Rotations

SCHEDULE

The number of weeks listed below are approximations and will vary secondary to holidays and vacations.  Each resident has 4 weeks of vacation every academic year.

PGY 1

  • Obstetrics x 10 weeks
  • Obstetrics Night Float x 10 weeks
  • Gynecology x 10 weeks
  • OB Ambulatory/Postpartum/Triage x 4 weeks
  • Antenatal Ultrasound x 2 weeks
  • Ambulatory (Sub-specialties) x 4 weeks
  • Family Planning x 5 weeks
  • SICU x 4 weeks

Throughout your intern year, the major emphasis is on creating a foundation of knowledge and technical skills that you will build upon over the 4 years of your training.

Obstetrics/Obstetrics – Night Float

On your obstetrics rotations, you are part of the resident team that covers Labor and Delivery, triage, and postpartum.  This rotation is focused on training in basic obstetrics: labor management, vaginal deliveries, cesarean sections, OB triage, and postpartum care. You will be working with our OB, MFM, midwifery, and family medicine faculty.  Our L&D performs approximately 3000 deliveries and about 7500 unique triage visits annually.

Gynecology

You are part of the resident team dedicated to the inpatient gynecology service.  Our gynecology service encompasses benign gynecology, MIGS, and our sub-specialty services (GYN Onc, Urogyn, CFP, and REI).  As the intern, you are learning gynecologic surgical skills (i.e. hysteroscopy, laparoscopy, cystoscopy, and assist on laparotomies), inpatient post-operative care, seeing consults from other services and the Emergency Department, as well as gaining early exposure to our gyn sub-specialties.

OB Ambulatory/Postpartum/Triage & Ambulatory (Sub-specialties)

During the first half of your intern year, the focus is on basic postpartum care, L&D triage, outpatient prenatal care, and lactation support with our inpatient lactation consultants and in our outpatient breastfeeding medicine clinic.   In the latter half, the emphasis shifts to providing early exposure to the sub-specialties with the addition of outpatient clinic sessions in Urogynecology, GYN Oncology, MFM, and Project Respect (a multi-disciplinary clinic specializing in the treatment of substance use disorders during pregnancy & postpartum).

Antenatal Ultrasound

This two-week rotation takes place in the Antenatal Testing Unit to learn basic obstetrical US skills (fetal survey, growth US, BPPs, AFIs) with our MFM faculty and sonographers. By the completion of this rotation, interns are proficient in basic obstetrical ultrasounds and have gained additional experience with advanced obstetrical ultrasounds.

Family Planning

You have the first of 2 dedicated Family Planning rotations. Interns learn to provide all methods of contraception, 1st trimester medication and aspiration abortion, and all aspects of early pregnancy loss care. You will also develop the skills and knowledge to provide comprehensive reproductive health care – counseling, contraception care, early pregnancy loss care, pain management in procedures, ultrasound, diagnosis and management of early pregnancy loss and fetal demise, and preventing and managing rare abortion complications. Residents perform ambulatory procedures including manual vacuum aspiration, dilation and evacuation, and intrauterine device and contraceptive implant insertions.

SICU

Our SICU is a multi-disciplinary surgical intensive care unit that is led by our colleagues in the Department of Anesthesia and the Division of Trauma Acute Care Surgery.  This rotation enables our interns to gain skills and knowledge in the principles of critical care medicine.  OBGYN interns participate fully in the management of critically ill patients and gain invaluable experience in cardio-pulmonary monitoring and airway management.

PGY 2 

  • High-Risk Obstetrics x 10 weeks
  • Gynecology Night Float x 10 weeks
  • Lahey Gynecology x 20 weeks
  • Ambulatory (Sub-specialties) x 6 weeks
  • Elective x 2 weeks

The PGY 2 year continues to build on the basics with continued sub-specialty exposure and increased clinical responsibilities and participation in more advanced surgical procedures.

High Risk Obstetrics

The PGY2 High Risk Obstetrics rotation builds on the fundamentals learned in your intern year.  Residents care for patients with a myriad of complex issues including medically complicated pregnancies, active substance use disorders, and critically ill postpartum patients.  The resident is responsible for the admission and management of all high-risk patients to the antepartum service. Additionally, residents will be on Labor and Delivery assisting in high risk deliveries.

Gynecology – Night Float

As the GYN Night Float resident, the PGY2 experiences more independence as the consultant to the Emergency Department and the inpatient floors.  Additionally, the PGY2 has increased operative responsibilities and is responsible for any emergent surgical care from service patients, inpatient consults, or through the ED.

Gynecology – Lahey Hospital and Medical Center 

The 2nd year emphasizes building more advanced surgical skills.  Residents spend approximately 20 weeks (divided) as part of a 4-member resident team with the Lahey Gynecology Department which is comprised of highly-skilled faculty in minimally invasive gynecologic surgery, urogynecology, and gyn oncology.

Ambulatory (Sub-specialties)

We continue your exposure to the sub-specialties with outpatient clinic sessions in REI, Urogynecology, GYN Oncology, and MFM.

Elective

Each PGY 2 has a two-week elective during which they have protected time to work on scholarly projects, advocacy, educational activities, community outreach, or pursue subspecialty electives at outside institutions locally or nationally.

PGY 3 

  • Gynecology Consult x 10 weeks
  • Lahey Gynecology x 10 weeks
  • High Risk Obstetrics x 10 weeks
  • Obstetrics Night Float (Chief of Service) x 5 weeks
  • Family Planning x 5 weeks
  • Jeopardy x 5 weeks
  • Elective x 4 weeks

PGY 3 rotations are designed to provide a progressive increase in the level of responsibility for the various services, as well as increase involvement in more complex medical and surgical patients and procedures.

Gynecology Consult

The PGY3 residents have major responsibilities in this rotation and hone their ability to triage and oversee a busy service under the guidance and supervision of the weekly GYN Service Attending and the GYN Chief residents.  Alongside our GYN Inpatient PA, they manage the pre/post-operative, consultative, and emergency care of service patients, as well as interface with the Emergency Department.  Additionally, they are in the operating room for any emergent surgical cases or for their assigned case of the week.

Gynecology – Lahey Hospital and Medical Center 

The PGY 3 takes on greater responsibilities and spends progressively more time in the operating room advancing their skills in minimally invasive and abdominal surgeries.  Along with the PGY3 from the Tufts OBGYN Residency Program, they act as co-chiefs and lead the gynecology inpatient service at Lahey. They oversee the junior residents and medical students on the team. They are also responsible for the assignment of surgical duties and supervision of postoperative care of all patients. They direct the management of patients admitted to the service from the Emergency Department as well as consultations from other services. Each resident typically completes their FLS certification by the end of their 3rd year.

High Risk Obstetrics/Obstetrics – Night Float

The PGY3 takes on higher responsibilities and acuity in our high risk obstetrics service culminating in becoming the chief of the service in the second half of the academic year when on obstetrics night float.

Family Planning

Your third year is the second dedicated rotation in Family Planning.  Similar to other rotations, there is a progressive increase in the responsibility for more medically and surgically complex patients, as well as the attainment of more advanced technical skills with dilation and evacuation.

Jeopardy

The Jeopardy rotation is a flexible coverage-based schedule that meets educational goals and coverage needs.  Beyond backup coverage, the jeopardy residents are often in the OR, buddy-scrubbing major cases, and using this time for independent study/scholarly activity.

Elective

The PGY 3 elective block is 4 weeks during which they have protected time to work on scholarly projects, advocacy, educational activities, community outreach, global health electives or pursue subspecialty electives at outside institutions locally or nationally.

PGY 4

  • Obstetrics Chief (Days) x 10 weeks
  • Obstetrics Chief (Night Float) x 5 weeks
  • Gynecology Chief x 20 weeks
  • Ambulatory x 4 weeks
  • Jeopardy x 8 weeks

During the final year of residency, the emphasis is on leadership of the clinical services which demonstrates the union of high level clinical knowledge and mastery of surgical skills.  The fourth year is a high-volume surgical year both on L&D and on the inpatient gynecology service and our residents are supervising and teaching junior residents through procedures.

Obstetrics Chief – Day & Night Float

The Chief Resident supervises the resident team in care of all in-house OB patients, including those on the labor floor, in the OR, triage, and on the high risk postpartum service.  The goal is to promote autonomy under the supervision of our attending faculty.  Moreover, they hone their collaboration skills as they work alongside our Midwifery and Family Medicine faculty on the patients assigned to their care.

Gynecology Chief

Two PGY 4s are the chiefs of the GYN inpatient service. They oversee the junior residents and medical students on service. They are also responsible for the assignment of surgical duties and supervision of postoperative care of all patients. They direct the management of patients admitted to the service from the Emergency Department as well as consultations from other services. The resident gains skills and competency in hysterectomies by all routes. The resident operates in all difficult abdominal and endoscopic cases.

Ambulatory

In the PGY4 ambulatory block, the schedule is personalized and designed to develop experiences to meet their individual professional goals.  Examples of some of these experiences include Centering in Pregnancy, Project Respect (a multi-disciplinary clinic specializing in the treatment of substance use disorders during pregnancy & postpartum), OB US, Positive Hope (HIV in Pregnancy Clinic), Colposcopy, Vulvar Derm, Pelvic Floor PT, GYN Sub-specialty clinics.

Jeopardy

The Jeopardy rotation is a flexible coverage based schedule that meets educational goals and coverage needs.  Beyond back-up coverage, the jeopardy residents are often in the OR, buddy scrubbing major cases, and using this time for independent study/scholarly activity.

Continuity Clinic

During all four years of training, interns and residents have their own continuity clinic where they are the primary physician for their patients throughout their residency.  Each year, the residents elect a PGY 4 as our Ambulatory Chief.  The scope of their role encompasses spearheading the management of the resident practice with particular focus of providing support to the junior residents who are developing their outpatient clinic skills.

Annual Program Review

Every year, we have a formal meeting(s) to review every single aspect of the program with all the residents to ensure that all rotations and educational experiences support the overall educational mission of our training program.