Annual Report

Continuing Medical Education

Grand Rounds

Conferences

Noon Conferences

Residency Program

Resident Research

ABOG Fellowships

Research Fellowship

Senior Electives

Clerkship

Faculty and Residents

Commitment to Teaching

Center of Excellence

Residency Program Summary 2007-2008

For Applicants

Rotations | Workshops/Training | Women's Health Research | Conferences | Faculty | Supervision |

Core Competencies | Benefits | Application | Contract

General Information

• 9,430 deliveries and 8,315 gynecological surgeries-FY2005

• Eleventh largest obstetrical service in the United States

• Patient mix is approximately 75% private, 25% clinic

• 32 residents

• 43 full-time faculty, 6 CNMs

• 90 ob/gyn private attending physicians
  (4 ob/gyn teams, 1 gyn-only team)

Rotations (with 32 residents)

Continuity Clinics

Call

Residents participate in day and night teams when assigned to the Obstetrics rotation.  The day team starts at 6:00 a.m. and ends at 6:00 p.m. or when checkout rounds are completed.  The night team starts at 6:00 p.m. and finishes after turnover rounds are completed.  All residents (except those assigned to nights) rotate on the weekend and holiday call schedule.  These are 24 hour assignments.

Workshops/Training

PG-1 Skills Orientation

New residents participate in a five-day orientation that ensures their acquisition of basic skills they need in ambulatory care, labor and delivery, and gynecologic surgery. Full-time and voluntary faculty, nurse midwives, and nurse practitioners teach this hands-on course. Residents are trained also in ACLS and PALS.

Endoscopy Course

Residents participate in a laparoscopy and hysteroscopy course that emphasizes knowledge and skill acquisition.  Faculty provide coverage for residents to attend this afternoon course held two times per year.

Forceps Training Workshops

Residents are expected to attend 2 different forceps training workshops during their training. These sessions are held throughout the year.

Neonatal Circumcision Training Workshop

The PG-2 residents complete this workshop, which is held at the beginning of their second year.  A physician in private practice teaches the residents the basics of circumcision including the use of local anesthesia.  Each resident performs the procedure on a simulation model.

Advanced Obstetrical Skills Workshop

The faculty midwives teach the PG-2 residents clinical pelvimetry, laceration repair, pudendal block, management of shoulder dystocia, alternative birthing positions, and methods to teach medical students the hand maneuvers of a delivery.  The session includes a pre- and post-test, and practice stations for each skill.

Workshop for New Leaders

Recognizing that leadership is an essential component of a successful team, the midwifery faculty provides a workshop for the rising 4th year residents.  The purpose of the workshop is to apply creative thinking  to leadership issues.  Residents have an opportunity to work together to create class goals for the year as well as focus on individual goals revolving around leadership.

Ultrasound and Genetic Amniocentesis Education

PG-1 and PG-3 residents receive formal education and training in ultrasound and genetic amniocentesis respectively. They complete a course that includes lecture, assigned readings, and a practicum with checkout. The residents gain considerable experience in the application of ultrasound on most of the rotations.

Surgical Skills Lab - PG-3 & PG-4 residents

Residents, one-on-one with faculty, perform bowel and ureteral resections, anastomoses. This is a one-day lab offered on a Saturday in March.

Training in Performing Elective Terminations

PG-2 residents learn to perform elective abortions at Planned Parenthood or with other providers in private practice. Residents who opt out of performing terminations because of moral, ethical, or religious objections still must learn how to manage the complications of abortions.  Residents are also expected to learn the methods for counseling patients about abortion. Residents can also participate in the Women's Primary Care Clinic medical abortion clinic, supported by a grant from the Ryan Foundation.

Specialty Clinics

Residents actively participate in pediatric gynecology, vulvar, chronic pelvic pain, and primary care clinics at the WPCC. They also attend clinics in urogynecology, diabetes, and gynecologic oncology. The residents schedule their surgical cases for their clinic patients through the Gyn Specialty clinic.

Private Office Management

PG-3 residents assigned to the private gynecology rotation spend time in the office of an obstetrician/gynecologist in private practice. The resident learns aspects of office, business, and time management.

Resident Research

Residents are required to complete a research project by the end of their third year. Residents give a formal presentation of the research design (objectives, literature review, methods) of their project in their second year, and a formal presentation of the completed study in the third year. Residents pick faculty to precept their research projects.  Residents receive a $1000 stipend to defray expenses for their research.  Most residents publish their research in peer-review journals.

Women's Health Research Concentration

Residents can elect to pursue training for a research career in women's health during residency that will prepare them for postgraduate research fellowships.

Weekly Conferences

 Noon Conferences for Residents

Other Medical Education Conferences

Departmental Full-Time Faculty

• Maternal-Fetal Medicine (6 FTF, 3 fellows)

• Reproductive Medicine and Infertility (8 FTF, 1 fellow)

• Gynecologic Oncology (9 FTF, 4 fellows)

• Breast Health (2 FTF, 1 fellow)

• Ambulatory Care (6 FTF, 6 NPs)

• Urogynecology and Gynecological Surgery (4 FTF, 3 fellows)

• Research Division (3 FTF)

• Triage (5 FTF)

• Midwives (6 FTF)

• Director of Medical Education (1 FTF)

Supervision

Residents have 24-hour coverage from physicians assigned to the clinical service. Residents are supervised by private attendings and CNMs on labor and delivery. Patients on the High Risk Service are managed by the residents under the supervision of full-time faculty and fellows of the Division of Maternal-Fetal Medicine.

Teaching

The department values good teaching.  Residents are expected to supervise and teach medical students and their junior residents.  An Excellence in Teaching pin is awarded to those residents and faculty who consistently achieve high marks from the medical students.  The annual resident retreat covers topics on teaching techniques.

Resident Preceptors

Residents are assigned a nurse midwife preceptor for the first year of training.  In subsequent years, residents pick two faculty preceptors, one from the full-time and one from the voluntary faculty, to serve as their mentors.  Residents also pick a faculty preceptor to guide them in their research projects

Additional Resident Support

A clinical psychologist meets with the PG-1 residents each month, and with the other classes each quarter.

Medical Consultation Service

Five Obstetrical and Consultative Medicine faculty, two fellows, and the medical resident assigned to obstetrical medicine service, are available for inpatient and outpatient consults to the residents.

Behavioral Medicine Consultation Service

Three full-time Psychiatrists are available for inpatient and outpatient consults to the residents.

Evaluation

Residents are evaluated on several criteria and by several sources. In addition to clinical and surgical skills, residents are evaluated on their teaching performance of medical students every six months. Residents are required to take the CREOG In-Training Examination. PG-2 and PG-3 residents must perform at or above the 25th percentile on this test.

Benefits

Duty shoes: One pair of duty shoes per academic year up to $75.

Meals: Dinner and breakfast are provided for the on-call resident on weekends.

Insurance: Health insurance provided - several major medical plans available, with family coverage available. Dental coverage for residents. Professional liability insurance provided. Life and disability insurance provided.

Leave: Parental leave is allowed for up to six weeks per birth. Total sick leave, parental leave, and vacation time is limited to no more than 8 weeks per year, as established by ABOG, and no more than 20 weeks total in the residency program.  Residents, as hospital employees, accumulate paid time off (PTO) days on a weekly accrual basis.  In addition to paid vacation and holiday time, the equivalent of one day of paid sick leave for each month of continuing employment is accrued.  Please consult with the Department Administrator for further explanation of these benefits.  The department offers the benefit of "Parents in a Pinch" for residents and faculty needing last-minute child care.

Outside Employment

Professional and patient care activities that are external to the educational program are called moonlighting.  The program and institution do not require moonlighting as part of the resident’s training.  Moonlighting is counted toward a resident’s duty hours.  No moonlighting is permitted without specific prospective, written permission by the program director.  PG-2 through PG-4 can moonlight in the hospital’s triage area.  Residents must maintain an acceptable level of performance, both academically and clinically, to moonlight. A formal moonlighting policy is in writing.

Accreditation Status

The Brown University Residency Program in Obstetrics and Gynecology is fully accredited by the Accreditation Council for Graduate Medical Education through 2010. The program was last reviewed on October 25, 2005.

Application

Only electronic applications received from the Electronic Residency Application Service (ERAS) are accepted.  Interviews are by invitation only.

International Medical Graduates (IMGs) must have a valid ECFMG certificate and be a U.S. citizen, a U.S. permanent resident, or obtain a J-1 Exchange Visitor Visa. Please refer to the Educational Commission for Foreign Medical Graduates web site for certification details: www.ecfmg.org.  An H-1B1 will be considered if the IMG holds an H-1B1 visa through another institution, or is a graduate of a U.S. medical school. U.S. clinical experience is preferred. Women and Infants Hospital does not offer observerships.  IMGs must provide certified copies of their medical school diploma, dean's letter, and medical school transcript with translations, if needed.  IMG applicants must be recent graduates (within the last five years).  IMGs should also provide documentation of internships/residencies already served. 

A passing grade on the USMLE Step 1 is required as part of the application. The application must be completed by the deadline of November 7. The following will be needed in order for your file to be complete:

• An ERAS Common Application Form

• Completed NRMP application with NRMP number

• A copy of Step1, and when available, Step 2 USMLE scores

• IMGs only  – ECFMG Certificate

• A copy of medical school transcript

• Dean's Letter

• Three letters of recommendation (1 from Ob/Gyn)

• A personal statement

• A head and shoulders photograph if not included in ERAS

It is your responsibility to follow-up to ensure your file is complete. ERAS should verify that your application has been received and when it is complete.

Interviews

The program selects about 80 candidates for interview.  Selection criteria include Medical Student Performance Evaluation (Dean’s Letter), successful performance on USMLE exams including the CSA, letters of recommendation, and personal statement.  Research, volunteerism and work experience are also considered.

Interviews are held on Tuesday and Wednesday over a span of 5 weeks.  Two groups of applicants are interviewed each day and share a luncheon with the residents.  A social evening for the applicants and residents is held on Tuesday night to facilitate a more casual discussion about the residency. 

Want to Compare Residency Programs in Obstetrics and Gynecology?

APGO Website

Policy On Resident Recruitment, Appointment, And Reappointment

Recruitment

All Women & Infants postgraduate training programs follow ethical guidelines (e.g., NRMP rules) in recruiting qualified applicants to their programs.  If applicants are recruited through a match, the match guidelines regarding recruitment are followed.

Appointments, reappointments  

1.  All contract letters are for one year and each resident must be reappointed for each subsequent year of training, contingent upon satisfactory completion of the current post-graduate year.  Women & Infants will honor the full term of the contract letter except when a resident’s performance justifies termination. 

2.  Recommendations for the appointment and reappointment of residents will be initiated by programs.  Each program will send a copy of the signed resident agreement to the department of medical education.

3.  A resident whose performance has failed to meet the level of competence for reappointment to a subsequent year shall be notified by his/her department in writing.  Specific guidelines for decisions on termination or non-reappointment are found in the disciplinary procedures in the program’s handbook. 

4.  Residents are expected to notify their department sufficiently in advance (preferably by March 1^st) if they do not intend to return the following year.

Appointment and/or reappointment do not constitute an assurance of successful completion of a residency program or post-graduate year.  Successful completion is based on performance as measured by individual departmental standards. 

Women and Infants Hospital of Rhode Island Institutional Policies for Eligibility, Selection, Evaluation, Promotion, Dismissal, and Supervision of Residents and Fellows*

1. Eligibility: Applicants with one of the following qualifications are eligible to apply to Women and Infants Hospital accredited graduate medical education programs: 1) Graduates of medical schools in the United States and Canada accredited by the Liaison committee on Medical Education (LCME), 2) Graduates of osteopathic medicine in the United States accredited by the American Osteopathic Association (AOA), 3) Graduates of medical schools outside the United States and Canada who meet one of the following qualifications: a) Have received a currently valid certificate from the Educational Commission for Foreign Medical Graduates or b) Have a full and unrestricted license to practice medicine in a U.S. licensing jurisdiction 4) Graduates of medical schools outside the United States who have completed a Fifth Pathway program provided by an LCME-accredited medical school. Applicants that do not meet the above criteria are not eligible for enrollment in ACGME approved graduate medical education programs at Women and Infants Hospital.

2. Selection: Women and Infants Hospital has as its policy to consider all candidates for graduate medical education regardless of sex, age, religion, color, national origin, disability, or veteran status. Programs select from eligible applicants on the basis of their preparedness, ability, aptitude, academic credentials, communication skills, and personal qualities such as motivation and integrity. Women and Infants graduate medical education programs strongly support the use of organized matching programs wherever possible. The ACGME accredited residency program in obstetrics and gynecology participates in the National Resident Matching Program (NRMP) and accepts applications through ERAS.

3. Evaluation: Residents are evaluated in writing at intervals determined by the program requirements and meet face-to-face with the program director to review their performance. The evaluation will consider scientific knowledge, clinical practice and judgment, technical skills, performance on examinations (if applicable), professional behavior, teaching skills and behavior, and achievement in mastering the learning objectives of the program. The program will maintain a permanent record of evaluation for each resident and have it accessible to the resident and other authorized personnel. Residents will also have the opportunity to submit to the program director at least annually, anonymous written evaluations of the faculty and the educational experiences. Residents are encouraged to discuss educational issues with their program director, the director of medical education, or through the organizational outlets described in the program handbook. Residents must perform satisfactorily (at or above the 25th percentile) on the CREOG In-Training Examination.

4. Promotion: In general, residents are eligible for promotion from one year of training to the next based upon satisfactory completion of the learning objectives of the rotations, performance on examinations, technical achievement, professional behavior, teaching skills and performance, clinical practice, judgment, and performance.

5.  USMLE: Applicants accepted for residency positions at the postgraduate year one level are required to take USMLE Step 2 before beginning residency training. Applicants who fail to pass the exam before the beginning of the academic year will be allowed to begin residency training, with the stipulation that they take and pass USMLE Step 2 within three months of entering the program. Should the resident fail to pass USMLE Step 2 within three months of entering the program, his or her appointment as a resident will be revoked. Residents that are graduates of LCME-accredited medical schools are expected to take and pass USMLE Step 3 within six months of completing their first postgraduate year. Graduates of foreign medical schools must take and pass USMLE Step 3 within six months of completing the third postgraduate year. Any resident who does not take, or fails to pass, USMLE Step 3 within the appropriate time frame is subject to suspension or revocation of his or her appointment as a resident.

6. Dismissal: Residents and the programs will follow the hospital policies on due process and disciplinary procedures described in the program handbook. The basis for dismissal may be failure to achieve the learning objectives of the program, unprofessional behavior, substandard clinical practice and judgment, failure to demonstrate an adequate knowledge base, failure to develop sufficient technical skills, failure to develop sufficient teaching skills, unprofessional teaching behavior, or substandard performance. When appropriate, attempts at remedial action must have been made and been unsuccessful. A resident may be suspended at any time, if the event is of such magnitude that in the opinion of the program director such action is warranted. The program director would follow the policy on due process and disciplinary procedures in such actions.

7. Supervision: Faculty are ultimately responsible for the clinical care given to patients. Supervision of residents may be provided by a combination of upper level residents, fellows, and faculty. Each program provides supervisory faculty to its residents. Each program maintains a backup system of supervisory faculty member that residents may also contact. Lines of supervision are described in a program's resident handbook.

___________
* "Resident" is used here to designate both residents and fellows as ACGME or Board Approved Program trainees. Reviewed, Revised, and Approved by the WIH GMEC

Direct all inquiries about the residency program to:
 

Gary Frishman, MD

Associate Residency Program Director

Women & Infants Hospital of Rhode Island

101 Dudley Street

Providence, Rhode Island 02905

Email:  GFrishman@wihri.org