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Faculty: Karen James, M.D. Resident Chairperson (2004-2005):
Goals
By the end of residency training, residents will be able to:
Learning Methods
Didactics (first through third year) Regular Tuesday afternoon didactics will cover the common ambulatory topics in gynecology from menopause and hormone replacement therapy to abnormal uterine bleeding and pelvic masses. Attendance is required for didactics per residency guidelines. Feedback to speakers and curriculum coordinators is encouraged to ensure a quality didactic experience.
Continuity Clinic (first through third year) Each resident's continuity clinic provides a longitudinal opportunity to diagnose and manage common ambulatory gynecologic problems for patients of all ages. Preceptors are available for case discussion, as well as, assistance with gynecologic procedures including cervical and vulvar biopsy, endometrial biopsy, IUD placement or removal, and diaphragm fitting. Dilation and curettage for missed abortions may be scheduled with an available attending (Drs. Tuggy, James, Breuner, or Garcia) at Swedish Medical Center's Ambulatory surgery center. Each resident's continuity clinic also provides an opportunity for consultation and referral to outside gynecologists. Our preferred gynecologic consultants include the following:
Planned Parenthood (second year) Each second year resident will spend one block (four weeks) working at Planned Parenthood's University District Office. This rotation emphasizes contraceptive counseling, initiation and management; pregnancy detection and counseling; diagnosis and management of infections of the gynecologic and urinary systems; and disease prevention. The Planned Parenthood Clinician's Manual is a useful resource for residents learning to care for ambulatory gynecologic problems. When possible, it is more useful to read the manual prior to beginning the rotation. For interested residents, opportunities to learn dilation and curettage may be possible during this rotation. Please discuss this with Karen James at least two months prior to your rotation to ensure your continuity clinic can accommodate these special sessions. Clinics are Mondays (10:30 to 7:00) and Wednesdays (9:00 to 5:00). Free street parking is intermittently available; nearby pay parking lots are also available. Vacations are discouraged, but may be taken on an individual basis during the last three weeks of the rotation. Emergency Department (First and Third Year) Visits to the emergency department for evaluation of abnormal uterine bleeding, infections of the female reproductive and urinary systems, and pelvic pain are common. First year residents spend one block (4 weeks) and third year residents spend five weekends (Friday, Saturday and Sunday) in Swedish Medical Center's emergency department. GYN Rotation (Third Year) The third year GYN rotation includes training with community OB/Gyn physicians and training in colposcopy and LEEP. Residents will spend two to three half days per week working with a community OB/Gyn and one to two half days per block with Dr. Hickok, an infertility specialist. Most OB/Gyn attendings have requested a maximum of two or three residents per year. Because each attending has a unique clinic schedule, please contact Karen James prior to completion of your continuity clinic schedule to determine which attending you will be working with (see following list).
Training in colposcopy and LEEP begins through a didactic and hands-on workshop early in the third year. Additional case-based training is available through the "Advanced Colposcopy" CD-ROM; this should be completed by the resident early in their Gyn rotation. In addition, residents will develop their clinical and procedural skills through the First Hill Gyn clinic. This clinic occurs on Wednesdays, alternating full days and one half days (afternoons) every other week. Residents at Downtown Family Medicine and 45th Street Clinic may also perform colposcopy during their continuity clinic. For residents interested in doing colposcopy and LEEP after graduation, additional experience is available at the First Hill Gyn clinic during the three blocks when no resident is assigned to a Gyn. Aradia Elective (Third year): A one block elective is available for residents interested in learning dilation and curettage and pregnancy ultrasound. Please contact Aradia Women's Health Center at 206-323-9388 for more information. Aradia requires a commitment to three full clinic days per week (Wednesday, Friday and Saturday). On-Line Resources The American Academy of Colposcopy and Cervical Cytology (www.asccp.org) has a useful web site including current diagnostic and treatment algorithms for abnormal pap smears, CME offerings, books, and patient educational materials.
Planned Parenthood Resources:
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