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Program Curriculum - Additional Rich Learning Opportunities Laparoscopy Experience
Surgical Simulation The University of Missouri has recently built a $3M simulation center, and our Department has built a simulation and education annex to support resident and medical student education and simulation. We train our residents using the Noelle birth simulator, as well as laparotomy, hysterectomy, and basic operative technique simulation. We have recently invested in production equipment to produce surgical education videos that will be available to our residents and students on demand, through our extensive computer network to view on large-screen high-def TVs. Continuity Clinics
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Our residents are trained in advanced laparoscopy techniques such as adnexal surgery, significant adhesiolysis, total and supracervical laparoscopic hysterectomy, laparoscopic myomectomy, appendectomy, and endometriosis surgery. Techniques learned by our residents include rapid and safe entry, port placement, intra- and extra- corporial knot tying, laparoscopic clipping and stapling, safe adhesiolysis, bowel manipulation, safe use of energy including bipolar cautery and use of the harmonic scalpel, Gyrus and Ligasure devices. Our residents participate monthly in a day-long didactic and hands-on laparoscopy training laboratory sponsored by the MU’s minimally invasive surgery fellowship program. In this workshop, our residents attend didactic lectures in the first half of the morning and participate in hands-on training stations (6 stations) of increasing difficulty the latter half of the morning. Lunch is provided, and then the residents participate in an afternoon-long animate porcine lab in which they can practice their techniques in vivo. Our residents routinely perform laparoscopic cholecystectomy, bowel resection, and reanastomosis and hernia repair in the pig! 
Our residents have an average of two continuity clinics a week, one gynecology and one obstetric clinic. In the Gyn clinic, residents develop a relationship with their patients and become familiar with outpatient issues such as chronic pelvic pain, vaginitis, sexually transmitted disease, contraceptive counseling, abnormal bleeding, abnormal radiographic findings, pelvic organ prolapse, urinary incontinence, dyspareunia, and routine health maintenance and screening. In the obstetric clinic, residents follow pregnancies from beginning to end and manage both normal and complicated pregnancies. Common complications of pregnancy include gestational diabetes, thyroid dysfunction, prior adverse pregnancy outcome, intrauterine growth abnormalities, asthma, bleeding, preterm labor, and multiple gestations. 
