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Winthrop University Hospital

Residency Training : Obstetrics & Gynecology

"Winthrop's Ob/Gyn Program is committed to creating and sustaining an optimal educational environment for acquiring knowledge, developing technical skill and fostering sensitivity toward women and their families."


  • Message from the Chairman
  • Introduction & Philosophy
  • Program-At-A-Glance
  • Organization of the Department
  • Rotation Schedule
  • General Obstetrics & Gynecology
  • Subspecialties in Obstetrics & Gynecology
  • Curriculum
  • Research & Conferences
  • Career Placement
  • Faculty
  • Professional & Social Environment
  • Application Procedure
  • Message from the Chairman

    A_Vintzileos
    Dr. Anthony Vintzileos, Chairman and Program Director (effective Sept 4, 2007)
    Winthrop-University Hospital has had an abiding commitment to women's healthcare since the early part of this century, when it became the first Long Island hospital to establish a separate pavilion for women. The Department of Obstetrics and Gynecology has supported and sustained that focus. Our resolve to provide residents with the finest education and training experience is second only to our commitment to provide women with exceptional patient care.

    The faculty and staff are committed to creating and sustaining an optimal educational environment for acquiring knowledge, developing and honing technical skill, and fostering sensitivity toward women and their families. We pride ourselves on selecting house staff members who are energetic, enthusiastic, diligent and dedicated to providing unparalleled patient care.

    Our goal is to train physicians to be excellent clinicians with the ability to continue learning and advancing so they always remain outstanding practitioners. However, in this very challenging healthcare environment, we also focus on helping them prepare for a successful medical practice. Our broad-scoped opportunities meet the academic and clinical needs of primary care obstetricians and gynecologists, as well as those who choose to become subspecialists.

    We appreciate your interest in our residency training program and invite you to visit us, evaluate our program and explore the many opportunities that await you at Winthrop.

    Dr. Anthony Vintzileos
    Chairman and Program Director
    Winthrop-University Hospital
    120 Mineola Boulevard
    Mineola, NY 11501

    Introduction & Philosophy

    The belief that learning is not a finite experience, but rather a life-long continuum, is the fundamental educational principle of the Department of Obstetrics and Gynecology. Therefore, the Ob/Gyn training program provides a broad learning experience in the current standards of patient management and in the most up-to-date advances.

    The department strives to teach each resident to become a compassionate, supportive, competent, and ethical physician and primary care provider for women. In reaching these objectives, the program provides increasing levels of responsibility, appropriate supervision, formal instruction, counseling, and critical evaluation for each resident, while never losing sight of each resident's individuality.

    The program strives to enhance the educational experience by providing a comprehensive didactic program, an active research environment, and requiring the integral participation in at least one research project before completion of the residency program. The program maintains an environment of academic inquiry and scholarship. Residents are expected to obtain the skills and knowledge to serve as an educator and consultant to patients, colleagues, and medical students.

    The program teaches each resident the skills of comprehensive patient assessment and management as well as when to call on subspecialty expertise and consultation. By reaching the program objectives, the resident should acquire the necessary knowledge, skills and attitudes to pass both written and oral ABOG examinations, become a Diplomat of the ABOG, and a valued member of the profession.

    Program-At-A-Glance

    1
    The New Life Center

    2
    Surgical Training Lab
  • An independent four year approved residency program with four residents in each year
  • Competitive salaries and benefits, subsidized housing on the hospital campus, and 24 hour hospital support services
  • Consistent resident performance above the 80th percentile nationally in many obstetric and gynecologic procedures including: forceps delivery, vaginal birth after cesarean, multifetal deliveries, surgical procedures on antepartum patients, hysterectomy, major surgical procedures for Gyn neoplasia, surgery for incontinence, hysteroscopy, and laparoscopy.
  • A recent approval of a three-year Maternal-Fetal Medicine Fellowship program which started July 2007.
  • An expanded Gyn Oncology department with 4 Gyn Oncologists, an active surgical presence, and an extensive didactic program.
  • An expanded Reproductive/Endocrinology & Infertility Division is staffed by 6 full-time Board certified reproductive endocrinologists. This division maintains an active operative presence.
  • An expanded Division of Urogynecology and Reconstructive Pelvic Surgery with 2 full time Urogynecologists performing advanced diagnostic and therapeutic modalities
  • A large and diverse patient population with approximately 5000 deliveries per year and more than 4000 gynecologic procedures available for resident education
  • All training and education on site through the many resources available at Winthrop
  • A dedicated full-time, part-time, and voluntary faculty and a supportive administration
  • Full time faculty actively involved in research, well published in major peer review journals, and a senior editor of a major perinatal journal
  • Competitive placement of residents in postgraduate fellowships and private practice
  • The Women's Contemporary Care Center, a modern private practice center used by the full-time faculty, residents and specialty divisions for patient care. Each resident is assigned a weekly four hour office session and, under the supervision of a faculty member, builds a private practice over the four years, including primary care, patient education, obstetrics, and gynecologic surgery.
  • The New Life Center: An ultra-modern labor-delivery-recovery (LDR) facility that opened in 1998. It includes 16 LDR suites, special monitoring rooms equipped with the most advanced computerized technology, programs for high-risk patients and separate areas for cesarean section mothers. The center houses the new Conference Center and Ob/Gyn Resident Educational Resource Center comprising the resident library, lecture facility, computers, web access, training videos, and other educational materials. In addition, adjacent to the Conference Center is our newly designed and expanded Health Sciences Library.

  • Organization of the Department

    Winthrop-University Hospital is one of the region's leading healthcare resources. It is a tertiary care 591 bed teaching hospital that includes a Category I Cancer Center; a Level I Trauma Center; a nationally accredited Sleep Disorders Lab; a Regional Poison Control Center; a Neonatal Intensive Level 3 Referral Center care Unit that treats newborns transferred from other area hospitals; and cardiac and pulmonary programs that have received outstanding ratings. In addition, the Women's Health Services maintains a 1-800 number that serves as a successful tool in reaching out to the community with educational programs, referrals, support groups, and educational forums. The Department of Obstetrics & Gynecology serves patients from all of Nassau County, as well as Eastern Queens and parts of Western Suffolk County. Approximately 5000 deliveries are performed annually. This includes 1500 patients who were followed at Women's Contemporary Care Associates (the department's ambulatory center) and community clinics. In addition, there are over 2000 major and approximately 2000 minor gynecologic surgeries. All obstetric and gynecologic patients are teaching cases and are available to the residents for such purposes. At Women's Contemporary Care Associates (WCCA), approximately 1500 patient visits are scheduled per month. Of these patients, 60% are obstetric and 40% gynecologic. In addition, over 8000 triage visits are made to the triage unit at the New Life Center and approximately 12,000 surveillance tests and ultrasound scans are performed at the division's ultrasound lab.

    Resident Rotation Schedule

    PGY 4 OB
    GYN
    URO
    GYN
    ONC ONC OB
    GYN
    Breast
    OB
    GYN
    Breast
    URO
    GYN
    URO
    GYN
    OB
    GYN
    OB
    GYN
    ONC   ONC

    PGY3
    OB
    GYN
    OB
    GYN
    MFM MFM OB
    GYN
    OB
    GYN
    REI REI OB
    GYN
    OB
    GYN
    ELECT. OB
    GYN
    PGY2 ONC ONC OB
    GYN
    OB
    GYN
    REI REI OB
    GYN
    OB
    GYN
    MFM MFM ONC ONC
    PGY1 OB
    GYN
    OB
    GYN
    MICU OB
    GYN
    OB
    GYN
    OB
    GYN
    OB
    GYN
    OB
    GYN
    OB
    GYN
    OB
    GYN
    SONO
    OB
    GYN
    OB
    GYN
    OB-G - Obstetrics & Gynecology; MED-Medicine
    MICU - Intensive Care Unit
    Ob - G/Sono-Obstetrics & Gynecology with Ultrasound
    ONC - Oncology
    MFM - Maternal-Fetal Medicine
    Repro - Reproductive Endocrinology & Infertility
    Uro-G - Urogynecology & General Gynecology
    Breast - Ambulatory/Breast; Elective-Tailored elective time


    The overall philosophy of the training program is to provide our residents with increasing levels of experience and responsibility as early as possible within the areas of obstetrics, operative gynecology, and ambulatory care.

    The resident rotation schedule is structured differently from many other programs in that we do not separate the Obstetric and Gynecologic experiences. We integrate them with the intention of mimicking the true post-training environment and enhancing the continuity of care for our patients and providers.

    Another feature unique to our program is the ambulatory center where residents follow their own complement of patients throughout their four years. Our outpatient center was presented at the 1995 CREOG/APGO meeting as a model for resident training in ambulatory care. The center functions as a private practice, with patients followed by specialty physicians, residents, and full time faculty. It is equipped with a procedure room, laboratory, 6 consultation rooms, and 12 patient examination rooms. There is a center for patient education and one mobile ultrasound unit with curvilinear and endovaginal probes. The procedure room is equipped with colposcopy, cryotherapy, LEEP, electrocautery, hysteroscopy, cystourethroscopy, urodynamics, biofeedback, and suction curettage. This facility is tied into the perinatal diagnostic center where gynecologic and obstetric ultrasound and fetal testing are performed.

    Beginning at the PGY-I level, residents attend one half day session per week for patient care. Each resident follows his/her complement of patients. The number of patients increases as the resident advances in the program. Sessions consists of two residents and one supervising faculty member. The attending does not schedule private patients during these sessions so that complete attention can be directed towards supervision. The residents will work with the same nurse and faculty for a minimum of one year at a time.

    The work schedule adheres to the Bell Commission and includes night call approximately every third to fourth night with three residents covering each of the following: L&D, house and emergency room, and chief call. An in-house attending physician is on call every night for direct supervision and consultation, as needed. Residents are exempt from Ob-Gyn call during their PGY-1 rotations in medicine and MICU. Call during that time is arranged through the Department of Medicine.

    PGY-1

    First year residents rotate for a total of 11 months through obstetrics and gynecology as a combined service. The fundamentals of diagnosis and management, anatomy, and disease/normal physiology are emphasized. PGY-1 residents actively participate in management, performing normal deliveries, cesarean sections, ultrasound, and minor procedures including office diagnostic, D&C, hysteroscopy, laparoscopy, cerclage and marsupalization. Other rotations include one month of MICU and one month of Gyn ultrasound.

    PGY-2

    Second year residents expand on their knowledge and proficiency in diagnosis and management of common obstetric and gynecologic problems. There is greater participation in complicated obstetric deliveries including forceps, vacuum, and difficult cesarean deliveries. In addition, there is greater involvement in difficult gynecologic surgeries including operative laparoscopy and hysteroscopy. Some minor laparotomies are performed at this level. During the 2nd year, residents spend 2 months in Reproductive/Endocrinology and Infertility service.

    Two months are spent rotating through the MFM service where residents act as consultants with the assistance of the chief resident and MFM faculty and attend the high risk clinic. Residents learn how to perform genetic and third trimester amniocentesis and are expected to perform 10-20 procedures. A portion of their rotation is spent at the MFM ultrasound lab where they receive hands-on experience in fetal anatomy scans and survey.

    PGY-2 residents rotate for four months on the Gyn Oncology service where they are an integral member of the management team. This resident works closely with the PGY-4 and oncologist in managing both the inpatient and outpatient. The PGY-2 assists on many of these operative cases and is expected to master the clinical and technical skills necessary for proper pre and post-operative treatment.

    PGY-3

    During this year, residents are increasingly responsible for management of laboring patients, post ops and antepartum patients. The third year resident continues to expand on the experience and skills achieved in previous years with greater participation in management and in supervising junior residents. Rotations include two months on the MFM service and two months on the Reproductive Endocrinology and Infertility services.

    The PGY-3 MFM resident is responsible for the assessment of all patients to be admitted to the MFM service under the supervision of the chief resident and faculty. During this rotation, residents perform amniocentesis, assist in complicated procedures, receive additional hands-on training in fetal anatomy scans and survey, and serve as consultants under the MFM faculty.

    While rotating for two months through REI, residents learn the fundamentals of diagnosis, evaluation, and treatment of patients with endocrinopathies and infertility. Skill is acquired in the use and interpretation of diagnostic modalities such as ovulation prediction/assessment, semen analysis, post-coital testing, laboratory interpretation, ultrasound, endometrial assessment, and HSG. In addition, residents learn the techniques of ovulation induction and assisted reproduction.

    PGY-4

    During their fourth year, residents continue to enhance their diagnostic and management skills while assuming the responsibility of supervising their junior colleagues both in surgical skills and academics. It is not uncommon for "chief" residents to act as the first assistant in obstetric and gynecologic cases while supervising their junior colleagues in their role as primary surgeon.

    Each PGY-4 resident will rotate through the Gyn Oncology service for four months. Here, they will develop a thorough understanding of the diagnosis and treatment of malignancies and the appropriate level of mastery of the surgical techniques and objectives of this service. All Gyn Oncology surgeries are performed by the PGY-4 resident and include radical hysterectomy, pelvic & para-aortic lymphadenectomy, and the staging of ovarian, uterine, vulvar and vaginal malignancy. Additional emphasis is placed on intraperitoneal and extraperitoneal anatomy.

    During the Administrative/Breast rotation, residents enhance their experience and skills in the diagnosis and management of breast disease through participation in the mammography suite. Residents are involved in breast examination, mammography interpretation, and aspiration/needle localization. Additional responsibilities on this rotation include administrative duties as well as the same experience of the standard obstetric and gynecologic rotation.

    Each PGY-4 resident is required to enhance his/her educational experience through participation in a research project that is presented during grand rounds. Faculty assists in guiding the resident along this process. A topic is selected and the hypothesis formulated. After execution of the study and collection of the data, results are analyzed and interpreted. A number of these studies have been published in peer review journals and presented to the Nassau Ob/Gyn Society.

    General Obstetrics & Gynecology

    3
    State-of-the-Art labor and delivery rooms

    Obstetrics

    Approximately 5000 deliveries are performed annually and over 8000 triage visits are assessed in our new state-of-art New Life Center. There are 16 computerized labor-delivery-recovery rooms (LDR), 5 triage rooms, and 2 extended stay/evaluation rooms. All patients are available for teaching purposes.

    The educational exposure to normal obstetrics begins in the outpatient setting where residents follow their own complement of patients one day per week. Residents learn how to recognize the normal changes of pregnancy, aspects of the history and physical that indicate possible medical or obstetrical complications, and how to schedule appropriate testing and interventions.

    Residents at each level are involved in the evaluation and admission of obstetrical patients. Once the patient is admitted, residents are involved in the assessment and management of the intrapartum/postpartum course and perform a significant number of these obstetrical procedures. Many of the patients admitted receive prenatal care by the residents and faculty at Women's Contemporary Care Associates (the ambulatory setting). Other patients include transfers from area Level I and II hospitals, Department of Health clinic, Planned Parenthood, and voluntary faculty practice. In an effort to maximize the continuity of care, residents make every effort to manage the intrapartum and postpartum course of the patients they have been following in the outpatient setting within the guidelines of the state regulatory provisions and hospital policy on working hours/on-call. All resident activities are supervised by full-time and voluntary faculty.

    Junior residents (PGY-I and PGY-II) are responsible for the initial evaluation of patients presenting to the labor and delivery suite. Performing under the direct supervision of senior level residents and faculty, residents make management decisions after a thorough evaluation. Residents learn how to instruct patients for discharge regarding outpatient follow-up as well as the signs and symptoms that require reevaluation before their scheduled appointments.

    Upon admission, residents of all levels are actively involved in the management of normal obstetrical patients (antepartum, intrapartum and postpartum). The program strives to provide junior level residents with a major role in this process under the supervision of senior level residents and faculty. In this respect, the senior residents play a more supervisory role in the management of normal intrapartum/postpartum obstetrics and uncomplicated cesarean deliveries. However, operative vaginal deliveries and more difficult abdominal deliveries are usually performed by the more senior residents.

    Gynecology

    Continuity of care is a primary concern in the residency program and is stressed throughout all levels of training and exposure. Each resident follows a complement of patients one afternoon per week at the ambulatory center, under the supervision of a full-time faculty member. The typical panel of patients consists benign gynecology, infertility, endocrine disorders, contraceptive and menopausal management, geriatric and adolescent care, and sexually transmitted diseases. Procedures are scheduled to include colposcopy, cryotherapy, LEEP, hysteroscopy, Norplant management, urodynamic testing, pregnancy termination, incomplete abortion, and breast cysts aspiration. Various biopsies (uterine, cervical, vulvar, vaginal, dermatological, etc.) and ultrasounds are performed on the day of presentation if possible. Residents are responsible for the review of all labs and testing, as well as notifying their patients of the results and treatment plans.

    The experience gained in operative gynecology begins at the PGY-1 level with a gradually increasing level of responsibility and exposure throughout the residency program. Residents are extensively involved in a large gynecology surgery service that was above the 70th percentile for many gynecologic operations according to the 1998-1999 annual report. Cases are performed under the direct supervision of full-time and voluntary faculty of the division.

    2000 minor gynecologic surgeries are performed by the department annually. All cases are available for resident teaching purposes. Residents assume graduated responsibility according to their level of training. The abundance of operative material ensures that all residents secure early exposure to surgery under ideal supervision.

    Operative gynecologic procedures performed by the PGY-I resident include dilatation and curettage, diagnostic and operative hysteroscopy, diagnostic laparoscopy, laparoscopic tubal sterilization, and minor operative laparoscopic surgeries. The PGY-II resident is involved in similar cases, with greater involvement in operative hysteroscopy and operative laparoscopy. Minor laparotomies may also be performed at this level. The PGY-II resident will additionally assist on gynecologic oncology surgeries.

    The majority of cases that require laparotomy and vaginal surgery are performed by the PGY-III and PGY-IV residents. During these two years of training, residents will obtain greater involvement in the more difficult surgeries as their training progresses. Some of the most difficult laparoscopic surgery will also be performed at this level. Most vaginal reconstructive surgery is performed at the PGY-IV level with some urogynecologic and reconstructive cases performed at the PGY-III level. The PGY-IV resident rotating on oncology will perform all gynecologic oncology surgery under the supervision of the gynecologic oncologist.

    We have an operative Laparoscopic Training Lab supervised by the faculty to further enhance the experience in basic and advanced laparoscopy and laparotomy. Topics covered in the basic lab include proper laparoscopic entry, laparoscopic survey of pelvic and abdominal anatomy, laparoscopic instruments, salpingostomy, tubal occlusion, removal of endometrial implants, and closure of trocar sites. Topics concerning laparotomy include principles of abdominal incisions, survey of pelvic/abdominal anatomy, salpingo-oophorectomy, cystotomy repair, enterotomy repair, hypogastric ligation, and abdominal wound closure. During the advanced course, topics include dissection of the ureter, pelvic and para-aortic lymph node dissection, bowel resection, vena cava repair as well as laparoscopic cystotomy, suture techniques, salpingo-oophorectomy, and supracervical hysterectomy.

    Subspecialties in Obstetrics & Gynecology

    4
    Labor and Delivery Ultrasound Training

    Maternal Fetal Medicine

    The Division of Maternal Fetal Medicine consists of 5 full-time faculty including the Chairman. In addition to evaluating and following referrals from the voluntary and full-time faculty, residents see patients referred from two area hospitals within the Winthrop network. The large number of referrals (over 4000 per year) leads to a rich resident experience in this specialty. Residents rotate for four months during their second and third years.

    The PGY-1 residents learn how to manage all complications that occur during labor in normal as well as at-risk patients. During antepartum and intrapartum rounds conducted each morning, they are active participants in the discussion of all patients and high-risk situations that may have occurred the previous day. They are trained in the principles and techniques of vacuum and forceps application. The PGY-1 residents are taught the principles of normal and high-risk intrapartum management. There is a combination of theoretical and practical teaching. As the year continues the residents' level of surgical exposure is increased as their technical skills improve.

    The PGY-2 residents are assigned to the MFM service for two months of the year and are supervised by the Chief Resident and MFM faculty. They are responsible for all patients admitted to the antepartum unit. They routinely participate on all complicated surgical procedures and deliveries, being supervised by the Chief Resident and Attending Physician. The PGY-2 residents, while assigned to the MFM service, act as consultants with the assistance of the Chief Resident and MFM faculty, and attend the High-Risk clinic. During this experience the residents learn how to perform amniocenteses. Each resident is required to perform at least 10-20 amniocenteses during the year, including genetic as well as third trimester procedures for fetal lung maturation and intra-amniotic infection. They spend a portion of their week at the MFM ultrasound laboratory where they receive hands-on experience in fetal anatomic scans under the supervision of the MFM faculty. The PGY-2 resident continues caring for patients discharged from the antepartum unit at the High-Risk clinic.

    The PGY-3 residents are assigned to the MFM service for two months of the year. They are responsible for the assessment of all patients to be admitted to the MFM service under the supervision of the Chief Resident and MFM faculty. During this rotation the PGY-3 perform amniocenteses, receive hands-on experience in fetal anatomic scans, assist on complicated procedures, and serve as consultants under the supervision of the Chief Resident and MFM faculty.

    Resident experience in high-risk obstetrics is complemented by the Perinatal/ Neonatal joint conference. Each conference begins with a prospective presentation by an obstetrician/gynecologist on various complications in pregnancy that may result in neonatal morbidity. The resident's presentation is followed by discussion among the various specialists and the rest of the staff with the perinatologist and neonatologist acting as the coordinators. A lively and interactive discussion regarding the management of high-risk pregnancies and the immediate care of the newborn follows and concludes with a discussion of potential quality improvement indicators and suggestions for improving health outcomes and minimizing risk. At the Chairman's meetings, complicated cases are presented and discussed in depth, including medical, social and ethical components of care. In addition, at the biweekly Journal Club, relevant articles are picked by the faculty for evaluation of clinical relevance, study design, research methodologies, and understanding by the individual resident.

    Gynecologic Oncology

    The gynecologic oncology service at Winthrop-University Hospital has expanded with the addition of four gynecologic oncologists. Operative cases and outpatient office sessions are each scheduled on two separate days per week. During the PGY-II and PGY-IV years, each resident is assigned four months on this service.

    Experience in the diagnosis, evaluation, and treatment of gynecologic oncology patients is obtained in the second and fourth year rotations. The PGY-II resident is an integral member of the Oncology team, working closely with the PGY-IV resident and Oncologist in managing these patients both as outpatients and inpatients. Emphasis is placed on learning the basic knowledge and skills needed to understand disease biology, epidemiology, diagnosis, evaluation, treatment, and prevention. The PGY-II assists on many of these operative cases and is expected to master the clinical and technical skills necessary for proper post-operative and pre-operative treatment. Office diagnostic procedures including biopsy and colposcopy are performed under the supervision of the oncologist.

    The PGY-IV resident assists the Gynecologic Oncologist in the surgical management of all patients referred for Gynecologic malignancy. This resident is expected to master the proper preoperative and postoperative management of these patients by overseeing these areas of management and supervising the junior resident. The PGY-IV resident is expected to develop a thorough understanding of the diagnosis and treatment of these malignancies and the appropriate level of mastery of the surgical techniques and objectives of this service. Some surgeries performed include radical hysterectomy, pelvic and para-aortic lymph node dissection, as well as the surgical staging of ovarian, uterine, vulvar, and vaginal malignancy. Additional emphasis is placed on teaching intraperitoneal, extraperitoneal, and retroperitoneal anatomy.

    As many patients on the Gynecologic Oncology service are older and have multiple pre-existing medical conditions, the postoperative management can be extensive. Residents learn how to manage these patients through a multidisciplinary approach and how to interpret invasive monitoring.

    Reproductive Endocrinology and Infertility

    The division of Reproductive Endocrinology and Infertility is staffed by six full-time reproductive endocrinologist, three women's health nurse practitioners and a physician's assistant. The group has an office based in vitro fertilization laboratory performing over 1400 procedures of assisted reproductive technology. The division evaluates and manages over 2000 new patients annually with approximately 3400 follow-up visits. Through their rotation on this service, residents obtain the knowledge and skills necessary to evaluate and manage infertility patients and those with endocrinopathies. Each resident spends a total of three months on this service. Two to three office and up to two operative sessions are scheduled each week. This rotation serves to enhance the clinical and technical skills obtained under the full-time faculty supervision in the daily continuity sessions with regard to this subspecialty.

    During their rotation on this service, residents learn the fundamentals of diagnosis, evaluation, and treatment of patients with endocrinopathies and infertility. Skill is acquired in the use and interpretation of diagnostic modalities such as ovulation prediction/assessment, semen analysis, post-coital assessment, laboratory interpretation, ultrasound, endometrial assessment, and hysterosalpingography. In addition, residents learn the techniques of ovulation induction and assisted reproduction. During this rotation, residents actively participate in the management of these patients under the direct supervision of the full time reproductive endocrinologist.

    The Division of Reproductive Endocrinology and Infertility maintains an active operative presence through full time and voluntary faculty. Residents learn the skills of diagnostic and operative hysteroscopy/laparoscopy, tubal cannulation, tubal surgery (fimbrioplasty, neosalpingostomy, etc.), adhesiolysis, resection and ablation of endometrial implants, and microsurgery.

    Urogynecology and Reconstructive Pelvic Surgery

    The Urogynecology and Pelvic Reconstructive Surgery division has recently expanded with the addition of a Fellowship trained Pelvic reconstructive surgeon. With the expansion of the division, biofeedback training, functional electrical stimulation, transurethral collagen injections, and neuromodulation have been added as treatment options. The division evaluates and treats all forms of urinary incontinence, pelvic organ prolapse, perineal defects, anal sphincter repair, enterocele repair, fistula repair and surgical complications.

    Residents are expected to learn the proper anatomy and physiology of the lower urinary tract and pelvic floor as well as the mechanisms and predisposing factors to incontinence and pelvic floor disorders. Emphasis is placed on learning the proper screening techniques for the general population. Once the patient is identified, the residents learn how to properly assess and evaluate these patients through a comprehensive history and physical examination as well as the most recent diagnostic tools. These tools may include site specific evaluation of the pelvis, POPQ diagrams, simple and complex cystometrics, cystourethroscopy, uroflowmetry, pressure flow studies, urethral pressure profile, valsalva leak point pressure, voiding diary, and levator assessment.

    Once the evaluation is complete, residents learn how to formulate a treatment plan using the many medical, surgical, and non-surgical options available. Some of these treatments include pelvic floor exercises, pharmacological therapy, pessary, as well as minimally invasive and advanced surgical therapies. Common surgical techniques include abdominal and laparoscopic urethropexy (MMK or Burch), abdominal and vaginal paravaginal repair, vaginal slings, anterior/posterior colporrhaphy, sacrospinous ligament fixation, McCall culdopexy, colpocleisis, repair of perineal breakdown, fistula repair, and enterocele repair/prevention. Surgical procedures are performed by senior level residents under the supervision of the Urogynecology Pelvic Reconstructive Surgery division.

    Minimally Invasive Gynecologic Surgery

    Ultrasonography

    Residents receive extensive training in both Obstetrical and Gynecological ultrasound by a well trained and experienced faculty. This training is done under the supervision of the MFM division.

    The Antepartum Testing and Ultrasound service is accredited by A.I.U.M. since 1998. In 2006, approximately 16,000 ultrasound examinations were performed in this laboratory which contains 4 advanced ultrasound devices. There are additional 4 ultrasound units, which are distributed in the gynecology ambulatory center, the labor and delivery, the hospital antepartum satellite laboratory and the emergency department.

    Educational exposure to Obstetrical Ultrasound begins in the PGYI level in the Labor and Delivery Area and continues throughout the four years. Under the supervision of the full-time faculty, residents perform ultrasound assessments in the triage area including amniotic fluid assessment and performance of biophysical profile, estimated fetal weight, placental localization, assessment of fetal presentation and multifetal pregnancy assessment. During the MFM rotation, the PGYI and PGYII residents spend time in the ambulatory service where they can receive hands on experience in fetal anatomy surveys under the supervision of the faculty. Residents also gain exposure to fetal echocardiography, amniocentesis, percutaneous umbilical blood sampling (PUBS) and chorionic villus sampling (CVS). Instruction in sonography is also given during daily MFM rounds and during the High-Risk office sessions.

    There is one dedicated session per week for gynecological ultrasonography and residents learn from observation and hands-on training. Cases include transabdominal and transvaginal techniques, evaluation of first trimester pregnancies and ectopic pregnancies, evaluation of adnexal masses, color Doppler application, and saline sonohysterographies. All PGYI residents do a one-month rotation in ultrasound. Residents also have extensive exposure to gynecologic ultrasound in the Emergency Department and during their office sessions.

    Residents attain increased levels of independence as they demonstrate increasing proficiency. In the PGYIII year, all residents rotate on the Reproductive Endocrinology rotation. Extensive ultrasound exposure is gained under the reproductive endocrinology specialist.

    Gyn Pathology

    In the outpatient setting at Women's Contemporary Care Associates, residents learn the proper selection, handling, and performance of various pathologic tests such as pap smear, colposcopy with biopsy, endometrial biopsy, vulvar/vaginal biopsy, and breast aspiration. Results are reviewed with both the Gynecology and Pathology. In addition, PGY-II or PGY-III residents may attend a weekly colposcopy session where abnormal pap smears are reviewed. Colposcopic evaluation, cryotherapy, as well as LEEP procedures are performed as needed. Residents learn the principles behind these tests as well as the indications and complications. During their surgical rotations and during the Gynecologic Oncology rotation, residents learn the fundamentals of gross inspection and interpretation of benign and malignant pathology.

    This may involve evaluation of uterine contents (products of conception and its appropriate appearance for gestational age; gestational trophoblastic disease; hysteroscopic appearance of the endometrium; uterine polyps and myomas), inspection of the pelvis during laparoscopy/laparotomy (endometriosis, benign and malignant ovarian pathology, tubo-ovarian abscess/complex, hydrosalpinx/pyosalpinx, PID, etc.), and inspection of the abdomen for pathologic findings (diseases of the bowel, appendix, gallbladder, liver, stomach, and spleen).

    Residents attend monthly pathology conferences under the supervision of the Pathology and Gynecologic Oncology faculty. Here, cases are presented for review including gross examination and microscopy. Formal discussion is held on the microscopic findings, gross evaluation, diagnosis, and management. Lectures, grand rounds, and case presentations are used to enhance the educational experience.

    Curriculum

    The Department of Obstetrics and Gynecology is committed to providing a rich scholastic environment for its residents and faculty. "Blocked" didactic time is utilized where residents are shielded from other responsibilities. The curriculum provides residents with formal experience in: normal and high-risk obstetrics, oncology, reproductive medicine & endocrinopathies, urogynecology & pelvic floor dysfunction, breast disease, human sexuality, operative gynecology, genetic disorders, family counseling, management of the critically ill patient, ethics & medical jurisprudence, pathology, epidemiology & statistics, adolescent care, benign gyn conditions and gyn malignancies. The didactic experience includes:
  • Weekly lectures
  • Formal service rounds
  • Chairman's rounds & case presentations
  • Fetal surveillance rounds
  • Journal club
  • Tumor board
  • Grand Rounds
  • Visiting professor conference
  • Ambulatory care conference
  • Ultrasound seminar
  • Reproductive-Endocrinology rounds
  • Perinatal/Neonatal conference
  • Clinical case presentation
  • Pathology conference
  • Life Learning Exams - ABOG
  • Obstetrical Pathology Conference
  • Fetal Echo Conference
  • Obstetrical High Risk Drills
  • Gyn Teaching Rounds
  • Oncology lectures
  • Patient safety rounds
  • Cultural Competency lectures
  • Seven hours weekly are reserved for lectures, seminars, and conferences. The lectures include faculty and outside guest speakers. As a method of monitoring the didactic experience and preparing residents for certification, first through fourth year residents take the annual CREOG in-service examination. Our residents have scored at or above the national average over the past seven years.

    Research & Conferences

    5
    Faculty supervision in research
    The department has a distinguished scholastic tradition with many of the members currently involved in clinical and/or basic science research or having published in peer review journals. The program strives to enhance the educational experience of its residents by providing an active research environment and educating the residents in the proper methodology of research.

    Residents are required to select a topic to research early in their residency for presentation to the Department at Grand Rounds in June of their Chief year. A faculty member in the relevant area is selected to assist and guide the resident along this process. After selection of the topic and review with the Departmental faculty, a literature review is conducted and hypothesis formulated. Proper methodology and study design is selected. During this process, residents have access to the hospital's biostatistics department for assistance in such areas as study design, sample size, and interpretation of data. After execution of the study and collection of data, results are analyzed, interpreted, and presented at Grand Rounds. A majority of these studies have been published in peer review journals (Obsterics & Gynecology, Journal of Ultrasound in Medicine, Journal of Reproductive Medicine) over the past three years and presented to the Nassau Ob/Gyn Society.

    A sample of recent resident research topics include the following:
  • "Immediate Maternal and Neonatal Effects of Forceps and Vacuum-Assisted Deliveries"
  • "The E1/E2 Controversy. A Randomized Controlled Trial of Vaginal Misoprostol vs. Dinoprostone Vaginal Inserts For Preinduction Cervical Ripening"
  • "Fetal Acidosis and Protein Injury"
  • Residents are given one week of conference time per year and attend relevant professional conferences where they can be exposed to current trends and research.

    Division of Gynecologic Oncology

    There are several ongoing trials with the gynecology oncology group (GOG).
    GOG is an NCI funded cooperative clinical trials group for gynecologic oncology patients.

    Career Placement

    For the past 7 years, approximately 50% of our graduates have attained subspecialty fellowships with the remainder practicing general obstetrics and gynecology. Many of our graduates are currently on staff at Winthrop-University Hospital.

    Recent fellowship appointments include:
  • Winthrop University Hospital - Maternal-Fetal Medicine
  • New York University Medical Center - Reproductive, Endocrine & Infertility
  • University of Arizona - Maternal-Fetal Medicine
  • Albert Einstein Medical Center - Reproductive Endocrinology & Fertility
  • New York Presbyterian Hospital (Columbia Presbyterian Medical Center) - Pelvic Surgery
  • Georgetown University- Maternal-Fetal Medicine
  • New York University Medical Center- Maternal-Fetal Medicine
  • Cornell University (New York Hospital Medical Center)- Maternal-Fetal Medicine
  • Galloway Fellowship (Sloan Memorial Medical Center)- Gyn Oncology
  • Mount Sinai Medical Center- Reproductive Endocrine & Infertility
  • University of Oregon Health Science Center- Reproductive Endocrine & Infertility
  • University of Texas, Southwestern Medical Center at Dallas Parkland Memorial Hospital - Pelvic Reconstructive Surgery
  • Rosewell Park Cancer Institute - Gynecologic Oncology
  • Northside Hospital - Advanced Laparoscopic Surgery
  • University of Connecticut - Maternal-Fetal Medicine
  • UCLA - Reproductive Endocrinology and Infertility
  • Cleveland Clinic Florida Weston - Pelvic Reconstructive Surgery
  • Harvard Medical School - Medical Genetics
  • Emory Medical Center - Pelvic Surgery
  • Moffitt Cancer Center - Gynecologic Oncology

  • Faculty

    The Department of Obstetrics and Gynecology is comprised of a very large and dedicated teaching faculty. There are approximately 90 voluntary members in private practice and 19 primary teaching faculty. The faculty is actively engaged in teaching, research, patient care, and administration. Each member has a deep love of teaching and a genuine interest in the education and careers of the residents.

    All full-time faculty members are board-certified or board-eligible. Many have specialty training in maternal-fetal medicine, oncology, reproductive endocrinology & infertility, menopausal management, adolescent medicine, advanced laparoscopic surgery, human sexuality, and urogynecology & reconstructive pelvic surgery.

    Various awards for excellence in residency teaching were presented to members of our faculty by the Council of Resident Education in Obstetrics and Gynecology (CREOG) and the 1998 Excellence in Teaching Award given by the Association of Professors of Obstetrics and Gynecology (APGO).

    The Department's administrative divisions include: Obstetrics, Gynecology, Maternal Fetal Medicine, Genetics, Oncology, Reproductive Endocrinology & Infertility, Ambulatory Care, Psychosexual Health, and Urogynecology & Reconstructive Pelvic Surgery.

    Key Faculty

  • Anthony Vintzileos, MD, Chairman
  • Gynecology

  • Valerie Cucco, DO
  • Cynthia Fretwell, MD
  • Svetlin Ivanov, MD
  • Elana Kastner, MD
  • Mary Kriner, MD
  • Fredric Moon, DO
  • Patrick Vetere, MD
  • Maternal-Fetal Medicine
  • Genevieve Sicuranza, MD, Chief
  • Martin Chavez, MD
  • Wendy Kinzler, MD
  • Gynecologic Oncology

  • Eva Chalas, MD, Chief
  • Kent Chan, MD
  • Edward Jimenez, DO
  • Jeannine Villella, DO
  • Reproductive Endocrinology and Infertility

  • Gabriel San Roman, MD, Chief
  • Kristen Cain, MD
  • Maria Saketos, MD
  • James Stelling, MD
  • Linda Sung, MD
  • Bradley Trivax, MD
  • Urogynecology & Pelvic Reconstructive Surgery

  • George Lazarou, MD, Chief of Gynecology & Urgynecology
  • Minimally Invasive Gynecologic Surgery

  • Farr Nezhat, MD
  • Patrick Vetere, MD

  • Professional and Social Environment

    Winthrop-University is one of the region's leading healthcare resources, a tertiary care hospital that offers its residents exposure to advanced and sophisticated medicine, state-of-the-art diagnostic and therapeutic technologies and scholarly research at the forefront of medical science.

    The Hospital includes a Category 1 Cancer Center; level 1 Trauma Center; a nationally accredited Sleep Disorders Lab; a Regional Poison Control Center; a Neonatal Intensive Care Unit that treats newborns transferred from other area hospitals for more advanced, specialized care; and cardiac and pulmonary programs that have received outstanding ratings.

    The ample facilities for medical education include the Hollis Health Sciences Library, which features computer and AV labs. In this fully automated library, users can search the catalog, view a list of new materials, place a hold on, or renew an item from within the library or from another computer on the Hospital network.

    Despite the intense educational atmosphere, Winthrop offers residents a superior quality of life and very supportive learning environment permeated with a deep sense of caring and concern.

    Benefits »

  • Salaries are highly competitive.
  • Residents are provided subsidized housing. Off-site allowances are provided for those who cannot be accommodated on campus.
  • Free meals, uniforms and laundry services, as well as health club reimbursement, are available.
  • Residents are entitled to four weeks of vacation annually.
  • Full malpractice insurance is provided.
  • Residents' families receive health and dental benefits.
  • Attendance at professional conferences is encouraged.
  • Recreational programs are offered.
  • Planned social activities include:
  • 6
    Graduation dinner dance
  • Holiday Party: The Department thanks its staff (including nurses, secretaries, etc.) for their service and commitment. For the past several years, this affair has been held at a beautiful country club.
  • Graduation Dinner Dance: Ob/Gyn faculty, attendings, residents, administrators attend this joyous affair for the graduating chiefs and their families.
  • Employee Appreciation Day: Winthrop-University Hospital hosts this annual, day-long event for employees, with the administrative/ management staff serving breakfast, lunch and dinner. Prizes are raffled, souvenirs distributed and music provided.

  • Application Procedure

    Fellowship

    All Fellowship applicants please submit the following.
    1. Curriculum Vitae
      • Include any and all activities since medical school
      • Account for any time not in residency training
    2. Personal Statement (limit one page)
    3. Letters of Recommendation (up to three)
      • Include one letter from residency director
      • Include one letter from immediate superior of any activity after residency
    (Please note that interviews will be granted in July, August and September for the following year. The deadline is September 30th.)

    Contact and Application for Maternal-Fetal Medicine Fellowship:

    Wendy Kinzler, M.D.
    Maternal-Fetal Fellowship Director
    Winthrop University Hospital
    259 First Street
    Mineola, NY 11501

    Residency

    All first-year residents are selected through the National Residency Matching Program (NRMP). Candidates for residency through the NRMP participate through the Electronic Residency Application Service (ERAS). The program considers only individuals who have passed Part I of the USMLE and who intend to take or passed Part II of the USMLE. This also applies to individuals who have passed Level 1 of Comlex and intend to take or passed Level 2. A limited number of candidates are selected for an interview; no candidate is ranked without an interview.

    For further information, contact:

    L_FrisciaLorraine Friscia
    Residency Program Coordinator
    Department of Obstetrics & Gynecology
    lfriscia@winthrop.org
    Tel: (516) 663-8660 Fax: (516)742-7821
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