Obstetrics & Gynecology
At A Glance
Program Type: Military Medical Center
Location: Bethesda, MD
Accredited: Yes, Accreditation Council for Graduate Medical Education (ACGME)
Program Length: 4 years
Required Pre-Requisite Training: Medical School Graduation, if prior completed internship in GS&O, may start at PGY2 level with approval but if completed other internship, would still need to complete 48 months (4 years) of GS&O training
Categorical Year in Specialty Required: Yes
Total Approved Complement: 24
Approved per Year (if applicable): 6
Dedicated Research Year Offered: No
Medical Student Rotation Availability: 4th year
Additional Degree Concurrent with Training (e.g. MPH): No
Program Description
The National Capital Consortium (NCC) Residency in Gynecologic Surgery & Obstetrics (GS&O) proudly cares for service members and their dependents at the Walter Reed National Military Medical Center (WRNMMC). As the only tri-service GS&O program within the military, our resident physicians serve in the Army, Navy, and Air Force. Our faculty similarly represent all military services and the civilian sector, allowing for incredible breadth of mentorship and experience. The academic environment is further enhanced by working among fellows from four separate fellowship training programs on-site, as well medical students from the Uniformed Services University of Health Sciences (USUHS).
In addition to being the only tri-service GS&O residency, the NCC GS&O department is also home to several tri-service GS&O fellowship programs, including Urogynecology, Gynecologic Oncology, Reproductive Endocrinology & Infertility and Minimally Invasive Gynecologic Surgery. Our fellowship programs are also affiliated with civilian institutions such as NIH and Inova and are combined military-civilian fellowships.
Mission, Vision and Aims
Mission
Our mission is to foster a scholarly, supportive environment and promotes excellence in education, research, healthcare delivery, personal well-being, and leadership development.
Vision
Our vision is to graduate world-class, military obstetricians and gynecologists who care for active duty or retired service members and their families. As America's military officers and physicians, we are dedicated to upholding the ethical values, integrity, and standards expected of those devoting their lives to public service.
Aims
- Foster an atmosphere and community that is supportive and conducive to learning and professional growth.
- Support high quality and evidence-based care while creating an environment that promotes research and quality improvement initiatives.
- Recognize the needs of diverse trainees and patient groups and the importance of providing culturally-sensitive medical education and patient care.
- Develop and train exceptional physicians who are leaders in the military and in women’s health care.
- Provide a framework where trainees can have graduated autonomy and progress through milestones to ultimately obtain a comprehensive skillset in gynecologic surgery and obstetrics and graduate ready for independent practice anywhere in the world.
Curriculum and Schedules
Our program has several weekly didactic sessions:
- Morning report every Monday, Wednesday, and Friday mornings from 7 - 7:30 a.m. to discuss interesting cases or short topics.
- “Beta book” on Tuesday mornings from 7 - 7:30 a.m. to review patients that need ongoing follow up for ectopic pregnancies, pregnancies of unknown location, and molar pregnancies. This conference is followed by Gyn team academics before clinic starts.
- Preoperative conference on Thursday mornings 7 - 8:30 a.m. with all the Gynecology teams to review upcoming surgeries.
- Obstetric didactic sessions on Thursday mornings 7 - 7:30 a.m. for the OB team.
- Resident academics is protected time on Thursday afternoons from 1 - 5 p.m. This academic schedule rotates between a monthly Morbidity and Mortality conference, OB and GYN simulation sessions, various lecture topics (including resident presentations and faculty presentations). Topics include a variety of bread and butter OB and GYN topics, subspecialty topics, DEI, and military/leadership/professionalism topics. Several M&M conferences per year are multidisciplinary and include colleagues in Pediatrics/NICU, General Surgery, Anesthesiology, and Radiology. We also have a quarterly Radiology conference run by the OBGYN and Radiology residents to review imaging on specific GS&O topics. We have a journal club several times per year as well during didactic time. Approximately quarterly, this didactic time is used for resident and faculty wellness events.
- Each subspecialty service has their own didactics that includes resident on those respective rotations.
1st Year | 2nd Year | 3rd Year | 4th Year |
---|---|---|---|
OB Days | OB Days | REI | GYN |
Gyn Onc | Gyn | MIGS | Gyn Onc |
REI | Kaiser OB Days | ATAMMC GYN | ATAMMC GYN |
Night Float | Night Float | MSK Gyn Onc | OB |
Gyn | Urogyn | OB | Night Float |
VHC OB Days | VHC OB Days | Night Float | Urogyn |
PEDS/US | Inova Maternal Fetal Medicine | ||
ER | VCU Family Planning |
Elective rotations are available for residents who desire one. Some elective that residents have taken in the past include an NIH research elective (longitudinal over the course of a year), subspecialty rotations at other military hospitals and clinics or federal sites, local electives at the home institution, and additional months on existing rotations to obtain extra exposure. Note that civilian elective rotations may be limited by liability coverage availability.
We use a night float system for Sunday through Thursday nights where a 2-3 person resident team is in house for a shift. They cover Labor and Delivery, any inpatients admitted to GS&O services, consults from the ER and other inpatient services, and transfers/consults from other area military hospitals or clinics. Friday night through Sunday evening is covered by other residents not on the night float block in 12-24 hour shifts. These call shifts are in-house and are scheduled to ensure residents stay within duty hour limits.
- In addition to local-GME level military specific training opportunities, we incorporate military-specific mentorship through a variety of avenues within the program. Residents meet with service-specific faculty leaders during protected academic time at a quarterly interval. Topics during these blocks of time include service unique requirements (online training, proper wear of the uniform and customs/courtesies, leave-processing, officer evaluation reports, service-specific fitness requirements, military pay topics, etc.).
- Guidance is provided on setting career goals, seeking unique service opportunities (i.e. service on the USNS COMFORT, Air Force New Horizons missions, etc), pursuing sub-specialty GME training, etc...
- The residents also meet with their service-specific PD and/or APD semi-annually (at a minimum) for career guidance, the pursuit of unique military experience (i.e. The Female Physician Leadership Course), feedback on military specific performance (fitness performance, leadership potential, volunteer hours, etc.).
- The program also actively maximizes surgical experiences and well as office-based procedural experiences specific to women's health issues. We also incorporate the unique challenges to Women’s Health in military medicine into case discussions, such as at morning report and preop conference to ensure residents graduate with the ability to care for military women and their families in any environment.
The following training are required once during training (unless otherwise specified):
- Emergencies in Clinical Obstetrics (through ACOG) every two years
- Fetal Monitoring every two years
- Neonatal Resuscitation every two years
- Simsei laparoscopic simulation modules (through the PGY2 year)
- DaVinci robotic training modules (prior to Minimally Invasive Gyn rotation in the PGY3 year)
- Institute for Healthcare Improvement Quality training
- EMIGS (replacing Fundamentals of Laparoscopic Surgery) certification (by the end of PGY3 year)
- ACOG Liability modules
- Combat Casualty Care Course (for Army and Navy Trainees) or ATLS
We have a robust simulation curriculum that includes Obstetrics and Gynecologic simulations. We have access to simulation center at Walter Reed, Forest Glen, and USUHS. We have monthly simulation sessions during didactics that alternate between OB and GYN sessions. These sessions include hands-on training with high fidelity and low fidelity models, standardized patients, and team-based drills. The facility also hold regular team-based drills on the Labor and Delivery unit.
In addition to the local leadership resources through the GME office, the program also weaves leadership training into everyday teaching. Over the course of their training, residents are expected to have graduated autonomy in patient care. This includes leading the clinical team during the course of care in the clinic, Labor & Delivery, and in the operating room. Additionally, our residents are encouraged to take on leadership roles at the program and hospital level as well as a national level. Many of our residents are involves as Junior Fellows officers through our Armed Forces District of ACOG and other national medical organizations.
Scholarly and Professional Development Opportunities
Residents are expected to complete at least one research project during their training. Interns present a case report during Annual Intern Research Day within the department in the fall. PGY2-4 residents are expected to produce at least one original contribution of scholarly activity from one of the following options:
- Basic science study
- Prospective study (cohort, controlled trial, RCT)
- Retrospective cohort / case control
- Cross sectional or other epidemiologic study
- Meta-analysis/review
- Primary leader of a Quality Improvement project with a finalized formal report.
- This original QI Project must be separate from the mandatory QI Team project as part of the GS&O Program QI Curriculum.
Due to our multiple associated fellowship programs, affiliation with USUHS, and partnership with the NIH, resident have ample opportunity and support to participate in research projects. Funding is available for resident to attend and present at national meetings if they have projects accepted for presentation. Residents regularly attend our Armed Forces District meeting through ACOG, the ACOG Annual Clinical Meeting, and other society meetings such as Society of Gynecologic Surgery (SGS), American Association of Gynecologic Laparoscopists (AAGL), Association of Professors of Gynecology and Obstetrics/Council on Resident Education in Obstetrics and Gynecology (APGO/CREOG), American Urogynecologic Society (AUGS), Society of Gynecologic Oncology (SGO), Society of Maternal Fetal Medicine (SMFM), and American Society for Reproductive Medicine (ASRM).
A series of lectures on Quality Improvement are part of the Academic curriculum. Residents are also expected to participate in Quality Improvement initiatives during their training. The baseline requirement is to participate in a project with a senior resident in the first half of training and to lead their own project as a senior resident.
This project is expected to be presented at the program’s Annual Robert C. Park Resident Research Day in Gynecologic Surgery and Obstetrics. Many residents have completed multiple projects during their training and have presented these projects at national meetings and published their project in peer-reviewed journals. A few examples of recent projects include compliance with aspirin recommendations in pregnancy, allergy testing protocols for penicillin-allergic pregnant women, Prep guideline knowledge and implementation, wellness initiatives, resident education initiatives (recently on topics such as DEI curriculum, clitoral anatomy, and female genital mutilation).
There are a number of professional development options for residents through the local GME office, including those for interns. Going out to GMO tours, rising chief residents, and graduating chief residents.
In addition, our program focuses on professional development throughout the course of residency. It is woven into clinical practice and case discussions on a regular basis. Additionally we have didactics topics a few times a year specifically focused on professional development. Chief residents are also eligible to attend USUHS Faculty Development courses. Military service-specific professional development is also covered during quarterly didactic sessions with a mentor from each branch of service. These sessions include a focus on leadership and career advancement both in the military and in academic medicine.
Participating Sites
- Walter Reed National Military Medical Center (WRNMMC) - home site
- Alexander T. Augusta Military Medical Center (ATAMMC)
- Virginia Hospital Center
- Holy Cross Germantown (Kaiser)
- Inova Fairfax (Maternal Fetal Medicine)
- Memorial Sloan Kettering (Gynecologica Oncology
- Virginia Commonwealth University (Family Planning)
Applicant Information, Rotation and Interview Opportunities
Medical student rotation options generally involve a 4-week rotation. We split this rotation into two 2-week blocks where students can rotate on Labor and Delivery, the Gynecology service, Urogynecology, Gynecologic Oncology, Reproductive Endocrinology and Infertility (REI), Minimally Invasive Gynecologic Surgery (MIGS), and Maternal Fetal Medicine (MFM). While rotating, each student will also have an opportunity to present an evidence-based topic to the department at morning report.
We offer in person interviews during the rotation for any applicant who is doing a rotation with us. For all other applicants, we provide virtual interviews. During the interview, applicants have an opportunity to meet current residents and faculty. A resident team will provide a program presentation at the start of the interview session to provide information about the program and answer questions in a low-key environment.
Program graduates take the American Board of Obstetrics and Gynecology (ABOG) or the American Osteopathic Board of Obstetrics & Gynecology (AOBOG) exams. The ABOG qualifying (written) exam is offered annually in July.
After passing that exam, each exam candidate then collects a 12-month case list. The certifying (oral) exam is also offered on an annual cycle in the fall and is based on this case list. The AOBOG written exam is offered annually in April/May. The AOBOG oral exam is offered biannually in the spring and fall but does not require a case list from the candidate.
Teaching Opportunities
Residents have the opportunity to teach medical students from the USUHS during the clerkship as well as small group and hands-on skill teaching in the non-clinical years. Additionally residents have the opportunity to teach both USUHS and HPSP students during their 4th year audition rotations. Residents can become a teaching fellow within the department at USUHS and can apply to be an Assistant Professor in the department at USUHS once they graduate from residency.
Other teaching opportunities include cross-program education to residents in other programs within the National Capital Consortium as well as to other military residency programs through ACOG and in particular the Armed Forces District of ACOG.
Faculty and Mentorship
We have subspecialty educators and fellows at the main institution in Urogynecology and Reconstructive Pelvic Surgery, Gynecologic Oncology, Reproductive Endocrinology and Infertility, and Minimally Invasive Gynecologic Surgery. Additionally, we have subspecialty faculty in Maternal Fetal Medicine. Beyond the home institution, we have outside rotations with faculty in Maternal Fetal Medicine, Gynecologic Oncology, and Complex Family Planning.
The program has a formal mentor program in place and utilizes “speed mentoring” to help residents identify at least one faculty mentor. Residents are encouraged to have more than one faculty mentor for various goals. For example they may have a faculty mentor specific to the uniformed service they are in as well as a subspecialty faculty mentor for a subspecialty in which they would like to do fellowship. In addition to the formal mentorship program, most residents also have several informal faculty mentors they will go to when needed.
Well-Being
Our program has monthly wellness activities and supports each resident in taking individual wellness weekdays off once per quarter. Our program level wellness activities include regular sessions during protected academic time, such as in-house group activities and local field trips.
Faculty also cover all clinical duties for one weekend annually in June to allow for a resident retreat. Part of our program wellness includes a “House Cup” program where each resident is sorted into a House with a faculty and residents in varying year levels in each House. Each House earns points based on quiz scores, wellness activities, and excellence in clinical care. Results are tallied throughout the year and the winning House at the end of the year earns a trophy for that year.
Contact Us
Obstetrics & Gynecology Residency Program
Location: Walter Reed National Military Medical Center, Building 9, 2nd Floor
Monday–Friday
7 a.m. to 4:30 p.m.
Phone: 301-295-2045
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