Dr. Luis Bracero, MD, FACOG, a Maternal/Fetal Medicine Specialist, Dr Byron C. Calhoun, MD, FACOG, FACS, MBA, Vice-Chair, Obstetrics and Gynecology/Maternal-Fetal Medicine Specialist, and the Obstetrics and Gynecology generalists attend this service. One resident from each year level is on service at all times. Medical students, sub-interns, and interns from the Charleston Area Medical Center, Family Medicine program, and osteopathic interns also participate on the service. This team rounds daily on all antepartum, labor, and postpartum patients. Rounds include didactic instruction as well as reviews of the current literature. Multiple opportunities are provided to discuss patients and review disease processes and management. The CAMC Women and Children's Hospital delivers about 3300 neonates per year, and residents are responsible for almost one-half of these. We assist on all clinical faculty Cesarean sections. We receive about 10-15 high-risk obstetric transports per month. Residents have the leading role in managing these patients.
Techniques of operative vaginal deliveries are utilized frequently. Residents manage busy high-risk obstetric clinics under faculty supervision beginning the first year. A unique interactive web-based limited obstetrical ultrasound curriculum is offered to all residents. Residents participate in all aspects of ultrasound learning and become proficient in the performance of ultrasound. We use state of the art equipment, complete with color Doppler capability, 3-D, and 4-D imaging. There are multiple opportunities to perform both non-genetic and genetic amniocenteses and other antepartum procedures. By the end of the four years of residency training, an average resident will perform or will assist in over 200 vaginal deliveries, between 250-300 Cesarean sections, as well as significant Ob/Gyn ultrasounds (leading to a certificate of competency) and numerous antepartum diagnostic and therapeutic procedures.

Gynecology

Benign Gynecology Service:

Dr. Stephen Bush, Dr. Todd DePond and Dr. Paul Dietz, as well as other clinical faculty attend the gynecology service. Didactic instruction, review of surgical indications, pre-operative work-up and technical aspects of the different surgeries are covered in detail. Residents scrub in all gynecology service surgeries as well as the majority of the clinical faculty surgery cases. Intraoperative instruction is an important aspect of our training. Residents have the opportunity to learn different surgical techniques from several different attendings with diverse training backgrounds. Post-operative care is provided on an individual basis, with residents performing rounds informally under the supervision of the primary attending overseeing the case. Caseload is consistently high with each resident scrubbing in 2-3 major and 5-6 minor cases per week. We conduct regular colposcopy clinics and average around 15 colposcopies per week. The average resident will perform or assist in about 100-200-abdominal and 50-60 vaginal hysterectomies, 50-100 laparoscopic hysterectomies, and varied multiple vaginal operative procedures by the end of the residency.

Minimally Invasive Surgery

Minimally invasive surgery includes:

•Diagnostic and surgical treatments of female patients utilizing minimally invasive techniques such as diagnostic and operative laparoscopy, which can assist in the diagnosis and treatment of Gynecologic disorders previously requiring opening of the abdomen. These procedures reduce postoperative pain and facilitate shorter recovery periods. The learning modality is being accelerated by utilization of newer teaching techniques which are being used by residents, resulting in acceleration of the learning process while aiding in mastering the current delicate surgical techniques. Comprehensive Dry lab hands-on training is only available to few prestigious medical training centers nationwide. The CAMC Simulation Center is one of the best in the State.

Furthering this concept will be the utilization of treatment by outpatient diagnostic procedures such as outpatient diagnostic hysteroscopy. This procedure will aid the physician in rapidly diagnosing problems with abnormal uterine bleeding, and to discern which patients require further surgical and/or conservative management. These procedures accelerate the diagnostic workup and treatment options.

Obstetrics and Gynecology Generalists:

Gynecologic Oncology

Michael A. Schiano, M.D., a Board Certified Gynecologic Oncologist attends the Gynecologic Oncology Service. There are two senior residents or one senior and one junior resident on his service at all times, as well as medical students. Each Wednesday, the residents present all oncology cases before an attending, other residents, and medical students. As with gynecology and reproductive endocrinology case discussions, this provides an excellent opportunity for review of disease processes, work-up, indications, and technical aspects of gynecologic oncology cases, as well as didactic instruction. As a major referral center for this region, we see and manage diverse oncology clinical entities. Caseload is never lacking, with an average of 9-10 cases per week, 4-5 of which are major surgeries. Intraoperative instruction is emphasized. Because there are no gynecologic oncology fellows, the Obstetrics and Gynecology residents either first or second-assist on all cases. This allows residents to hone their surgical skill and become very proficient at dvanced surgical techniques. Dr. Schiano also conducts daily teaching rounds with intensive instruction in postoperative care, adjuvant therapies, and basic oncology principles. Residents are responsible for management of ICU patients under Dr. Schiano’s guidance and become very adept at caring for the critically ill. The average resident will assist in or perform about 50-60 surgeries for invasive cancer by the end of their residency.

Reproductive Endocrinology & Infertility

Pickens Gantt, M.D. , who is a fellowship trained Reproductive Endocrinology and Infertility specialist, attends the Reproductive Endocrinology and Infertility service.

Medical students and residents are active participants in seeing all aspects of female infertility and the procedures associated withevaluating and treating the infertile patient. The residents will have the opportunity to learn vaginal ultrasound, follicular scan, hysterosalpingogram, sonohysterogram, and intrauterine insemination.

A fully equipped embryology laboratory enhances student learning in regard to advanced reproductive techniques such as in vitro fertilization.

Surgically the resident shall learn evaluating the patient who needs surgery, surgery indications, counseling the surgery patient, and the opportunity to actively participate in infertility surgery.

Didactic lectures will be given on Wednesdays where the medical students and residents will learn all the aspects of reproductive endocrinology and infertility such as polycystic ovarian disease, delayed puberty, contraception, and the other related subjects pertinent to endocrinology and infertility.

All surgical cases are discussed in rounds and conferences, which gives an opportunity to all the students and residents to learn patient management.