All residents spend approximately 50% of their educational time on the obstetrics
and maternal-fetal medicine service and the other 50% on gynecologic and gynecologic
subspecialties. Each rotation lasts 4 weeks.
With faculty supervision, residents of all levels provide complete prenatal and postpartum
care for low risk patients at the Texas Tech Amarillo outpatient facility. These patients
are all seen through continuity clinics and are followed by the same resident throughout
the pregnancy. In the event of a resident's absence, patients are seen by another
resident team member or by one of our nurse practitioners or physicians assistants.
All of our resident inpatient care is performed at Northwest Texas Hospital, which
is a tertiary care center, and the major teaching hospital for Texas Tech University
Health Sciences Center at Amarillo. The residents deliver approximately 2200 babies
per year and are supervised by in-house faculty. Normal obstetric deliveries, which
include the use of outlet forceps and vacuum extraction, are performed by house officers
under the direct supervision of in-house faculty.
All unassigned obstetrical patients who present at Northwest Texas Hospital are cared
for by the Texas Tech Ob/Gyn residents and faculty.
First year residents on the obstetrical service learn to manage normal laboring patients
and are also instructed in interpretation of fetal heart tracings, the use of basic
ultrasound procedures, identification of high risk factors, and obstetrical anesthesia
and analgesia. They are expected to manage patients in labor and delivery areas and
keep timely notes on all patients. The upper level obstetrical resident, who has the
responsibility for managing labor and delivery, is available for immediate supervision
in addition to a faculty member who is available at all times.
All 1st year residents are required to participate in the Advanced Life Support in Obstetrics (ALSO) course given by Dr. Paul Tullar. This is an outstanding course that prepares
residents for a variety of obstetrical emergencies.
High Risk Obstetrics
Northwest Texas Hospital is a tertiary care center and the major teaching hospital
for Texas Tech University Health Sciences Center. The 30 bed Level 3 neonatal intensive
care unit is staffed by neonatologists, all of whom are full time faculty of the Department
of Pediatrics of Texas Tech. Our department has the only maternal fetal medicine specialists
in the region, and virtually all of the high risk obstetrical patients are managed
by the Texas Tech Ob/Gyn Department. The referral area for high risk patients extends
beyond Amarillo to the upper 27 counties of the Texas Panhandle, the Panhandle of
Oklahoma , western Oklahoma, southern Kansas, and eastern New Mexico. In addition
to ground transportation, Northwest Texas Hospital operates the only helicopter transport
service in the region. Our neonatology service also provides a transport team. The
chief resident on the team is responsible for the overall management of the patients
under the direct supervision of faculty. The third year resident's major inpatient
duties include the care of the high risk antepartum patients as well as those in labor.
The second year resident, along with the PGY-1 resident, work in labor and delivery
under upper level resident and faculty supervision. The first year resident works
with the team but is primarily responsible for the low risk patients.
Our antepartum testing center provides non-stress testing, contraction stress testing,
biophysical profiles, Doppler flow studies, and 3-D ultrasound. Transabdominal and
vaginal ultrasound are available for fetal diagnosis. Ultrasounds are performed by
residents at all levels under the supervision of our maternal fetal medicine faculty
and with the help of the department's AIUM-certified sonographers. Ultrasound-directed
amniocenteses are performed in the antenatal testing center for the confirmation of
fetal lung maturity, and mid-trimester amniocenteses are performed for various maternal
and fetal problems. Residents are also able to participate in interventional procedures
for fetal therapy when performed by maternal-fetal medicine faculty.
The high risk obstetrical outpatients service is located in the Texas Tech Amarillo
outpatient facility. Approximately 60-80 patients are seen each week by the resident
team under supervision of faculty. Patients seen in these clinics represent a variety
of problems including diabetes, thyroid disease, chronic hypertension, preterm labor,
and fetal anomalies.
The Ob/Gyn Department works very closely with the neonatologists and the Department
of Pediatrics. A monthly perinatal conference is held jointly with that department.
Our department has a weekly Morbidity and Mortality conference in which high risk
patients are regularly discussed. Residents interact on a regular basis with the neonatalogists
regarding the status of problem babies.
Topics of high risk obstetrics are regularly included in our didactic sessions and
teaching rounds. Additionally, residents may participate in research protocols that
address high risk obstetrical problems.
Genetic counseling services and antenatal genetic testing are provided by our maternal-fetal
medicine service and geneticist. Residents participate with faculty in counseling
and genetic amniocentesis. When genetic abnormalities are found, the resident participates
in counseling the patient regarding outcome and possible therapy. Residents at the
first year level learn basic ultrasonography during their imaging rotation. Genetic
disorders are regularly discussed in didactic sessions and presented in joint conferences
with the pediatric department. In addition, our department invites visiting professors
to present genetic topics. Dr Golder Wilson, board certified in medical genetics,
supervises the department's genetics program.
Ultrasonographic services in the Department of Obstetrics and Gynecology consist of
obstetrical ultrasound, gynecologic ultrasound, Doppler flow vascular studies, fetal
echocardiography, follicular sonography, saline hysterosonography, selected ultrasound
guided intrauterine therapy procedures, and 3D/4D.
During the first year of residency, a one month rotation is devoted to learning various
imaging and technical skills that will be used throughout training. At that level,
residents work with faculty to learn basic ultrasound skills. The department uses
state of the art ultrasonographic equipment in all of our clinical areas and employs
three experienced certified sonographers who are valuable to the resident's educational
process. Residents use ultrasonography under faculty supervision in the labor and
delivery area, emergency rooms, antenatal testing unit, and other out patient facilities.
Their exposure to ultrasonography is extensive and progressive. The program was recertified
by the American Institute of Ultrasound in Medicine in 2011 for an additional 3 years.