Resident Education 

GENERAL INFORMATION

The University of Colorado Residency Program in Obstetrics and Gynecology primarily utilizes three hospitals under the auspices of the University of Colorado School of Medicine: University of Colorado Hospital, Denver Health Medical Center and Rose Medical Center.  Residents are rotated through each of these hospitals for both their obstetric and gynecological experiences.  The length of the training program is four years.  The program is fully accredited by the Residency Review Committee for Obstetrics and Gynecology for a complement of nine residents for each of the four years. 

Dr. Ronald S. Gibbs is the Chair of the Department of Obstetrics and Gynecology of the University of Colorado School of Medicine.  Dr. Kirsten J. Lund serves as the Program Director and Dr. John C. Slocumb serves as the Associate Program Director of the Residency Program.

 This Obstetrics and Gynecology Residency Training Program is a categorical one in which interns are matched through the National Resident Matching Program (NRMP) and expected to complete four years of training which fulfills the requirements for certification by the American Board of Obstetrics and Gynecology.

 UNIVERSITY OF COLORADO HOSPITAL (UCH)

University of Colorado Hospital is the primary teaching hospital of the residency program and of the University of Colorado School of Medicine.  It is located on the Health Sciences Center Campus.  At UCH, there is a full complement of both routine and tertiary care obstetric and gynecologic programs, including a high-risk obstetrical/neonatal intensive care unit, gynecologic oncology, reproductive endocrinology and infertility, and urogynecology.  The inpatient population consists of approximately 75% public/25% private on the Obstetrics service and approximately 67% public/33% private on the Gynecology services. 95% of all patients have a full time UCH faculty member as the attending physician; the remaining 5% have clinical faculty members as the attending physician.  The outpatient care for all UCH patients is provided at the Anschutz Centers for Advanced Medicine (ACAM), a new facility located 5 miles east of the main campus.  The University is in the process of moving the entire Health Sciences Center to this location over the next several years. 

DENVER HEALTH MEDICAL CENTER (DHMC)

Denver Health Medical Center, the city-county hospital for Denver, is located four miles west of UCH.  It is included in the integrated residency program to provide education and training in the care of predominantly publicly funded patients.  Graduate medical education programs in virtually all specialties at DHMC are integrated into the University of Colorado programs. DHMC faculty have full time appointments through the School of Medicine, and supervise residents in the full range of obstetric and gynecologic care including high-risk obstetrics, reproductive endocrinology and infertility, and urogynecology and pelvic reconstructive surgery.  UCH faculty attend at DHMC in GYN oncology.  All patients seen at DHMC have a full time faculty member as the attending physician.

 ROSE MEDICAL CENTER (RMC)

Rose Medical Center which is located one block east of UCH, provides education and training in the care of private obstetric and gynecologic patients. RMC is integrated with other University of Colorado residency training programs including surgery, medicine, and family medicine.  Attending physicians whose patients are regularly involved in the teaching program have Clinical (volunteer) faculty positions.

 ADDITIONAL TRAINING SITES

While on the UCH Gynecology service, residents provide gynecologic care at the Veterans Affairs Medical Center (VAMC).  VAMC is located next door to UCH. Resident commitment to care at VAMC consists of four general outpatient clinics, two colposcopy clinics and two half-days in the operating room each month.  All of these are staffed by a UCH faculty member.   Residents also provide, with attending supervision, on-call consultation services to the VAMC.  There is no in-house night call at the VAMC.

 In order to provide additional education and experience in GYN oncology, residents spend one block in the OBG-3 year with the private practice of Drs. Frank Major, Clinical Associate Professor, and Lisa Adler, Clinical Assistant Professor.  During the days, residents spend time in their offices and in the OR at Presbyterian/St. Luke’s hospital, which is 2.3 miles northwest of UCH.  During nights and weekends, residents take call at DHMC. 

 STRUCTURE OF PROGRAM

The organization of the program encourages progressively increasing resident responsibility throughout the 4 years of training.  Each resident presents at least one research project supervised by a faculty mentor at the Department’s Annual Resident Research Day. 

A team approach to the care of patients is an integral part of the resident training program.  Each service is headed by a chief resident who consults with attending faculty, and is responsible for the patients on his/her service.  The chief resident delegates responsibilities for individual patients to junior residents, according to their level of training and competence. 

 Daily rounds with the obstetric and gynecologic attending physicians provide a close teaching relationship between the faculty and the residents.  Residents are required to attend these rounds as well as weekly teaching conferences at the University.  These conferences are designed to provide an educational base for presentation and review of current cases. At all institutions where residents take night call, an attending is in the hospital 24 hours per day. At all institutions, attending physicians are present at all operative procedures and complicated deliveries. At all institutions, there is an attending physically present in, and designated to supervise, all resident outpatient clinics.

 Medical students rotate year-round on the Obstetrics and Gynecology Services at Denver Health Medical Center and the University of Colorado Hospital.  Residents participate actively in student education.

 PROGRAM EDUCATIONAL OBJECTIVES

1.                  Prepare residents to practice obstetrics and gynecology independently and competently.

2.                  Prepare residents for all phases of a career in obstetrics and gynecology, including private or group practice, academic, fellowship or research positions.

3.                  Prepare residents to serve as consultants to non-Ob/Gyn physicians.

4.                  Fulfill learning objectives (taken from CREOG learning objectives) by year and by rotation.

5.                  Perform satisfactorily on each block rotation as evaluated by senior residents and faculty and as summarized in the semi-annual review with residency directors. 

6.                  Perform an adequate number of procedures and experiences by achieving or surpassing all department minimums.

7.                  Complete and present a research project.

8.                  Pass the yearly oral examination.

9.                  Score above the 50th percentile in the yearly CREOG examinations.

10.              Attend all rounds and conferences for each rotation, and 75% of Grand Rounds and departmental conferences.

11.              Perform medical administrative responsibilities including keeping accurate and up to date case logs and completing all operative and discharge reports in a timely manner.

12.              Effectively participate in teaching of other residents and medical students in clinical settings, conferences and on rounds.

13.              Demonstrate resident competency in patient care, medical knowledge, practice-based learning, interpersonal and communications skills, professionalism, and systems-based practice.

 The departmental Education Committee is comprised of the residency and medical student clerkship directors, faculty from each departmental division and from each institution, and one resident from each level of training.  The committee meets quarterly to discuss issues related to resident and student education.  The educational objectives and mission of the department are evaluated at these meetings.  The educational objectives are also presented annually at a departmental faculty meeting and ratified by vote of the faculty.  In addition, monthly resident and chief resident meetings provide opportunities for all residents to participate in this evaluative process.  We currently evaluate resident competence in many areas, and are in the process of altering our evaluation tools, to better mirror the ACGME Core Competencies.

 EVALUATION OF RESIDENTS (SEMI-ANNUAL AND FINAL)

Residents have a responsibility for ongoing self-assessment with regard to their professional development.  They keep complete records of procedures and patient care experiences.  They ensure that their administrative record-keeping is up to date. OBG-4s play an integral role in the performance evaluation of junior residents; “resident progress” is a standing topic at monthly chief resident meetings.

 Faculty complete written evaluation forms on all residents who rotate on their services.  Among the performance measures assessed are the educational objectives for each rotation in each year.  These forms specifically ask for the evaluation of such areas as residents’ technical skills, fund of knowledge, clinical judgement, administrative responsibilities, ability to care for patients, interaction with members of the health care team, maturity and integrity.  There is space for written comments as well.  A checklist of rotation- and year-specific educational objectives is a part of this form.  These evaluations are filed for nearly all rotations, and a copy is immediately and confidentially sent to the resident.  Residents have free access to their files.

A program director meets twice yearly with each resident.  The purpose of this meeting is to evaluate overall progress towards training objectives.  Topics of review include faculty evaluation forms, CREOG scores and preparation, oral examination performance, experience numbers, medical record and dictation status, conference attendance and progress towards the research project.  Time is also designated for informal discussion regarding the resident’s progress, adjustment, fulfillment and future plans.  If necessary, corrective actions are taken at these meetings.  A written summary of each meeting, along with their current log of cases, is placed in the resident file and a copy is given to the resident.  At the end of the residency the Program Director reviews the fulfillment of all program learning objectives for each resident and certifies in a letter that each resident has fulfilled these objectives.   

EVALUATION OF FACULTY BY RESIDENTS

At the end of each rotation, residents receive a standardized form for evaluating faculty.  This form evaluates areas such as fund of knowledge, teaching interest, and technical ability.  Residents may complete these forms individually or as a group, depending on their comfort level.  Signatures are not required in order to protect resident anonymity.  Residents are strongly encouraged to complete evaluations for all faculty, as promotion of faculty is contingent upon resident evaluations as evidence of excellence in teaching.  Faculty also receive copies of each evaluation submitted.

 EVALUATION OF PROGRAM BY RESIDENTS

All residents receive a program evaluation form during their spring evaluation meeting.  This form includes evaluation of each rotation specific to that year.  Forms are turned in by the residents, reviewed by the Program Directors and faculty, and used in planning changes to the residency.

 RESIDENT RESEARCH/SCHOLARLY ACTIVITIES

All residents present a research project on a designated resident research day at the end of the OBG-3 year.  This is attended by a large number of faculty and nearly all residents.  The graduating senior class also invites a Visiting Professor for a lecture presentation.  Clinics and elective surgeries are not scheduled for this day.  Each resident has a faculty mentor who assists and advises the resident in the conduct and presentation of this project.   Residents submit written proposals for research, with an identified mentor, by the end of the OBG-2 year.  There is a six-week elective rotation block in the OBG-3 year, which may be used a research time, or the resident may conduct his or her research during other times of the year.

 Residents, usually OBG-4’s, attend national meetings including the ACOG annual clinical meeting, the ASRM and SMFM meetings.  Any resident who has a paper or abstract accepted at a national or regional meeting is allowed to attend, with their expenses covered by the department. 

VACATION/LEAVES OF ABSENCE/NIGHT CALL

Vacation is taken in each of the four years on specified rotations.  Because residents will always take a week vacation on these rotations, their absence is expected and planned.  On no rotation does night call average more than one night in three; this includes rotations on which one or more residents take vacation.  Vacation schedules are reviewed by the Program Directors before the start of each year, to ensure that vacation leave is well distributed, and to avoid having too many residents out during any one week.  Leaves of absence and illnesses are taken as needed.  If a resident must go on leave when they are on a rotation which cannot accommodate this absence, arrangements are made for residents to cover from other, less demanding services.  Any resulting inequities, such as significant differences in resident experience or amount of night call, are assessed and rectified upon the resident’s return from leave.  Every effort is made to ensure that the remaining residents have no more than 1 night in 3 on call, and have 24 hours each seven days, on average, away from the hospital. 

BLOCK SCHEDULE (SAMPLE OF INTERN YEAR) *vacation taken within rotation

SALARIES AND FRINGE BENEFITS

Salary levels for 2002-03 currently:

 Level I = $37,596; Level II = $39,888; Level III = $42,120; and Level IV = $44,184

 The University of Colorado and its integrated hospitals provide professional liability coverage for residents.  Coverage includes all medical activity engaged in within the scope of the training duties during the course of the resident’s graduate medical education, but does not cover them for activities which are not part of their training program.  Residents are not permitted to engage in outside employment without approval of the Department Chair and Program Directors.

 The University provides a Colorado Housestaff Health Benefits Program for residents and their dependants free of charge.  This includes health and dental insurance, as well as life and disability insurance.  Residents are provided on-call meal tickets as well as scrubs.  There is a $20.00 fee for issuance of white lab coats, inclusive of laundry services. 

Residents are granted three weeks leave for interns and four weeks leave for Levels II through IV, which encompasses attendance at scientific meetings each year.  Vacations must be taken on specific services approved by the Department. 

REQUIREMENTS AND APPLICATION PROCEDURES

Applications are only accepted through the Electronic Residency Application Service (ERAS). It is the candidates’ responsibility to make sure that all required documents submitted through ERAS reach our program successfully by the deadline of November 1 of each year.  Due to the competitiveness of candidates applying to our program, we are unable to accept applications submitted after this deadline.

 Applications will be accepted from all graduates of US medical schools accredited by the Liaison Committee on Medical Education (LCME).  The Educational Commission for Foreign Medical Graduates (ECFMG) serves as the ERAS coordinator for foreign medical graduates.  Refer to the ERAS web site for more information (http://www.aamc.org/eras).

 This program requires three letters of recommendation: one from the Chair of Obstetrics and Gynecology of your medical school; one from a faculty member outside of Ob/Gyn (i.e., Medicine or Surgery); and one from any faculty member who has most directly observed your clinical and surgical work.  Letters of recommendation should be addressed to our Residency Program Director, Kirsten J. Lund, MD.  Candidates must request the National Board of Medical Examiners to transmit NBME, USMLE or ECFMG transcripts to us through ERAS.

 Invitations for on-site interviews will be issued once our Residency Selection Committee has reviewed all applications.  Interviews are scheduled during December and next January. 

Thank you for inquiring about our Obstetrics and Gynecology Residency Program at the University of Colorado Health Sciences Center.  Should you have any questions concerning our training program, please call the Residency office, 303-315-3169 or via email to alicia.gore@uchsc.edu