Obstetrics and Gynecology Residency

Welcome to the Department of Obstetrics and Gynecology at Cooper University Hospital!We are excited at the opportunity to meet you, and hope that your visit is both gratifying and informative. The following summary of our residency program is designed to provide you with an overview of the excellent clinical and academic experience gained at Cooper University Hospital. We anticipate that when you meet our dedicated faculty, residents, and administrative staff, you will realize the true strength of our program. We wish you much success as you begin your career as an Obstetrician and Gynecologist, and hope that we can share this journey together.

Obstetrics
Residents are exposed to normal obstetrics at Cooper University Hospital. The residents rotate on the obstetric service for three months each in PGY’s 1, 2, and 4. Additional exposure to obstetrics occurs on the night float rotation for three months during PGY’s 1 and 2, two months during the PGY 3, and 1 month during the PGY 4. The PGY 2 resident also participates in a one month outpatient rotation with a generalist experiencing obstetrics in a private practice. Resident experience on the obstetric and night float rotations involves evaluation and management of all patients presenting to Labor and Delivery. Their exposure includes, but is not limited to, triage, labor and delivery, and postpartum. There were approximately 2200 deliveries and approximately 4200 triage visits last year at Cooper University Hospital. Up to fifty percent of the deliveries performed at Cooper are from the resident’s Continuity of Care Clinic. Additionally, yearlong exposure to normal obstetrics takes place at the Women’s Care Center, where each resident provides weekly continuity outpatient prenatal care.

Teaching rounds on the Obstetric service at Cooper Hospital occur daily involving the residents and faculty. These rounds include a morning and evening board review of the patients admitted to Labor and Delivery. Additionally, a structured rounds takes place on the postpartum floor with the covering faculty and obstetric team.

Twice a month, an interactive obstetric morning report conference led by the chief resident on the obstetric service provides a forum for the clinical review and discussion of obstetric patients and related topics. These conferences are well attended by faculty and often lead to a lively discussion of alternatives in patient management. Individual teaching sessions occur between residents and faculty during the discussion of management regarding every obstetric patient seen on both an inpatient and outpatient basis. The weekly didactics round out the formal teaching of normal obstetrics via faculty lectures, monthly fetal monitoring strip reviews, and presentation and discussion of obstetric text chapters, and ACOG practice bulletins and prologue questions.

Maternal Fetal Medicine
The resident gains experience in high risk obstetrics during rotations in Maternal Fetal Medicine (2 months in PGY 3, and 1 month in PGY 4). They also gain experience in high-risk obstetrics during rotations in Obstetrics at Cooper University Hospital, since over 50% of the admissions to Cooper’s Obstetrical Units are High Risk. As a Regional Perinatal Center, Cooper University Hospital receives the majority of the maternal transports from the entire Southern NJ Region. While on the MFM Service the resident is exposed to the management of high risk inpatients in the Maternal Intermediate Care Unit (MICU), Maternal Advanced Care Unit (MACU), as well as out-patients in the High Risk Clinic at Women’s Care Center. The resident is also exposed to high-resolution fetal ultrasound, including 3-D and 4-D ultrasound, vaginal ultrasound and antepartum fetal assessment, including amniocentesis, CVS and PUBS, in the Antepartum Diagnostic Center.

There are daily attending rounds with a Board Certified Maternal Fetal Medicine attending. These teaching rounds stimulate the discussion of interesting cases and review the management plans developed by the resident. There is also a High Risk Conference after each High Risk Clinic run by an MFM attending, where a multidisciplinary team discusses the management of patients and interesting MFM topics. The Division of Maternal Fetal Medicine also provides frequent didactic education on Friday afternoon at the resident didactic session.

Gynecology
Residents receive extensive experience in operative gynecology at Cooper University Hospital. Residents rotate on the gynecology service for two months during PGY 1, one month during PGY 2, and three months in the PGY 4. The PGY 2 and 3 residents spend two and one month respectively rotating in gynecology at Mercer Hospital in Trenton. This rotation provides vast exposure to specialty and general gynecologic surgery. Currently, PGY’s 2, 3, and 4 on the night float rotations perform additional operative gynecology at Cooper. The PGY 2 also spends a one month rotation with a generalist in their private office participating in outpatient gynecology procedures and same day surgeries.

The gynecologic experience involves preoperative evaluation, conducted on both an emergency basis and through the weekly Preadmission Testing and Colposcopy clinics. Also, the residents perform such outpatient procedures, as LEEP, Hysteroscopy, and Cryoptherapy in the Women’s Care Center. The residents participate in all surgical procedures as either the primary surgeon, or the assistant, depending upon the complexity of the case and their level of training. Last year, this experience totaled approximately 1800 major and minor operative procedures. In addition to participating fully in faculty and attending cases, the residents have weekly dedicated available OR block time for cases generated from the PAT clinic and Colposcopy clinic.

Teaching of operative gynecology occurs on many levels at Cooper University Hospital. Each morning, the gynecology team makes teaching rounds on every postoperative patient with assigned rotating faculty. Additionally, individual teaching occurs intraoperatively, appropriate to the residents’ level of training, with topics generally covering anatomy, preoperative evaluation, and operative management. A bi-weekly interactive morning report, devoted to gynecology topics, led by the chief resident, stimulates clinical and academic discussions with faculty through case management reviews. The weekly didactic teaching session incorporates review of gynecologic topics through faculty lectures, text chapter reviews, and discussion of ACOG publications and prologue questions.

Gynecology/Oncology
Cooper Hospital has the largest Gynecologic Oncology service in the Delaware Valley and provides the residents with extensive exposure to gynecologic malignancies. PGY 2 and 3 residents rotate for two months per year, while PGY 1 and 4 residents spend one month on the Gynecologic Oncology service. The Cooper residents function as chief of the service and oversee and manage a team composed of rotating Ob/Gyn residents from neighboring institutions, and medical students.

Residents are exposed to all aspects of care provided for those with gynecologic malignancies. These range from preoperative evaluation, to operative and postoperative management, to administration of chemotherapy, and associated complications. The rotation also includes weekly outpatient experience at the Oncology clinic in the Women’s Care Center.

Resident teaching about gynecologic malignancies is vast and multidisciplinary in nature. Operative cases and attending rounds provide opportunity for daily teaching on current clinical topics. Rounds are expanded on a weekly basis to include input from the nursing and social work staff. A weekly conference, with attendance by all the Gynecologic Oncology faculty and faculty representatives from the Department of Pathology, focuses on the pertinent pathology and clinical management of all current inpatients with gynecologic malignancies. Additionally, a monthly, hospital wide tumor board incorporates all aspects of care required by those with malignancies.

Female Pelvic Medicine and Reconstructive Surgery
The Division of Female Pelvic Medicine and Reconstructive Surgery provide the residents with experience in urinary incontinence and pelvic floor dysfunction. This experience is enhanced by the presence of an approved three-year fellowship in Urogynecology at Cooper University Hospital, which last year accounted for approximately 300 surgical procedures related to incontinence and pelvic reconstruction. The PGY 3 and 4 residents each rotate exclusively for one month per year on service, and are exposed to the full complement of services related to the assessment and treatment of incontinence and pelvic floor dysfunction. The residents rotating on the gynecology service gain operative, postoperative and outpatient urogynecology experience during the months when there is no assigned resident on service. The Urogynecology experience is primarily hospital based, focusing on operative and postoperative care. However, a weekly Urogynecology clinic in the Women’s Care Center, and resident participation in sessions at the private attending office, provides ample opportunity for office evaluations and detailed urodynamic testing.

The formation of the fellowship in Female Pelvic Medicine and Reconstructive Surgery has greatly enhanced the academic experience for the residents. The Division holds a monthly journal club, which provides a forum for the discussion of current literature, related to the study of incontinence and pelvic floor dysfunction.

Additionally, the residents are exposed to the research projects of the fellows and have the opportunity to participate in the production of educational surgical videos. On a daily basis, the residents engage in clinical teaching rounds with the fellows and attending staff. Both the fellows and attendings are active participants in grand rounds and resident didactic sessions, providing formal lectures on a wide array of urogynecology topics.

Reproductive Endocrinology and Infertility
The resident gains experience in infertility and reproductive endocrinology through one month rotations in the PGY 2, 3 and 4. The rotation is designed to expose the resident to both outpatient management and inpatient care. The resident attends daily office hours with the members of the Division of Reproductive Endocrinology where new and established patients are seen. The resident also participates in the various stages of in vitro fertilization. The resident participates in egg retrieval, embryo transfer and sperm analysis in the andrology lab at the Cooper Institute for Reproductive and Hormonal Disorders. The resident has opportunity to perform many vaginal probe ultrasounds for follicle evaluation and early pregnancy diagnosis. The resident performs and interprets hysterosalpingograms at the surgical center with the Reproductive Endocrinology and Infertility (REI) attending. The resident scrubs on all REI surgical cases with the attending, and rounds with the attending on all postoperative patients.

Resident teaching occurs during rounds and in the office when the resident has one on one time with the reproductive endocrinologist. The faculty also use time in the operating room to educate residents regarding anatomy and surgical technique. The weekly didactic teaching session incorporates review of reproductive endocrinology and infertility topics through faculty lectures, text chapter reviews, and discussion of ACOG publications and prologue questions. As part of the weekly gynecology morning report, interesting REI cases are occasionally discussed, and their management reviewed. Additionally, residents rotating on service prepare weekly lectures for the REI faculty on pertinent and interesting topics.

Research
The residents are exposed to basic medical epidemiology and statistics throughout their four-year experince at Cooper Hospital. The weekly Grand Rounds lecture series host speakers from diverse academic backgrounds who present epidemiologic designs and utilize medical statistics to address challenging clinical topics.

As part of the ACGME Housestaff Lecture Schedule, residents receive lectures on Research Design and Statistics. The PGY 3 and 4 residents are required to present one Grand Rounds lecture each year integrating clinically relevant research. The monthly journal clubs provide opportunity to teach medical epidemiology and statistics in a more interactive manner. During the weekly didactics, the residents are lectured in epidemiology and statistics by research-minded faculty. In addition, medical library representatives lead an interactive discussion and navigation of evidence-based resources, including the Cochrane database and the American College of Physician’s Journal.

Participation in research is a mandatory program requirement that must be completed with a paper suitable for publication. This research project is to be performed with guidance from a Cooper faculty advisor, and formally presented to the department and guest faculty during the fourth year of residency. Subsequently, it is expected that the resident submit their research for participation in the Cooper University Hospital resident research poster competition and to the Obstetrical Society of Philadelphia for the S. Leon Israel Award. The residents’ projects have been received quite favorably, taking first and third place in the Cooper University Hospital Poster Competition in both 2001 and 2002, and fifth place in 2003. In 2007 one of our senior residents received a second place award in the Cooper Resident Research Contest.

Continuity Clinic
Each resident is assigned a continuity of care clinic upon entering the residency program, which is maintained until graduation in the fourth year. The continuity clinic is one half-day session a week at the Women Care Center (WCC). There are approximately 9000 outpatient visits per year at the WCC. It is only during the elective in the third year that the residents are not scheduled for a continuity of care clinic. During all other rotations whether in or out of the department, the resident returns to cover his/her clinic.

A typical schedule includes new patient visits whether an obstetrical patient or a gynecology patient, multiple problem visits, multiple follow up visits, prenatal visits, post-op evaluations, and postpartum visits. The patient population is predominantly African American (51%) and Hispanic (31%), with some Caucasian (13%) and Vietnamese (5%) women.

The resident’s continuity of care clinic incorporates all aspects of primary Ob/Gyn care including annual gynecology exams, normal obstetrical care, postpartum evaluation, and gynecologic problems. The residents see these patients for initial evaluation and follow with them for all of their subsequent visits. When residents identify patients in their continuity clinics with more complicated pregnancies, endocrine disorders, and pre-malignant and malignant gynecologic problems, they can refer these patients to the appropriate resident specialty clinics for care.

There is a dedicated faculty attending assigned to cover each clinic. Each patient is reviewed with the attending giving the resident the opportunity for one-on-one learning. The attending physician has no other responsibilities during this assignment and is fully available to supervise, guide, and teach the residents in the care of their patients. At the discretion of the supervising attending, increasing responsibility for patient care is given to the resident.

On Call Facilities and Clinical Support Services
All residents are provided adequate, private on call facilities. Each level resident is assigned a secure call room, above Labor and Delivery, which consists of a bed, desk, television, and appropriate lighting. A computer, with access to the Internet and Intranet, is available for use twenty-four hours per day in several of the call rooms. Bathroom facilities are located down the hallway. The rooms are cleaned and stocked every day, including weekends. Additionally, a resident lounge, located on Labor and Delivery, is fully equipped with a computer, television, sofas, and bathroom facilities. Locker space is provided in the lounge area. Office space is made available to the residents in Women’s Care Center.

Food and beverages are provided at all Departmental Conferences. Meal money is provided for each resident to cover the cost of on call meals. The department also supplies an educational stipend of $250 for each PGY 1, $500 for each PGY 2, $1000 for each PGY 3, and $2000 for each PGY 4. Additionally, all incoming residents receive a Personal Digital Assistant (Palm Pilot) for personal and clinical use.

CLICK HERE to view the complete Obstetrics & Gynecology residency brochure

Contact Information

Director: Robin L. Perry, M.D.
Coordinator: Rosalind Robinson
Phone: (856) 963-3963
Fax: (856) 365-1967
Email: robinson-rosalind@cooperhealth.edu
Address: Cooper University Hospital, Department of Obstetrics and Gynecology, Three Cooper Plaza, Suite 221, Camden, New Jersey 08103

Rotations

PGY - 1		PGY - 2
3 Months	Obstetrics	3 Months	Obstetrics
2 Months	Gynecology - Cooper	1 Month	Gynecology - Cooper
1 Month	Oncology	2 Months	Oncology
1 Month	ER	1 Month	REI
1 Month	ICU	1 Month	General Practice / Anesthesia
1 Month	Ultrasound	3 Months	Night Float
3 Months	Night Float	1 Month	Gynecology - Mercer
PGY - 3		PGY - 4
2 Months	Maternal Fetal Medicine	3 Months	Obstetrics
2 Months	Gynecology - Mercer	1 Month	Maternal Fetal Medicine
2 Months	Oncology	3 Months	Gynecology - Cooper
1 Month	REI	1 Month	REI
1 Month	Urogynecology	1 Month	Urologynecology
1 Month	Research	1 Month	Breast
1 Month	Elective	1 Month	Oncology
2 Months	Night Float	1 Month	Night Fload

Night Float and Call Schedule
CLICK HERE to view the full Obstetrics & Gynecology brochure for a complete description of how duty hours are assigned. Night call is covered on weekends by the night float resident. All other residents not on the night float rotation share weekend call. Our residency program is in compliance with the 80-hour workweek restriction.