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Rotations & Call

2018/2019 Rotations

Obstetrics 3 months
Gyn/Gyn-Onc 3 months
Night Float 2 months
Specialty Clinic 3 months
PAG, REI, HROB, Breast, CPP Longitudinal
ICU/ED 1 month
Obstetrics 4 months
Gyn/Gyn-Onc 3 months
Night Float 2 months
Specialty Clinic 2 months
REI, FPMRS, Path, CPP, HROB, Family Planning Longitudinal
Elective 1 month
Obstetrics  2 months
Joepardy: Procedures, Clinic, Ob leadership 1 month
Night Float 2 months
Specialty Clinic Experience 3 months
FPRMS, Onc, Family Planning Longitudinal
Kaiser Walnut Creek (Benign gyn with L&D call) 3 months
Elective 1 month
Obstetrics Chief  3 months
Benign Gynecology Chief 3 months
Gyn-Onc Chief 3 months
SFO Clinic and South San Francisco Minimally Invasive Surgery 3 months

NOTE: Family Planning training at UCSF occurs in all PGY2-4 Specialty Clinic rotations and at Kaiser San Francisco on Benign Gyn Surgery; Care of transgender occurs in specialty clinic assignments for PGY1-4.

Call Schedule & Rotation Descriptions

Call Schedule

Night Float: 5:30 PM – 7AM Monday-Friday; 7:00 PM – 7AM Sunday. Goal is to assign two “golden weekends” each rotation.

In preparation for night float, interns will meet for short call with chief residents in order to review OB emergencies, antepartum admissions and other night float pearls.

Saturday Call: 7 AM – 7 AM (the only regularly scheduled 24-hour call for PGY 2-4; PGY 1’s have 12 hour duty shifts on Saturday call)

Sunday Call: 7 AM- 7:30 PM (2 residents cover L&D/Gyn/ER)

Call assignments are made to be in full compliance with ACGME Duty Hour Guidelines. There are some holiday and Friday 24-hour calls for PGY 2-4’s when covering for NF.

Senior residents round on respective in-patient services (ante-partum; gynecology and gyn-onc) on weekends.

Calls and non-night float duty shifts in San Francisco
Total Average Calls/Yr/Resident 24hr Calls 12hr Fri-Sun Calls
PGY4 8 13
PGY3 7 14
PGY2 11 19
PGY1 6 24

PGY1

Obstetrics:  Interns perform vaginal deliveries, vacuum deliveries, and cesarean sections. They learn to evaluate fetal wellbeing using internal and external fetal monitors, oxytocin stress tests, non-stress tests, biophysical profiles, and ultrasounds for growth. They also become familiar with epidural and spinal anesthesia methods. Interns join the other Labor & Delivery residents in making postpartum rounds each morning, and also actively co-manage patients admitted with antepartum complications.

Gynecology:  Interns perform most minor procedures, such as dilation and curettage, laparoscopic tubal ligation and diagnostic laparoscopy. They also have the opportunity to scrub with other residents on more advanced surgical cases First year residents learn to provide pre- and post-operative care for patients with both benign and malignant gynecologic conditions. Interns carry the gynecology consult phone, allowing them to evaluate patients in the emergency room.

Outpatient clinic: These three months provide an introduction to the outpatient practice of both generalists and sub-specialists. Interns establish their own continuity clinic, with a focus on providing gynecologic care. They also spend time in teen clinic, procedure clinics and a special clinic devoted to providing gyn care to breast cancer survivors at UCSF. There is focused attention to REI, Chronic Pelvic Pain, ultrasound and breast.

Medicine (wards & ICU): Interns spend one month on internal medicine wards and one month in the intensive care unit. These months provide valuable insight into managing complex patients, as well as giving interns the opportunity to build relationships with internal medicine staff and residents.

Night Float:  During these two months, interns truly master how to “run the board” on Labor & Delivery, as well as manage a busy triage. By the end of intern year, most interns have done nearly 200 vaginal deliveries and 70 cesarean sections (both primary and repeat).

PGY2

Obstetrics: The second year residents run the labor and delivery floor under the supervision of the senior resident and the staff physician. They perform more difficult cesarean sections and operative deliveries and manage more complicated antepartum patients. They also share in the responsibility for teaching medical students.

Gynecology:  Second year residents learn to perform abdominal hysterectomies and myomectomies, operative laparoscopy, and diagnostic hysteroscopy and cystoscopy. They develop more autonomy in evaluating ER patients, with the support of senior residents and staff.

Clinic:  Residents begin to see prenatal patients and also do a greater number of procedures in their continuity clinics. They spend more time rotating through specialty clinics, with focused attention to urogynecology, reproductive endocrinology, chronic pelvic pain clinic, ultrasound and pathology. Residents have ample opportunity to gain expertise in family planning at a special clinic at the Women’s Option clinic at UCSF Mt. Zion.

Elective: This month is an excellent opportunity to explore one’s special interests within Ob/Gyn. Residents have chosen to learn obstetrics and gynecology through travel to different countries, working in specialty clinics in San Francisco, or rotating through US based facilities. Please see Elective.

Night Float: Second year residents care for the gynecology patients overnight and see all emergency room patients. This provides them with the opportunity to perform urgent gynecologic surgeries if the need arises. They also continue to play a key role in managing Labor and Delivery.

PGY3

Obstetrics: Residents care for increasingly complicated antepartum and laboring patients, and assume more teaching responsibilities for junior residents. Residents also have the opportunity to perform cerclages and amniocenteses.

Gynecology: Three of the four months on gynecology are spent at the nearby Kaiser Permanente Medical Center in Walnut Creek. This allows the resident to perform a large number of diverse gynecologic surgeries including vaginal, abdominal and laparoscopic hysterectomies, incontinence procedures including TVT and TOT, and prolapse procedures such as vaginal repairs, abdominal sacrocolpopexies and colpocleises.

Clinic: Senior residents continue to manage their continuity clinics while also attending specialty clinics, including colposcopy. There are also month long separate rotations in Urogynecology and REI with our sub-specialists.

Elective: During the one-month elective period an effort is made to provide additional exposure to some aspect of interest in our specialty. The elective may be spent in the outpatient department, at another Kaiser Permanente Medical Center, at a university with an approved residency program, or at an international site arranged by the resident.

PGY4

During this unique year, fourth years assume the role of “chief” for 3-month blocks of time on the four services listed below. They meet weekly with the program director to discuss the state of each service and focus on resident training, strategizing together about any problems that arise. Chiefs also plan the resident retreat, a consistent highlight of the year.

Obstetrics:  Chiefs are responsible to the staff for all admitted antepartum, laboring, and postpartum patients; for teaching junior residents and medical students; and generally assuming responsibility for the service. They attend Maternal Fetal Medicine clinic weekly. In the operating room, they perform cerclages and amniocenteses and staff junior residents through cesarean sections with the supervision of staff physicians.

Gynecology:  Chiefs assume responsibility for all pre- and postoperative patients and other gynecology inpatients; for teaching junior residents and students; and for performing the most complicated gynecologic surgeries. They organize a weekly preoperative conference, and are responsible for coordinating morning teaching.

Gynecologic Oncology: Chiefs work very closely with the busy gynecologic oncologists. They assist to provide clinic preoperative care, operate on all gynecologic oncology patients and are responsible for the work-up and postoperative management of these patients. They are also responsible for monthly presentations at tumor board.

Clinic:  Residents serve as administrative chief residents during the three months of the clinic rotation. They organize daily teaching for the clinic and gynecology residents and schedule all resident and medical student clinics. Approximately a third of the time the chief is at South San Francisco performing benign surgical procedures, mostly advanced laparoscopic hysterectomy and vaginal hysterectomy.

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