Chiefs with tough choices

R1s got the first choice with our Holiday Book fair but the R4s took it every bit as seriously. I love the concentration here!

TS

iPad vs. Textbook

Last Thursday we held our randomization for our iPad vs. Textbook Initiative. For the uninitiated, the WashUOBGYN Residency Program will be outfitting half of the residency with iPads while the other half get an equivalent textbook fund. We will evaluate residents in terms of objective performance on exams as well as satisfaction with educational resources.

Before the randomization, everyone left with a textbook. Just a little gift from Dr. Peipert to the residents.

In this video, you will see our "Holiday Tree". We used a computerized generator to randomize residents to iPad or textbooks. Their choice is written on a card and placed in an envelope with their name on it. One by one, we let residents come to the front to pick their card.

Here's a video of R1 Natalia selecting her card.

A great time was had by all but now the real work starts!

Happy Holidays and Happy Learning!

Tony Shanks

Resident Christmas Gift: iPads vs. Books

We are less than one week away from a very special residency Christmas "party". There are several things that are happening this Thursday (December 16).

First: Dr. Peipert has collected over 50 textbooks (including Williams, Gabbe, Speroff) and plans to give them to the residents as a Christmas gift. Interns will get the first choice followed by R2s then R3s followed by R4s. I tried to do a Yankee Swap (see: The Office) but was vetoed. So EVERYONE gets something!

Second: and this is a doozy. We are going to start our iPad vs. Textbook study. What is that you ask? Well, it is exactly as it sounds. The entire residency program is going to be randomized to receive either an iPad or an equivalent amount of money to purchase textbooks. We will then spend the next 12 months evaluating resident performance on CREOGS as well as module quizzes. Other things that we are going to track include satisfaction, study patterns and overall pieces of paper saved. As we've mentioned many times before, our residency video library is being digitalized and will now be able to be uploaded (via iTunes) to each iPad. This is a very exciting project and a huge undertaking for the department. (I really haven't moved very far from trying to get the program to buy me a Wii during my chief year.)

Third: The Department Christmas party. Enough said.

Alumni, I would be happy to give you more info if you desire and I can always come up with ways to get you involved in the program.

Happy Holidays!
Tony Shanks

Congratulations to the Chief Class!

R4 Molly Stout is featured in the newest Green Journal. Great job Molly! We are very happy/lucky that you will continue your career at Wash U as an MFM Fellow.

To recap, here are where are fellowship-bound chiefs are headed:

Malika Anad - Urogynecology, Mayo
Colleen McNicholas - Family Panning, Washington University
Rupal Shroff - Minimally Invasive, Indiana University
Sahar Stephens - Reproductive Endocrinology, University of Colorado
Molly Stout - Maternal-Fetal Medicine, Washington Univeristy

Special shoutout to John Hoff for matching in Oncology at the University of Kentucky.

We are so proud of all you!

Now let's work on getting some great jobs for the remaining 4!

CHOICE and Dr. Peipert

Washington University has a weekly magazine and this week's feature is none other than our own Dr. Peipert! Included is a detailed description of the CHOICE Project as well as some more background about the man himself.

It's a great article and we are very fortunate to have him here!

Congratulations!

Yesterday was Fellowship Match day and there was good news all around.

Molly Stout - MFM Washington University in St. Louis
Sahar Stephens - REI University of Colorado
John Hoff - ONC University of Kentucky

Mallika Anand has already matched in Urogyn at Mayo. Family Planning and Laparascopy matches will be in a couple of weeks.

We would love to celebrate with everyone but Molly is in Maui attending the ACOG meeting. Sure is rough being a Chief Resident!

Congratulations to all and we will celebrate when everyone is back.

Tony

St. Louis' Best Newspaper Columnist

We take a break from our normal OB/GYN postings to congratulate Evan Benn for being named St. Louis' Best Columnist (courtesy Riverfront Times)! Evan writes a column for the Post-Dispatch that features our wonderful local beer and fare.

Evan does have strong ties to the program. His wife is one of our fantastic second year residents and he also provides great tips on where to eat and what to drink. Evan was also recently named "Mayor of WashU OB/GYN" courtesy of Foursquare. Though the Foursquare award is a dubious one, the RFT one is not. You can follow Evan on twitter @EvanBenn. Congrats Evan!

TS

Congratulations!

Big Props to R3 Lindsay Reed for receiving a "Resident of the Year Award" from the Washington University School of Medicine Class of 2011! This is a tremendous honor and we are all very proud of her.

Resident Journal Club

The resident Journal Club featured a recent article in NEJM regarding Valproic Acid Exposure and the risk of Congenital Malformations.

The article was presented by R3 Shayna Norman and the discussion led by R4 Dan Czarnecki. The highlights of the article are listed below and the discussion questions follow the summary. Big thanks to Dr. Norman and Dr. Czarnecki for doing a great job!

NEJM Study Summary:

Objective: This was a retrospective case control study performed to investigate if the use of valproic acid monotherapy in the first trimester infers an increased risk for congenital malformations other than spina bifida.

Study design/Results: Utilizing the EUROCAT antiepileptic database ,and previously identified 14 malformations from prior cohort studies, the authors found that in comparison to no antiepileptic drug (AED) exposure, valproic acid leads to significant increase in the risk for spina bifida, ASD, cleft palate, hypospadias, polydactyly, and craniosynostosis. The associations persisted when comparing exposure to monotherapy of a different AED, except craniosynostosis.

Strengths: Minimally affected by recall bias, large study population, type of antiepileptic used was known in 99.9% of cases, and monotherapy was well delineated, diverse study population (14 countries), able to control for chromosomal abnormalities.

Weaknesses: Basis for defining cases (14 malformations) dependent on literature review, no information on type or severity of epilepsy, dosage, or outcome data, could cause confounding, no baseline comparison between cases and controls, difficult to apply to general population given all cases and controls had congenital malformations.

Impact: Valproic acid use in the first trimester should be avoided if possible due to its known teratogenic effects. Valproic Acid is pregnancy category D, illustrating that there are some cases in which the benefits may outweigh the risks of congenital anomalies. This study has reaffirmed this classification. Further study on dosage and indication is warranted as well as investigation into long term outcomes

Discussion questions:

1. How were Valproic Acid-associated malformations chosen from the literature? Was this the best way to choose outcomes? How would you characterize their method? Why do you think they did it this way?
2. Essentially, what type of study was this? Who were the cases? Who were the controls?
3. Were these the most appropriate control groups? Do we know if cases and controls were similar-appearing groups? Could there be confounders?
4. What are the main issues when using databases as the foundation for your study design? Did these issues affect this study?
5. Is any Valproic Acid exposure the same? Do we have the necessary information in this study to draw a cause/effect relationship?
6. Are all the results this study reports as significantly different actually statistically and/or clinically significant? What does an odds ratio of 12.7 mean in table 3? How can some of the wide confidence intervals be explained?
7. What is the difference between risk associated with elevated odds ratios and absolute risk?
8. How should we counsel a patient who is well-controlled on Valproic Acid for her epilepsy and would like to conceive? Should we offer first trimester terminations for exposures?

OB 201 Starts Today!

Today is a great day for a variety of reason. First, the NFL kicks off (Go Colts!) and Drew Brees (Boiler Up!) takes on that flip flopper and the Vikings.

More importantly, Dr. Anthony Odibo kicks off our OB module with a lecture on Cervical Insufficiency and Cerclage. I dare you to pubmed him. We're extremely fortunate to have such prestigious faculty willing to participate in resident education and today's lecture is a prime example of that.

Our monthly Journal Club follows Dr. Odibo's lecture and it will be led - as always - by Dr. Alison Cahill. I dare you to pubmed her as well. Today's Journal Club focuses on medications and potential adverse neonatal effects.

See you all there. And if I don't, watch the video on line!

Tony

New study by Dr. Cahill

Huge study on the horizon for Dr. Alison Cahill and company.

“The technology became accepted practice before we knew if it worked or not. The stillbirth rate has not changed, and the rate of cerebral palsy has increased,” says Alison Cahill, MD, assistant professor of obstetrics and gynecology at Washington University School of Medicine in St. Louis and a Robert Wood Johnson Foundation physician faculty scholar. “We also believe EFM has had a negative effect by contributing to the drastic rise in cesarean section rates in the past 20 years.”

Cahill and her colleagues at the School of Medicine have received a five-year, $3.5 million grant from the National Institute of Child Health and Human Development to better understand the link between fetal heart decreases during labor and brain damage to newborns. The scientists will compare fetal heart rate patterns to neonatal outcomes in 7,000 term deliveries.

From the STL Post-Dispatch

Dr. Matthew Powell with some quotes in today's article regarding BRCA.


"For years, women with a rare gene mutation that puts them at higher risk for cancer have chosen to have their healthy breasts and ovaries surgically removed as a preventive measure.
New data on the subject, released today, suggest the surgeries do reduce a woman's risk of developing breast and ovarian cancers and improve her chances of living longer.
"It's just verifying what we already would expect to be true," said Dr. Matthew Powell, assistant professor of gynecology at Washington University School of Medicine. "Now we have longer-term follow up and more concrete numbers for our patients to really grasp."
The study is the largest to date to find advantages for preventive surgery for women who carry BRCA gene mutations (found in fewer than 1 percent of the general population).
Women with the faulty genes have a dramatically higher cancer risk than other women — five times greater for breast cancer and at least 10 times greater for ovarian cancer.
The study, appearing in today's Journal of the American Medical Association, found benefits for women with two different BRCA gene variants whether they had previously had breast cancer or not."

Congratulations!

There were 9 prizes given out for the 2010-2011 ACOG Research and Fellowship Awards and Wash U had two of them!

David L. Eisenberg MD, MPH took home the the ACOG/Bayer Healthcare Pharmaceuticals Research Award in Long Term Contraception.

R2 Laura Meints, MD, MBA came away with the ACOG/Merck and Company Inc. Research Award on Adolescent Health Preventive Services.

Congratulations to both!

TS

Lou Fest 2010!

This summer marks the first ever Lou Fest!

I'm super-pumped for a couple of reasons. 1) It's being held in our backyard - Forest Park. 2) She & Him + Wilco Frontman Jeff Tweedy are the headliners! It's like someone stole my iPod and decided to make a concert out of it.

Tony Shanks

GYN Module Quiz

The GYN module quiz is coming up soon! It is tentatively scheduled for September 2 at 5PM though we may move it up a day to accomodate the research retreat. What are these things you ask? Allow me to explain...

We are very proud of the research opportunities that are available to all our residents. In order for them to take full advantage, it is imperative to have a good grasp of general concepts in research and statistics. So the R2s get a full day break from clinical responsibilities and have a "research retreat" hosted by Dr. Peipert at his beautiful home (complete with pool!). We've actually had a hard time in the past getting residents to leave Dr. Peipert's pool!

The module quizzes are our assessment of residents after our lecture blocks. For the uninitiated, we teach topics (OB, GYN, GYN-ONC, REI and Primary Care) in 3 month blocks and then use TurningPoint technology to assess the residents. Last year we had 4 module assessments and we learned that a resident's score was positively correlated to their performance on CREOGs (the annual inservice). For every 1% increase in overall module performance, their CREOGs increased by nearly 1% (submitted to APGO, natch ;). This allows us to identify residents that may need assistance BEFORE CREOGS and it also gives us some nice data to introduce a variable to see if we can improve performance. Something like, I don't know, iPads!

I will post the official date for the module quiz in the next 48 hours. Until then, enjoy the video lectures!

Tony Shanks

Advice for Residency Applicants

With interview season coming around the corner we thought it would be a good idea to solicit some advice from our interns. These talented individuals are the closest to the process and are in a great position to offer some pointers. First up is Natalia Grindler. She interviewed at at >20 obgyn residency programs (not normal, she knows) and she shares some advice on interview season:

-Try to respond to interview offers as soon as you can; dates fill up quickly and if you can't get the date you need, you might not be able to visit that program.
-Go to the resident social events if offered. These are the best places for figuring out whether residents are happy there and whether the program is a good fit for you- plus it's more free food!
-Try to be nice to everyone you meet on the interview trail. You never know where you will end up and who your co-workers will be.
-Keep in touch with the programs you are interested in.
-Enjoy your fourth year!

Thanks Natatlia!

Interview Days!

Can you believe it? Residency interviews are right around the corner and we are gearing up for another fantastic season. We are going to have 5 dates and - back by popular demand - the BUS TOURS are back!

The dates are:

November 8
November 22
December 10
December 13

The fifth date will be either Dececmber 3 or 20. I will have it finalized within the week.

Unfortunately, they won't let ME drive the bus but I do plan on being on it. So residents and alumni, save the date. Prospective candidates, get ready for some STL fun!

Tony Shanks

Resident Videos

We are very proud of our educational curriculum at WashUOBGYN. We are also fortunate to have so many willing faculty that can teach in their various areas of expertise. In case you are not aware, we have two-hours of protected teaching time on Thursday afternoons every week. We recognize that there are going to be times when residents cannot make the scheduled times (vacation, nights, etc). In those events, it's nice to know that we record these videos and make them accessible via the web. Above is just a sampling of what the residents get.

Tony Shanks

Nice work Anna!

There is a great showing this weekend at the Infectious Diseases Society of OB/GYN. Our Program Director Jeff Peipert is joined by one of our fantastic attendings - Jenifer Allsworth. Also in the group is one of our interns, Anna Graseck. I'll let one of her co-residents have the blog...

"Wishing the best of luck to R1 Anna Graseck who is presenting at this weekend's 37th Annual Meeting for the Infectious Diseases Society of Obstetrics and Gynecology. Only a few months into intern year and already presenting at a conference- that's the WashU OBGYN way! Congrats Anna!" - R1 Natalia Grindler

Proposal Title: Comparison of an Observational Cohort Study and a Randomized Trial of Home versus Clinic-based Screening for Sexually Transmitted Infections in Long-Acting Reversible Contraceptive Users Anna S. Graseck, MD, Gina M. Secura, PhD, MPH, Jenifer E. Allsworth, PhD, Tessa Madden, MD, MPH, and Jeffrey F. Peipert, MD, PhD

Proposal Abstract:

Objective: To assess whether there are meaningful differences in the results of an observational cohort study (OBS) compared to a randomized clinical trial (RCT) of home versus clinic-based screening for sexually transmitted infections (STIs). Methods: We compared two studies (OBS and RCT) performed in women enrolled in the Contraceptive Choice Project. The OBS study consisted of the first 462 women enrolled. Participants were offered a choice of home versus clinic-based testing at the 12-month time point. All testing and treatment were free to participants and their partners. Subjects in the clinic group could screen at a local family planning clinic or their regular provider. The RCT randomized a distinct sample of 565 women using long-acting reversible contraception (LARC) to home versus clinic-based testing. We analyzed the rates of screening (test received) by group using Poisson regression with robust error variance, and compared the OBS and RCT studies. Results: In the OBS study, women were more likely to choose to screen for STIs at home (76%) than at a clinic (16%) or with their own medical provider (8%, P<.001). Slightly more than half of the participants (57%) completed screening. Participants in the OBS study who chose home-based testing were more likely to complete a test compared with clinic-based testing (65% v. 23%, RR 2.8, 95% CI 1.9–4.0). In the RCT, the subjects in the home group were more likely submit a test than the clinic group, and the effect estimate was very similar (56% v. 22%, RR 2.5, 95% CI 2.0-3.2). Conclusion: In both the OBS and RCT, subjects were more likely to be tested for STIs with home-based, self-collected testing. This analysis demonstrates that the internal validity of an observational study can be quite high, even when compared to the gold-standard RCT. Mechanisms to facilitate home-based testing should be further explored.

Congratulations!

Our sincerest congratulations to Dr. Malika Anand who recently matched at Mayo for her Urogynecology Fellowship! This is a tremendous accomplishment and we are very proud of her.

Summer School

This year marks the first time that we are doing something called "Summer School". We got the idea from other residency programs and have adapted it for us. "Summer School" are sessions designed to teach us things - very early in the year - that we might not necessarily learn in didactic lectures. That doesn't mean that they aren't important. You could make the argument that these sessions are THE MOST important things we learn.

Our first session was titled LOST! and it it taught us to work in groups and figure out our strengths as both leaders and supporters.

Our next session is tomorrow. We will be learning about FEEDBACK and it's role in the workplace. I remember back to my nights rotation where once a week I would have feedback sessions with my junior residents. I find that both getting and giving feedback is essential to lifelong development as a physician. Tomorrow, Dr. Peipert will lead this discussion and I'm looking forward to it.

Our last session will be this month also. Dr. Thomas Defer is a very well respected Internal Medicine physician here at WashU and may be an even better appreciated public speaker. He will lead us in a discussion on TEACHING - specifically, how to teach medical students and junior residents.

While I have you, I might as well bring up the fact that our OB Thursday morning curriculum has been revamped this year as well! We will be highlighting General OB topics in a fun and interactive way. Today, Dr. Schreiber has just procured a state of the art model to teach fourth degree repairs. Trust me, you want to practice on the model before having to do it in real life!

Thanks for reading!
Tony Shanks

The Great Food of St. Louis

"PiTruckSTL Friday = @PiTruckSTL at BJC @ 11am! We bring the pizzas (sausage or zucchini & red onion), you bring your appetite." - Tweeted by PiTruckSTL

St. Louis has many great things to offer but one of the best is the fantastic food. The New York Times recently had a great article describing what to do with 36 hours in our wonderful city. After living here for several years, I can concur with the article. The cuisine is wonderful.

One of these establishments is Pi - known for it's Barack Obama approved deep dish pizza. Recently, the folks at Pi launched a traveling wagon delivering it's wonderful pies to the area. One of the frequent stops is our very own Barnes-Jewish Hospital. If you haven't tried it out yet, please do.

Then do yourself a favor and try out all of the other places that are featured in the article. I've been to Pappy's Smokehouse, Franco and Winslow's Home recently and the hype is well deserved.

TS

Maternity Hospital Society Golf Tournament

Dr. Peipert is trying to jumpstart the Maternity Society with a Golf Tournament on Monday, September 27 at Glen Echo Golf Course. Infomation will be coming in the mail.

We recognize that not everyone is a golfer - present company included. So we are also in the process of trying to host a wine tasting event. Both events will be great chances to meet other OB/GYNs in St. Louis while helping to promote our educational activities. Please email me for more info.

Tony Shanks

R3's Dominating Green Journal

Congrats to Shayna Norman for her August publication in the Green Journal. Her study, "Ultrasound-Detected Subchorionic Hemorrhage and the Obstetric Implications" is a great read.

Also, congrats to MEILING (one word) for remaining in the top four of the "Top 10 Articles" in Obstetrics & Gynecology. I'm sure it's because it's a great article and not because Meiling keeps downloading it.

Alumni Updates

I just ran into Caroline Morgan, WashUOBGYN Class of 2007. She is doing phenomenally well and it got me to thinking, "why don't we have the alumni post updates of what they are doing and where they are at?"

So periodically we will let distinguished alumni be the voice of our blog. It will help us all see that there is light at the end of the tunnel. (And not just a train headed our way.)

Tony Shanks

LUMAS

For the uninitiated, LUMAS (Lung Maurity and Antenatal Steroids) was a prospective, randomized controlled trial that was performed at Barnes-Jewish Hospital. The study looked at the effects of steroids after 34 weeks in patients with a NEGATIVE TDX-FLMII for fetal lung maturity.

Residents had an active hand in recruiting patients and the results are available in this month's AJOG.

In case reading isn't your cup of tea (and it really should be) here is Reuter's video version of the study.

Thanks to recent graduate John Hoff for pointing this out.

OB 201

I'm in the process of creating the second year of our OB module. To refresh your memory, we have created a two-year didactic curriculum that allows a resident to hear/see every lecture live twice. (A motivated resident can watch videos an unlimited amount of time because we record the lectures!) Here is our tentative fall schedule:

September 9, 4PM: Cervical Insufficiency/Cerclage – Dr. Odibo
September 9, 5PM: Journal Club – Dr. Cahill

September 16, 4PM: Hematologic Disorders – Dr. Macones
September 16, 5PM: Ultrasound in Pregnancy – Dr. Bernhard

September 23, 4PM: Viruses – Dr. Stamilio
September 23, 5PM: Ethics – Dr. Brown and Dr. Wall

September 30, 4PM: Postterm Pregnancy – Dr. Rampersad
September 30, 5PM: Green Day! – Dr. Shanks

October 7, 4PM: Endocrine Disorders – Dr. Kay
October 7, 5PM: Journal Club – Dr. Cahill

October 14, 4PM: Pyschiatric Diseases – Dr. Houser
October 14, 5PM: Fetal Death – Dr. Shanks

October 21, 4PM: Alloimmunization – Dr. Cahill
October 21, 5PM: Ethics – Dr. Brown and Dr. Wall

October 28, 4PM: IUGR – Dr. Dicke
October 28, 5PM: Green Day! – Dr. Shanks

November 4, 4PM: Maternal Cardiac Disease – Dr. Tuuli
November 4, 5PM: Embryology – Dr. Nelson

November 11, 4PM: Seizure Disorders in Pregnancy – Dr. Harper
November 11, 5 PM: Journal Club – Dr. Cahill

November 18, 4PM: Green Day!
November 18, 5PM: Ethics

November 24, 7 AM (Wednesday): Puerperium – Dr. McNamara

December 2, 4PM: OB Anesthesia – Dr. Leighton
December 2, 5PM: OB Quiz

What is great is that people go to conferences to attend lectures by these doctors. We are lucky enough to have them lecture for free! (I hope they don't think that they are getting reimbursed.)

Tony Shanks

Thank you to Malika Anand for giving me the heads up on this great article about our Chairman, Dr. Macones.

Weekend Fun!

A slew of residents attended the Lady Gaga concert in St. Louis. Attendance at this concert rivaled our showing at SMFM! (That's saying a lot.)

R4 Rupal wanted me to be sure that I showed off pictures of residents OUTSIDE of the hospital.

Tony

It's July so that means new Protocol Books! I just got done looking at the proofs and they look phenomenal. Previous editions have featured Obstetrical Protocols only. This year, the resident manual will also include the Oncology Handbook AND Dr. Bernhard's Clinic Primer. Alumni, please contact me if you are interested in obtaining a book.

Tony Shanks

The internet is a powerful tool for education and we pride ourselves at Wash U at taking full advantage of the media. Above is a screen capture of our residency website. Highlighted by our educational calendar, it serves as homebase for all of our educational endeavors. As we move forward, I'll occasionally highlight different aspects of the site. Today, is the overview.

The calendar serves as a way to know what lectures are coming. Remember, we have our didactics arranged in "modules". Currently we are in the GYN module. We will have 12 lectures on the subject followed by a quiz utlizing Turning Point technology. The quizzes are low risk but it does provide an opportunity to identify areas that residents could potentially improve on.

The lectures have hyperlinks embedded within the calendar and our lectures are also video recorded if you are unable to attend (vacation or nights rotation). The feedback has been overwhelmingly positive and even our faculty can be caught watching the videos to keep up!

Tony Shanks

The residents had a journal club last week regarding the recent Green Journal article on double vs. single-layer closure of the uterus. Dr. Alison moderated the discussion and Dr. Mei Ling Hua was the R3 assigned to lead the discussion. Below are Dr. Hua's conclusions.

-This was a multicenter case control study to look at the effect of hysterotomy closure type on the risk of uterine rupture during VBAC.
-There are many risk factors that contribute to risk of uterine rupture during VBAC -Hysterotomy closure type (single-layer vs double-layer) is a modifiable risk factor -This study found a 2-fold increased risk of uterine rupture with single layer closure, even after adjusting for confounding variables.
-Strengths: multicenter, large number of cases, strict definition of uterine rupture, control group well selected (3 controls per case; matched for time period and institution, but delivered prior to case of uterine rupture)
-Weaknesses: Retrospective design, no information on doseages of OT or prostaglandin, and whether used consecutively, no definition of double-layer closure, no info on what the confounding variables were.
-Impact: Absolute risk of uterine rupture is low and performing a double-layer closure is not without risk. A randomized control trial would be a better way to answer this question, but would be expensive.

Dr. Jeffrey Peipert is not only our Residency Program Director but he is also Vice Chair for the Division of Clinical Research. Below are some links to keep you current with our research endeavors. It's impressive stuff!

TS

DCR - Division of Clinical Research

DCR Newsletter

Dr. Stewart Massad is a national leader in colposcopy and we are fortunate to have him run our resident colposcopy clinic. Below are some podcasts highlighting recent updates.

Enjoy!
Tony Shanks

CDC Podcasts

The Centers for Disease Control and Prevention has released a series of podcasts on cervical cancer screening and prevention. These educational sessions present interviews with national authorities including Drs. Phil Castle, Alan Waxman, Stewart Massad, Walter Kinney, Lisa Flowers, and Tom Cox. To download these free podcasts, go to http://www.cdc.gov/podcasts, select the “Browse” tab, and then select the “Women’s Health” series, or click on the titles below.

* Natural History of HPV and Cervical Cancer
* Costs Associated with Cervical Cancer Screening
* Management of Cervical Cytology with HPV Test
* Cervical Cancer Screening with HPV Test
* HPV Testing Among Providers
* ACOG Recommendations and Guidelines for Cervical Cancer Screening and Management
* Case Studies - Cervical Cancer
* Cervical Cancer Screening in Underserved Populations
* Future Directions - Cervical Cancer

Intern Surgical Series

Dr. Gladys Tse heads our surgical skills training sessions and everyone loves them! This summer she will be doing a resident wide training session regarding general OB principles. Additionally, she performs resident year-specific training. (This is all in addition to our dedicated didactic curriculum.)

Today, interns got to learn about sterilization with Filshie clips.

Here is a link to more info regarding the device.

TS

Inaugural Post

The Washington University in St. Louis OB/GYN Residency Program prides itself on being one of the greatest in the country. Now, we can keep you current with what we are doing at our fine institution.

We have so much to offer in terms of clinical and research experience and we are proud of our didactic curriculum, our surgical series and our use of video technology. However we are most proud of residents. These talented and friendly people form the backbone of our program and it is with them in mind that we start our journey together into the blogosphere.

Special thanks to Natalia Grindler for keeping me current!

Tony Shanks
Associate Residency Program Director