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.
Dr. Thahir Farzan, a board-certified gynecologic oncologist, joined the Harrington
Cancer Center staff in July 2012. Dr. Farzan performs the full range of gynecologic
oncology surgeries including robotic surgery. Residents are expected to assist Dr.
Farzan in the surgical and postoperative management of his cases.
Residents participate in the diagnostic work-up and staging of new malignancies. Additionally,
the residents learn oncological outpatient diagnostic procedures such as colposcopy,
colposcopic-directed biopsies, conization, and vulvar biopsy. They also gain experience
in the interpretation of CT scans and other imaging studies. The residents are provided
with the opportunity to follow patients who have undergone radiation treatment and/or
chemotherapy, and consequently residents see complications that are associated with
these modes of therapy. Many of the oncology patients are referred from other physicians,
and the residents are exposed to doctor-doctor interaction that will become an important
part of their future practice.
Infertility and Endocrinology
Residents are exposed to infertility and reproductive endocrinology problems through
their own continuity patients and through patients that are referred to our Reproductive
Endocrinology and Infertility service. The department has an infertility team consisting
of faculty, resident staff, infertility nurse, sonographers, and laboratory support.
Our department has a highly productive endocrinology research laboratory, and has
in-house capability for the broad range of endocrinologic assays. These resources
are available for patient service, research, and educational purposes. Residents actively
participate in a variety of endocrinology related research projects and have a record
of presentations and peer-reviewed publications in this area.
Residents assigned to this service are exposed to general reproductive endocrinology
problems, ovulation induction, use of GnRH analogues, follicular and 3D sonography,
intrauterine insemination, hysterosalpingography, and office hysteroscopy. Surgical
procedures for infertility are performed by the attending faculty or the upper level
resident depending upon the level of expertise. The department does not perform in-vitro
fertilization procedures but works closely with the Lubbock campus of Texas Tech University
Health Sciences Center.
Reproductive endocrinology and infertility topics are presented in a monthly conference
to the entire department and additionally are included in small group sessions with
the continuity team assigned to the endocrine service.
BSA and NWTH each operate multispecialty cancer conferences that review histologic
specimens. Residents are encouraged to attend.
All residents are responsible for review of the pathology of surgical specimens on
their operative cases and for liberally consulting with the pathologist regarding
Colposcopy clinics are attended by residents covering the oncology service. Correlation
is made between the abnormal pap smear, colposcopic findings and histologic specimens
obtained by directed biopsy or LEEP conization.
Diagnosis and Management of Breast Disease
The breast examination, diagnostic techniques, and management of benign and malignant
breast disease are topics that are covered in our didactic lecture series. Residents
are expected to perform a breast examination on all obstetrical and gynecologic patients,
teach self-examination, and arrange for appropriate screening procedures. Residents
are also taught to aspirate breast masses by our faculty when applicable. Persistent
masses, or those with any features of malignancy, may be referred to the breast surgery
service. Arrangements are made for the resident to participate in the consultation,
and if fine needle aspiration, open biopsy or mastectomy is recommended, the resident
has the opportunity to assist in those procedures since we do not have surgery residents
at our institution. A breast consultation service was established by the Department of Surgery in 2009 under the direction of Dr. Rakhshanda Rahman, and residents have an opportunity
to rotate onto her service. This center has recently been named a Center of Excellence