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