INTRODUCTION

The residency is a four-year program, fully approved by the American Council for Graduate Medical Education (ACGME), with three residents at each level plus a fourth first-year resident in a preliminary position. The faculty is committed to providing all residents with the knowledge and skills that will enable them to perform as superb practitioners in obstetrics, gynecology, and primary health care for women. Approximately 90% of our graduates have sought and obtained private practice opportunities in recent years. The remainder have gone on to fellowship programs. At the same time, they seek to prepare for fellowship training those residents who wish to pursue this course. Finally they recognize that certification is vital for practice, and strive to give residents the preparation they need to pass the written examination of the American Board of Obstetrics and Gynecology. For the last four years all graduating residents have passed this examination.

Residents spend all but five months of the 48 month residency at Flushing Hospital Medical Center (FHMC), an acute care teaching hospital with 293 beds and a wide range of sophisticated inpatient and outpatient services provided by hundreds of physicians and dentists. FHMC is located in Flushing, Queens County, New York, possibly the most ethnically diverse neighborhood in the world. Patients include many native-born people, and also immigrants from all over the world, especially East Asia, South Asia, Latin America, and the Balkans. Residents gain exposure to patients with a wide range of health problems and socioeconomic circumstances. Approximately 2/3 of obstetric patients receive prenatal care from private physicians, and 1/3 receive prenatal care in the hospital clinic. There are few unregistered patients. A higher proportion of the gynecologic patients have private physicians. Residents’ participation in their operations is sufficiently active to allow the vast majority of our residents to develop superb surgical skills..

FHMC is part of the MediSys Health Network (“MediSys”). MediSys is the not-for-profit parent organization of FHMC as well as several other not-for-profit healthcare provider organizations, including Jamaica Hospital Medical Center, and Brookdale University Hospital and Medical Center

FHMC performed 2100 deliveries and over 2000 gynecologic procedures in 2005. It’s Women’s Health Clinics received over 16,000 patient visits. It has a new labor and delivery suite supported by a computerized record system.

Faculty consists both of hospital-based and office based attending physicians. Both the full-time attending staff and private attending physicians play important roles in the teaching program. A supervising 24 hour in-house faculty member conducts daily rounds. Full-time and part-time faculty physicians supervise residents’ work in the clinics, the delivery suite, the operating suite, the Emergency department, and on patient floors. In addition, the Chairman, Vice Chairman and subspecialists with offices in the hospital are available for consultation by the residents. The operative experience of our residents is substantially higher than the national average.

There is an extremely active didactic teaching program. Daily rounds with faculty members assure continuity of care. In addition, there are rounds and meetings with senior attending physicians and heads of all our subspecialty divisions as well as the physician-in-charge of Gyn Surgery. Fridays from 7:30 am until 2 p.m. are dedicated to formal instruction. Grand Rounds, Morbidity and Mortality Conference, and perinatal case presentation series,. The remainder of the education time is dedicated to lectures, monthly Journal Club and monthly administrative meetings. Endocrine conference is held on Wednesday mornings weekly. In the course of the year, there will be instruction in radiation therapy, oncology, ultrasound, psycho-sexual counseling, breast disease, anesthesia and urogynecology. There is mandatory attendance by all residents at each conference. This time is protected except for off-service residents and backup coverage of the delivery suite.

Attendance at all local meetings of the Queens GYN Society is arranged for all residents. In addition, resident’s attendance at other local and national meetings is encouraged.

The Curriculum:

General:
The faculty seeks to educate residents broadly in the field of obstetrics and gynecology. Its philosophy is that formal education and hands-on experience must interact in the education of skilled practitioners who graduate from the program ready to care for patients independently. At the same time, the program is committed to conscientious observance of the ACGME Essentials and of all regulatory requirements. With regard to the former, this entails a strong commitment to continuity of care and to education in the six competencies required by the ACGME. With regard to the latter, we are committed to scrupulous observance of ACGME and New York State work limitation rules.

The main basis of clinical experience is the clinical rotation. For the most part, rotations consist of a mixture of inpatient and outpatient experience in either obstetrics or gynecology. Exceptions consist of outpatient experiences in Maternal and Fetal Medicine and Reproductive Endocrinology; of two months each year of Night Rotation, an inpatient experience; and of off-service rotations in medicine, emergency medicine, and intensive care.

However, the clinical rotation does not teach residents longitudinal care, which is of cardinal importance in a primary care practice. Residents must learn to attract patients and keep their confidence. The also must learn to care for ongoing problems. Finally, they must be able to learn care of the well patient, including prevention and screening. This best can be accomplished by an experience in which residents participate in such care. Residents are therefore expected to maintain and attend a continuity clinic on all rotations except Reproductive Endocrinology.

The program is affiliated with Weill Medical School of Cornell University. Weill provides faculty coverage. In addition, the rotation in reproductive endocrinology is given at Weill’s teaching hospital, New York-Presbyterian.

Inpatient Care:
Residents are assigned to rotations as outlined below:

Gynecology:
Residents learn a broad range of operative skills, including operative laparoscopy and hysteroscopy. They operate, care for postoperative and other inpatients, and perform consultation. The operative experience is graduated. Residents perform more difficult operations with increasing experience. Chief residents are responsible for supervising the non-operative work of the other residents on the team. Laparoscopic surgery has been a major part of our surgical training. All residents are trained in the most current endoscopic techniques with state of the art equipment.
PGY 1: 4 months, typically scrubbing on procedures such as D&C, tubal ligation, and biopsies
PGY 2: 4 months, typically scrubbing on procedures such as benign adnexal procedures (open and laparoscopic) and abdominal hysterectomies
PGY 3: 4 months, typically scrubbing on procedures such as abdominal and vaginal hysterectomies
PGY 4: 5 months, typically scrubbing on procedures such as oncologic operations, pelvic floor repair, incontinence surgery, and laparoscopically assisted operations

Obstetrics:
Residents are taught all obstetric procedures commonly and appropriately used by generalists in the field, including ultrasound. Experience at Flushing is augmented by rotations at Jamaica Hospital Medical Center, which serves a high risk, more indigent population than does Flushing. Rotations are assigned as follows:
PGY-1: 3 months (Flushing), 2 months ( Jamaica)
PGY 2: 3 months (Flushing, 1 month ( Jamaica)
PGY 3: 2 months
PGY 4: 5 months

Night Float:
All residents spend two months on the night float team. They cover the delivery suite, participate in emergency operations, and give consultations in the emergency department and on the inpatient floors. All work is performed under the supervision of an in-house supervising physicaisn.

Other Rotations:
These rotations are essential to round out residents’ clinical skills. They are:
PGY-1 Medicine: 2 months
PGY-2 Medicine: 1 month
PGY-2 Surgical ICU: 1 month
PGY-3 Maternal and fetal medicine: 1 month
PHY-3 Reproductive endocrinology and infertility:
Reproductive endocrinology is given at New York-Presbyterian Hospital. The others are at FHMC

Ambulatory Care
Residents spend one day weekly in the Women’s Health Center (clinic), where they staff general clinic and specialty clinics. 23,000 patients were seen in the Women’s Health Center in 2005. In the General clinic, they see patients and work with mid-level providers such as nurse practitioners. A continuity clinic exists, and it is anticipated that all patients not in subspecialty clinics sill have a continuity provider within two years. Residents care for patients under the direction of on-site attending physicians. Specialty clinics include:
Obstetric high risk clinic
Infertility clinic
Oncology clinic
Colposcopy clinic
Breast clinic
Pediatric and adolescent clinic
Urogynecology clinic

Admission
All applicants must apply through ERAS. No applicant will be accepted who has not passed Steps 1 and 2 of the United States Medical Licensing Examination. The most qualified candidates will be invited for an interview. The program will accept candidates without an interview only under the most extraordinary circumstances. The program accepts three categorical residents and one preliminary resident. Categorical first-year residents will be promoted if their performance is satisfactory.

Criteria for selection include past academic performance, character, personality, and anticipated fit with the other residents and staff.

NOTE: The description of this program presented in this brochure is believed to have been accurate at the time it was written (December 2005). All information therein is subject to change without notice.