This article, from the “To the Point” series by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, is a guide for advising medical students applying to Obstetrics and Gynecology residency programs. The residency application process is changing rapidly in response to an increasingly complex and competitive atmosphere, with wider recognition of the stress, expense, and difficulty of matching into graduate training programs. The COVID-19 pandemic and societal upheaval make this application cycle more challenging than ever before. Medical students need reliable, accurate, honest advising from faculty in their field of choice in order to apply successfully to residency. The authors outline a model for faculty career advisors, distinct from mentors or general academic advisors. The faculty career advisor has detailed knowledge about the field, an in-depth understanding of the application process and what constitutes a strong application. The faculty career advisor provides accurate information regarding residency programs within the specialty, helping students to strategically apply to programs where the student is likely to match, decreasing anxiety, expense and over-application. Faculty career advisor teams advise students throughout the application process with periodic review of student portfolios and are available for support and advice throughout the process. The authors provide a guide for the faculty career advisor in Obstetrics and Gynecology, including faculty development and quality improvement.

The June 2022 U.S. Supreme Court decision on Dobbs v Jackson Women’s Health Organization resulted in state-specific differences in abortion care access across the country. The primary concern in the obstetrics and gynecology education community has been the impact on resident and fellowship training programs. However, the impact on undergraduate medical education and the broad implications for future generations of physicians are crucial to address. It is estimated that 48% of matriculants to MD-granting medical schools will receive their medical education in the 26 states with significant abortion restrictions or bans. Undergraduate medical educators need to continue to adequately teach the basic science, clinical care, and population health outcomes of reproductive medicine, including pregnancy and abortion. In addition, students in states with more restrictions on abortion will have less or no clinical exposure, and those in states with few restrictions may be excluded due to overcrowding of learners from restricted states. Students’ own health care also needs to be considered, as access to abortion care for themselves or their partners may create applicant pool demographic shifts by state as applicants consider options for where to pursue their medical education. It is important to ensure that teaching of foundational science of pregnancy, abortion, and reproductive health continues throughout the United States. Undergraduate and graduate medical educators will need to closely monitor the downstream impact of decreased clinical exposure of abortion. Further study of the personal health impact of abortion care access for medical students and awareness of the changing applicant pool demographics by state is needed.

This study sought to investigate the effects of placental laterality on the measurements of uterine artery (UtA) Doppler velocimetry and their application in predicting early-onset preeclampsia (PE). We conducted a prospective cohort study on all women with singleton, uncomplicated pregnancies scheduled for first-trimester nuchal translucency at our institution. Pulsatility index (PI) for both UtAs was measured by Doppler velocimetry, and placental laterality was determined. Additionally, pregnancy outcome data were abstracted from the medical records. Receiver operating characteristic curves (ROCs) were plotted. Of the 304 patients enrolled, 247 met the inclusion criteria. Among these patients, 240 had uncomplicated delivery, while 7 had early delivery at <34 weeks due to PE. For the uncomplicated pregnancies, PI measurements of the UtA ipsilateral to the placenta were similar (left versus right UtA: 1.06 ± 0.38 vs. 1.04 ± 0.40; P = .745). However, PI measurements of the UtA contralateral to the placenta differed significantly (left versus right UtA: 1.45 ± 0.51 vs. 1.3 ± 0.47; P = .027). In predicting early-onset PE, the ideal cut-off value for the placental side PI was 1.91, with sensitivity 100% and specificity 96.3%. For nonplacental side PI, the ideal cut-off value for PI was 1.975, with sensitivity 57.1% and specificity 79.2%. Using the mean of the left and right UtA PI, the ideal cut-off value was 1.63, with sensitivity 100% and specificity 74.2%. ROC analysis confirmed that PI measurements of the UtA on the placental side were significantly lower than those on the contralateral side, PI measurements of the UtA ipsilateral to the placenta were similar.

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