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Program Highlights

Program

Uniquely combining the high surgical volumes of a large private hospital with a large resident clinic service (7,000 office visits, 800 deliveries), the Academic Obstetrics and Gynecology Program stresses continuity of care and an excellent ambulatory experience in a fully equipped resident office setting. Click on the following topics for details:

OBGYN Clinical Experience

Obstetrics

  • More than 4000 deliveries a year
  • Tertiary Care Center
  • Maternal Fetal Medicine presence in house - 3 full time faculty
  • Obstetric Emergency Department with Midwife staffing over 9000 visits per year
  • Single hospital in Michigan providing care to incarcerated women (this includes gynecologic care)
  • Above national average for cases obtained in operative assisted vaginal deliveries
  • Level IV NICU
  • Only hospital in SE Michigan that has Perinatal Certification

Gynecology

  • Well over 650 hysterectomies performed yearly with balanced blend of vaginal, laparoscopic and robotic techniques
  • Early surgical exposure with many residents obtaining ACGME minimum case numbers by late 3rd year and early 4th year
  • Subspecialists well represented on faculty with access to Family Planning rotation in 2nd year
  • Robust Pre-Operative conference promoting peri-operative planning
  • Graduates report ease in transitioning to independent surgical practice after graduation

Ambulatory Training

Our residency continuity clinic underwent extensive renovations in 2018-2019 and features 12 patient rooms, a dedicated procedure room (for colposcopy, LEEPs, hysteroscopy, etc.), and an antenatal testing room. Continuity clinic is not just a label but also a reality at the Academic Ob/Gyn Center (AOGC). All residents have the opportunity to schedule patients they see in the ED as consults for follow up visits in their weekly continuity clinic. Through our grouped prenatal care program (CenteringPregnancy) residents will see the same patients throughout the entirety of their pregnancy through delivery and postpartum. Along with the necessary clinical education needed to practice obstetrics and gynecology, our residents learn about coding, proper documentation, communication skills, and systems necessary to run an efficient productive office. Our clinic is committed to working with the underserved and has the ability to offer resources to our patients that include in-house Maternal Fetal Medicine, Urologic Gynecology, Minimally Invasive Gynecologic Surgery, and a full time social worker.

Research and Scholarly Activity

There are multiple avenues for research opportunities that residents can take advantage of during their training. It is a required aspect of resident education to take part in some form of research, and several of our current residents and previous graduates have worked on projects that have generated papers, posters, and presentations at local and national conferences. Below are just a few of the activities our residents and faculty have been involved in:

Awards

  • Get the Facts, Not the Flu: A Quality Initiative to Improve Influenza Vaccination Rates in Pregnant Patients – 1st place Winner of the Michigan QA/QI Summit 2020 - Authors: Kelsey Behan, Martha Walsh
  • Evaluating Trinity Health Ann Arbor's Diagnostic Criteria for Gestational Diabetes: A Quality Improvement Assessment – 3rd place Winner at the Michigan QA/QI Summit 2020 - Authors: Rachel Rezmer, Pooja Green

Prior Research Projects

  • Comparison of loneliness questionnaire for prenatal and postpartum patients as well as correlation with PHQ-9. - Dr. Kristen Duman
  • Effects of OB Surgical Home on SSI rates, analysis of risk factors for OB SSI. - Dr. Nathan Parker
  • CMV knowledge assessment before and after a focused assessment. OB/GYN attitudes and perceptions regarding CMV prevention. - Dr. Carter Anderson

Ongoing Research

Implementation of nursing protocols at Huron Valley to improve care of pregnant incarcerated women. - Dr. Deb Landis-Lewis

Identifying patients who are good candidates for a trial of IUI at the Gago Center for Fertility - Dr. Tina Chaalan

Prolapse recurrence rates after surgery with and without hysterectomy - Dr. Cydney Siggins

Hospital utilization and pregnancy outcomes for incarcerated patients – 10 year retrospective observational study. - Dr. Kelsey Behan

Descriptive study of semi structured in depth interviews by Food Gatherers looking at why individuals with self reported unmet needs in food security do not opt to receive assistance to address their need in the primary care setting. - Dr. Kelsey Behan

Development of PCOS Centering Groups - Dr. Kelsey Behan

Provider attitudes regarding same day discharge for minimally invasive hysterectomy - Dr. Nathan Parker

Retrospective chart review of EMBs showing “polypoid tissue” and “fragments of polyp” and subsequent evaluation/incidence of clinically relevant polyps. - Dr. Amanda Elbin

Anemia protocol development including ferritin screening and Fe transfusions - Dr. Bre Murphy

Identifying risk factors for recurrent pregnancy loss - Dr. Carter Anderson

Significance of perigastric echogenic foci on fetal ultrasound including patient outcomes and management. - Dr. Hailey Roberts

Factors predicting success for same day discharge - Dr. Galit Rudelson

Didactics

Residents have the opportunity to reflect upon and learn new information to complement their clinical education. Our protected time reserved for resident education includes Wednesdays from 3-5 p.m. and Thursdays from 8-10 a.m. Additionally, most services include 30min of time each morning devoted to reviewing practice bulletins, seminal journal articles and the major Obstetrics or Gynecology textbooks. These sessions provide up-to-date evidence-based knowledge in basic sciences, ethical principles, communication skills, professional development, sexuality, legal/business aspects of medicine, as well as preventative medicine.

Core Curriculum: Faculty direct our Core Curriculum lecture series. Core Curriculum follows the format of the CREOG educational objectives ensuring that our residents are apprised of all information necessary for a practicing obstetrician/gynecologist entering private practice or advancing to subspecialty training. Core time is dedicated to basic sciences, ensuring a deeply rooted medical education foundation on which to build throughout the resident's professional life.

Monthly Morbidity and Mortality: All reportable obstetrics and gynecology morbidities are discussed in a non-confrontational forum allowing for education of the entire department. In addition to learning quality management principles, the resident is challenged to act as a Monday morning quarterback by thoroughly assessing the patient care rendered and offering alternative strategies.

Journal Club: Journal Club provides a forum in which to learn the skill of critical appraisal of the literature. Residents learn the important lifelong skill of analyzing an article to determine if his/her practice pattern should change based on the author's findings. Journal Clubs are a favorite resident activity because of the opportunity to interact socially with faculty through lively intellectual discussions.

Maternal Fetal Medicine Rounds: While on the Maternal Fetal Medicine service, residents have the opportunity to be involved in genetic counseling for advanced maternal age, abnormal ultrasounds in pregnancy, and personal or family history of genetic disorders. Residents are also involved in performing amniocentesis and advanced ultrasonographic techniques. Most Fridays residents are able to participate in NICU rounds where the sequela of caring for high risk pregnancies is seen, allowing time to discuss with our neonatologists the nuances of early preterm deliveries. Finally, four Core Curriculum lectures are dedicated to genetic disorders and counseling as well as one Grand Rounds lecture per year.

Professional Practice Curriculum: To prepare for a career in medicine, young physicians need to acquire professional practice knowledge and skills. Our curriculum includes a series of in-depth educational experiences to allow residents an opportunity to incorporate these skills into their practices. Topics addressed throughout the four-year curriculum include:

  • Maintaining your professional credentials
  • Personal and family financial security
  • Total quality improvement
  • Healthcare policy and financing
  • Medical malpractice
  • Employment agreements
  • Medical practice economics

This educational series repeats every two years and blends the expertise of faculty with community professionals from the insurance, financial & estate planning, and legal professions. Residents also are offered the opportunity to spend elective time in the offices of local malpractice defense firms for first-hand exposure to the realities of medical malpractice.

Mock Oral Exams: Yearly mock oral exams provide an invaluable tool to assist the graduating resident in preparing for the American Board oral exam. The ability to think on one's feet is critical to passing the exam, but often is a learned skill. The mock oral exam at SJMAA is modeled after the American Board exam with three general areas tested, Obstetrics, Gynecology and Ambulatory Medicine. Each resident is examined by a total of eight faculty members divided into four thirty-minute sessions. Computer generated cases challenge the resident to develop patient management plans and to test their core medical knowledge. Residents receive written feedback from the faculty and meet with the Program Director to review their performance.

Student Interactions and Teaching Experiences

Residents, as well as medical students from the University of Michigan, Michigan State University, University of Toledo, Wayne State University, and PA students from Eastern Michigan University, play key roles in caring for all patients, including private patients. Professional camaraderie among residents, students, nurses and attending physicians is the rule, rather than the exception. A strong staff mentor system and quarterly evaluations provide feedback and support for resident progress. Mentors act as guides leading us along on our professional journey. The mentor/mentee relationship is an integral part of our resident's professional development and socialization into medicine. Interns choose a trusted faculty member to guide and support them during their residency training, often with this relationship extending years beyond training.