OB/GYN Residency Greenville - Curriculum
Our clinical curriculum is crafted with intentionality to balance obstetric and gynecologic training. We place great emphasis on graduated autonomy, ensuring close supervision of early residents to develop foundational knowledge and skills as well as plenty of autonomy for Chief residents to develop confidence in forming management plans and performing complex OB and GYN procedures independently. We frequently seek resident feedback on curricular improvements and are responsive to that feedback. We also evaluate each resident’s performance to identify individual curricular needs. As such, our curriculum is flexible and is shaped to meet collective and individual resident needs.
All core rotations last four weeks. Below is a description of core rotations and experience in each over four years (number of rotations and PGY levels).
Labor and Delivery
Experience: 8 rotations (PGY-1 x 2, PGY-2 x 2, PGY-3 x 2, PGY-4 x 2)
Description: A team of four residents (one of each PGY level) rounds on postpartum patients prior to 7am signout. During the day, they manage the L&D unit (low and high-risk patients), perform obstetric cases (cesarean deliveries, external cephalic versions), and see patients in OB triage until evening signout at 5pm. The team also includes a nurse practitioner who helps see postpartum patients and a certified nurse midwife who sees triage patients and supervises PGY-1 and -2 residents in vaginal deliveries.
Night Float
Experience: 8 rotations (PGY-1 x 2, PGY-2 x 2, PGY-3 x 2, PGY-4 x 2)
Description: A team of four residents (one of each PGY level) manages all inpatient services from 5pm until 7am. The PGY-1 is responsible for L&D, OB triage, and the postpartum unit. The PGY-2 is responsible for all gynecologic services, ED consults, and GYN surgeries. The PGY-3 is responsible for the MFM service. The PGY-4 supervises the entire resident team and acts as teaching assistant on all surgical cases.
Gynecology
Experience: 8 rotations (PGY-1 x 2, PGY-2 x 2, PGY-3 x 2, PGY-4 x 2)
Description: A team of four residents (one of each PGY level) performs the full spectrum of gynecologic operative cases and operate 5 days each week. They operate with both core faculty physicians and community faculty physicians. The team manages the inpatient benign gynecology service, including admissions, postoperative care, and inpatient and emergency department consultations. In addition, the GYN team sees patients in our perioperative clinic and presents all upcoming cases for discussion at a weekly perioperative conference.
Maternal-Fetal Medicine
Experience: 4 rotations (PGY-1, PGY-2, PGY-3 x 2)
Description: A team of two residents rounds with the MFM attending and fellow on our busy and complex high-risk service. The average census is 18 patients between the antepartum unit, L&D, and the intensive care unit. We see a large variety of maternal and fetal pathology and serve a large catchment area with the most advanced level of specialty care in the area in our Level III NICU. This team also performs operative cases on service patients including cesarean delivery, cervical cerclage, and PUBS.
Ultrasound
Experience: 2 rotations (PGY-1, PGY-4)
Description: In the first of two dedicated ultrasound months, interns learn all the key components of obstetric ultrasound, including first trimester dating, second trimester anatomy ultrasound, performing fetal biometry, and antenatal surveillance with biophysical profile. In the second rotation, chief residents tailor their experience to include a mix of obstetric and gynecologic ultrasound that will most benefit them in their post-graduation fellowship or practice.
Obstetric Clinic
Experience: 4 rotations (PGY-1, PGY-2, PGY-3, PGY-4)
Description: A team of residents, nurse practitioners, and midwives sees patients in our Obstetrics Clinic. Interns see low-risk patients, while PGY-2/3/4 residents see high-risk patients. They are directly supervised by an MFM faculty member. The broad range of pathology includes patients with diabetes, hypertensive disorders, fetal anomalies, adult congenital heart disease, multifetal gestation, and many other comorbidities.
Gynecologic Oncology
Experience: 5 rotations (PGY-1, PGY-2, PGY-3, PGY4 x 2)
Description: A team of two or three residents operates with our three busy GYN Oncologists and manages the inpatient Gynecologic Oncology service. This includes admissions, care of postoperative patients, and consultations. Residents usually operate 4 days each week. This is an excellent opportunity for experience in robotic and abdominal hysterectomies and management of medically complex and critically ill patients.
Reproductive Endocrinology and Infertility
Experience: 2 rotations (PGY-2, PGY-3)
Description: One resident works directly with our five REI faculty members seeing patients in their office and performing cases in the operating room. Cases include advanced hysteroscopy, diagnostic and complex operative laparoscopy, myomectomy, and hysterectomy. Residents gain excellent experience with transvaginal GYN ultrasound during this rotation, and they also spend time in the ART lab. Residents participate in the weekly IVF conference, including clinical and didactic discussions.
Female Pelvic Medicine and Reconstructive Surgery (Urogynecology)
Experience: 2 rotations (PGY-2, PGY-4)
Description: One resident operates with our two FPMRS faculty members and sees patients in the office with them. This rotation provides immersive experience in vaginal surgery, including vaginal hysterectomy, incontinence procedures, repair of pelvic organ prolapse, and colpocleiesis. Outpatient, residents become familiar with the full range of evaluation and treatment procedures, including simple cystometrics, urodynamic testing, cystoscopy, and pessary use.
Pediatric and Adolescent Gynecology
Experience: 1 rotation (PGY-1)
Description: One resident works with our two PAG physicians and two NPs in the outpatient office, operating room, and inpatient for consultations. The clinical focus includes learning the normal menstrual cycle and managing abnormalities including absent, frequent, infrequent, heavy, or irregular menses. Residents also obtain in-depth knowledge of contraception, sexually-transmitted infections, and bleeding disorders while learning unique best practices in caring for children and teenagers.
Research
Experience: 1 rotation (PGY-3)
Description: While residents have been working on their research project longitudinally from the first month of residency, they have a dedicated month for manuscript writing and revision and preparing for their oral presentation of the project at the annual C.M. Easley Research Symposium.
Family Planning/Selective
Experience: 1 rotation (PGY-4)
Description: Our four-week rotation in family planning includes training in provision of medical and surgical pregnancy termination, experience in comprehensive contraceptive counseling, and outpatient treatment of spontaneous abortions. For residents who opt out, this selective may be tailored to the individual desires of the resident. Other experiences include a substance use disorder elective, international mission work, GYN operative experience, outpatient gynecology or general OBGYN, and time for board exam preparation and study.
Float Rotation
Experience: 2 rotations (PGY-1, PGY-2)
Description: Residents on the Float rotation get a variety of gynecologic experience and are available to cover for rotations who are out due to illness. Gynecologic experiences include performing minor GYN surgical cases that can’t be covered by the GYN team, GYN/transvaginal ultrasound experience, and weekly Vulvar Clinic. This resident also staffs a weekly outpatient procedure clinic that includes office hysteroscopy, manual vacuum aspirations, SIS, HSG, and ultrasound-assisted procedures.
Additional clinical experience
Core rotations cover 11 months of the year. The final four-week block (June of each year) is broken into two-week blocks of extra experience in the core rotations. This allows us to give extra experience as needed or allows residents to make up for rotations missed for parental or other leave. Additional selective months may be granted in the third or fourth year to allow for exceptional clinical experience.
Boards Study and Preparation
All chief residents conclude their clinical rotations and call mid-June and have two weeks of time dedicated to boards preparation. Residents are provided with a complementary 6-month subscription to the TrueLearn® Written Board Exam question bank to aid in preparation.
First Year
Labor and Delivery x 2
Night Float x 2
Gynecology x 2
Maternal-Fetal Medicine x 1
Ultrasound x 1
Obstetric Clinic x 1
Pediatric and Adolescent Gynecology x 1
Gynecologic Oncology x 1
Float x 1
Second Year
Labor and Delivery x 2
Night Float x 2
Gynecology x 2
Maternal-Fetal Medicine x 1
Obstetric Clinic x 1
Reproductive Endocrinology and Infertility x 1
Female Pelvic Medicine and Reconstructive Surgery x 1
Gynecologic Oncology x 1
Float x 1
Third Year
Labor and Delivery x 2
Night Float x 2
Gynecology x 2
Maternal-Fetal Medicine x 2
Obstetric Clinic x 1
Gynecologic Oncology x 1
Reproductive Endocrinology and Infertility x 1
Research x 1
Fourth Year
Labor and Delivery x 2
Night Float x 2
Gynecology x 2
Obstetric Clinic x 1
Gynecologic Oncology x 2
Female Pelvic Medicine and Reconstructive Surgery x 1
Family Planning/Selective x 1
Ultrasound x 1 (or additional Selective)
Boards Study
Within the structured rotations, residents participate in the following longitudinal experiences:
GYN Continuity Clinic
Experience: one half day weekly on most rotations
Description: Residents see the full spectrum of gynecologic conditions appropriate to their PGY level. First year residents focus on providing routine GYN and primary care, contraception, and STI services. Upper-level residents see more complex conditions, including infertility, pelvic pain, abnormal uterine bleeding, and pelvic organ prolapse.
Centering Pregnancy Clinic
Experience: Intern Year
Description: Centering Pregnancy is a nationally recognized program of group prenatal care. First year residents are each assigned a group that they follow through the year. The groups are assigned such that patients’ EDD falls during the resident’s L&D and night float rotations, so the resident is able to deliver their Centering Pregnancy patients for optimal continuity of care.
Colposcopy Clinic
Experience: 4-6 sessions each year
Description: Two residents perform colposcopic examinations and LEEP procedures in the outpatient OBGYN Center with one GYN faculty member.
Vulvar Medicine Clinic
Experience: 4 sessions during each Float rotation
Description: Residents see patients with one of our vulvar medicine specialists in their outpatient office, gaining exposure to a wide variety of common and rare vulvovaginal conditions (dermatoses, vaginitis, pain syndromes, etc.)
The resident experience is enhanced by multiple conferences which occur weekly, monthly or quarterly. These include:
- Morbidity and Mortality conference
- Grand Rounds
- Didactics – 3hrs per week (OB/MFM, GYN, REI, FPMRS, Gyn Onc, Business of Medicine, Wellness, Diversity/Equity/Inclusion, Primary Care, Professional Development)
- Simulations
- Perinatal Quality Conference
- Tumor Board
- High Risk Care Conference
- Fetal Care Conference
- Journal Club
The Accreditation Council for Graduate Medical Education (ACGME) requires that “each program must provide an opportunity for residents to participate in research or other scholarly activities and residents must participate actively in such scholarly activities.” One way we accomplish this requirement is with our award-winning resident research program.
The Resident Research Program Opportunities
- Learn the scientific method of research
- Gain an understanding of how to review the medical literature
- Become knowledgeable in basic research statistics
The ultimate outcome of resident research projects is an oral presentation of each project at the C.M. Easley Resident Research Symposium and submission for publication in a peer-reviewed scientific journal. Residents are encouraged to submit their projects to the American College of Obstetricians and Gynecologists (ACOG) District IV meeting which leads to consideration for acceptance to the ACOG annual clinical meeting and receipt of the Donald F. Richardson Award for outstanding research by a resident in OBGYN. Residents are also encouraged to submit their research to other state, regional, national and specialty society meetings. Funding is available for residents to travel to present at these meetings.
A curriculum for team-based resident research was launched in 2016 and has been very successful and well received. Each class of six residents is divided into two research teams, each of which has two faculty coaches to guide them through the process of developing and implementing a research project. At the time of manuscript submission, each resident will have authorship on three papers (one as first author).
The robotic surgery program at Prisma Health was established in 2010 with the acquisition of our first da Vinci robot. In the first full year, 370 robotic surgeries were performed (most by gynecologists), and these numbers have steadily risen. With more widespread adoption of robotic technology by gynecologists and other surgical specialties, Prisma Health has since acquired two additional robotic surgery units and a robotic surgery simulator. As of 2020, we have seven general gynecologic surgeons, three gynecologic oncologists and two urogynecologists who routinely utilize these systems.
As additional surgeons adopt this technology and demand for these techniques increases in the surgical marketplace, resident training in robotic surgery is increasingly important. Our goal is to graduate residents who are ready to be granted robotic privileges if they are entering a practice that utilizes this technology.
All OBGYN resident participate in the Robotic Surgery curriculum. The curriculum includes basic (mandatory) and advanced (optional) pathways. As part of the basic pathway, all interns complete dry lab training to learn the basic elements of the technology and become proficient in docking the robot. Residents then complete training modules on the robotic simulator to learn operation of the camera and robotic arms. All residents participate in at least ten cases as bedside assistant or first assistant. Those who choose to complete the advanced pathway perform additional simulation modules and complete fifteen additional robotic cases as surgeon. Upon successful completion of the advanced pathway, residents are provided a letter from Prisma Health recommending them for robotic privileges. The graduate may then include this letter when they apply for medical staff privileges at their new institution.
The standard elective rotation is a four-week Family Planning curriculum. Residents who opt out have the option to utilize the time for experience in:
- A focused concentration on a specific subspecialty
- International Missions
- Research
- Training in Primary Care
- Off-service rotations (Emergency Medicine, Internal Medicine, etc)
- Outpatient gynecology
- GYN surgery
- Additional Boards study time
**Additional elective blocks can be granted in the resident’s third year for unique educational opportunities**