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8110 Gatehouse Road, Falls Church, VA 22042

Didactics and Research: Inova OB-GYN Residency Program

Training for life: We guide outstanding physicians to cutting-edge careers in women's health.
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Rotation Structure

The residency is a four-year program in obstetrics and gynecology that meets all requirements as specified by the ACGME and is fully accredited by the RRC. Residents primarily train at a single site, Inova Fairfax Hospital, where their training covers primary care, as well as basic and sub-specialty obstetrics and gynecology.  See website page "About Us" to see the rotation schedule for AY1718.


Continuity Clinic

Inova Fairfax Medical Campus OBGYN residency training program offers a true continuity clinic experience where residents are identified as the primary care giver for the same group of patients throughout their residency. Residents perform a certain percentage of their continuity clinic deliveries themselves. Adherence to the 80 hr. work-week is required. Residents are encouraged to manage their own clinics as if they were in their own practice. Interns begin clinics in July of their PGY1 year.

During the academic year 2016-17 the PGY4s, PGY3s and the PGY1s will have their once-a-week continuity clinic experience at the Inova OB Cares Clinic, located at 6400 Arlington Blvd, Falls Church VA 22046.

The PGY2s will have their once-a-week continuity clinic experience at the Inova Medical Group (IMG) OBGYN practice located at Inova Medical Group Obstetrics and Gynecology, 1005 N. Glebe Rd, Suite 430, Arlington, VA 22201.


Didactics Schedules

Weekly
 Mondays, 8am-9am

 Weekly
Wednesdays 715am

Weekly
 Fridays 8am-12 pm

 Monthly,
IFH GME Educational Grand Rounds 12 pm

 IFH OBGYN Department Grand Rounds, MM Resident Presentations

 
Gyn Onc Team Faculty, Team members in Gyn Onc Teaching Conferences

 IFH OBGYN Residency Didactic Sessions 
(protected time)
resident didactics and simulation training (includes Journal Club, PICO Sessions, primary care, GYN ONC, Obstetrics, 
Gynecology, Maternal Fetal Medicine, Reproductive-Infertility-Endocrinology, OB Anesthesia, ACLS, Team STEPPS, NPR content

 Team Training, Physician Wellness, Patient Experience, Legislation, Physician Advocacy, Compliance, Ethics, 
Health Equity, Social Media, Financial Management/Repayment Strategies, Digital Tool Kit, Patient Safety, 
Disaster Preparedness, Patient Hand Offs, Fatigue

In addition to didactics and traditional bedside teaching, residents will also be involved in simulation training that will allow learners to sharpen technical and behavioral skills. Simulation sessions focused on operative gynecology will include sessions on 
OR instrumentation, 
pre-operative and intra-operative safety procedures, 
intra-operative complication management and laparoscopic dexterity drills, and, 
Cadaver lab.

Obstetric simulation for PGY1 residents will focus on 
normal vaginal deliveries, 
basic suturing techniques, 
complications such as postpartum hemorrhage and shoulder dystocia, and, 
normal labor and delivery management protocols. 

Competency of upper level residents will be evaluated through hospital required, unannounced, labor and delivery critical event simulation exercises. These events, which will include post partum hemorrhage, shoulder dystocia, maternal cardiac arrest, eclamptic seizure, terminal fetal bradycardia and post operative shock, will be conducted using the department’s Noelle patient simulator on labor and delivery or the gynecologic post-op ward.

ASTEC Training Center 
ICAMS Training Center 


Research

The OB/GYN program places a major emphasis on resident scholarly activity. As such, research methodology, statistical analysis, protocol IRB approval and publication requirements will all be presented to residents as part of their didactic education. Upon entry into the program, each resident will be assigned a faculty advisor who will assist the trainee in selecting a research question. All PGY1 residents will be required to choose a research question and perform a thorough literature analysis of the subject. At the end of the first year the resident will present his / her research topic and proposed research question to the department at an annual research day. In the second and third years of training, the resident will be required to carry out the investigation needed to answer his / her research question. In the final year of training the resident will be required to synthesize the data into the form of a publishable or presentable project. This project will be presented at the annual research day which will be proctored and judged by invited authorities in the field of the resident's research.

The department is very fortunate to have the Women’s Health Integrated Research Center on the Inova campus. This is a world class research institute that focuses on the genetic and molecular profile of diseases unique to women’s health. We hope that residents will avail themselves of the unique opportunities to correlate clinical conditions with genomic research. Currently Dr. Maxwell, Department Chair, has a DNA and tissue database of over 2000 patients that encompasses the clinical spectrum from oncologic disease to obstetrical abnormalities.

OBGYN Residency Curriculum Manual with Goals, Objectives, Milestones 


 Inova Fairfax Hospital OBGYN Resident Simulation Curriculum

1. Operative Vaginal Delivery

  • Describes indications and contraindications for operative vaginal delivery
  • Compares and contrasts the risks and benefits of vacuum delivery versus forceps delivery
  • Correctly demonstrates the use of vacuum extractor (Kiwi) on mannequin
  • Identifies the parts of forceps and describes the use of different forceps
  • Counsels patient regarding the risks and benefits of vacuum/forceps
  • Correctly applies Simpson forceps to Occiput Anterior presenting fetus
  • Correctly applies Kielland forceps to Occiput Posterior presenting fetus

2. Episiotomy and Fourth Degree Repair

  • Correctly identifies the anatomic structures of the perineum (vaginal mucosa, bulbocavernosus muscle, transverse perineal muscle, external anal sphincter, internal anal sphincter)
  • Correctly identifies a second degree, third and fourth degree perineal laceration
  • Using simulated foam boards, correctly demonstrates reapproximation of the vaginal mucosa, vaginal musculature, repair of external and internal anal sphincters

3. Shoulder Dystocia

  • Correctly lists the risk factors for shoulder dystocia
  • Correctly lists the causes of fetal injury during shoulder dystocia
  • Demonstrates teamwork approach to management of shoulder dystocia
  • Correctly demonstrates McRoberts and suprapubic maneuvers
  • Correctly demonstrates Rubins, Woods corkscrew maneuvers and delivery of posterior arm
  • Describes Zavanelli maneuver, indications and outcomes
  • Correctly lists elements of documentation of shoulder dystocia delivery

4. Breech/Piper Forceps

  • Correctly lists risk factors for breech presentation
  • Correctly lists complications of vaginal breech delivery
  • Discusses indications and contraindications of vaginal breech delivery
  • Correctly demonstrates technique of spontaneous vaginal breech delivery
  • Correctly demonstrates techniques of vaginal breech extraction, nuchal arm and Mauriceau-Smellie-Veit maneuver
  • Correctly demonstrates application of Piper forceps
  • Lists options for management of entrapment of fetal head during breech delivery

5. Eclampsia

  • Correctly lists signs and symptoms of pre-eclampsia and severe criteria
  • Correctly lists causes of obstetrical seizures
  • Demonstrates immediate management of eclamptic seizure using teamwork
  • Correctly lists anti-seizure medication, dose, route, interval
  • Correctly lists anti-hypertensive medication, dose, route, interval
  • Correctly lists complications of severe pre-eclampsia

6. Obstetrical Emergencies: Cord Prolapse, Inverted Uterus

  • Discusses risk factors for cord prolapse
  • Correctly identifies cord prolapse
  • Demonstrates management of cord prolapse using teamwork
  • Discusses indications for vaginal versus cesarean delivery during cord prolapse
  • Discusses risk factors for inverted uterus
  • Correctly demonstrates management of inverted uterus using teamwork

7. Postpartum Hemorrhage

  • Discusses risk factors for postpartum hemorrhage
  • Correctly demonstrates a systematic approach to the assessment of a bleeding postpartum patient
  • Correctly demonstrates management of atonic uterus
  • Correctly lists uterotonic medications including dose, route, interval and contraindications
  • Correctly lists code hemorrhage blood products, indications and complications

8. C-Section/C-Hyst

  • Discusses indications for primary cesarean section
  • Identifies surgical instruments utilized for routine cesarean section
  • Identify key anatomic structures involved in the entry and closure of the lower abdomen
  • Identify key steps of primary cesarean section

9. Fundamentals of Laparoscopy/Intro to Da Vinci

The objective of this exercise is to develop basic laparoscopic skills for the individual; The five tasks are: Task #1: Peg transfer Two Maryland dissectors, one peg board, 6 rubber ring objects Time limit to complete is 300 seconds, starts when peg is touched, ends when last object dropped in place Description: Transfer a total of 6 pegs from one side to another and back. Picking them up with one hand, transferring them in midair and placing them back. Task #2: Precision cutting One Maryland dissector, one pair of endoscopic scissors, one jumbo clip and one 4x4 piece of gauze with a pre marked circle, 2 alligator clips Time limit 300 seconds starts when gauze is touched, ends when circle is separated Description: Cut using endoscopic scissors a premarked circle within 5mm of the mark Task #3: Ligating Loop One grasper, one pair of endoscopic scissors, one jumbo clip one prettied ligating loop or endoloop, one red foam organ with appendages. Time limit 180 seconds starts when loop or instrument is visible and ends with the strings cut Description: Place an endoloop around an foam organ with appendages Task #4: Suture with extracorporeal knot Two needle drivers, one knot pusher, one 2-0 silk suture of 90 cm in length or 120 cm in length, one pair of endoscopic scissors, one penrose drain, with marked targets, one suture block Time limit 420 seconds starts when instruments are visible and ends with cutting the strings. Description: Load the needle out of the FLS box, place inside the box, laparoscopically load the needle and place a simple suture in marked penrose drain. Place 3 throws and push each one down with the knot pusher and then cut the string. Do not avulse the penrose drain from its place. Task #5: Suture with Intracorporeal Knot Two needle drivers, one 2-0 silk suture of 15 cm in length, one pair of endoscopic scissors, one suture block, one penrose drain with marked targets Time limit 600 seconds starts when instruments are visible and ends with cutting the strings Description: Load the needle onto the needle driver laparoscopically. Then place a single suture in the marked penrose drain. Do 3 throws and make sure there are no air knots. Cut the string. Do not avulse the penrose drain from its position.

10. Hysteroscopy/Cystoscopy

SIM curriculum in progress