Curriculum

Schedule

The fellow will spend 50% of the time at UConn Health and 50% of the time at our affiliated hospital, Saint Francis Hospital and Medical Center. The year is split into 10 five-week blocks alternating between the two hospitals. See samples of the block and monthly schedules.

Rotations

Minimally Invasive Gynecologic Surgery: 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. The fellow will be 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 III/IV. The fellow will perform minimally invasive hysterectomies with competency in laparoscopic, robotic and vaginal techniques.

Gynecologic Oncology: The fellow will be further exposed to complex minimally invasive surgery and exploration of the retroperitoneal space.

  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 treatment for pelvic floor disease and incontinence. During this rotation, the fellow will also rotate in pelvic floor physical therapy.

  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.

General Surgery: The fellow will work with a general surgeon who specializes in minimally invasive surgery learning to perform 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 learn how to evaluate patients and their surgical diseases. The fellow continuity clinic will meet two half days a month and the fellow will work up patients who are possible candidates for minimally invasive surgery. Twice a month the fellow will also cover the half day gynecology preoperative clinic for the residents.

  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: The fellow will have the opportunity to advance their skills in gynecologic ultrasound specifically in 3D imaging for preoperative evaluation/diagnosis of patients. The fellow will advance skills in: transvaginal sonography, sonohysterography, intraoperative sonography, hysterosalpingo contrast sonography, and transabdominal sonography.