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Perfecting techniques, learning professionalism: At the U, educating tomorrow's obstetricians and gynecologists is about more than just teaching medical skills.

Residents in obstetrics and gynecology at the University of Minnesota are, in a strictly literal sense, all over the map.

(From left) Resident Diane Horvath-Cosper, M.D., associate professor Phillip Rauk, M.D., and resident Jeanne Nugent, M.D., talk with a patient about her care plan.

From the University’s research hospitals to urban county hospitals to suburban private settings, new physicians in the Department of Obstetrics, Gynecology, and Women’s Health’s residency program work in a variety of environments.

The diversity in training sites—residents have rotations at six different hospitals—is a great opportunity to work with patients from all walks of life, says Phillip Rauk, M.D., the department’s residency program director. It also makes bringing all of the residents together a bit of a challenge.

But the advantages are worth it, says third-year resident Lindsay Darrah, M.D., who chose the University partly because of its range of training sites.

“[The variety] lends itself to taking care of an extremely diverse population,” Darrah says. “And in those different settings, we work with a lot of different staff docs and attending physicians. Over the past three years, I’ve identified a fair number of models of how I want to be as a doctor.”

Learning and camaraderie

The need to regularly corral residents from a half-dozen sites across the metro area has led to some innovative offerings.

Residents are freed from all other responsibilities to attend a weekly didactic session. Topics range from hands-on lab skills trainings to morbidity and mortality conferences to discussions of professionalism.

Chief resident Robin Marushin, M.D., says participation would be much lower if residents’ Monday afternoons weren’t reserved for didactics. At some institutions, the understanding is, “You can come if you’re not doing X, Y, or Z,” she says. “But you always are.”

For first-year residents, LaValleur adds, the Monday sessions are preceded by lunch with non-grading faculty—another way the department fosters support and camaraderie among residents. “It has made a huge difference—residents caring about each other, thinking about each other. That’s not present in every program.”

Darrah says she definitely feels supported by her peers. “I genuinely like the people I work with,” she adds. “I would bend over backward for my classmates, and I think they would do the same for me. I enjoy going to work every day. I feel lucky.”

Residency director Phillip Rauk, M.D., and third-year resident Jeanne Nugent, M.D., discuss a patient's chart.

Supporting resident research

As part of their experience, University obstetrics and gynecology residents are encouraged to pursue a research project. Through the Fritz and Mary Corrigan Resident Research Fund, established in 1999, residents work with faculty mentors to explore an area of interest.

Rauk says the requirement isn’t intended to turn every resident into a researcher, but rather to give each resident, through a self-directed endeavor, a solid understanding of the scientific process. Residents identify their research projects in the first year, formalize the process in their second year, and present their results at a conference in their fourth year.

Second-year resident Mike Kassing, M.D., for example, is studying the endometria of women who are preparing for gastric bypass surgery, as endometrial cancer is twice as common in overweight women. In his project, he intends to biopsy the endometria of 150 women before they undergo gastric bypass surgery and then again one year after surgery. His study could influence cancer screening guidelines for women who are overweight.

Finding the passion

Every year, hundreds of high-achievers apply to the University’s obstetrics and gynecology residency program. Sixty to seventy are interviewed, and ten are admitted.

“We really get the top people—and when our residents apply for fellowships, they get the ones they want,” LaValleur says. “We have an excellent reputation.”

The University’s obstetrics and gynecology residency program is designed to promote not just mastery of clinical skills and knowledge, but also respect for patients, peers, and the medical profession.

And that is largely taught is by example. “There would be times in my training when I would hear: ‘The ovarian cancer in 17,’ not ‘Annie Johnson, who has ovarian cancer, in 17,’” LaValleur says. “Today we are always thinking about the patient as a person—not as just a uterus, tubes, and ovaries.”

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