The University of Hawaiʻi John A. Burns School of Medicine Residency Training Program in Obstetrics and Gynecology is located in Honolulu, Hawaiʻi. The program was originally established in 1949 and is based at Kapiʻolani Medical Center for Women & Children with additional rotations at the Queen’s Medical Center and Kaiser Medical Center.
The residency program is fully accredited by the Accreditation Council of Graduate Medical Education and approved for a total of 24 categorical resident positions, six at each level of the four-year program. Six new residents are accepted annually through ResidencyCAS to fill the first-year positions. Residents are accepted at other levels only in the unusual event that one of the positions become available.
The UH Ob/Gyn Residents of the University of Hawaiʻi acknowledge that it is a privilege to be part of this residency program and this profession. We are committed to providing quality healthcare to all the women of our island community and beyond. We are dedicated to evidence-based lifelong learning and becoming technically proficient physicians in the field of obstetrics and gynecology. We will stay abreast of, and when possible directly participate in, current research in our field with the ultimate goal of providing superior care for our patients. We strive to maintain an environment that encourages camaraderie and good rapport among the entire healthcare team. As colleagues, we will support each other professionally as well as personally, and build lifelong friendships.
Women's Health: As physicians, we wish to be competent, compassionate and responsible practitioners making evidence based decisions. We will act as our patients' advocates, treating them with respect, integrity and compassion as we honor the trust they have placed in us. To be effective providers of women's health care, we recognize the importance of training in the entire scope of obstetrics and gynecology, primary care medicine, and through the full range of health care delivery systems. We strive to stay at the cutting edge of technology in our field while remembering the importance of a holistic approach to each and every patient.
Education: We will use our hospital and ambulatory experience to take advantage of our exceptional clinical volume while maintaining a strong academic focus. As we strive to perfect our practice of evidence based medicine we recognize our roles as both students and teachers. We will be enthusiastic, motivated and self directed learners while striving to be inspirational, available and up-to-date educators. We aim for an educational environment which honors and respects the significant contributions our diverse faculty and teaching staff have to offer while fostering an opportunity for open intellectual discussion. We aspire to reach our full potential and wish to be held accountable through feedback which is timely, direct, specific and respectful.
Research: We will foster intellectual curiosity as we strive for a respected research program that is clinically based, self-directed and faculty mentored.
Team Spirit: We build camaraderie by maintaining an excellent rapport between residents, faculty, administration and support staff. We will be supportive and respectful of our fellow residents in a collaborative and sharing culture.
Balance: While realizing the importance of immersing ourselves in these four years of postgraduate training we acknowledge the importance of being well rounded and having a life separate from the program. We are dedicated to being active participants in our community, dependable, balanced and supportive family members, and self-aware, spiritually centered and self improving individuals.
Since Hippocrates, professors of medicine have made liberal use of two techniques:
The most effective learning technique is to make a mistake, then be required to answer for it later, preferably in a forum that generates a lot of stress.
The second most effective learning technique is to watch some other miserable soul answer for his mistake and thank the stars above you didn’t do that.
Adapted from the Witherspoon series by John A. Kona
M&M conferences began around 1917 as a system to investigate the reasons and responsibility for adverse outcomes. The Accreditation Council for Graduate Medical Education mandated M&M conferences in 1983 and many physicians view these conferences as the most important they attended during their training.
The primary function of M&M is education. An effective M&M provides the forum to discuss, evaluate, develop and disseminate effective strategies for improved patient care. M&M conference is the best place to teach and cultivate the culture of medicine, to stress the value of knowledge, skill and alertness in caring for patients. Errors, mistakes, and bad outcomes contain valuable lessons for all physicians. These weekly reminders of what can happen when we lose our intensity or ignore the fundamentals are good for physicians at all levels.
The atmosphere of M&M is a dynamic one that fosters a cooperative esprit de corps within the department. M&M conferences are to be free flowing exchanges, the intention is not to place blame or find fault, rather to seek better understanding of the events and to focus on the goal of improved patient care. The review of cases should be a straightforward, unvarnished explanation of what happened. Often the analysis helps everyone to understand that in medicine there are outcomes that are unavoidable. Outcomes due to a lapse in knowledge or implementation and outcomes due to systematic or protocol problems can be decreased through an effective M&M conference.
The discussions during M&M should focus on best patient care practices and contain concise “Clinical Pearls” rather than being a lecture or didactic session. Anecdotes and opinion, even “expert opinion” should be identified as such and play a limited role in the discussion. The conference is not intended to be a risk management, quality assurance, or peer review process and thus the meetings are not to be recorded.
M&M is a closed meeting. Attendance at this conference is limited to students, residents and faculty, and all who are not providing emergency care are expected to arrange their schedules in order to attend.
All complications from the previous week (Tuesday to Tuesday) are forward to the moderator by the resident running the service, no later than Wednesday. These will be collated and forwarded to the Chair, the Division Chiefs, and the Attendings of the Week (OB, Gyn, MFM and Queens) two days prior to the conference. These individuals will confirm the accuracy and completeness of the lists and are free to designate cases that they feel should be given a priority for presentation. Monthly Obstetrics and Gynecology statistics are included in the first M&M of every month. Cases with unanticipated or unfortunate outcomes from all sub-specialties as well as from the outpatient clinic should be included on the case lists.The start of the conference alternates each week between Obstetrics and Gynecology. All deaths and a few of the most educational cases are prepared for presentation by the residents, however the resident running the service must be prepared to discuss any patients on their list. The selected cases are presented in a stepwise fashion to simulate the chronology of the case as it unfolded to the OB/GYN team. The faculty on service is to review the presentations with the residents to keep them complete bt concise and to help with anticipated questions from the audience or moderator. Residents in the audience should listen actively and expect to be asked management questions along the way, appropriate for their level of training and expertise.
A short discussion led by the resident running the service will begin each M&M conference. The literature relevant to the case is summarized, information regarding controversial and unanwered questions will be provided and the important clinical pearls are to be reviewed. A short discussion led by the Chief on service follows each presentation. The disease process, diagnostic workup, and evaluation of tests and procedures are important topics for discussion. The literature relevant to the case is summarized and the clinical pearls are provided. The Chair or moderator’s role is to make sure the discussion stays on track, the emphasis stays on education and the learning environment stays safe. However, if laziness, ignorance, or complacency, is revealed during the discussion, the Chair or moderator is allowed to (and should) make that clear.
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The Department of Obstetrics, Gynecology and Women’s Health began as the Obstetrics and Gynecology Residency Training Program in 1949 at Kapiolani/St.Francis Hospitals. The training program was the first of its kind in the Hawaiian Island chain and marked an important milestone in State Obstetrics and Gynecological training and care. An independent two year Residency Program was also training residents at Queen’s Medical Center.
Both programs offered one-year positions with no advancement guaranteed. At that time, a resident in OB/GYN was required to have three years of Obstetric and Gynecological training in order to become eligible to sit for the American Board of Obstetrics and Gynecology. But there was no specific level of expertise required within that guideline.
Dr. K.S. Tom, the first Asian American to be certified by the American Board of Obstetrics and Gynecology and Chief of OB/GYN at Kapiolani and St. Francis Hospitals, integrated the three OB/GYN institutions in order to develop a focused three-year program in OB/GYN. The three-year OB/GYN Residency Training Program was given provisional approval by the ACGME in 1951. This success came on the heels of two important developments: the Residency Review Committee’s decision to terminate all two-year programs in 1950, and the Queen’s Medical Center agreement to join the Kapiolani-St.Francis Program.
In 1965, after much effort by key supporters, the Hawaiʻi state legislature approved the development of a two-year medical school. Dr. Windsor Cutting was selected as the first Dean. He brought with him two outstanding scientists, Dr. Terrance Rogers and Dr. Robert Noyes. Dr Noyes, an OB/GYN physician, was given the position of Professor of Anatomy and Reproductive Medicine. His office was in the Mary Foster wing of Kapiolani Hospital. Dr. Noyes began active involvement with resident research and training and replaced Dr. Krieger as the Program Director in 1966. Dr. Noyes remained at the University of Hawaiʻi until 1976 when Dr. Rogers was named Dean following the death of Dr. Cutting. During that same year, Dr. Satori Nishijima was asked to serve as Interim Chair of the section of Obstetrics and Gynecology. Drs. Ralph Hale and Charles Odom served as part-time faculty members.
In 1972 the legislature approved an expansion of the Medical School to a four year program. Dr. Ralph Hale was named Dean of Student Affairs and assigned the duty of developing a curriculum for students in Obstetrics and Gynecology. The Department of Obstetrics and Gynecology was to be developed with Dr. Hale and Dr. Odom as faculty. In 1972, Dr. Hale was named the Program Director, and the Residency Training Program officially became the University of Hawaiʻi Department of Obstetrics and Gynecology Residency Training Program. Dr. Hale was named the first Chair of the Department of Obstetrics and Gynecology. In 1973, the first four-year class was admitted to the Medical School and graduated successfully in 1975. Problem Based Learning (PBL), the most significant curricular change for medical students and one which proved to be a great success, started in 1989.
Ann Chang, MD
annchang@hawaii.edu
Lynne Saito-Tom, MD
lsaito@hawaii.edu
Ricardo Molero Bravo, MD
rmolerob@hawaii.edu
Tracee Suetsugu, MD
tracees@hawaii.edu
Lisa Kellett
kellett@hawaii.edu
Darlene Hubbard
dhubbard@hawaiiresidency.org
Nao Kamakawiwoole
nkamakawiwoole@hawaiiresidency.org
Sabrina Carll
scarll@hawaiiresidency.org
