Resident Training Program Objectives

The educational objective of the New York Weill Cornell Center residency program in Obstetrics and Gynecology is to have each graduate excel in the clinical practice of obstetrics and gynecology. The underlying theme of this academic department is that a clinical department should be excellent clinically. Training is thus broad-based, including a focus on primary care for women, but also encompassing exposure to the various sub-specialties within obstetrics and gynecology -- endocrinology and infertility, oncology, maternal-fetal medicine, urogynecology, pathology, and infectious disease. Every graduate is well prepared to provide preventive primary care for each patient . 

In addition to an emphasis on primary care, our graduates are equipped to serve as consultants in the care of women for other primary care physicians in Internal Medicine, Pediatrics and Family Practice. They receive a broad clinical exposure in all areas of Obstetrics and Gynecology. Residents gain experience in all three of the recognized subspecialties (Oncology, Endocrinology-Infertility, and Maternal-Fetal Medicine) at both of the institutions through which they rotate: a high level teaching community hospital (The New York Hospital Medical Center of Queens) and a world class tertiary academic medical center (New York Weill Cornell Center). 

Since July 1, 1990 there has been 24-hour in-house attending coverage of the entire service. These attendings are drawn from junior faculty and fellows. 

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This single document contains information about:

• Resident Training Program Goals
• Training Facilities
• New York Presbyterian Hospital Weill Cornell Center
• The New York Hospital Medical Center of Queens
• Resident Training Program Rotations
• Educational Conferences
• Resident/Faculty Evaluations
• Chief Resident's Day
• Frequently Asked Questions
• Application & Interview

Resident Training Program Goals 

The primary educational goals of the program are: 

1. To provide a volume of experience in obstetrics and gynecology, by way of a diverse clinical exposure, that will allow each resident to master his/her skills. 

2. To provide an extensive exposure to primary preventive care. 

3. To provide a state of the art knowledge and exposure to didactic teaching in all areas of clinical obstetrics and gynecology, including the subspecialties. 

4. To provide both an exposure to the extensive basic science and clinical research ongoing at our institution and the opportunity to perform research by the requirement of completion of one project presented at the end of the Chief year (PGY-4) at the Annual Chief Residents' Day. Understanding of research design, methodology and statistical analysis is thus necessary. 

5. To provide on-site supervision by experienced, board certified or eligible faculty in all areas of clinical Obstetrics and Gynecology, and in areas of primary care. 

6. To instill in each resident a long term goal of continuing self education. 

7. To provide a system of evaluation of residents and faculty that is dynamic and mutually beneficial. 

Training Facilities

New York Presbyterian Hospital Weill Cornell Center

The New York Presbyterian Hospital Weill Cornell Center opened a new state of the art hospital in May 1997. This new facility has been designed with improvements in the flow of patients in the areas of labor and delivery and the operating suites and recovery rooms that allow the residents to operate and run the respective services much more efficiently. This facility is built directly east of the previous hospital and is thus intimately connected to all of the areas where the residents must gain access with the exception of The New York Hospital Medical Center of Queens (NYHMC-Q). 
 

New York Hospital-Cornell Medical Center Faculty

The Department has a number of divisions, with appointed chiefs that are listed below: 

The in-patient teaching program is centered at the New York Weill Cornell Center; the service includes 68 beds divided between obstetrics and gynecology. The residents are divided into three teams: obstetrics, gynecology and oncology. The Obstetrics Service has five residents at a time: a service chief, three daytime junior residents (an intern, a PGY-2 on antepartum and a PGY-2 on labor and delivery) and a night float who covers from 6 pm to 8 am. There is also a night float chief resident who covers both obstetrics and gynecology at night. There are rounds every morning with the attending to review the service, as well as specialty conferences which include: perinatal, neonatal, ultrasound, ethics, genetics, quality assurance, fetal heart rate monitoring and a didactic lecture series. There were 5000 deliveries in the year 2001.

The Gynecology Service has seven residents at any one time: a service chief, four junior daytime residents and two night float residents who work 6 pm to 8 am five days a week. These various night float residents allow us to be in compliance with the NY State Resident Work Hour Guidelines as set forth by the Bell Commission. There are Attending Rounds three days per week, as well as Endocrine, Quality Assurance and a didactic lecture series. 

Operative gynecology is taught by both full-time and private attendings in the New York Weill Cornell Center operating rooms (as well as at NYHMC- Queens as detailed below). Two to three rooms of major cases and two to three rooms of minor cases run each day. Residents scrub on cases at all levels of training, with an attempt made to match their experience with the difficulty of the case. In addition, the residents have their own case load with attending coverage as described. Many of our cases are now handled in an active ambulatory surgery area. This includes a wide experience in operative laparoscopy and hysteroscopy including CO2, KTP and YAG laser procedures. 

The New York Weill Cornell Center Gyn Oncology Service currently has two residents at any one time. The chief resident on oncology performs all radical surgical procedures during his/her two-month rotation. The junior residents assist on these cases as well as take care of all inpatients on the service including any post operative patients with complications. There is a weekly Tumor Board. The oncology attending makes rounds every day. 

Endocrinology and infertility experience is obtained in three ways. During the ambulatory care rotation the chief residents run an endocrine/infertility clinic one session per week. In the Chief year, there is a dedicated block of time where the PGY 4 residents spend each day with an RE&I attending and fellow. In addition, all residents gain experience in laser surgery, microsurgery, and other endocrine/infertility procedures during their time spent in the operating rooms on the gynecology service. The Center for Reproductive Medicine and Infertility is the largest assisted reproduction program in the USA (approximately 1200 retrievals/year) and also encompasses a large ovulation induction program. The resident is actively involved in vaginal ultrasound scanning for infertility, management of fertility medications and learns the proper work-up for an infertility patient. There is an active fellowship in reproductive endocrinology and infertility with seven fellows. 
 

Primary Preventive Care

Education in primary and preventive care is provided by four months in outpatient medicine, one month in the Emergency room, and one month of Geriatrics. These six months are equally divided (two months each) into the PGY 1-3 years. All of these individual rotations are done in a block of one month each. 

The four months of outpatient medicine is spent working in the Cornell Internal Medicine Associates (CIMA), which is the Internal Medicine residency program's clinic. This clinic is supervised by a cadre of senior and junior attendings, all of whom are dedicated to the instruction of the residents, and see their own private patients in the same physical area. During the residents' time at CIMA there is an emphasis on primary care outpatient management. The residents will learn the essentials of the treatment of infectious diseases, hypertension, cardiovascular diseases, diabetes, asthma, common metabolic disorders and psychiatric, social and family issues. 

An additional month of outpatient medicine is spent at the emergency department of The New York Hospital Medical Center of Queens (NYHMC-Q), where the residents become knowledgeable in all aspects of the acute care of patients. This month functions as the one month of emergency medicine required within the six months of primary care instruction. The emergency room is part of the EMS network for New York City; a diverse patient population is attracted through this network, including rape cases. 

The last month is Geriatrics, which is designed to focus on both preventive care for the elderly and treatment of common medical problems from which elderly patients suffer. The geriatric rotation has included weekly sessions in osteoporosis, breast and urogynecology clinics. It is anticipated that next year's rotation will incorporate time at the New York Weill Cornell Center's new outpatient geriatric facility on the upper East Side. 

Ambulatory Obstetrics and Gynecology 

Education in ambulatory Ob/Gyn is provided through the Division of Women's Health and its busy clinic (over 18,000 visits per year). This past year this clinic has been restructured to provide almost entirely continuity care. Residents attend clinic sessions 1/2 to 1 day a week throughout their four years no matter which rotation they are on. Patients are scheduled to see their individual residents using a computerized system accessible throughout the hospital. Thus, a resident can make a follow-up appointment in his or her clinic for an ER patient right in the ER.

Specialty clinics are still held for colposcopy, high risk obstetrics, oncology, urogynecology and endocrine/infertility. Each chief spends two months supervising the clinic, running the specialty sessions and booking patients for surgeries to take place during the chief's subsequent Gyn rotation. 

The New York Hospital Medical Center of Queens (NYHMC-Q)

At NYHMC-Q there are four residents on the service at any time, one from each post-graduate year, including a chief resident for six months out of each year. The service includes obstetrics, high risk obstetrics, gynecology, gynecologic oncology, and the emergency room. The duties are apportioned each day by the chief resident. Residents are able to obtain a wide range of experience in primary care, obstetrics, high risk obstetrics, gynecology, oncology, infertility, and the management of patients presenting to the emergency room. Specifically, the volume and breadth of vaginal surgery and operative laparoscopic procedures provides a boost to the already large volume performed at the New York Weill Cornell Center. In addition, during the two months spent each year at NYHMC-Q, the residents are involved in both surgery and inpatient management of oncology patients with the gynecologic oncologists at NYHMC-Q. The residents who are on call at NYHMC-Q cover the emergency room and see every female patient who presents to the ER with abdominal pain. 

New York Hospital Medical Center-Queens (NYHMC-Q) Faculty

• Chairman - Gary Eglinton, MD
• Associate Chairman - Daniel Skupski, MD 
• Maternal-Fetal Medicine, Director - Daniel Skupski, MD 
• Gyn Oncology, Director - Dennis Yi-Shin Kuo, MD 
• Reproductive Endocrinology & Infertility - Tony Tsai, MD
• Outpatient Ob/Gyn Ambulatory Care - Steven Schuster, MD
• Residency/Student Programs - Wesner Thenor, MD 

Resident Training Program Rotations

The training program in Obstetrics and Gynecology is a four year program with increasing responsibility with each successive year. There are now 25 residents in the program with a plan to take 6 residents each year. 

PGY-1The first year resident will gain supervised skills in obtaining an outpatient history, perform a general physical examination, make diagnoses and formulate a plan of care for outpatient medical, obstetrical and gynecologic patients. In patient rotations in obstetrics and gynecology, and oncology are highly supervised to enable the candidates to gain triage skills in these areas, to learn the fundamentals of a general and pelvic examination and to develop diagnostic skills including Pap smear, obtaining cultures, do microscopic examinations, be instructed in intrapartum fetal heart rate monitoring and level one ultrasound. They will do a number of supervised procedures in obstetrics and gynecology. 

The PGY-1 rotation schedule is as follows: 

 Please note that it is the policy of the New York Weill Cornell Center that all residents be eligible for medical licensure in the State of New York at the completion of their first year of training. 

PGY-2

The second year resident will continue to upgrade the skills learned in the first year. They will have more detailed supervised instruction in colposcopy, fetal heart tracing evaluation and supervised care of more complicated obstetric and gynecologic patients. They will do more complicated supervised operative care in obstetrics and gynecology. 

The rotation schedule is as follows: 

 

9 weeks Obstetrics  1/2-1 day/week Ob/Gyn Continuity Clinic 9 weeks  Ob/Gyn-(NYHMC-Q)* 9 weeks Nights (gyn)  8 weeks  Gynecology 9 weeks High Risk Ob/Ultrasound 4 weeks Emergency Room -(NYHMC-Q)* 4 weeks Vacation

PGY-3
 

The third year resident will continue to hone the skills learned in the first two years. They will be the primary surgeon under supervision for uncomplicated major cases in gynecology (abdominal hysterectomy, myomectomy, etc.) 

The PGY-3 rotation schedule is as follows: 
 

1/2-1 day/week Ob/Gyn Continuity Clinic 9 weeks Ob/Gyn-(NYHMC-Q)*  9 weeks Nights (ob) 18 weeks Gynecology (including 1/2 days at Pathology during this time) 8 weeks  Ambulatory Medicine 4 weeks Geriatrics  4 weeks  Vacation

PGY-4

The fourth year residents will continue to hone the skills learned in the first three years. They will have the responsibility to determine the diagnosis and care for all patients on their service. They will supervise junior residents in uncomplicated deliveries and gynecologic procedures and will be the primary surgeon for complicated obstetrical and gynecologic cases. The PGY-4 rotation schedule is as follows: 

 

9 weeks Obstetrics 1/2-1 day/week Ob/Gyn Continuity Clinic 4 weeks  Ob/Gyn (NYHMC-Q)*  9 weeks  Nights 9 weeks Gynecology  9 weeks Oncology  8 weeks  Endocrine/Ob-Gyn Ambulatory  4 weeks  Vacation

Both the Obstetric and Gynecologic Services have a Day Team (7am-7pm) and a Night Team (6pm-8am). In the chief year, every service is covered by the service chief until 6 pm, when the night chief takes over. We are in compliance with the New York State regulations regarding residents' work hours.Basic Cardiac Life Support (BCLS) and Advanced Cardiac Life Support (ACLS) certification and continuing education in accordance with requirements of The New York Heart Association, Inc. is required.

All rotations are done at the New York Weill Cornell Center, unless indicated by (*) NYHMC-Q = The New York Hospital Medical Center of Queens 

Educational Conferences

There is full time staff participation in the subspecialty conferences, Quality Assurance conference, Grand Rounds, Resident Lecture Series, and Journal conferences. These conferences emphasize literature review and current research in the clinical areas under discussion. 

Grand Rounds (weekly) Link to Ob-Gyn NEWS
Quality Assurance Conference (weekly)
High-Risk Ob Conference (weekly)
Tumor Board (weekly)
Endocrine Conference (weekly)
Monitor Conference (weekly)
Resident Class (weekly)
Combined Neonatal Rounds (weekly)
• Gynecology Case Conference (weekly) 

Daily morning rounds on Obstetrics with Attending
Attending rounds three days per week on Gynecology
Genetics/Ultrasound Conference (weekly)

Resident/Faculty Evaluations

Twice a year each resident is formally evaluated in a meeting with the Program Director and senior faculty present. Each resident receives a written copy of the following items which form the basis of the evaluation: 

1. Written evaluations from the directors of each of the rotations in the prior year; the resident experience is discussed. 

2. Results of the CREOG exam (All residents are required to take the CREOG exam.)

3. Resident surgical experience recorded in our clinical database. 

4. Results of medical student evaluation of resident teaching 

At the end of each year of training, residents are asked to complete an evaluation form for each Faculty member with whom they have had contact during the academic year. 

Chief Residents Day

Each resident during the course of his/her four years must complete an original research project under the direction of a faculty sponsor. At the end of the Chief's year in June there is a "Chief Residents'/Alumni Day Program" at which these projects are presented and evaluated by a Visiting Professor. Full time faculty are involved in research and include the residents in projects regularly.

FREQUENTLY ASKED QUESTIONS 

Each year at our interview sessions, we are asked many of the same questions about our residents and the residency program. In an effort to answer some of these questions for you, we have prepared this sheet for your use. 

1. How many residents are there in the program and where do they come from? There are 25 residents in the program and, we plan to take seven residents (six through the Match, one outside the Match) for July 1, 2003. The current residents come from the following medical schools: 

If you would like the name and/or phone number of any these people, we would be glad to oblige.

2. What do the residents do after they graduate?

3. What happens at night? All services are covered by a night float team (Chief, PGY-3-OB, PGY-2-Oncology, PGY-1-Gynecology) from approximately 6 pm to 8 am five days a week. We are in compliance with New York State regulations regarding residents' working hours. 

4. How often do I go to clinic? Each resident attends their continuity clinic 1/2 day per week. Various rotations also incorporate specialty clinic time; for example, the antepartum resident attends high-risk OB clinic. During the course of the residency, the primary care months of outpatient medicine and geriatrics also involve 'clinic' time.

5. How much surgery do the residents get to do? On the Gynecology service, approximately 95% of operative cases have a resident as the primary surgeon or 1st assistant by both full-time and private attendings. Resident cases (clinic patients) constitute 15% of the surgery. At our most recent residency review, the average chief resident leaving the program performed 125 abdominal hysterectomies and 20 vaginal hysterectomies, plus a similar number of major cases that did not involve hysterectomy. There is also a high volume of major operative and laser laparoscopy cases. 

6. How big is the Obstetrics service and how many deliveries will I do? How about breeches and midforceps? We do 5000+ deliveries at the New York Weill Cornell Center. Twenty percent of these deliveries are clinic patients. Of the remaining private deliveries, about 25% are Cesarean Sections, all done by the residents. Of the remaining private vaginal deliveries, only about one-third are done by residents; this varies from attending to attending, and depends on the level of training of the resident. In New York City, it is just a fact of life (and malpractice) that private attendings are reluctant to give away deliveries. There are few vaginal breeches and few midforceps deliveries; this reflects the standard of practice in the New York area at a private hospital. There are six MFM full-time faculty and three MFM specialists on the private staff, as well as, three MFM fellows.

7. What about the Human Reproduction and Infertility service? There are nine attending physicians who specialize in reproductive medicine and infertility. Residents on the clinic service and the gynecology service work closely with the attending physicians. There is one RE+I clinic per week run by the fourth year resident with the fellow. There are many abdominal procedures, including laser and microscopic surgery. The department opened its IVF center, with office and OR space devoted exclusively to IVF, in September 1986. It is the largest and most successful IVF program in the United States, performing over 1200 retrievals per year. There are highly successful microfertilization and donor egg programs. Residents participate in the activities of the IVF program. There are seven RE + I fellows.

8. Are there rounds and conferences each week? The Residency Description you received in your folder today includes information on our weekly conference schedule. During the summer, Grand Rounds are suspended. Every Monday morning is resident class, a series of didactic lectures on basic topics in Ob/Gyn. This class is sometimes used as a general residents' meeting time.

9. How many faculty members are there? There are 35 full time members of the Ob/Gyn faculty who are Obstetrician-Gynecologists. They are available to you and are involved in your education on a full time basis. In addition, there are two Gyn pathologists, and a variety of other physicians who are involved in your education on your various outside rotations.

10. Are there fellowships, and how do fellows interact with the residents (do they steal my cases?)

Oncology - there are no fellows at New York Weill Cornell, chief residents perform the surgery 

MFM - one fellow per year at New York Weill Cornell; does not interfere with the chief residents on obstetrics

RE + I - seven fellows who share RE+I surgery as appropriate (about 1/2 done by residents, 1/2 by fellows)

11. I've heard about New York Weill Cornell Center housing - is it available to me? Subsidized housing is available, but no longer comes out of pretax dollars. Residents are not required to live in hospital housing.

Application & Interview

Dear Applicant: Thank you for your interest in our residency program in Obstetrics and Gynecology at New York Presbyterian Hospital Weill Cornell Center. The information above offers a general description of our training program. 

As you may know, all applicants for GME-1 positions in obstetrics and gynecology are expected to apply using the Electronic Residency Application Service (ERAS) from the Association of American Medical Colleges (AAMC) and the Educational Commission for Foreign Medical Graduates (ECFMG). You may obtain detailed information on the application process by contacting your Dean's Office or the Educational Commission for Foreign Medical Graduates (ECFMG) or by visiting the AAMC ERAS website.

We will accept electronic applications only. The deadline for applications will be November 1st. Your file will be considered complete and reviewed for interview when the following documents have been received:

Completed application form
Dean's letter 
Medical School transcript
Letters of Recommendation (at least 2) 

When completing your application please be sure to check the box indicating your request for electronic transmission of your licensure test scores. Also, please be sure to update your electronic application with any changes such as contact address, e-mail address, telephone number, or honors received. Interviews are held between December and January (exact dates to be determined). You will be notified via e-mail and/or surface mail whether or not you have been selected for interview. Please understand, however, that because of the large applicant pool, it will not be possible to interview everyone. If you have any additional questions please contact the Ob/Gyn Academic Office at cumc-obgyn@med.cornell.edu or call (212) 746-3058. Our fax number is (212) 746-8490. 

Sincerely, 

Colette Carmeris
Program Administrator 

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