The program employs a four-year curriculum based on the recommendations of the Council on Resident Education in Obstetrics and Gynecology (CREOG) of the American College of Obstetricians and Gynecologists, as well as those of the ACGME. As a resident, you will be involved with clinical rotations in a variety of subspecialties, continuity and subspecialty clinics, research, and didactic lectures.
Clinical Rotations
With six residents per year, each rotation is approximately eight to nine weeks long, unless otherwise noted below. Clinical experience takes place at Mount Sinai Morningside and Mount Sinai West. These hospitals are both on the Upper West Side of Manhattan and easily accessible to each other, within three miles. Transportation between the hospitals is provided; housing is near Mount Sinai West. As the hospitals have been affiliated with each other since 1979, most physicians work at both sites. Mount Sinai West is home to thriving services in both obstetrics and gynecology, while Mount Sinai Morningside, a trauma center, has a busy gynecology service but no labor floor. Full consult services are available at each hospital.
PGY-1 Rotations
The first year is an overview of the basics and the breadth of obstetrics and gynecology. Clinical skills and experiences are introduced in a stepwise fashion, starting with simulation of basic procedures during orientation, and progressing to more complicated surgeries by the end of the year.
- Obstetrics (two rotations)
- Benign Gynecology (two rotations)
- Emergency Medicine (two weeks)
- Reproductive Endocrinology (four weeks)
- Neonatology/NICU (one week)
- Pediatric and adolescent gynecology
- Ultrasound (one week)
PGY-2 Rotations
The second year moves beyond the basics of obstetrics and gynecology. During the maternal-fetal medicine (MFM) rotation, residents work closely with MFM fellows and subspecialists to coordinate inpatient and outpatient care of complicated pregnant patients. On the labor floor, second-year residents expand their surgical skills by progressing to complicated cesarean sections.
On the gynecology rotations, residents expand their surgical skills, including laparoscopy. During this time, residents also begin to take an active role in managing complex problems such as ectopic pregnancy and ovarian torsion. To complement these expanding skills, gynecologic oncology and family planning are introduced this year. The family planning service is a regional referral site and allows residents to provide care for complicated family planning patients. Residents become proficient in surgical and medical abortion, contraception management, and sterilization procedures.
- Obstetrics (two rotations)
- Benign Gynecology (two rotations)
- Maternal-Fetal Medicine
- Gynecologic Oncology
- Family Planning
- Transgender Medicine and Surgery
PGY-3 Rotations
During the third year, residents gradually take on more responsibility on the labor floor with support from the chief residents and attendings. Having completed the maternal fetal-medicine rotation, the PGY3 is now ready to manage chronic and acute complications on the labor floor. Gynecology also expands on the previous two years of experience and introduces more complex operative experiences. PGY3 and 4 have a focused ambulatory experience that provides an intensive experience that mimics the outpatient experience of an attending generalist and subspecialist..
The third year also includes flexible time for a global health rotation and an elective that is scheduled based on the resident’s interest.
- Obstetrics (two rotations)
- Benign Gynecology (two rotations)
- Ambulatory
- Global health or elective
- Research
PGY-4 Rotations
In the final year of residency, the depth and breadth of clinical skills is expanded and the chiefs take on a leadership role. Chief residents are given autonomy to manage their own services under the supervision of an attending. This also includes an active role in mentoring and teaching their junior residents. The chiefs take the lead in managing the most complex inpatients on both obstetrics and gynecology, especially on the gynecology oncology service.
- Obstetrics (two rotations)
- Gynecology (two rotations)
- Gynecologic Oncology
- Ambulatory
Night Float Rotations
All residents participate in a night float system that adheres to the ACGME work-hour rules. Night float is assigned in two-week blocks to minimize fatigue and personal life disruptions. When not on nights, residents take call on weekends. All residents have an average of two weekends off per month.
Rotation in Global Health
The Division of Global Women’s Health is committed to expanding access to health care and medical training worldwide. The division is one of the first programs in the United States to offer a preparatory course in global health for residents. Residents within the Mount Sinai Health System are encouraged to participate in an elective rotation at an affiliated resource-limited site, either within or outside the United States.
Ambulatory Experience
Through the Continuity Clinic, residents have the opportunity to follow the same group of patients through their four-year residency. Beginning in the first year, this clinic is a constant in the residents’ weekly schedules. Assigned patients remain under a resident’s care until graduation. The clinical experience spans all aspects of obstetrics and gynecology.
In addition to our continuity clinics, we have a full spectrum of subspecialty clinics. These include colposcopy/oncology, reproductive endocrinology, high-risk obstetrics, family planning, and urogynecology clinics. Residents rotate through these clinics in parallel to their inpatient experience. Subspecialty faculty supervise and teach during these clinics.
Teaching Conferences, Didactic Lectures, and Simulation
Tuesday mornings include five hours of protected academic time devoted to resident education. These include a mix of simulation activities, problem-based learning, traditional lectures, and wellness activities.
Wednesday morning begins with patient safety and quality rounds: presentations of the department’s clinical statistics and interesting cases, conducted on a rotating basis by the heads of the subspecialty divisions. The second hour is Grand Rounds: lectures on topics pertinent to women’s health care, featuring speakers who are nationally or internationally known.
Other highlights include:
- Journal Club, which meets once a month to discuss articles pertinent to the specialty and to review research methods, including study design and statistical concepts
- In the second and third postgraduate years, a monthly meeting to facilitate the planning and execution of the required research project
- Additional teaching conferences and rounds held by each clinical division on a weekly or daily basis
- Weekly chapter review sessions supervised by faculty, during each clinical rotation; these reviews cover topics in the rotation’s assigned reading from major textbooks and pertinent journal articles
- One-on-one obstetric simulation sessions, each year, with our maternal-fetal medicine faculty. These sessions take place in our state-of-the-art simulation center on our birthing simulators, life-sized, motorized manikins of a pregnant woman. The simulation scenarios allow residents to practice the management of normal labor, operative obstetric techniques, and rare, life-threatening complications, such as shoulder dystocia and postpartum hemorrhage.
- Access to practice surgical skills on state-of-the-art laparoscopic simulation equipment at Mount Sinai Morningside, Mount Sinai West, and Mount Sinai Beth Israel, in structured sessions with gynecology faculty and independently. Through our laparoscopic simulation curriculum, we prepare residents for the Fundamentals of Laparoscopy certification.
Research
Throughout the residency experience, we encourage and support participation in research studies. To further facilitate, we retain a full-time medical writer, statistician, and an epidemiologist. In addition, we provide an annual seminar on research study design and statistics. In recent years, many residents have completed several projects, presenting results at national or local meetings, in peer-reviewed publications, at the medical school’s annual Research Fair, and at the department’s annual Research Day.
During the second and third years of the program, residents conduct a research project. To facilitate this, our research faculty members meet regularly with the residents to aid in the planning and execution of their studies. The final presentation is delivered at our annual Resident and Fellow Research Day and feedback on the project is provided by a visiting professor of distinguished background. Research is evaluated by principles of study design and statistical analysis, practical development of research objectives and time allocation, and quality of public presentation.
Advising and Evaluations
As a class, residents are assigned a set of advisors to continue with them through all four years of residency. This advising system is designed to provide continuity of support and guidance. The residents and their advisors meet regularly, away from the hospital and workday, to discuss progress in residency. Individual residents also find mentors with specific clinical or subspecialty interests, but the advising system is a constant, designed to build camaraderie within the class and guide residents as they mature through the program.
We are committed to evaluating our residents on the six core competencies developed by the ACGME. After each rotation, the relevant division director and faculty complete milestone-based evaluations. To gain a better understanding of the whole picture of the resident, we perform 360-degree evaluations, soliciting feedback from nurses, ancillary staff, patients, and students. Residents also review the faculty, the rotations, and each other anonymously, via a web-based program. The program director and faculty advisors review evaluations twice annually. We take into consideration every resident’s strengths and specific career goals. Our goal is to make sure everyone graduates with a core of skills and knowledge, but beyond that, we aim to foster each individual’s interests and strengths.
Residents have a strong voice in the development of the residency program’s curriculum and structure. There are three chief residents each year: two administrative chiefs, who focus on scheduling and resident teams; and one education chief, who focuses on the didactic curriculum. The residency program holds quarterly meetings in which all residents participate; in these meetings, we reassess the curriculum and work to make positive changes. Beyond input into our program, there are many opportunities for residents to have a voice in their education and work experience: union representatives, patient safety committees, clinic task force, wellness committee, and graduate medical education committees. We take pride in our program’s inclusive, flexible atmosphere and work to make the residency experience a great one for every resident.
Upon graduation, residents are prepared to enter any subspecialty fellowship program in obstetrics and gynecology, or to begin practicing as general obstetrician-gynecologists. Each year, we have a mix of graduates entering fellowships, faculty, or private practice. To learn more, see the list of our graduates.