University of Washington ObGyn residents participate in normal and high-risk obstetrics rotations at three sites:
University of Washington Medical Center
The University of Washington Medical Center (UWMC) is a tertiary -are facility and delivers approximately 2,200 low and high-risk patients per year. The UWMC Obstetrics L&D team is comprised of R1, R2, and R4 ObGyn residents on day and night rotations (see sample schedule and objectives). An additional antepartum team is comprised of R2 and R3 ObGyn residents. (insert link to OB schedule/objectives document) Residents participate in evaluation and management of every patient in the labor and delivery unit including triage, postpartum, the labor suite and antepartum. Residents work extensively with ObGyn generalist educators and Maternal-Fetal Medicine (MFM) faculty and have daily informal resident teaching during board rounds and walk rounds. The formal obstetrics curriculum occurs in the context of high risk clinics, Grand Rounds, Morbidity & Mortality conference and journal club. The resident didactic series, which is repeated in 2-year cycles, covers aspects of maternal physiology, obstetric ultrasound and medical complications. The low-risk weekly OB didactic schedule covers normal labor, operative deliveries and common medical complications of pregnancy. A multi-disciplinary weekly neonatology/fetal therapy conference covers additional genetics and ultrasound topics.
Continuity clinics at Harborview Medical Center (HMC) and Women's Health Care Center on Roosevelt (WHCC) provide education and experience managing normal low-risk pregnant patients in a longitudinal outpatient setting. Residents care for high-risk pregnancies at the Maternal Infant Care Clinic (MICC) located at the UWMC with direct supervision by Maternal-Fetal Medicine faculty and fellows. Residents have significant exposure in these clinics to women with diabetes, hypertensive disorders, maternal medical complications and fetal anomalies.
Ob and Gyn ultrasound training is currently being performed at the UWMC as part of the inpatient and outpatient obstetrical services, in addition to other clinical sites. Ultrasound performance cards are completed by residents and verified by the faculty and include a complete first trimester pregnancy assessment, second/third trimester ultrasound including fetal biometry, cervical length and limited anatomy.
UWMC is also the home of a surgical simulation lab (ISIS) with a dedicated ObGyn Resident Surgical Simulation Education Program (SSERP). These modules include obstetric emergencies, hemorrhage, operative deliveries and episotomy repair.
Swedish Medical Center
Swedish Medical Center is a tertiary care facility in downtown Seattle with a large volume labor and delivery unit. UW ObGyn residents rotate at Swedish Medical Center as R3s for 8 weeks and work primarily with the private Maternal-Fetal Medicine group but may also perform deliveries with the Labor Suite hospitalists and other private ObGyns. Residents typically perform 20-30 vaginal deliveries, 30-50 cesarean deliveries and additional procedures such as operative deliveries, amniocentesis, cerclage placement and surgical pregnancy termination for fetal anomalies or demise. Additional training in performing and interpreting obstetrical ultrasound is an important educational objective of this rotation.
Yakima Valley Memorial Hospital Medical Center
Yakima Valley Memorial Hospital is a community medical center approximately 90 minutes east of Seattle. In Yakima, R2s and R3s rotate for four weeks with a group of community ObGyns who are dedicated to the education of our residents. Local housing is provided for residents rotating in Yakima. The Yakima site provides a "bread-and-butter" ObGyn experience for our trainees with significant volume of both obstetric and benign gynecologic procedures. In 2010-2011, on average, each resident performed 40 spontaneous vaginal deliveries, 37 cesarean deliveries and 8 operative deliveries during these rotations. Additionally, our residents serve as consultants for the family medicine residents and gain ambulatory ultrasound experience. The Yakima rotation consistently receives among the highest number of excellent resident rotation ratings of all the rotations in our program. The Yakima valley is also well known for access to outdoor recreational and activities related to the large number of vineyards and wineries.