Schedule

The fellow will spend 50% of their time at UConn Health and 50% of their time at our affiliate hospital, Saint Francis Hospital and Medical Center. The fellow will alternate monthly between UConn Health and Saint Francis Hospital.

Rotations

Minimally Invasive Gynecologic Surgery: The fellow will become competent and meet the minimal case numbers in: advanced hysteroscopy, laparoscopy/robotic assisted laparoscopy procedures for various benign gynecologic conditions: myomectomy, adnexal surgery, adhesiolysis, endometriosis stage I-IV. The fellow will perform minimally invasive hysterectomies with competency in laparoscopic, robotic and vaginal techniques. UConn Health is a Center of Excellence in Minimally Invasive Surgery and the referral center for complex gynecologic pathology. The fellow will also work closely with our multidisciplinary endometriosis care team and meet regularly to work together to create surgical plans as well as operate together to improve patient outcomes. Although the fellow will meet all the surgical experience requirements the focus will be on reproductive surgery involving fertility promoting and fertility sparing treatment of endometriosis, uterine myoma, uterine anomalies, and adnexal diseases.

Gynecologic Oncology: The fellow will be further exposed to complex minimally invasive surgery and exploration of the retroperitoneal space. Fellows will gain further understanding of risk reducing surgery for patients with genetic pre-disposition to cancer and learn fertility sparing surgeries for patients with cancer.

1. Educational Objectives: Describe the normal anatomy of the retroperitoneal spaces.
2. Clinical Objectives: Understand risk reducing surgery for patients with genetic pre-disposition to various gynecologic cancers. Understand fertility sparing surgeries for patients with cancer.
3. Surgical Objectives: Understanding and competency in exploring the retroperitoneal space. Understanding of risk reducing and fertility sparing oncologic surgeries.

FPRMS: The fellow will be exposed to the treatment for pelvic floor disease, pelvic floor pain conditions, and incontinence. Fellows will learn more about the nonsurgical and surgical management of the of the various conditions and gain competency in performance of vaginal surgeries. The fellow will also become competent in performing cystoscopy, surgical management for urinary/fecal incontinence and pelvic organ prolapse, postoperative care, and management of complications of these procedures.

1. Educational Objectives: Describe the normal function innervation and anatomy of the pelvic support system.
2. Clinical Objectives: Elicit an appropriate history and perform an appropriate physical exam. Determine a differential diagnosis and order appropriate further testing. Consider the nonsurgical and surgical management of the of the various conditions as well as their risks and benefits.
3. Surgical Objectives: Understanding and competency in performance of a vaginal hysterectomy. Understanding and competency in performance of cystoscopy. Understanding of surgical management for urinary/fecal incontinence and pelvic organ prolapse. Understanding of the postoperative care unique to these patients and recognition and management of complications of these procedures.

Colorectal Surgery/Urology: The fellow will work with colorectal surgery and urology while preparing for and performing endometriosis surgery. They will gain confidence in performance of lysis of adhesions, enterolysis, and repair of minor bowel injuries.

1. Educational Goals: Further appreciate the anatomy of the pelvis.
2. Surgical Goals: Learn to perform advanced adhesiolysis and enterolysis with proper surgical technique when working with the bowel. Understand how to repair small bowel injuries.

MIGS Clinic: The fellow will work in both the faculty clinics as well as the fellow continuity clinic at each site and learn how to evaluate patients and surgically plan. Fellows will learn how to determine the best plan of care and to prepare the patient for the operating room. The fellow will learn to take increasing responsibility and ownership of their patients. The fellow will also have understanding and competency in office-based hysteroscopy.

1. Educational Objectives: Diagnosis and evaluation of gynecologic diseases: endometriosis, adnexal masses, myoma, adhesions, abnormal bleeding, with history, physical and imaging (advanced gynecologic ultrasound). Management both medically and surgically.
2. Clinical Objectives: To determine the best plan of care and to prepare the patient for the operating room. Learning to preop patients assessing any medical needs prior to the surgery and setting appropriate expectations for the patients for their postoperative course. Learning what is the normal postoperative course and recognizing and treating postoperative complications. In the fellow continuity clinic, the fellow will learn to take increasing responsibility and ownership of the patients. The fellow will also have understanding and competency in office-based hysteroscopy.

Gynecologic Ultrasound: Throughout the two years, the fellow will have the opportunity to advance their skills in gynecologic ultrasound specifically in imaging for preoperative evaluation and diagnosis of patients. The fellow will advance skills in: transvaginal sonography, sonohysterography, intraoperative sonography, 3D gynecologic ultrasound, hysterosalpingo-contrast sonography, and transabdominal sonography. The training will occur during the fellow’s clinic time at UConn Health and as a twice monthly rotation within the Gynecologic Ultrasound division at Saint Francis Hospital.