Residency Training in the time of COVID-19
We understand that the application process this year is both different and even more stressful than usual. We wish you could experience what we regard as the two exceptional strengths of our program. The first is the residents, and the community of people dedicated to making both their experience and their education as rich and fulfilling as possible. Our residents have always been our best ambassadors, so if you are interviewing with us, please, spend time with them and ask all the hard questions. Their satisfaction scores on national surveys are consistently well above median, and we are quite proud of this. Our second strength is our clinical volume. Last year’s Chief Residents had to stop doing elective surgery in March because of the COVID surge, and this did not change until after their graduation. Despite this pause in their training, all of our Chief Residents graduated above ACGME procedural minimums in every category. Our residents leave fully prepared to perform minimally invasive hysterectomies through multiple modalities including robotics. We do not expect this to change in the future.
A Strong Independent Academic Medical Center that Values Residency Education
WellSpan York Hospital's residency in obstetrics and gynecology is a four-year categorical program approved for four residents at each level. We are a regional medical campus of Drexel University, and a primary affiliate of Penn State, and Jefferson medical schools. Wellspan York Hospital is a tertiary-care and regional referral center, serving a population base of over 800,000 as part of the WellSpan Health System. York Hospital is an ACGME training site with continuing accreditation status, and has had an Ob/Gyn residency since 1944. Wellspan supports seven other residency programs and six fellowships. Medical students from several schools rotate here for both primary care and subspecialty clerkships.
Faculty and Leadership that make education their highest priority
WellSpan has made the commitment to residency education because it wants well trained physicians as part of its communities and organization. Many of the faculty, including subspecialists, did some part of their training here, and chose to stay or return. Every service is capable of functioning safely without residents, which is why we are able to offer educational time every week, in addition to several full day educational and community building experiences throughout the year. Our residents work hard, but our resident surveys confirm that they recognize that we are prioritizing education over service.
The OB/GYN Residency program is organized by the Program Director, Dr. Paul Burcher and Associate Residency Program Director, Dr. Patricia Reddy.
The teaching staff consists of four Perinatologists, two Reproductive Endocrinologists, three Gynecologic Oncologists, three Gynecologic Oncology Fellows, eight robotic surgeons, a laborist group, four clinic preceptors, three Urogynecologists, and a fellowship trained Adolescent/Pediatric Gynecologist. In addition, the residency program has 15 highly trained and dedicated clinical teaching faculty, six midwives, and two CRNPs.
Residency is a time during which patient care and education are occurring simultaneously. Residents have education sessions every morning as part of morning report, and a half day of protected teaching time every Wednesday. Two senior residents work with leadership to design and organize the teaching schedule based upon the CREOG 11th edition curriculum. We incorporate problem and case-based learning, skill sessions, multidisciplinary simulations, OSCE, journal club, and patient communication education sessions in our teaching methods. We have a robust boot camp curriculum for incoming residents to prepare them for functioning and learning efficiently in the clinical environment.
A Well-Balanced Approach to Quality Education
The first two years of residency concentrate on obstetrics and gynecology with rotations in obstetrics (3 months), gynecology (3 months) and night float (3 months). In addition, PGY-1 residents spend one month of critical care in an ICU setting, one month in special gynecology where they are introduced to pediatric and adolescent gynecology, breast surgery, and urogynecology, and a one-month introduction to maternal fetal medicine and ultrasound. In addition to obstetrics, night float, and gynecology, PGY-2 residents have rotations with time spent in REI, gynecologic oncology, family planning, urogynecology. In the program’s third year, emphasis is placed on the four subspecialties with two-months each in maternal fetal medicine, gynecologic oncology, REI, and urogynecology. There is also one month of research and elective. During the third and fourth year, residents spend one month each year doing a gynecologic surgery rotation at Chambersburg Hospital where they are able to focus on minimally invasive hysterectomies.
The final year of the program is divided between gynecology, obstetrics, ambulatory medicine, and elective time. The Chief Residents take on a supervisory and leadership role and assume full responsibility for the Obstetrics Service, Gynecology Service and Ambulatory Women's Health Clinic.
Exceptional Surgical Training
Our residents have exceeded ACGME minimums in most surgical categories before starting their last year of residency. First year residents gain significant surgical experience in minor gynecologic cases and cesarean sections. Second year residents increase their proficiency with laparoscopy, begin doing hysterectomies, and complete their robotic simulation training. Third year residents are performing open, vaginal and robotic hysterectomies, as well as more specialized urogynecology and oncology cases.
All of our graduating residents exceed the new standards for laparoscopic and vaginal hysterectomy, while still surpassing the previous, higher standard for open hysterectomies. Our surgical volume continues to exceed our capacity to cover every surgical case with a resident, so residents have some flexibility in tailoring their surgical experience to their own future plans. For surgical patients from the resident outpatient site, the residents do the workup leading to the decision for surgery, and with the attending physician, decide on the surgical approach. During these cases, the chief resident truly acts as a teaching assistant taking a junior resident through the surgery in most cases.
Empowered Residents with a Voice
Our residents are involved in decision making regarding their residency education at every level. Residents help design the two-year rotating didactic schedule, plan the educational activities of morning report, and lead problem-based learning sessions. Monthly resident business meetings are an opportunity for residents to suggest changes in the residency and identify problems.
Each year residents spend a half-day with faculty doing a deep dive into the residency experience and provide input for larger residency projects and changes. Residents write both the call schedule and assign the operating room schedule each week.
Residents sit on numerous hospital committees in quality improvement, ethics, and graduate medical education, as well as local, state and national medical committees. We support our resident participation in these activities as it establishes a pattern of engagement that we hope will continue throughout their careers.
Comprehensive Outpatient Experience
Over 13,000 outpatient visits in the residents’ state of the art clinic provide a vast range of clinical cases and resident experience. Residents are responsible for the ambulatory and follow-up care of their own service patients, who are a diverse group, spanning the age spectrum. Residents attend continuity clinics during all four years. Visit types and lengths, as well as level of responsibility are tailored to the PGY level. Four dedicated attending preceptors provide graduated supervision and support.
Office procedures such as colposcopy, LEEP, hysteroscopy, and ultrasonography (with one-on-one teaching with a certified ultrasonographer), along with subspecialty patient panels including high risk OB (with MFM attending supervision), gynecologic endocrinology and urogynecology allow our residents to be fully prepared for future ambulatory practice.
Diverse Inpatient Experience
Our inpatient teaching service provides care to both resident service and attending faculty patients. Our annual deliveries average 3100, with about 600 deliveries on the residents' service. Ob/Gyn residents manage all the patients admitted to Labor and Delivery, working with laborists, WellSpan physicians and midwives. The dedicated laborist faculty team is in place to aid resident teaching and learning, and to manage the more high risk patients with MFM consultation when needed. WellSpan York Hospital has a Level IIIB NICU, caring for the most complex neonatal problems including extreme prematurity.
A Strong Academic Foundation Enhances the Resident Clinical Experience
Every resident has a faculty mentor chosen based upon their interests and future career goals. Residents who identify an interest in fellowship training work with their mentor on research projects and other scholarship to build their CV for a fellowship application.
A Clinical Research rotation and curriculum is in place, and a Ph.D.-level Clinical Research Specialist is available to assist with teaching and performance of research and quality improvement projects. The Department of Obstetrics and Gynecology also conducts an active research program, with residents encouraged to become involved in ongoing research and required to participate in at least one research project during their four years of training. In the 2019-2020 academic year for example, the faculty and residents had multiple peer-reviewed publications, book chapters, and national presentations.
Opportunities for Advocacy, Medical Service, and Global Health
WellSpan supports a Global Health curriculum in which many residents choose to participate. This includes two years of monthly meetings, followed by two trips to a medically underserved area. Currently available placements include a surgical elective in Ghana (working with board-certified US trained Ob/Gyns, so the experience counts toward residency surgical experience), or working in an Indian Health site. Residents are also encouraged to seek out other clinical experiences in medically underserved communities during their three months of elective rotations.
Our residents are also involved in community health outreach and education, as well as legislative advocacy both at a state and national level. One senior resident is asked to coordinate advocacy activities each year, and the residency leadership is supportive of this by developing flexible schedules on days where a significant number of residents are participating in an advocacy project.
A Supportive Environment
Despite its large size, WellSpan York Hospital provides a friendly backdrop for your residency. The sense of community is real; a resident can expect supportive relationships among each other and with teaching faculty. The residents and attending physicians socialize throughout the year including yearly scheduled events such as a welcoming picnic for interns, a Christmas party, a winter retreat, and a graduation party.
As part of our commitment to placing education first, residents are expected to only perform tasks that require a physician’s training. Ancillary staff perform blood draws, IV starts, EKGs and patient transports.
The WellSpan health system uses a single electronic medical record (EPIC), and resident evaluations are logged and reported using the myTIPreport website and app.
Are you a Match?
Candidates likely to be ranked highly in our application process are graduates of US or Canadian medical schools, allopathic or osteopathic, with good class standing, and strong letters of recommendation. Board scores should reflect an ability to pass future exams for board certification but are not a major factor in our selection process. Our residents work and play well with others and tend to be engaged members of the medical and larger community. While many of our graduates have gone on to subspecialty fellowships, we are proud to train obstetric and gynecologic specialists who are interested in clinical or academic practices. Regional ties are great, but we are also happy to have the opportunity to convince you that Central Pennsylvania should be your home for years to come.