Phoenix Integrated Residency in Obstetrics and Gynecology

 

What is PIROG?

 

PIROG is the Phoenix Integrated Residency in Obstetrics and Gynecology, a four-year residency program, fully accredited by the ACGME that is integrated between two Medical Centers:

PIROG trains physicians to be capable of independent practice in our specialty, to be eligible for competitive fellowship programs, and to function as leaders in the community. The structure of our program allows the resident to gain experience by caring for service, non-profit, and private patient populations. Both institutions are committed to high quality post-graduate education and academic excellence. The Obstetrics Services at both hospitals combined have over 10000 deliveries per year (35% high risk). Both hospitals are tertiary care centers and receive maternal-transport patients. The large OB/GYN services are cared for by the full-time and parttime attending staff, our OB/GYN house-officers, Emergency Medicine and Family Medicine residents, Certified Nurse-Midwives, fourth-year medical students on elective rotations, and third-year medical students from the University of Arizona and Creighton University School of Medicine.

Resident's who graduate from our program have received surgical instruction and experience in patient care covering the entire spectrum of gynecology and obstetric practice. Our graduates are proficient in those areas outlined by the American Board of Obstetrics and Gynecology as well as the Residency Review Committee of the ACGME.

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What Makes PIROG Excellent?

 
  • Combination of large public and large private hospital
  • Ability to function with graded autonomy, but supervised
  • Close working relationship with dedicated faculty
  • Laparoscopic simulator in the department with year-specific curriculum and learning modules

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Teaching Plan

 

Clinical competence and academic excellence are attained by giving graded responsibility to the resident through exposure to all areas of obstetrics and gynecology under the direct supervision of board certified specialists and sub-specialists present in the department 24 hours a day. There is a strong emphasis on teaching. Senior residents actively participate in mentoring junior residents. Faculty members direct learning through didactic, experiential, research, and small group and individual processes. Each Friday morning, there is block of protected didactic time. All residents attend these sessions.

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Research

 

The Program Director and faculty support research and scholarly activity. Residents are introduced to research during their first year through a series of tutorials, self-directed learning, and one-on-one mentoring. The program has a research requirement of one scholarly project to be completed during the residency. Residents are required to develop a research protocol, and encouraged to present findings on local, regional, and national levels. Dean Coonrod, M.D., M.P.H. directs departmental and resident research projects. Opportunities to share research efforts with peers occur during monthly research conferences, Journal Club, and an annual Research Day. See example resident research projects below.

  • Emergency Cervical Cerclage Placement: A Retrospective View
  • The Effects of Troglitazone on Ovulation in Women with Polycystic Ovary Syndrome
  • Effects of Cultural Sensitivity Seminars on Level of Understanding and Comfort Level in Dealing with Spanish Speaking Only Population
  • Comparison of Health Care Access by Level of Acculturation & Family
  • Cohesiveness in Mexican American Women
  • Single Umbilical Artery and the Impact on Perinatal Outcome
  • Funic Reduction: Reconsidering the Management of Umbilical Cord Prolapse
  • Cervical ripening with Misoprostol in the Outpatient Setting
  • Misoprostol and Failed Pregnancy

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Experiental Learning

 

The house-office training program with seven residents at each level spans four years. A night float system is used at both hospitals to insure compliance with ACGME duty hour regulations. During all four years the residents have responsibility for patients in community-based primary and continuity care clinics. Graded responsibility begins with building a strong foundation in care of normal women’s health and low risk obstetrics. As the resident gains knowledge and experience, responsibility for operative management, high risk and gynecologic health problems, and teaching & administrative duties are added.

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Overall Residency Concept

 
  • Team” concept
  • Continuity of care
  • Mixture of private and resident care
  • Graduated responsibility and authority
  • Limited work hours (meets ACGME requirements)
  • Combine exposure to primary care and subspecialties

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Teaching Experience

 
  • Friday morning (7-10 a.m.)
  • Mortality & Morbidity conference
  • Grand Rounds
  • Didactic Lectures
  • Journal Club (every month)
  • Multi specialty conferences
  • Tumor Board
  • 24-hour in house attending supervision at both sites
  • 22 full time teaching attendings
  • Large community voluntary teach faculty
  • Multiple areas of teaching/skills
  • Endoscopic surgeries, colposcopy, urogynecology
  • Domestic violence, perinatal substance abuse
  • Ethics, genetics, reproductive technology, breast disease

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The Post Graduate Years

 

PGY I - In July all PIROG interns are oriented to the program by spending two weeks at Maricopa Medical Center and two weeks at St Joseph’s Hospital and Medical Center. This “orientation month” acclimates the interns to our residents and faculty and allows the incoming interns to perform procedures early in the year. For the remainder of the year, emphasis is placed on routine obstetrical care and deliveries, common gynecologic procedures, and primary and preventative care. The resident spends two blocks each in obstetrics, gynecology and night float, one block is spent in the ICU, Family Medicine, and Emergency Medicine.

PGY II - The second year consists of two blocks of obstetrics, one at MMC and one at SJH. Two blocks are dedicated to gynecology surgery; the block at SJH is on the gynecology-oncology service. Two blocks will be spent on night float, one at each hospital. The final block is high-risk obstetrics at MMC.

PGY III - During the third year emphasis is placed on building a depth of knowledge and experience and further development of operative and clinical care management skills. This year is enhanced by opportunities to experience private practice as the resident spends time with subspecialist in their offices. The specific rotations are Urogynecology, Reproductive Endocrinology and Infertility, and Gynecology Oncology. It is during this year when the resident may take an elective rotation, such as offsite rotations to subspecialty training sites.

PGY IV - Full responsibility for management of patients’ care is given during this final year. The resident further develops skills in practice management and leadership. During the final year the residents gain experience in the following areas: Obstetrics at MMC and SJH, Gynecology at both MMC and SJH, Gynecology-Oncology, night float at MMC and a private practice gynecology rotation. During the private practice GYN rotation the resident operates at affiliated institutions. There is also time for refining laparoscopic skills on the simulator and medical coding instruction.

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Continuity Clinics

 

Continuity Clinics make up a vital part of our training. We prepare our residents to be primary care providers by having the continuity clinics situated within the Family Health Centers. By doing this, we stress learning the primary care of women by having generalist faculty be the teachers of this experience. These clinics occur one half day per week and are designed to include the exposure to obstetrics and gynecology as well as primary health care for women.

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The Faculty

 

The OB/Gyn teaching faculty includes:

  • 23 Board Certified Obstetrician/Gynecologists
  • 12 Board Certified sub-specialists
  • 5 Maternal and Fetal Medicine
  • 3 Reproductive Endocrinology and Infertility
  • 2 Gynecologic Oncology
  • 2 Medical Genetics
  • A number of Board Certified Obstetrical Anesthesiologists

More than 20 community-based adjunct faculty members provide a comprehensive, well-rounded resident education experience. Residents are trained in laparoscopic hysterectomy, hysteroscopy, laser surgery, colposcopy and urethroscopy. Other spheres of teaching cognitive and technical skills include Genetics, Domestic Violence, Perinatal Substance Abuse Care, Urodynamics, Reproductive Technology, Ethics, and Benign Breast Disease.

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Procedures Performed at PIROG

 
2005 Graduating Chiefs
Average
% vs
National
Average
SPONT. DELIVERY
434
89
FORCEPS
35
91
VACUUM
27
72
C- SECTION
282
81
AMNIOCENTESIS
25
83
ABDOMINAL HYST
59
17
VAGINAL HYST
42
78
INCONTINENCE / PELVIS FLOOR SURGERY
91
91
OPERATIVE LAPAROSCOPY
77
69
CONIZATION OF CERVIX
25
55

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Block Rotation Schedule

 

PGY-1

  • Orientation month (July)
  • GYN - MMC
  • GYN - SJH
  • OB - MMC
  • OB - SJH
  • Night Float - MMC
  • Night Float - SJH
  • ED - MMC
  • MICU - MMC or SJH
  • Family Medicine - MMC or SJH

PGY-2

  • Gynecology - MMC
  • OB - MMC
  • High Risk OB - MMC
  • Gynecologic Oncology
  • Night Float - MMC
  • Night Float - SJH
  • High Risk OB - SJH

PGY-3

  • Gynecologic Oncology
  • Urogynecology
  • Reproductive Endocrinology/Infertility
  • Office Practice - SJH
  • GYN - SJH
  • Night Float Chief - SJH
  • Elective/Family Planning

PGY-4

  • Gynecologic Oncology
  • Private Practice Gynecology
  • Night Float Chief - MMC
  • OB - SJH
  • OB - MMC
  • GYN - SJH
  • Gyn - MMC

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Benefits (For 2006-2007 Academic Year)

 

Insurance - Professional Liability and Malpractice $1,000,000/$3,000,000 occurrence policy for medical services within the scope of the training program.

Personal Medical, Dental and Long and Short- Term Disability, Workman’s Compensation.

Personal Leave

  • PGY 1 & 2 - 3 Weeks
  • PGY 3 & 4 - 4 Weeks

Application & Residency Selection - Appointments at the PGY I level are made through the National Resident Matching Program in the ERAS system. Application deadlines correspond to this system.

Factors Important in the Resident Selection Process Include:

  • Academic qualifications
  • Interpersonal and communication skills
  • Dependability, responsibility, maturity, courtesy, confidence
  • Leadership skills
  • Dedication to Women’s Health
  • Sense of humor and work ethic

General Residency Statistics:

  • Approximate number of applicants per position - 25
  • Approximate number of interviews offered per position - 10
  • Percent of matched students who had “audition elective” - 11%
  • Percent of grads who pursue private practice vs. academic medicine - 71%

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Why Phoenix?

 
  • Phoenix is the United States’ fifth-largest city with a population of almost 1.4 million
  • Phoenix has consistently ranked among the nation’s top cities in which to live and vacation. Its climate and cultural and recreational amenities have caused its population to boom in the last twenty years.
  • With so many sunshine-filled days, Phoenix is the perfect place to experience unique and fun outdoor activities
  • Phoenix is home to a wide variety of arts including the symphony, ballet, museums and visual arts
  • Home of the Phoenix Suns basketball, Arizona Diamondbacks baseball, Arizona Cardinals football, Phoenix Coyotes hockey, Arizona Rattlers indoor football, Phoenix Sting (Lacrosse), Phoenix Mercury women’s basketball and ASU Sun Devil collegiate sports. Home of College Football’s Fiesta Bowl and Insight Bowl, and Major League Baseball’s Cactus League spring training each March.

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Last updated on October 7, 2008