Residency Program

Jennifer Hamm, MD, Program Director

We are dedicated to education. Our fully-accredited program is shaped by faculty members who are renowned and accessible—examiners for the American Board of Obstetrics and Gynecology, current and former presidents of national professional organizations, and physicians who have influenced the progress of American obstetrics and gynecology over the past decades. Our faculty are diverse in clinical interests, age, and geographic origin but are united by a dedication to training the next generation of obstetrician/gynecologists. Under the guidance of these leaders, you will perfect your diagnostic and treatment skills for the benefit of your patients.

We have a rich tradition of thoughtful surgical teaching at the University of Louisville (UofL). We maximize out-of-the-OR surgical learning so that time in the OR can be used to develop skills such as tissue handling and dissection that cannot be learned elsewhere. Our inanimate surgical lab is used to hone both laparoscopic and open surgical skills. UofL is a teaching site for the American Association of Gynecologic Laparoscopy courses, and you, our residents, have the continuing benefit of working throughout the year with the faculty members who teach these courses. First-year residents work with senior faculty on surgical techniques including knot tying, pedicle ligation, basic and advanced suturing, hysterotomy closure, fascial closure and advanced pedicle ligation. Second- and third-year residents attend a week-long endoscopic surgery course with fresh cadavers.

Our gynecologic surgery training is balanced by a challenging obstetrical experience on Labor and Delivery and in our outpatient clinics. We have a diverse patient population and large referral base that results in a broad range of clinical diagnoses and obstetrical conditions. Residents learn the management of routine and high risk obstetrical issues; ante, intra, and postpartum complications; spontaneous and operative vaginal delivery techniques; and cesarean sections. Residents receive training in maternal-fetal medicine, gynecologic oncology, reproductive endocrinology and infertility, and female pelvic medicine and reconstructive surgery by leaders in these sub-specialties.

In addition to our full time faculty, we are fortunate to have gratis clinical faculty who are deeply dedicated to postgraduate medical education. The time our residents spend with them offers an opportunity to expand their surgical experience while working in a community hospital environment. With them, residents are exposed to a vast array of gynecological procedures and cesarean sections.

Our obstetrics and gynecology residency program aims to:

Offer an educational environment that guides our residents in gaining the knowledge, confidence, and competence needed to be fully prepared upon completion of our program for the independent practice of obstetrics and gynecology or the pursuit of further training in the subspecialty discipline of choice.
Instill a life-long commitment to learning and the promotion of women’s healthcare.
Provide opportunities for residents to develop ethical, professional, and leadership skills.
Foster a desire to assist in the training of a new generation of medical students and residents.
Nurture a work ethic and spirit of mutual respect and camaraderie among colleagues on all levels of the health care team.

The resident's role

As a resident in our program you will have many roles - student, team member, teacher, professional. It is our mission to help guide you as you navigate your way through each of these roles, but you are expected to be an active member of this process.

You are a student. You are expected to take advantage of every learning opportunity. Be engaged during rounds. Ask questions. Learn from your missteps. Utilize the knowledge of your fellow residents, faculty, and nursing staff. Access the library resources that are electronically available in the hospital, at the medical school, or remotely from any computer. Attend weekly didactic sessions during protected time on Friday afternoons, and meet the goals and objectives for each of your rotations. During your residency, you are required to present one Grand Rounds’ topic and complete one research project. A faculty mentor will help guide you in selection, planning, and implementation of these projects. I encourage you to take advantage of the expertise of our research faculty.

You are a member of a health care team. Physicians, nurses, hospital staff, medical students, patients and families must work together to deliver the best possible patient care. Each member has special knowledge and training that is crucial to the success of the team. You are expected to use your interactions with team members to enhance your own education and understanding of patient care and the healthcare system as a whole. It is important to remember that in order to function efficiently, the team must show cooperation and respect among its members. As you move through your residency your role within the team will change, allowing increasing responsibility and leadership as your skills progress.

You are a teacher. Even as you are learning, medical students, patients, staff, and junior residents will look to you for answers. Often, residents have as much contact with medical students as the faculty. You are expected to serve as a role model for these students. Your behavior and enthusiasm for our specialty may be what inspires them to choose a career in ob-gyn.

You are a professional. You are expected to maintain the highest level of intellectual honesty and integrity, to treat others with respect, and to honor your responsibilities to your patients, colleagues, and society. This responsibility includes maintaining complete, timely, and accurate documentation in the medical record to allow for proper patient care, communication, and billing. Likewise, you are expected to enter electronically your duty hours and operative procedures on a weekly basis.

During your residency, you will learn the importance that each of these “roles” plays. Becoming an outstanding ob-gyn physician involves much more than learning the facts or becoming technically proficient. Being an outstanding ob-gyn physician involves incorporating every aspect of your education, each of your “roles”, into your daily interactions and activities, to use all that you have learned to continue to guide you on a path of life-long learning.

Our faculty are honored by the opportunity to guide the professional development and education of our next generation of specialists. We are committed to helping you achieve your ultimate career goal, whether private practice, academics, or the pursuit of fellowship training.

Rotation Overview

PGY1	PGY2	PGY3	PGY4
Obstetric Days	Obstetric Days	Antepartum	Obstetric Days
Obstetric Nights	Obstetric Nights	Gynecology Surgery	Obstetric Nights
Benign Gynecology	Ambulatory Surgery	Gynecology Oncology	Gynecology Oncology
Sonography	Gynecology Oncology	Pediatric/Adolescent	Gynecology Surgery
Ambulatory Clinic	Family Planning	Elective	Benign Gynecology
Gynecology Oncology	REI
REI	FPM&RS

Obstetrics Days
A resident from each post-graduate year trains on Obstetrics Days at University of Louisville Hospital (ULH), as well as a PGY-3 resident on the Antepartum rotation who cares for antepartum patients. Residents learn to triage patients, manage laboring patients, and perform deliveries, primary cesarean sections, circumcisions, and post-partum tubal ligations.

Obstetrics Nights
There are three residents on Obstetrics Nights: a PGY-1, PGY-2, and PGY-4. The week runs from Sunday night to Thursday night, with weekends free of any other duties. Changeover occurs at 5:30pm and again at 7:30am. During the night, the team manages all Labor and Delivery, triage, and any gynecology cases that present to the Emergency Room. The night residents have no other call or clinic responsibilities.

Benign Gynecology

The University Hospital gynecology team consists formally of three residents: a PGY-1, PGY-2, and PGY-4. However, the PGY-2 is assigned to the OPAS rotation (see below) which functions as a separate service. The PGY-1 and PGY-4 perform general gynecology examinations and consult on University Hospital. surgical patients who come to the service through clinics and private offices of the faculty attendings.

Outpatient Ambulatory Surgery

The PGY-2 resident on the OPAS rotation performs the outpatient ambulatory gynecology surgeries at the HCOC. Cases primarily consist of laparoscopy, hysteroscopy, conizations, tubal ligations, and other outpatient cases. The attendings on this service are nationally known for their laparoscopy skills and innovations.

Sonography
The one-month rotation during the intern year teaches basic ultrasound procedures (indications, technique, and principles) of a targeted fetal anatomy scan, Color Doppler, Doppler velocimetry, 3D/4D ultrasound, and gynecologic ultrasonography.

Ambulatory Clinic
The PGY-1 on the Ambulatory Care Clinic rotation sees patients in the scheduled new-obstetric-patients’ clinic and general ob/gyn clinic. Residents also receive directed education in formal ultrasonography.

Gynecology Oncology
The GynOnc team consists of one resident from each level of training. GynOnc is a busy service, as the University of Louisville draws from a large area including Louisville, Western Kentucky, and Southern Indiana. Residents are responsible for the pre- and post-surgical care of all patients and for those undergoing chemotherapy. All work is hospital based. The PGY-3 resident spends one half-day per week in the division director’s private clinic.

Private Gynecology Surgery
The Private Gynecologic Surgery service includes a PGY-3 and PGY-4 who operates at several area hospitals. During this rotation, residents assist during major surgical cases of the private physicians who serve as departmental gratis faculty members. In nearly all cases, the resident operates as the first assist or performing the majority of the surgical case functioning as the primary surgeon. The rotation mostly involves gynecologic surgery cases with a few obstetric operative deliveries. Surgical volume is high during this rotation, thus giving residents the opportunities to operate with different surgeons who share multiple viewpoints to familiar surgeries.

Reproductive Endocrinology and Infertility (REI)
During the REI rotations, in the first and second years, the resident works one-on-one with faculty in the Division of Reproductive, Endocrinology and Infertility, caring for patients who present for various infertility and endocrinology conditions. Residents gain operative experience in laparoscopy and hysteroscopy. The rotation is scheduled to follow the outpatient surgery rotation in which the resident learns laparoscopic skills.

Antepartum (High Risk Obstetrics)
During the PGY-3 year, the Antepartum rotation resident manages antepartum patients and participates in High Risk clinics, with some involvement in general Labor and Delivery care. The Antepartum resident participates in formal ultrasound training under the guidance of the Maternal Fetal Medicine sub-specialists.

Female Pelvic Medicine and Reconstructive Surgery (FPMRS)
The PGY-2 resident sees patients in the private attendings’ offices and clinics. During this rotation, the resident gains significant experience in the diagnosis, evaluation, and medical and surgical management of urinary incontinence and voiding problems, pelvic organ prolapse, and other pelvic and urinary dysfunctions. The resident works directly with the Female Pelvic Medicine faculty attendings and fellows during clinic and surgery.

Pediatric and Adolescent Gynecology(PAG)
During the third year of training, the resident rotates with two board-certified PAG physicians at a neighboring hospital and clinical office. Residents learn to address the physical and emotional needs of infants, girls, and young women in a gynecologic setting. Residents learn to treat bleeding disorders, vaginal/ovarian conditions; evaluate developmental delays; provide contraception counseling and evaluation; and test and treat for STDs.

On-call System

PGY-2, 3 and 4:

5 pm Friday – 8 am Saturday

8 am Saturday – 8 am Sunday

8 am Sunday – 5 pm Sunday

Night PGY-2 and PGY-4 cover from 5 pm Sunday – 7 am Monday and then from 5:30 pm –

7 am Monday, Tuesday, Wednesday, and Thursday.

PGY-1:

8 am Saturday – 8 pm Saturday

8 pm Saturday – 8 pm Sunday

8 am Sunday – 6 pm Sunday

OB Nights’ PGY-1 covers from 6 pm Sunday – 7 am Monday and then from 6:30 pm – 7 am Monday, Tuesday, Wednesday, Thursday, and Friday.

How to Apply

The Department of Obstetrics, Gynecology and Women’s Health participates in the National Resident Match Program through ERAS (Electronic Resident Application System). To be eligible for an interview, applicants must meet the following criteria:

A complete ERAS application
Three letters of recommendation and a Dean’s letter
Minimum score of 215 on Step I of the United States Medical Licensing Exam (USMLE)
Minimum score of 220 on Step II of the United States Medical Licensing Exam (USMLE)
Additional criteria for graduates of medical schools outside the United States and Canada:

These schools must:
- Be officially recognized in good standing in the country where they are located
- Be registered as a medical school, college, or university in the International Medical Education Directory
- Require that all courses be completed by physical, on-site attendance in the country in which the school is chartered
- Possess a basic course of clinical and classroom medical instruction that is
  - Not less than 32 months in length and
  - Under the educational institution’s direct authority.
The graduates must:

Have current valid certification from the Educational Commission for Foreign Medical Graduates (ECFMG)
Have had one to two years of allopathic clinical experience in the United States
Must be currently eligible for a J1 visa if accepted in our residency program

Interviews are extended to applicants who meet criteria following a review of all application materials.