While many institutions have a general research requirement for residents, few have formally defined it. Beginning in 2016, however, all Penn State Health Milton S. Hershey Medical Center OBGYN residents are required to complete an officially sanctioned rotation on a self-developed research question. This rotation is overseen by Timothy Deimling, MD, director of resident research and assistant program director, fellowship in minimally invasive gynecology surgery, and Rebecca Phaëton, MD, assistant director of resident research. The research rotation helps each resident develop projects and identify mentors who are experts in their respective fields, and comprises two five-week blocks beginning in the resident’s second year. The ultimate goal is that each resident presents a publication-ready manuscript.
Timothy Deimling, MD, far left and, Rebecca Phaeton, MD, far right, meet with second-year residents to develop research questions.
This was prompted by Dr. Deimling’s own experience as a resident; a research requirement frequently lacked dedicated time to develop that research. This reflects a common dilemma in medical education; clinical needs are prioritized at the expense of the more long-term research projects. As a Center of Excellence in the advancement of women’s health, Penn State Obstetrics and Gynecology has created this dedicated rotation to emphasize the importance of research, as well as the more widely recognized requirements of hands-on, clinical practice. The program is expected to expand, with measurement of future publication rates to mark its success. Continue reading
A residency training program that stresses minimally invasive hysterectomies is proving to be not only feasible, but a highly effective strategy for providing valuable surgeon training and improving patient outcomes. As leaders of Penn State Milton S. Hershey Medical Center’s Division of Urogynecology and Minimally Invasive Gynecologic Surgery, Gerald Harkins, M.D., and his colleague Matthew Davies, M.D., have closely tracked resident performance and patient outcomes. At the September 2013 Minimally Invasive Surgery Week and Endo Expo in Reston, VA, Harkins and his colleagues presented the first full twelve months of outcomes data from the training program. Among 537 patients who underwent hysterectomies for benign indications including abnormal bleeding, pelvic pain, fibroids, endometriosis, and prolapse/incontinence in a single year, 96 percent underwent minimally invasive surgery, either with vaginal or laparoscopic approach with a resident as the lead surgeon or the first assist, explained Harkins in an interview. Training new physicians and surgeons to provide up-to-date standards of care, including the use of minimally invasive techniques and robotic surgery, is a major challenge facing the health care field today. “Most physicians with established practices don’t have the necessary training in minimally invasive techniques, and so despite evidence that such techniques are safer and more cost-effective,1 60 percent of hysterectomies are still open procedures,” says Harkins. Recent nationwide OB/GYN residency training data suggest most U.S. trainees continue to lack needed minimally invasive surgical experience, with the average surgical resident completing sixty-four abdominal, eighteen vaginal, and twenty-three laparoscopic hysterectomies during training.2
Kristin Riley, M.D., fellow, assists Gerald Harkins, M.D. during minimally invasive gynecologic surgery. As part of its residency training program, residents act as lead surgeon or as first assist in 96 percent of the minimally invasive hysterectomy procedures at Penn State Milton S. Hershey Medical Center.