• Ethical conduct of research, including the role of the Institutional Review Board and human studies protections and procedures
• Formulation of hypothesis-driven experiments or analyses
• Orientation to scholarly resources and software for the conduct of research
• Training in statistical software for data management and analysis
• Fluency in public health study design and methodological research considerations
• Critical appraisal and evaluation of peer-reviewed literature
• Oral and written communication for research
• Training in basic grant structure and manuscript writing

• Demonstrates knowledge of institutional surveillance systems to monitor patient safety (e.g., surgical site infection, medical error reporting)
• Demonstrates knowledge of the epidemiology of medical errors and the differences between near misses, medical errors, and sentinel events
• Demonstrates knowledge of national patient safety standards, as well as their use/application in the institution
• Recognizes when root cause analysis is necessary and is capable of participating in root cause analysis

• Demonstrates a commitment to self-evaluation, lifelong learning, and patient safety
• Demonstrates understanding of the basic concepts of quality improvement
• Understands the level of evidence for patient care recommendations
• Identifies quality of care issues within one’s own practice with a systems-based approach

Provide ante/intra and postpartum care for patients with uncomplicated pregnancies (e.g, spontaneous vaginal deliveries, primary cesarean deliveries, common medical presentations, and diagnostic operative gynecology, including hysteroscopy and laparoscopy).

• 6 Rotations in Obstetrics (2 day time, 2 night, 2 ambulatory)
• 4 Rotations in Gynecology (2 surgery, 2 ambulatory)
• 2 Rotations in Gynecologic Oncology

Provide care for patients with common obstetrical complications (e.g, previous Cesarean section, abnormal fetal growth, multifetal gestation, preterm labor) and common peripartum medical comorbidities (e.g., hypertension, diabetes, infectious diseases). Manage urgent and emergent gynecologic concerns. Supervises and educates senior medical students.

• 3 Rotations in Obstetrics (2 surgery, 1 ambulatory)
• 2 Rotations in High-Risk Obstetrics
• 3 Rotations in Gynecology (2 surgery, 1 night)
• 2 Rotations in Gynecologic Oncology
• 1 Rotation in Reproductive Endocrinology and Infertility (REI)/Minimally Invasive Gynecologic Surgery (MIS) or Female Pelvic Medicine and Reconstructive Surgery (FPMRS)
• 1 Elective Rotation

Leadership focus: Building and supporting a clinical team

Provide care for patients with atypical presentations of medical and obstetrical complications; identify indications for consultation, referral, and/or transfer of care for patients with medical and obstetrical complications. Able to recognize surgical complications and formulate an initial management plan. Supervise and educate lower-level residents.

• 3 Rotations in Obstetrics (1 ambulatory, 2 night)
• 3 Rotations in Gynecology (3 surgery)
• 2 Rotations in Gynecologic Oncology
• 1 Rotation in Female Pelvic Medicine and Reconstructive Surgery (FPMRS)
• 1 Rotation in Minimally Invasive Gynecologic Surgery (MIS)
• 1 Rotation in Reproductive Endocrinology and Infertility (REI)
• 1 Elective Rotation

Provide care for patients with complex and atypical medical and obstetrical complications. Independently perform gynecologic procedures and demonstrate good intraoperative decision making, including the ability to modify a surgical plan based on operative findings, and recognize and manage surgical complications. Lead a multidisciplinary healthcare team and coach lower levels to optimize professional expectations.

• 3 Rotations in Obstetrics (2 days, 1 surgery)
• 7 Rotations in Gynecology (1 night, 4 surgery, 2 ambulatory)
• 1 Rotation in Female Pelvic Medicine and Reconstructive Surgery (FPMRS)
• 1 Rotation in Minimally Invasive Gynecologic Surgery (MIS)

Quality Indicators (QIs) are standardized, evidence-based measures of health care quality used to measure and track clinical performance and outcomes. The Obstetric and Gynecologic Quality Improvement/Patient Safety committees identify cases with quality improvement indicators. Resident physicians who participate in the case are asked to review the case, consider the quality improvement indicator and discuss how the clinical performance and patient outcomes could have improved.

Learning Objectives:

• Review perioperative care obstetric and gynecologic surgical cases
• Identify systems-based issues that may impact perioperative care
• Reviewed application of current U-M Medical School operational and safety guidelines (e.g. Assessing risk, optimization needed for patients with common comorbidities, antibiotic prophylaxis, blood product transfusions, complications, pain management, etc.)

During this interactive session, residents will be asked to briefly present and review the pertinent components of their cases. They are expected to be prepared to discuss the relevant history and clinical management decisions. Residents are expected to have a full understanding of their cases, demonstrating ownership of the patient care that was received. They are also expected to be prepared by reading appropriate text, practice bulletins, committee opinions, and/or literature pertinent to the case.

Learning Objectives:

• Develop and practice clear communication of clinical management and decision-making related to the practice of Obstetrics and Gynecology
• Demonstrate learners' understanding and discuss the pathophysiology, diagnostic evaluation, differential diagnosis, and treatment of clinical cases in Obstetrics, Gynecology, and Office Practice

This conference, led by our PGY3 residents, offers trainees an opportunity to discuss patient cases where errors, near-misses, or complications, may have occurred.

The learning objective is to provide a safe venue for residents to:

• Identify systems-based issues that lead to adverse patient outcomes/near misses
• Openly discuss medical mistakes
• Disseminate information learned from experience
• Reinforce a sense of professional accountability for patient safety
• Demonstrate competency in QI/PS principles

We believe that confronting structural racism and implicit bias to address health inequities is of the utmost importance. To prepare our residents to do so, U-M Medical School adapted a curriculum from Harvard Children, called Health Equity Rounds (HER). Our PGY4 residents are expected to identify a patient care encounter where structural racism and implicit bias affected patient care.

Learning Objectives:

• Identify and analyze the effects of implicit bias, structural racism and/or other oppressive and discriminatory attitudes or beliefs on patients in clinical scenarios
• Describe the historical context, impact, and present-day role of structural racism and/or other oppressive and discriminatory attitudes or beliefs on the health care system
• Highlight the intersectionality of race and other sources of implicit bias and discrimination in the case presentation
• Identify evidence-based tools to recognize and mitigate the effects of personally held implicit biases

It’s been said that effective grand rounds should disseminate knowledge, change physician behavior, and improve patient outcomes. Our PGY4 residents are expected to identify and delve deeply into a topic of interest, develop expertise in the topic, and present at Departmental Grand Rounds.

Examples Topics from Recent Resident Cohorts:

• A Journey for Joy: Musings of a Self-Help Junkie, Marisa Sturza, MD
• Why Does My Husband Make More Than Me?: Evaluating Differences in Medical Compensation by Gender, Erin Inman, MD
• Clinically Competent, Fiscally at Risk, Jasmine Ebott, MD
• Women's "Health" in Rural America, Ann Lozier, MD
• Vague Reassurances: The Evidence Around Common Pregnancy Restrictions and Why These Questions Matter, Cindy Lee, MD

Journal Club is an opportunity for residents to critically appraise and engage in discussions on recent articles from the medical literature.

Learning Objectives:

• Appraise the study design and statistical methods used
• Interpret and discuss the applicability of results to our patient population
• Identify how social determinants of health impact health outcomes and patient experiences