Residency Program

Subspecialties in Obstetrics and Gynecology

Maternal-Fetal Medicine

The Division of Maternal-Fetal Medicine cares for patients with pregnancies at increased risk of adverse outcome. After being identified as appropriate candidates by their referring physicians, both private and service patients are accepted onto the High-Risk Obstetrics service at any time during the gestational period. Each second-year resident spends two months on this service at The Mount Sinai Hospital, and each third-year resident spends two months on this service at Elmhurst Hospital Center.

Weekly high-risk and gestational diabetes clinics are staffed by the residents under the direction of the Maternal-Fetal Medicine fellows and faculty. Other activities performed on the High-Risk Obstetrics service include Level II ultrasound examinations and invasive fetal diagnostic and therapeutic procedures. Depending upon the nature of the procedure, the resident on service performs, observes, or assists in these activities. Postpartum high-risk patients are followed in a special clinic to ensure further continuity of care for those requiring ongoing medical services.

The resident is part of a high-risk team comprising full-time attendings in maternal-fetal medicine, fellows, full-time social workers, and nurse-educators. The entire team makes rounds each morning to discuss all patients on the service and to review the ongoing care of high-risk outpatients. The resident has ample opportunity to discuss cases in depth with the attendings on service.

Several regularly scheduled perinatal teaching conferences enhance resident education. These include monthly maternal-fetal medicine and pediatric pathology conferences, weekly maternal-fetal medicine and neonatology conferences, and weekly maternal-fetal medicine and genetics conferences.

Reproductive Endocrinology

The Division of Reproductive Endocrinology encompasses a wide array of clinical and research activities. Clinical activities include over 600 assisted reproductive technology cycles per year and over 200 surgical procedures for the diagnosis and management of reproductive disorders. An active research program is currently pursuing investigations into oocyte fertilization, implantation, and embryo-endometrial interaction.

During the four-year program, residents attend and assist in the presentation of conferences on selected topics in endocrinology and infertility. They also diagnose, admit, care for, and assist in or perform operative laparoscopy and other surgery. In the general obstetrics and gynecology clinics, residents are able to provide continuing care and follow-up for women with infertility problems or endocrine disease, receiving direct supervision and consultation from fellows and attendings in the Division.

A two-month rotation in the Division of Reproductive Endocrinology is provided at the third-year level, when residents attend endocrine and infertility clinics each week. Here they follow and manage patients under the direction of the division’s attendings. Residents also rotate through Mount Sinai’s in vitro fertilization program in its brand-new state-of-the-art facility.

Opportunities are available during the reproductive endocrinology rotation for residents to attend thyroid and other medical endocrinology clinics and conferences, and to participate in the many research activities of the Division.

Gynecology Oncology

Residents gain experience in gynecologic oncology by rotation through the Gynecologic Oncology service during two two-month blocks, once in their first year, and again in their third year. During these times the resident cares for patients with gynecologic cancer, under the direct supervision of the gynecologic oncology fellows and attendings. In addition, the resident attends specialized clinics, including the gynecologic oncology clinic and the colposcopy and dysplasia clinic.

Approximately two dozen inpatients are on the Gynecologic Oncology service at any one time. The first- and third-year residents scrub on all surgical cases with the oncology fellows and attendings. Weekly multidisciplinary conferences are held in which the management of all patients currently under treatment for gynecologic cancer is coordinated with radiation oncologists, pathologists, social workers, nurses, and other specialists.

Fourth-year residents utilize the resources of the Division of Gynecologic Oncology for the management of complex patients on the General Gynecology service. In addition, these residents may perform or assist in surgical procedures too advanced for the first- or third-year residents. During the fourth-year, residents attend the colposcopy and gynecology clinics.

Urogynecology and Pelvic Reconstructive Surgery

The Division of Urogynecology focuses on disorders of the lower urinary tract and pelvic floor. Chief Residents participate directly in the care of private patients and direct the care of a growing population of clinic patients who suffer from problems such as urinary incontinence, lower urinary tract symptoms, and pelvic organ prolapse. Under the supervision of the faculty, residents are taught how to diagnose and treat these problems, using a variety of objective and subjective tools, including simple and complex urodynamic testing and a variety of minimally-invasive and transvaginal surgical techniques. Once residents have demonstrated competence and expertise in this area, she or he takes charge of the weekly clinic session and has the primary role in appropriately guiding the therapeutic choices of their patients, in anticipation of their approaching development into Attending Physicians. An interdisciplinary approach incorporating the Departments of Urology and ColoRectal Surgery is currently being implemented. In addition, there are ongoing opportunities for clinical research and training in research study design and implementation