OB/GYN Residency Overview
Graduates of this program will also be qualified to provide consultation to other physicians. The program was designed using the CREOG "A Design for Resident Education in Obstetrics and Gynecology" along with the sixth edition of "Educational Objectives for Residents in Obstetrics and Gynecology."
The program is designed to meet or exceed all of the general and special requirements for resident education outlined in the AMA Directory of Graduate Medical Education Programs. Residents progress through a structured educational system from total supervision to independent function and are given an opportunity to acquire along the way the cognitive knowledge, technical skills, judgment, and compassionate approach to patient care necessary to practice in this challenging field. Successful completion of the program qualifies the graduate for Part One of the specialty board examination. Another goal of this teaching program is to introduce residents to basic science and clinical research and thereby stimulate a group of individuals who may pursue additional subspecialty training and/or seek career opportunities in academic medicine.
General Information about Obstetrics & Gynecology:
The residency program is directed by a Program Director located at both WHMC and BAMC (both are in San Antonio, TX) and an Associate Program Director. The initial selection of a Program Director and an associate Program Director is through a tri-service selection process developed by the Department of Defense. Selection of the Program Director and Associate Program Director is based on academic qualifications, not military rank or branch of service. The length of the program director's tenure is unspecified; however, applicants for the position must commit to a minimum of five years in that position. This commitment to at least five years of service has lead to increased stability in the program. The current faculty is composed of individuals both trained and board certified/eligible in Obstetrics and Gynecology, Gynecologic Oncology, Reproductive Endocrinology/Infertility, Urogynecology and Pelvic Reconstruction, Pathology, and Maternal Fetal Medicine. The tenure of the full time faculty is not specified, but experience has shown that the core physician staff spend between five to ten years at the two San Antonio medical centers. The Department's HMO (The Women's Health Center) enrolls women (18 years of age and older) and provides them with comprehensive primary health care as well as basic and consultative level obstetrical and gynecologic care. All of the PGY-2 through PGY-4 resident physicians as well as the staff generalists participate as primary care managers (PCM). The program director facilitates the residents' participation in the HMO and provides a strong educational experience in primary health care and preventive medicine. Additionally, the subspecialty clinics work closely with their patients' PCM's. In so doing, residents gain additional insight and educational experience in the field of primary care and preventive medicine.
Organization of Inpatient Teaching Service
The inpatient teaching services, i.e. Obstetrics/Maternal Fetal Medicine, Gynecology, Urogynecology and Pelvic Reconstruction, Reproductive Endocrinology/Infertility, and Gynecologic Oncology are under the overall supervision of each service chief. In general, within each service various staff members are assigned for service coverage on a one-to-four week basis. The house staff assigned to each of these services meet daily with the staff assigned to that service to coordinate clinical management as well as for educational purposes. Additionally, the residents also work with the staff in the outpatient subspeciality clinics. The faculty rotate in-house call on a nightly basis, from 1700 to 0600 hours the next day, with 24-hour in-house coverage on weekends and holidays at WHMC and at the affiliate hospital Darnall Army Community Hospital (DACH) where there are labor and delivery units.
At BAMC, the service faculty take call from home to assist the residents in the management of the gynecology inpatient services. If patients at BAMC require surgery, the staff are in-house for pre-op work-ups, surgery, and immediate post-op care. The inpatient house staff have continuity of responsibility for their respective services and are further required to have a change of duties briefing at 1700 hours for the night call rotations. This briefing takes place in each of the three hospitals and covers complicated patients on all the inpatient services, as well as those women in active labor. The same applies to the turnover time of 0800 hours on weekends. The staff on service are responsible for both patient care and resident education. Teaching responsibilities include direct patient contact, as well as a small group specialty-specific resident teaching sessions. House staff on inpatient services are required to attend all scheduled departmental conferences. There is a house staff night float system in place where PGY2 and PGY3 residents work from 1700 until 0700 Sunday through Thursday to cover labor and delivery responsibilities and the other year groups have a rotating call schedule which averages every fourth night.