Divisions of Gynecology
The Division of Gynecology at Carolinas Medical Center is focused on educating residents and medical students in ambulatory and surgical gynecology. The Division is composed of 5 general obstetrician/gynecologists and 2 urogynecologists. The division is involved in resident education across the entire spectrum from the operating room, to the ambulatory clinic, to labor and delivery, and into the classroom. While maintaining broad skills, each of the division members have special expertise in several niche areas such as urogynecology, laparoscopy, pediatric and adolescent gynecology, and gynecologic ultrasound.

It is our goal to provide the resident with exposure and experience in all facets of benign gynecology. Our ambulatory gynecology clinics, which evaluate over 5000 patients each year, provide experience in management of conditions such as contraception, sexually transmitted infections, abnormal uterine bleeding, vaginal infections, and adnexal masses. In the operating room, we strive to give the resident a strong foundation of good surgical skills and habits from which to expand. We provide experience in all forms of vaginal, abdominal, laparoscopic, and hysteroscopic surgery. This experience is enhanced through the ability to work with local private physicians in caring for their gynecologic patients.

The Gynecology team consists of a PGY-2, PGY-3, and PGY-4 resident. The PGY-2 resident is responsible for inpatient care, emergency department and in-house consultations, assists with major procedures, and performs most outpatient procedures such as tubal ligation, dilation and curettage, hysteroscopy, etc. The PGY-3 and PGY-4 resident divide their rotation between benign gynecology and urogynecology. The benign gynecology senior resident is responsible for all inpatient care and performs all major procedures. This resident is also responsible for supervision of the gynecology team. The urogynecology resident works with our urogynecologists within the department as well as an urologist who specializes in women's care.

Urogynecology Experience
The first year urogynecology experience within the general gynecology rotation includes an introduction to the anatomy of pelvic support and continence, staging of prolapse with the POP-Q system and urodynamic testing and pelvic physiotherapy. More extensive and in-depth training in urogynecology takes place during the PGY 3and 4 years. A 10 week block in the weekly urogynecology clinic involves evaluation of patients with prolapse and incontinence. Training is given in pessary fitting, cystometry and interpretation of multichannel urodynamics. A 5-week block exposes residents to both the ambulatory and operative settings, with operative experience in suburethral sling placement TOT/TVT, laparoscopic pelvic reconstruction, abdominal pelvic reconstruction and vaginal obliterative procedures.

Division of Maternal Fetal Medicine
The responsibility for the education and supervision of residents and medical students for the Obstetrics and High Risk Obstetrics is shared between the Generals faculty and the Maternal Fetal Medicine Division (currently 5 members). Carolinas Medical Center has approximately 7,00 deliveries per year and serves as the tertiary referral center for 9 surrounding counties. Thus, the obstetric experience is extensive and robust.

During the first year, residents are trained in prenatal care, routine labor and delivery (5 months) and have an ultrasound rotation that introduces them to the obstetrical and gynecological ultrasound. The second year experience includes an ultrasound rotation with more extensive exposure ot prenatal diagnosis and genetic issues as well as more advanced gynecological scans. The second year obstetrical resident also participates in the Diabetic and High Risk Obstetric Clinics and obtains extensive experience in labor management and operative obstetrics. The third and fourth years concentrate on inpatient and outpatient High Risk obstetrics. A Maternal-Fetal Medicine physician supervises and is on call for the High Risk Obstetric Service, 24 hours per day, 7 days per week. The Generalists and Maternal-Fetal Medicine Divisions are committee to the superior education and training for our obstetric residents.

Division of Gynecologic Oncology
The division of gynecologic oncology is composed of four board certified gynecologic oncologists. Last year, we evaluated approximately 550 new patients and perform 350 surgeries. Our number of laparoscopic cases continues to increase. We perform a number of total laparoscopic hysterectomies, pelvic lymph node dissections, and removal of ovarian masses using laparoscopic techniques. The residents actively participate in all surgical cases.

We are members of the Gynecologic Oncology Group (GOG) enrolling patients in clinical trials. This affords our patients the latest therapies for their gynecologic malignancies. Our in-patient service averages 10-12 patients. The residents participate in managing all hospitalized patients with daily rounds with one of the attending physicians.

Division of Reproductive Endocrinology and Infertility
The Division of Reproductive Endocrinology and Infertility (REI) within the Department of Obstetrics and Gynecology at Carolinas Medical Center is dedicated to the excellent training of OB/GYN residents through interaction within a full-service REI clinical practice, formal didactic instruction, and clinical and basic research. The Division is comprised of five sub-specialty board certified REI physicians. Residents will be involved with patients representing a wide spectrum of disorders including gynecologic endocrinopathies, abnormalities of sexual development, infertility, recurrent pregnancy loss, genetic reproductive failure, and problems in menopausal medicine. Residents in OB/GYN are expected to have thorough training in the selection and preparation of patients for in vitro fertilization and be familiar with advanced reproductive procedures through our Program for Assisted Reproduction. This experience will provide clinically applicable knowledge in gamete development, embryology, and the physiology of the hypothalamic-pituitary-ovarian axis.

Our philosophy is that many fundamental clinical concepts involved in gynecology, early pregnancy, and office practice require a thorough understanding of REI. The REI faculty is therefore also involved in teaching and consultation for cases of amenorrhea, abnormal uterine bleeding, endometriosis, and advanced endoscopic procedures. REI and Gynecology faculty have developed formal didactic and laboratory instruction in a resident endoscopic teaching course.

The formal REI resident rotation occurs during a nine week period in the third year of residency training. An individual resident will be involved in the evaluation and management of private patients referred to REI faculty and will have primary clinical responsibility in their own REI staff clinic with one-on-one faculty supervision. Residents will obtain direct experience in ultrasound and hormonal monitoring for cycles of ovulation induction, saline instillation sonography, hysterosalpingography, and intrauterine inseminations. Residents will participate in a broad range of both out-patient and in-patient surgeries related to REI. Time is allowed for directed reading for preparation of REI lectures for resident teaching conferences. For those residents seeking to pursue fellowship in REI, additional clinical experience and involvement in available active clinical and basic research projects is encouraged.