The OB/GYN Residency Program at UCSF Fresno provides a structured educational experience designed to prepare the graduating resident equally well for independent general practice of obstetrics and gynecology or for further subspecialty training. The overall educational objectives of the program are derived from the core competencies set forth by the Accreditation Council for Graduate Medical Education: (1) Patient Care; (2) Medical Knowledge; (3) Interpersonal and Communication Skills; (4) Professionalism; (5) Practice-Based Learning and Improvement; and (6) Systems-Based Practice.
PGY-1
Night Float/L&D – 14 weeks
Develop the knowledge and skills required to provide competent antepartum, intrapartum and postpartum care for uncomplicated obstetrical patients. The resident will develop an understanding of the labor process and become proficient at determining the correct timing of delivery, performance of spontaneous vaginal deliveries and performance of cesarean sections. The resident will gain experience with operative vaginal deliveries and become familiar with principles of obstetrical anesthesia. The resident will provide assessment and develop management plans for patients presenting to obstetric triage. The resident is expected to actively involve and instruct medical students in patient care.
High Risk OB/Prenatal Diagnostic Center- 12 weeks
The goal of this rotation is to integrate the resident’s knowledge base and clinical skills to counsel and care for high-risk obstetrical patients and to obtain supervisory and teaching skills in the management of pregnancy complications. The resident will also teach and assist medical students in the management of high risk obstetrical patients.
Gynecology- 12 weeks
Develop ability to manage gynecologic patients who present for surgery including post-operative care/complications, management of gynecologic medical patients, inpatient assessment of acute gynecologic issues (consultations) and assessment of acute gynecologic complaints to the emergency department. Participation in major and minor gynecologic surgeries. Perform as first assist on simple surgical cases
Ultrasound- 2 weeks
In addition, to provide PGY 1 residents with opportunities to practice and develop basic obstetric and gynecological ultrasound proficiency. Develop knowledge and skills of obstetric ultrasound including competence to confirm fetal viability, number of fetuses, position of fetus, placenta location, and perform AFI, BPP, endovaginal cervical evaluation and basic fetal biometry resulting in attainment of “Ultrasound Certification”. In addition, develop skills to correctly counsel patients regarding testing for and diagnosis of genetic conditions and common fetal anomalies
MICU- 4 weeks
For most PGY-1 residents this rotation constitutes the first exposure to critical care in a position of patient responsibility. Accordingly, interns are assigned to a supervising resident with whom patient management issues are addressed in conjunction with the TLC team. Interns are expected to integrate pathophysiologic processes and during the course of the rotation develop patient management skills applicable to the critically ill. Admission notes and daily progress notes are required on all patients, with the emphasis on integration and management. All procedures need to be supervised. Patient responsibility throughout the rotation will be delegated based upon competence. It is expected that all patients will be seen on resident work rounds and presented on teaching rounds
Internal Medicine Ambulatory- 4 weeks
On this rotation, you will be exposed to the diagnosis and management of common chronic diseases and a wide array of pathology in multiple sub-specialties.
Step Up- 4 weeks
This rotation occurs in the final block of the academic year. Step Up is designed to have residents functioning at their next training level the month prior to their advancement. During this rotation,residents will rotate through PGY 2 rotations for 1 week allowing them to become more prepared for their advancement.
PGY-2
Night Float/L&D – 24 weeks
Expand knowledge and skills required to provide competent antepartum, intrapartum and postpartum care for uncomplicated and high risk obstetrical patients. The resident will evaluate and manage the labor process, perform spontaneous vaginal deliveries, operative deliveries, cesarean sections and become competent with principles of obstetrical anesthesia. The resident is expected to actively involve and instruct medical students in patient care.
Gynecology- 7 weeks
Develop ability to manage gynecologic patients who present for surgery including post-operative care/complications, medical management of gynecologic complaints in the outpatient setting, inpatient assessment of acute gynecologic issues (consultations) and assessment of acute gynecologic complaints to the emergency department. Perform simple surgical cases and assist in major and complex gynecologic surgeries. All inpatient and consults will be examined directly by a senior resident.
Gynecologic Oncology- 11 weeks
To gain general knowledge of gynecologic cancers and pre-invasive neoplasias (surgical management, medical management, co-morbidities and risk factors, chemotherapy concepts), increase surgical training, expand understanding on how to Integrate data (consultations, lab testing, radiologic studies, pathology) and participate in supervision of medical students. In addition, this rotation will include time spent in the ER follow-up clinic and the pelvic floor medicine clinic as part of a longitudinal learning experience.
UCSF- 4 weeks
PGY 2 residents will spend 4 weeks in San Francisco to gain general knowledge in Urogynecoogy and Reconstructive Pelvic Surgery and Reproductive Endocrinology and Infertility.
Step Up- 4 weeks
This rotation occurs in the final block of the academic year. Step Up is designed to have residents functioning at their next training level the month prior to their advancement. During this rotation,residents will rotate through PGY 3 rotations for 1 week allowing them to become more prepared for their advancement.
Research- 2 weeks
Residents who are meeting their scholarly activity milestones will be provided dedicated time to work on research/quality improvement projects.
PGY-3
Night Float/L&D – 12 weeks
Comprehensive responsibility for the clinical and educational operations of the entire obstetrical service during the day. Directs the activities of the junior residents, outside rotating residents, and medical students. The PGY 3-4 NF resident will also assist with emergency gynecologic surgeries and evaluate patients presenting to the ER or inpatient consults.
High Risk OB/Prenatal Diagnostic Center- 12 weeks
The goal of this rotation is to integrate the knowledge base and clinical skills to counsel and care for high-risk obstetrical patients and to obtain supervisory and teaching skills in the management of pregnancy complications. The PGY3 PDC resident will be responsible for supervising the management of every patient admitted to the antepartum service, perform daily rounds on all antepartum patients and also coordinate the transfer of patients between antepartum and Labor and Delivery. In the PDC, the PGY 3 resident will manage patients and be responsible to supervise and teach junior residents and medical students in the management of high risk obstetrical patients under the direction of the MFM attending.
Gynecology- 11weeks
Expand ability to manage gynecologic patients who present for surgery including post-operative care/complications, management of gynecologic medical patients, inpatient assessment of acute gynecologic issues (consultations) and post-management of acute gynecologic complaints to the emergency department. PGY 3 residents will participate and/or perform minor and major gynecologic surgeries.
Step Up- 4 weeks
This rotation occurs in the final block of the academic year. Step Up is designed to have residents functioning at their next training level the month prior to their advancement. During this rotation,residents will rotate through PGY 4 rotations for 1 week allowing them to become more prepared for their advancement.
Research- 2 weeks
Residents who are meeting their scholarly activity milestones will be provided dedicated time to work on research/quality improvement projects.
PGY-4
Night Float/L&D – 16 weeks
Comprehensive responsibility for the clinical and educational operations of the entire obstetrical service during the day. Directs the activities of the junior residents, outside rotating residents, and medical students. The PGY 3-4 NF resident will also assist with emergency gynecologic surgeries and evaluate patients presenting to the ER or inpatient consults.
Gynecologic Oncology- 12 weeks
To increase general knowledge of gynecologic cancers and pre-invasive neoplasia (surgical management, medical management, co-morbidities and risk factors, chemotherapy concepts), increase surgical training, expand understanding on how to Integrate data (consultations, lab testing, radiologic studies, pathology) and participate in supervision and teaching of junior residents and medical students.
Urogynecology and Reconstructive Pelvic Surgery- 12 weeks
To manage patients with pelvic organ prolapse and urinary and fecal incontinence, vulvar dermatoses, pelvic pain, pelvic floor disorders, inpatient gynecologic consultations and assessment and management of gynecologic emergencies. The responsibilities of the service include daytime coverage of inpatient consults, emergency room, urogynecology clinic, assistant for surgical cases, and supervision of junior residents and medical students. The resident is responsible for management of pre-operative and post-operative problems with surgical patients. The resident is responsible for management of emergency department and inpatient gynecology consults and for urgent assessment of all post-operative patients on the gynecology service.
Community Surgery- 12 weeks
To expand surgical skills by observing, performing and comparing surgical techniques used by local physicians, an understanding of the pre-operative work-up for surgical patient, increase technical skills in open and minimally invasive gynecologic surgery. Resident will spend dedicated time at FPA Women's Health to expand and increase their experience in Family Planning.
