The OB/GYN Residency Program | Downtown Hospital

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	The OB/GYN Residency Program Residency Training Program for the Department of Obstetrics and Gynecology Message from Chairman and Residency Training Program Director New York Downtown Hospital has maintained a strong commitment to women's health care since its birth over 150 years ago. Downtown Hospital was founded in 1853 by the first female physician in the United States, Elizabeth Blackwell, a medical and social pioneer determined to provide care for the impoverished women and children of Lower Manhattan. Downtown Hospital is the only hospital in Lower Manhattan, an area of thriving commerce and residence, rich in tradition and diverse in population. The Hospital stands surrounded by a number of landmarks: the Brooklyn Bridge and South Street Seaport to the east; to the north, City Hall, Chinatown, and Little Italy; Wall Street to the south; and to the west the World Trade Center site and Battery Park City. Downtown Hospital serves one of liveliest business and tourist districts in the world, and its patient population is therefore unusually diverse. This diverse population provides a wide variety of clinical experiences and is a great resource for our teaching program. The residency program in Obstetrics and Gynecology (OB/GYN) at New York Downtown Hospital is designed to train competent and compassionate obstetricians and gynecologists in compliance with the special requirements of the ACGME, CREOG and ABOG. The residents are educated through an integrated program of clinical experience and didactic training covering the essential concepts of OB/GYN. This educational experience has been designed around the Core Curriculum in Obstetrics and Gynecology as formulated by the Council on Resident Education in Obstetrics and Gynecology. Our faculty and staff are committed to creating an educational environment that will help you acquire the knowledge, skills, and attitudes essential to the practice of obstetrics and gynecology and the pursuit of subspecialty training. We invite you to visit our Department and explore the many opportunities that New York Downtown Hospital has to offer. Thank you for your interest in our residency training program. OB/GYN Residency Training Program at a Glance The OB/GYN residency training program at New York Downtown Hospital strives to teach each resident to become a compassionate and ethical physician as well as a provider of excellent primary care for women. Residents are given increasing levels of responsibility, appropriate supervision, formal instruction, comprehensive didactic program, and critical evaluation throughout their training in order to achieve program goals and elicit the best from each individual. Highlights of the program include: • A four year residency program with three residents approved for each level of training. • Competitive salaries, benefits, and housing with 24-hour support services. • Consistent above-average performance for many OB/GYN procedures including vaginal delivery, vacuum, cesarean section, operative laparoscopic surgery, ultrasound, endocrine/infertility surgery, urogynecological surgical procedures, and primary and preventive care exposure. • A large and culturally diverse population with approximately10,000 outpatient visits and 2,600 births annually. • A modern and attractive Labor – Delivery – Recovery (LDR) Unit with eight fully furnished LDR suites, each including central computerized monitoring, neonatal resuscitation centers, kitchenette, baths with shower, sleeper couches and dining area. The LDR Unit also includes neonatal units, triage, operative suites, and recovery rooms. • The new Center for Female Continence and Pelvic Health, an expanded Urogynecology and Reconstructive Pelvic Surgery Division, and a full-time urogynecologist performing advanced diagnostic and therapeutic procedures. • An expanded Reproductive Endocrinology & Infertility Division affiliated with one of the largest IVF centers in Manhattan. • An expanded Maternal Fetal Medicine Division with two world-renowned specialists and a recently renovated and expanded Perinatal Diagnostic Unit with multiple 3D/4D ultrasounds and advanced fetal testing. • Expanded gynecological oncology training that includes on-site rotations with Downtown Hospital gynecological oncologists and a separate rotation at Memorial Sloan Kettering Cancer Center. • Separate rotations in outpatient medicine clinics, emergency medicine, and ICU. • A dedicated full-time and voluntary faculty and a supportive administration. • A full-time faculty actively involved in research and well-published in major peer review journals. • Competitive placement in post-graduate fellowship programs and private practice. • Hands-on laparoscopic, episiotomy, and suture training labs for residents. • One month of elective time during the third year of training. Rotation Schedule KEY: O – Obstetrics G – Gynecology ICU – Intensive Care Unit NF – Night Float AM – Ambulatory ER – Emergency Medicine V – Overlook Hospital E – Elective MSKCC – Memorial Sloan Kettering Cancer Center Departmental Organization The overall philosophy of the Residency Training Program in the Department of OB/GYN is to create an environment that provides formal instruction and constructive evaluation as well as increasing levels of experience and responsibility from the earliest levels of training onward. All patients -- whether service or private, including patients seen in the outpatient department, admissions, surgeries and deliveries -- are available for resident education. In addition, the Department strives to create an environment of research and scholarly activity that optimizes the academic efforts of all members of the Department and encourages a life-long commitment to the pursuit of knowledge. Downtown Hospital serves a culturally diverse population from Lower Manhattan including the many commuters and visitors to the area. In addition, patients are admitted from all over Manhattan, areas of New Jersey, Queens, Brooklyn, Long Island, Bronx and Westchester. Over 2,600 women give birth at the Hospital annually. Over 10,000 outpatients are patients are treated by the Department each year and over 5,000 surveillance tests and ultrasounds are performed in the Perinatal Diagnostic Unit annually. In addition to the many educational and clinical opportunities available within the Hospital itself, OB/GYN Residents obtain additional educational experiences from rotations outside the department. These include rotations in the first and second year in the outpatient internal medicine clinics, first year rotation in the ICU, second year rotation in the Department of Emergency Medicine and at Memorial Sloan Kettering Cancer Center, and a third year rotation at Overlook Hospital. In addition, third year residents are given one month of elective time where they may schedule an in-house or off-site rotation to complement their educational experience. Beginning in the first year of training, residents attend one half-day continuity clinic sessions per week in the outpatient clinics. These sessions consists of two to three residents and a supervising faculty attending. Attendings do not have other responsibilities or see other patients while supervising residents. Each resident follows his/her complement of patients under the supervision of a faculty attending. As residents advances in their training, the number of patients they oversee will increase. In addition to the continuity clinic sessions, residents will rotate through departmental specialty clinics including High-Risk Obstetrics, Urogynecology, Oncology, Breast, Perinatal Diagnostic Unit, as well as Reproductive Endocrinology and Infertility. The outpatient clinics are located on the Fourth Floor of the Hospital in a large, modern, renovated space adjacent to the Internal Medicine clinics. It is equipped with a procedure room, six examination rooms, two consultation rooms, and a conference space with library and computers. Procedures performed include colposcopy, LEEP, cryotherapy, endometrial sampling, complex cystometrics, cystoscopy, and office hysteroscopy. A mobile ultrasound with abdominal and endovaginal probes is available for use in each evaluation room. The Department employs a Night Float system to comply with the Bell Commission and the ACGME duty hour requirements. This improves the educational experience of residents while rotating on the various clinical rotations and services. Night Float is scheduled with two residents on a team. A fourth year resident is scheduled with a first year resident, and a third year resident is scheduled with a second year resident. PGY-1 First Year Residents First year residents rotate for four months in the Gynecology Service and four months in the Obstetrical Service. The fundamentals of diagnosis, work-up, management, anatomy, and physiology as well as appropriate consultation are emphasized. The first year resident actively participates in each service performing vaginal deliveries, cesarean sections, ultrasounds, and minor gynecology procedures such as D&C;, hysteroscopy, biopsy, polypectomy, laparoscopy, cerclage, and marsupalization. First year residents participate in and perform these procedures under resident and attending supervision from the first day of training. Additional rotations include two months in Ambulatory Medicine where residents function as active members of the Internal Medicine team, evaluating and managing outpatient medical conditions. Residents have their own panel of patients that they follow on this rotation. In addition, the first year resident rotate in the ICU as an integral member of the team, working-up and managing patients admitted to this specialized unit. PGY-2 Second Year Residents Second year residents expand upon their knowledge and proficiency in the diagnosis and management of obstetrical and gynecological problems. At this level, there is greater participation in both the basic and more advanced gynecologic procedures including hysteroscopic myomectomy, endometrial ablation, operative laparoscopy, and minor laparotomies. In addition, there is greater participation in basic and advanced obstetrical procedures including vacuum deliveries and difficult cesarean sections. A total of three months is spent on the gynecological rotation and three months on the obstetrical rotation. In addition to the fundamental rotations, second year residents spend two months on the Ambulatory Medicine rotation where they will function as active members of the Internal Medicine team, evaluating and managing outpatient medical conditions. An additional month is spent in the Department of Emergency Medicine. Residents will evaluate obstetrical, gynecological, and general medicine conditions while rotating through the ER and outpatient medicine clinics. Second year residents are introduced to Gynecologic Oncology while rotating for one month at Memorial Sloan Kettering Cancer Center in Manhattan. These residents function as integral members of the oncology team, learning the basics of managing gynecologic oncology patients including diagnosis and work-up as well as more intensive management, chemotherapy, and operative management. Residents work closely with attending physicians and fellows, assisting on the operative cases assigned to that oncology team. PGY-3 Third Year Residents Third year residents have more responsibility for the management of the obstetrical and gynecological patients and expand on their experiences from previous years with greater participation in more difficult cases and greater responsibility in managing and supervising the junior residents of the team. The third year residents rotate for two months on the Gynecology Service and three months on the Obstetrical Service. In addition to the core rotations, third year residents spend two months on the Ambulatory rotation working in various sub-specialty clinics including Urogynecology, Breast, Perinatal Diagnostic Unit, High-Risk, and Reproductive Endocrinology and Infertility (REI). Residents learn how to diagnose, evaluate, and work-up patients in these sub-specialty areas under the supervision of the specialist. Third year residents spend two months rotating at Overlook Hospital in Summit, N.J. where they function as the Chief Residents on all major and minor cases. In addition, residents will perform all cesarean sections and operative vaginal deliveries (forceps & vacuum) while on-call there. In addition, third year residents have a one month elective rotation of their choice to expand on a specific area of interest. This rotation may be performed either internally or at an outside medical center. PGY-4 Fourth Year Residents During the fourth year, residents will continue to enhance their diagnostic and management skills while assuming the responsibility as “Chief Resident”. During this year, residents will acquire the knowledge and skills necessary to function as an Attending in Obstetrics and Gynecology and to pass the oral and written OB/GYN Board examinations. As Chief Residents, fourth year residents assume greater responsibility in supervising and teaching the junior members of the team and students. It is not uncommon for the Chief Resident to function as First Assistant while taking the junior members through surgical procedures. Fourth year residents rotate for four months on the Gynecological Service and for four months on the Obstetrical Service. In addition, each Chief Resident rotates for two months on the Ambulatory rotation working in various sub-specialty clinics including Urogynecology, Breast, Perinatal Diagnostic Unit, High-Risk, and Reproductive Endocrinology and Infertility (REI). Residents improve their skills required to diagnose, evaluate and work-up patients in these sub-specialty areas. In addition, fourth year residents rotate through the Gynecologic Oncology Clinic where they are responsible for the outpatient, pre-operative, and postoperative management. Each fourth year resident is required to complete a research project to be presented on Resident Graduation Day. Faculty members assist in the selection, design, and interpretation of research project topics. After collection of the data, results are interpreted and compared with the study hypothesis. Past projects have been presented at national meetings and published in peer review journals. Curriculum The Department of OB/GYN is committed to providing a structured educational environment for residents through a comprehensive series of conferences and didactic lectures. This formal curriculum consists of lectures from Department and Hospital faculty covering a comprehensive list of topics in OB/GYN as well as primary and preventive care. This includes three hours of “blocked” lectures every Friday during which time residents are free from all clinical responsibilities. Topics include normal and high-risk obstetrics, oncology, urogynecology and pelvic support disorders, reproductive endocrinology and infertility, breast disease, operative gynecology, genetics, pathology, medical ethics and jurisprudence, and adolescent care as well as epidemiology and statistics. The curriculum is designed to repeat every two years. In addition to the didactic lectures, hands-on training courses with life-like models are available for suture and episiotomy training, as well as basic and advanced laparoscopic training labs. The educational experience includes: • Weekly Didactic Lectures • Fetal Surveillance Rounds / Obstetrical - Neonatal Case Conferences • Chairman's Conference • Reproductive Endocrinology & Infertility Conference • Journal Club • Tumor Board • “Lunch & Learn” Oncology Conference • Emergency Medicine Conference • Grand Rounds • Morning Report • Formal Service Rounds • Pathology Conference Research The program strives to enhance the educational experience of the residents by providing an environment rich in research and scholarly activities. The Department has a distinguished faculty with many of the members actively involved in both clinical and basic science research. Many faculty members have been published in peer review journals. Residents are taught the basics of epidemiology, statistics, data collection, and research. Residents develop the curiosity and skills needed to facilitate critical review of the medical literature and practice performance while applying this review to the improvement of patient care. During the PGY-4 year, residents are required to complete a research project to be presented on Resident Graduation Day. This project utilizes the skills and knowledge learned throughout the past three years in medical statistics and epidemiology. Review of the literature, formulation of a hypothesis, data collection, and interpretation as well as appropriate study design are important aspects of the project. The attending preceptor supervises residents on these projects; statistic evaluation or consults are obtained by a statistician. Many of these projects have been presented at major medical society conferences and have been published in peer review journals. Recent research projects include: • PCOS in the Asian Population • Randomized double-blind trial of active management of the third stage of labor • Pain Relief in Asian Obstetrical Patients: CLE vs IM Narcotics Recent publication topics include: • Endometrial brush biopsy for the diagnosis of endometrial cancer • Impact of exposure to polycyclic aromatic hydrocarbons from the world trade center on PAH-DNA adducts in umbilical cord blood and maternal blood • Complications after fertility-preserving radical trachelectomy • Clinical and patient estimation of fetal weight vs ultrasound estimation • Selective vessel ligation in the pelvis as a tool in certain surgical procedures • Possibilities for fertility restoration - new surgical technique • Hormone replacement therapy and breast cancer • Higher reporting of sexual dissatisfaction by female partners with male factor infertility • Fondaparinux combined with intermittent pneumatic compression vs IPC alone in the prevention of VTE after major abdominal surgery Faculty The Department of OB/GYN is comprised of a group of exceptionally skilled physicians from highly regarded medical centers throughout the country. The faculty is actively involved in teaching, research, and patient care. Each faculty member has a genuine interest in resident education and in promoting women's health care throughout the community. All faculty members are Board Certified or Board Eligible. Many have received awards for teaching excellence in resident education including honors from the Council of Resident Education in Obstetrics & Gynecology and the Award for Excellence in Teaching from the Association of Professors of Obstetrics & Gynecology. Residency Training Program Faculty: Ilona Brandeis, M.D., MPH, FACOG – Associate Chairman Mark Moradi, MD. – Director of Gynecological Oncology Boris Petrikovsky, M.D. – Director of Maternal Fetal Medicine William Huang, M.D., FACOG – Associate Director of Perinatal Diagnostic Unit Ilona Brandeis, M.D., MPH, FACOG – Grand Rounds Coordinator Christina Kong, M.D. – Quality Assurance Gynecological Review Lana Boter, M.D. - Quality Assurance Obstetrical Review Khaled Zeitoun, M.D. – Director of Reproductive Endocrinology and Infertility Shiu-Hung So, M.D. – Chinese Community Liaison Residency Training Program Coordinator Maria Pabon OB/GYN Attendings: Joseph Ahram, M.D. Lana Boter, M.D. Zhanna Fridel, M.D. Meredith Halpern, M.D. Allan Ho, M.D. Vanessa Pena, M.D. Anca Rosca, M.D. Sophia Wu, M.D. Raymond Wong, M.D. Benefits: In addition to the exciting educational opportunities provided at New York Downtown Hospital, residents experience a superior quality of life in a culturally diverse community of Manhattan. Benefits for residents include: • Highly competitive salaries • Subsidized housing adjacent to the Hospital • Free meals, uniforms, and laundry services • Four weeks of vacation annually • Full malpractice insurance is provided • Paid conferences • Stipend for books and educational materials • Resident lounge • Multiple departmental libraries • Convenient on-call facilities • Planned social activities including • Holiday Party - The department sponsors an annual holiday party in appreciation of its staff and residents. This party is held locally in downtown Manhattan • Graduation Party - The department sponsors an annual Graduation Day that includes presentation of research projects, invited visiting professor and a party held that evening. Residents, faculty, staff and family attend this event held in appreciation of the graduating chiefs and their families Career Placement Many of our graduates have attained sub-specialty fellowship training after completing their residency. Other graduates are either on staff at Downtown Hospital or remain locally within the New York area. Others have obtained faculty positions and private practice opportunities throughout the country. Recent fellowship appointments include: Mount Sinai Medical Center – Maternal Fetal Medicine University of Maryland - Urogynecology and Pelvic Reconstructive Surgery University of Southern California – Family Planning Montefiore Medical Center – Maternal Fetal Medicine Cornell Medical Center – Reproductive Endocrinology and Infertility University of Massachusetts – Maternal Fetal Medicine Application All residents are selected through the National Residency Match Program (NRMP). Candidates should apply through the Electronic Residency Application Service (ERAS). A limited number of candidates are selected for an interview. For further information, please contact: Maria Pabon - Residency Training Program Coordinator Phone: (212) 312-5880 Fax: (212) 312-5878 Email:[email protected] New York Downtown Hospital Department of Obstetrics and Gynecology 170 William Street New York, NY 10038 Podiatry Residency Internal Medicine Residency

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