Rotations

The four-year training period is organized into eleven rotations each year, the majority of which are spent at the two parent institutions, BWH and MGH. In addition, residents have rotations at Boston Children’s Hospital, Faulkner Hospital, and at Newton-Wellesley Hospital. The rotations form a logical progression from basic, general obstetrics and gynecology, through subspecialty rotations, and gradual assumption of a clinical leadership role. During each of years 2-4, there is a rotation for vacation coverage, and in PGY4 there is a rotation (“Jeopardy”) during which the Chief Resident is available to cover any clinical service in any capacity at any time there is a need.

Night coverage of services at BWH and MGH, Sunday through Thursday is provided by residents on night rotations with in-house attending supervision/back-up. From Friday evening through Sunday evening, coverage is provided by on-call resident/attending teams. Weekend call schedules are generated at least 4 months in advance.

Experience in all aspects of outpatient care are integral to our program. During PGY1 the major outpatient experience is in obstetrics, while during each of years 2-4, every resident has a weekly gynecology continuity clinic. In addition, there are discrete outpatient experiences in emergency gynecological evaluation and followup, evaluation and management of abnormal PAP smears, urogynecology, menopause, gyn oncology, reproductive endocrinology and infertility, complicated contraception, high-risk obstetrics, and diabetes in pregnancy.

During PGY1, there is a major emphasis on learning basic obstetrics on the labor floor and postpartum floors as well as in ambulatory obstetrics. Additionally, residents learn basic gynecology and minor surgical procedures as part of the benign gynecology teams, with an emphasis on Emergency Department consults and followup and as part of the gynecology service teams. An Ambulatory rotation introduces residents to a community outpatient gynecology practice, obstetrical ultrasound, basic reproductive endocrinology and infertility along with transvaginal ultrasound, ambulatory obstetrics including centering pregnancy, and one night on the labor floor. Finally, a rotation on the inpatient internal medicine service at BWH is the first of 2 off-service rotations.

The PGY2 rotations expose residents to more complicated obstetrics, through a rotation at MGH that focuses on performing cesarean sections, and a rotation at BWH that is the first of 2 rotations on the high risk ante- and post partum service. Gynecology rotations are largely subspecialty rotations, on Family Planning, REI, Pediatric/Adolescent Gyn at BCH, and in gyn oncology outpatient and surgery with BWH Gyn Onc. During two night gyn rotations, one at BWH and one at MGH, residents have experience with independently acting as a consultant to the Gyn ED and inpatient floors, with back up from the in-house chief resident. In the second off service rotation, the PGY2 ob/gyn resident alongside residents from anesthesia and surgery staff the Surgical Intensive Care Unit at BWH.

PGY3 rotations provide a broad experience with a progressive increase in the level of responsibility for services and for complicated surgical procedures. PGY3 residents have major responsibilities in leading services in high risk obstetrics, gynecologic oncology, and participate in complicated surgical procedures in obstetrics, gynecologic oncology, urogynecology, and minimally invasive surgery. PGY3 residents have a rotation in community gynecology where they participate in both outpatient and inpatient Minimally Invasive Gyn Surgery and in urogynecological surgical procedures. During PGY3 there is a “Research” rotations. This is a no-call rotation during which residents can choose to devote all of their time to their resident research projects or can participate in a Global Health experience.

During PGY4, the emphasis is on consolidating high level clinical knowledge and on leadership of clinical services. There are 3 clinical rotations that focus on high volumes of surgical procedures, one if which exposes the resident to 2 days a week of gynecologic ultrasound at a high-volume ultrasound practice. During one rotation as Obstetrical Clinic Chief, the PGY4 staffs multiple high risk and consultative obstetrical clinics and also serves as the supervisor for the PGY1 residents on the low-risk postpartum inpatient service. During rotations as Gynecology Chief at BWH and at MGH, and as BWH OB Chief for both days and nights, the PGY4, with back-up by on-site attendings, supervises the resident team in care of all in-house OB patients, including those on the labor floor, in the OB OR, and in OB triage.

The entire program is scrutinized annually to ensure that all rotation and experiences are clearly educational and are in support of our overall educational mission.


Sample Rotations Schedule

PGY 1

PGY 2

PGY 3

PGY 4

BWH Obstetrics BWH High Risk OB BWH High Risk OB BWH L&D Chief
BWH Obstetrics MGH OB BWH Surgical OB BWH OB Clinic Chief
BWH Obstetrics Nights MGH Gynecology BWH Late Night OB MGH Late Night OB
MGH Obstetrics MGH Gynecology Nights BWH Oncology BWH Late Night Chief
MGH Obstetrics Nights BWH Gynecology Nights MGH Oncology MGH Gynecology Chief
BWH Gynecology BWH Oncology BWH Gynecology BWH Gynecology Chief
MGH Gynecology Boston Children’s/ BWH Gynecology MGH Gynecology BWH Private Gynecology Service
BWH Oncology BWH Family Planning MGH Clinic Senior BWH-Faulkner
MGH Oncology BWH Reproductive Endo & Infertility Newton-Wellesley Operative/Ultrasound
Ambulatory SICU @ BWH Research Elective Jeopardy
Medicine @ BWH Vacation Coverage Vacation Coverage Vacation Coverage