The educational objectives for the Tufts MC OB/GYN residency program are broken down by year and rotation. They are
mandated by the Residency Review Committee for Obstetrics and Gynecology, and designed to give guidelines for
learning expectations for each rotation. These guidelines are to be used in tandem with the CREOG Educational
Objectives, which contain the required objectives for completion by all residents of an accredited program.
Achieving the educational objectives occurs through a combination of clinical experiences, scholastic conferences,
the didactic program, reading and simulation.
PGY-1
Benign Gynecology
This first year rotation is diverse and provides the intern excellent training both in the operating room as well as
in inpatient and ambulatory clinical care. In the OR, the intern will gain initial exposure to gynecologic
procedures and learn the basic skills of hysteroscopy and laparoscopy. They will manage patients admitted to the
general gynecology and urogynecology services, as well as provide consultation to other inpatient units and the
emergency room. A final element of this rotation is to participate in an introductory ambulatory experience both in
urogynecology and in a general gynecology clinic. During this time, the intern is expected to become proficient in
obtaining a complete and pertinent history, performing a pelvic exam, prioritizing patient problems, determining the
appropriate diagnostic studies, arriving at the correct diagnosis, deciding on the appropriate treatment, and
arranging follow-ups.
Labor and Delivery Day Float
While on the first-year rotation on labor and delivery, the interns serves as an integral part of the day coverage
team. Interns will be exposed to fundamental obstetrical skills, particularly extensive experience with normal
delivery and repairs, introduction to primary cesarean technique, and management of second trimester elective
inductions. As the PGY-1 progress through the intern year, they will start to admit and manage more complex
antepartum cases and perform repeat cesareans in preparation for the PGY-2 year.
Night Float
The first-year rotation on the night float service is a concentrated introduction to obstetrics and the general
running of labor and delivery including the recognition and management of common obstetrical problems. Interns
will be exposed to fundamental obstetrical skills, particularly extensive experience with normal delivery and
repairs, introduction to primary cesarean technique, and management of second trimester elective inductions.
They will also gain experience in the diagnosis and management of acute gynecologic problems as overnight
consultants in the emergency room.
Gynecologic Oncology
The first-year rotation in Gynecologic Oncology has two main educational objectives. The first is to acquire a basic
understanding of the principles and practice of gynecologic oncology. The second is to understand the principles of
postoperative care and to apply those principles both to routine and complicated postoperative patients. The duties
of the intern include management of the inpatient gynecologic oncology service and participation in evaluating
patients in the gynecologic oncology clinic under the direct supervision of the attending staff. While in the
operating room, the intern will gain initial experience opening and closing the abdomen for major gynecologic
procedures.
Outpatient Clinics Rotation
On this rotation, the PGY1 is introduced to outpatient obstetrics and gynecology, working directly with our faculty.
The week consists of both outpatient obstetrics, gynecology, as well as introduction to the Perinatal Diagnostic
Center (PDC), where the intern will have exposure to a variety of perinatal ultrasounds and work directly with our
MFM attendings . The PGY1 will also have their own clinic during residency continuity clinic at Tufts.
Surgical Intensive Care Unit
For this five-week rotation, the intern joins the MICU service alongside the surgical residents and attendings of
Tufts Medical Center. The main focus of this rotation is the differential diagnosis, evaluation and treatment and
serious medical co-morbidities. This rotation should give the resident a foundation for the management of
complicated medical conditions in pregnancy as well as the management of common post-operative complications and
gynecologic problems in patients with serious medical conditions.
Emergency Medicine
The Emergency Medicine rotation is a four-week experience in the Tufts Medical Center Emergency Department. The
focus of this rotation is the evaluation and management of emergent medical and primary care problems. During the
rotation, the intern should become accustomed to obtaining a focused history rapidly and doing a targeted physical
exam to evaluate emergency problems. Additionally, they should become familiar with obtaining appropriate
consultation on patients and in the coordination of follow-up care.
PGY-2
Reproductive Endocrinology & Infertility/Pediatric & Adolescent Gynecology/ Genetics
This rotation provides exposure to several clinical specialties: Reproductive Endocrinology & Infertility, Pediatric
& Adolescent Gynecology, and Genetics.
REI clinic: The resident will be exposed to both the diagnosis and management of infertility and
through this process will develop a proficiency in the performance and interpretation of transvaginal
ultrasonography. Additionally, the resident will be exposed to a large variety of the hormonal milieu of the female
patient with expectations to learn basic physiologic principles.
PAG clinic: the resident will become comfortable in the pediatric gynecologic examination. The
resident will learn how to perform an adolescent’s first gynecology exam and become aware of the stages of
adolescent development and pertinent adolescent issues. At a bi-monthly conference, the resident will discuss
different diagnoses and treatment regimens in patients with menstrual irregularities.
Genetics: The resident will work directly with Dr. Dallas Reed and her team in the genetics clinic.
Dr. Reed is double-board certified in Obstetrics and Gynecology and Genetics. The resident will learn how to take a
detailed family history, perform a pedigree, and counsel patients on available testing and results. Residents can
also attend consultations with Dr. Reed in the NICU for a variety of genetic conditions.
Family Planning
This service will focus on the counseling and management of both first and second trimester pregnancy terminations.
Additionally, the resident will be exposed to contraceptive counseling as well as epidemiologic discussions of
reproductive health issues. The resident is encouraged to voice their own thoughts and preferences for their desired
extent of participation and has the opportunity to opt-out of any procedures. There may be an opportunity to work at
Planned Parenthood of Boston every Friday under the supervision of the family planning staff.
Labor and Delivery Day Float
The second year resident will begin to manage more complex obstetric cases, including managing the maternal fetal
medicine postpartum service. Additionally, the PGY-2 will perform the majority of the repeat and more challenging
cesareans and other procedures that occur on labor and delivery. This resident will also help to admit high risk
obstetric transfers from other hospitals and, at time, help to manage the antepartum service with oversight from the
PGY-3 and PGY-4 on service. The PGY-2 will continue to develop their ultrasound skills, specifically biometry and
cervical lengths.
Benign Gynecology Service
The PGY-2 on the benign gyn service joins the PGY1 and PGY4 to make a dynamic team. During this rotation, the PGY2
participates in surgical cases with the generalist practice, MIGS, and Urogyn. They also help care for complex
in-patients as well as supporting the PGY1 with consultations. The PGY-2 also joins our MIGS attendings in their
clinic, helping to work up patients and prepare them for outpatient management or surgical intervention.
Southern New Hampshire Medical Center
Two residents, one third year and one second year, aid in the management of the obstetrics and gynecology services at
Southern New Hampshire’s Medical Center.
The PGY-2 at SNHMC will care for obstetric and gynecology patients on labor and deliver and in the operating
room. This will include participating in day surgery, gynecologic oncology, and benign gynecologic cases. The
PGY 2 will become proficient in minor gynecologic procedures and obstetric procedures, including vaginal and
operative delivery, cesarean delivery, and management of complications of labor. The PGY 2 will assist in managing
the labor and delivery unit, as well as the antepartum and postpartum services. You will also have the
opportunity to work with a family medicine resident during this rotation who will also be covering labor and
delivery. The PGY2 will participate in a outpatient continuity clinic where they will learn how to perform
office based surgical procedures and transvaginal ultrasound as well as general outpatient obgyn care.
During this rotation, residents take call during the week at Southern New Hampshire but not over the weekends. There
is an apartment available for residents to stay at while on rotation there.
Lowell General Hospital
In a similar design to Southern New Hampshire, two residents, one second year and one third year (starting AY 24-25),
rotate at Lowell General. Residents will have the opportunity to participate with patient care on labor and delivery
as well as gynecologic surgeries with both Lowell General Faculty and Tufts gynecologic oncology and urogynecology
faculty. Housing options provided during the week
PGY-3
Elective Rotation
The third-year elective does not have specific educational objectives but is meant to be a 10-week block that can be
tailored to the individual needs and interests of each resident. The resident will discuss a plan with the Program
Director well in advance of the beginning of the rotation. In the past, this rotation has been used for the
development of research projects, as a chance to participate in international medical programs, or as a time to
focus on additional training in areas of potential fellowship interests.
Maternal-Fetal Medicine
For this third year rotation, the resident will be in charge of managing the antepartum patients for both the
generalist and the Maternal-Fetal Medicine attending services. The focus of the rotation is the management of
patients with high-risk obstetrical complications as well as pregnancies of patients with complicated medical
conditions. Resident experience includes the following areas of patient care: antepartum service, labor and
delivery, Center for Perinatal Diagnosis (ultrasound clinic), and MFM outpatient clinic.
Gynecology Oncology Rotation
The PGY3 is an integral member of the Tufts Gynecologic oncology team. The resident supports the chief with
co-management of the inpatient service and provides mentorship to the PGY-1. The PGY3 continues to develop their
open, laparoscopic, and robotic surgical skills while operating with the gynecologic oncology faculty. Residents
participate in Gyn Onc morning report and tumor board. Additionally, residents have the opportunity to attend
clinic, where they will work up and counsel patients on their diagnosis and recommended management plan.
Lahey Hospital and Medical Center
For this third year rotation, the resident will team with three residents from Boston University Medical Center as
well as a MIGS fellow at Lahey in the management of the general gynecology and gynecologic oncology services. Lahey
Hospital and Medical Center is a high volume surgical center and an excellent rotation for enhancing skills in both
open gynecologic surgery as well as advanced minimally invasive procedures.
Southern New Hampshire Medical Center
Two residents, one third year and one second year, aid in the management of the obstetrics and gynecology services at
Southern New Hampshire Medical Center. The third year resident functions as the chief resident while at SNHMC with
responsibilities extending to the general supervision of the junior residents. The clinical experience for the chief
resident is predominantly gynecologic with coverage of both the gynecologic oncology service as well as the
high-volume generalist practice. You will also be covering complex patients on labor and delivery, inpatient
antepartum and postpartum patients. During this block you will also have exposure to outpatient surgery in the
clinics and transvaginal ultrasound as well as participation in the continuity clinic.
Lowell General Hospital (coming in AY 24-25)
In a similar design to Southern New Hampshire, two residents, one second year and one third year, rotate at Lowell
General. Residents will have the opportunity to participate with patient care on labor and delivery as well as
gynecologic surgeries with both Lowell General Faculty and Tufts gynecologic oncology and urogynecology faculty.
Housing options provided during the week
PGY-4
During their final year at Tufts Medical Center, the chief resident is responsible for the management of each of the
main divisions of care including: labor and delivery (day float and night float), benign gynecology (urogynecology
and general), gynecologic oncology, and clinical care. On all services the chief resident is responsible not only
for overseeing the management of patient care but also in the general supervision and education of the junior
residents and Tufts Medical students.
Day and Night Float Labor and Delivery
While on day float the chief will manage labor and delivery as well as be aware of the antepartum and postpartum
patient services. They work closely with the second year day resident as well as the third year MFM resident to
compromise the full obstetrical team. Additionally, the family planning intern helps to cover LDR and the chief is
responsible for their supervision and education. The night float chief functions in much the same way, however they
also cover the inpatient gynecology and oncology patients as well as cover any consults received overnight.
Benign Gynecology/Urogynecology
This chief works to manage both the generalist as well as the urogynecology service. Their primary role on the
service is to assist in all major gynecologic surgeries and run the inpatient gynecology unit with the intern. The
breadth of gynecologic surgeries is diverse with excellent exposure to both advanced laparoscopic and robotic
skills. Additionally, the chief will supervise the intern in their ambulatory responsibilities as well as with any
consults.
Gynecologic Oncology
While chief of the gynecologic oncology services, the resident will work closely with their intern as well as the
attending staff. The chief is primarily responsible for coverage of all procedures as well as managing the inpatient
service. When other responsibilities permit, the resident is involved in working with the attending staff in their
ambulatory clinic. Finally, the chief resident is responsible for one-on-one training of the oncology intern and
supervising them in the mastery of their FLS (Fundamentals of Laparoscopic Skills) testing.
Outpatient Clinics Rotation
This chief resident functions in an expanded ambulatory care position attending various clinics. The chief will have
opportunities to attend a variety of specialty clinics including family planning clinic, outpatient obstetrics and
gynecology clinics, colposcopy clinic, and breast clinic.
Float Rotation (coming AY 25-26)
The float chief will provide coverage for the gynecology and obstetric co-chiefs when other responsibilities such as
their continuity clinic or vacation time interrupt managing the service. This rotation will allow for both obstetric
and gynecologic experience throughout the week as well as outpatient clinical experience.
Continuity Clinic
PGY-2 through PGY-4
The continuity clinic experience occurs in the last three years of the residency. It is a half-day per week
ambulatory experience that focuses on antepartum and postpartum care, ambulatory gynecology, and well woman primary
care. The focus of the continuity clinic is ambulatory history taking, the outpatient physical exam and office
procedures, health screening and immunizations, and patient education. The resident is assigned a clinic location at
the end of their intern year and will continue to attend that clinic throughout the three years. The clinic
locations include: Tufts Medical Center, Neponset Health Center, Cambridge Hospital, Carney Hospital, South Boston Community Health Center, and Metrowest Medical
Center.
