cases. 
PGY 2/3 Team
PGY2: This resident’s primary responsibility is to manage the floor patients and be 1st call to see patients on the floor and admits.  These duties will also be shared with the PGY-3 resident.  He/she will also be expected to perform straightforward hysterectomies and other cases as deemed appropriate by the PGY-3 and/or fellow.  This resident attends colposcopy clinic on Friday morning.
PGY3: This resident has ultimate responsibility for his/her inpatient service and should communicate with the fellow on a regular basis regarding patient care. He/she should see all ICU patients on his/her service.  He/she will perform most of the major oncology cases.
PGY1 Oncology Clinic   
This intern attends all oncology clinics Monday through Friday from 0800-1700 and will see patients under the supervision of faculty.  The intern prepares and presents cases at Tumor Board each Monday at 1630 in the Hauth conference room. Tumor Board must be submitted to Dr. Conner/Novak by Friday at 1700.  The PGY-1 in clinic is not responsible for H&Ps of established patients being admitted to  UAB from clinic. This responsibility will fall to the inpatient Green or Gold team that assesses the patient upon admission.  He/she should be available to assist with floor work if needed.  This intern attends colposcopy clinic on Friday morning.
The GYN Continuity Clinic has 4 main goals:
  • To provide high-quality health care to underfunded and unfunded women who would otherwise have limited or no access to care
  • To improve patient satisfaction and care by assigning each patient a resident physician for continuity of health care.
  • To enhance resident education by providing residents the opportunity to see the outcome of their medical and surgical interventions.
  • To improve the competency of OB Gyn residents in all aspects of outpatient gynecology.
To achieve these goals, every effort is made to schedule patient follow-up visits and surgery with their resident physicians.  This is not always possible due to patient emergencies and your clinical schedule.  On occasion, you will have to see some of your “partner’s” patients.  We encourage each resident to aid each other in seeing all patients in clinic during any given session.
1st call to OB triage (MEU), postpartum, IUP, and routine labor management.  When possible, the PGY-1 will have OB Triage as their primary responsibility.

1st call to Gyn, Onc, OB transfers, and Emergency Department.  The PGY-2 supervises the PGY-1.  If two issues need solving at the same time, then help should be sought from the PGY-3.

Oversees the PGY-1 and PGY-2 and reports to the PGY-4.

Oversees L&D, IUP, PP service, Onc, REI and GYN services at night.  The chief resident should communicate regularly with the L&D charge nurse throughout the night regarding patient care plans, updates, and problems. Regular communication with surgery staff/anesthesia is also the responsibility of the chief resident and they should attend the 1900 Team Meetings Sunday-Thursday.

**All Night Float residents are freed from Continuity Clinic responsibilities as well as weekend call and rounding responsibilities during the rotation.
5th resident: See Short call/home call section of Resident Manual for details. 
The Res/US PGY-3 is expected to manage his/her own time during this rotation to complete research endeavors and specific ultrasound curriculum requirements.  This resident should not be absent from Birmingham during the work week unless specific prior approval has been obtained from the AC’s and the Program Director.  Every effort will be made to protect this resident’s time; however, this resident may need to be pulled to cover other services.
Research Component
The Research/US resident will be expected to make significant progress in and ideally complete his/her resident research project during this rotation.  There is an expectation that all projects will be presented in final form at the senior Resident Research Day at the end the PGY-3 year.  Projects that are incomplete will require an interim progress presentation at Resident Research Day. Read more about the Resident Research Program . . .
Ultrasound Component
The Research/US resident will be expected to complete the PGY-3 component of the Ultrasound Curriculum during this rotation.  Specifically, residents will be expected to complete the Advanced Obstetric Ultraound Skills and Advanced Gynecologic Ultrasound Skills curricula.  Scheduled opportunities to perform ultrasounds have been arranged in various obstetric and gynecology ultrasound clinics.  Read more about the Ultrasound Course . . .

Res US Schedule
Each chief resident will be responsible for scheduling his or her own 6-week elective. Only 4 weeks of the elective may be off-site with the other 2 weeks being at UAB, in the call pool and available for coverage if needed. If the Chief does not schedule a suitable elective, then he/she will serve on a clinical rotation at the discretion of the Program Director. The Residency Program Director must approve of electives in advance.  Each Chief is expected to attend their Continuity Clinic.  If a resident is planning to be out of the system during his/her rotation (4 weeks maximum), he/she must notify Continuity Clinic administration at least 4 weeks in advance to make alternate arrangements.  Each chief resident must submit a formal proposal by e-mail or hard copy to the Program Director at least 4 weeks prior to the beginning of his/her rotation outlining a plan for the rotation.  This proposal must be reviewed and approved prior to the beginning of the elective rotation. Also, a formal summary of the rotation at the rotation’s end will be required.

The purpose of this rotation is to improve GYN Continuity Clinic workflow and the available leadership for junior residents that are staffing the clinic.  PGY-4 residents on the GYN Continuity rotation will be responsible for staffing clinic Monday-Thursday mornings.  Afternoons will be protected to facilitate the scheduling of OR cases.  Additionally, Fridays will be reserved as administrative day to facilitate results follow up and surgical scheduling.  The PGY-4 on this rotation is expected to attend Tuesday AM GYN didactics and Friday AM GYN conference.

The REI service consists of a PGY 1 & 3.  Coverage of rounds, clinics, and surgical cases are discussed among each team on a weekly basis with final decisions made by the PGY-3.  The PGY-1 is responsible for making out the surgery/surgery follow-up schedule, as well as HSGs to be discussed at Wednesday noon conferences.
REI Schedule 
The PGY-2 will be expected to complete a 4 week rotation in the SICU under the supervision and instruction of the Critical Care Faculty and Fellows (Department of Anesthesiology ACs create the schedule, faculty and fellows are from Anesthesia and Surgery Critical Care). The 4 week rotation will consist of a Monday-Friday 0500-1800 schedule. During the other 2 weeks of the rotation, the resident will be expected to attend various US clinics and an US curriculum. The resident will not be in the call.

Learning objectives for the PGY-2 during the SICU rotation include:
  • Understand the pathophysiology of septic shock and the Surviving Sepsis guidelines
  • Recognize early warning signs of critical illness and indications for escalation of patient care
  • Improve ability to diagnose and manage acute blood loss anemia and DIC using crystalloid, colloid and blood product resuscitation
  • Understand the pathophysiology of ARDS and basic ventilator management
  • Enhance exposure to family discussions regarding critical illness and end of life care
  • Collaborate with Anesthesia and General Surgery colleagues
SICU Schedule

The GYN service consists of a PGY-1, 2, 3, and 4.  The service is responsible for covering patients of the WRH attendings, all consults, and all unattached patients.  Didactics will take place every Tuesday AM at 0700 in the Hauth conference room. There will also be didactics on select Wednesdays at noon.  Pre-op Conference for the GYN team is every Friday morning at 0800 following rounds.  The PGY-1 is responsible for distributing a surgery schedule to the whole team by the Thursday afternoon prior to pre-op conference.  The GYN team will also help cover other services when needed, so that residents may attend surgery cases scheduled from GCC.

The Urogyn team consists of a PGY 2 & 4.  They are responsible for covering the patients of Drs. Richter, Varner, Holley, Ballard, Ellington, and the Urogyn fellows.  The Urogyn team is expected to be at the Monday morning 0630 meeting with Dr. Varner and GYN didactics every Tuesday at 0700 in Hauth.  The Urogyn team is to cover all Urogyn surgical cases.  The Chief is to notify the GYN Chief as early as possible if help is needed to cover cases, such as when someone is on vacation, interviews, etc.

Univ Gyn Schedule

Beginning in academic year 2015-2016, the PGY-4 residents will supplement their surgical and clinical exposure with a rotation aimed at addressing several curricular areas.  Specifically, the PGY-4 on this rotation will be exposed to private practice surgical opportunities, ambulatory surgery, breast health, the Lynne Cohen clinic, and REI ultrasound and ambulatory care.  The Highlands resident will also be responsible for completing the ASRM REI modules during this rotation.

UAB Highlands
This service consists of a PGY-1 board, PGY-1 MEU, PGY-1 Antepartum (IUP), PGY-2 board runner, PGY-2 post-partum rounder (PPR), PGY-2 OBCC, PGY-3 Antepartum (IUP), PGY-3 OBCC, and Board Chief PGY-4.  The team runs L&D from 0600 to 1700 Monday through Thursday and 0600 to 1600 Friday. Teaching rounds/case discussions are as dictated by attendings on service. Each Wednesday, MFM didactic conferences are held 0630-0700 in the Hauth Conference Room (see conference schedule for details). Please see the Resident Handbook for the OBCC schedule.

Inpatient OB