GOAL OF UTMB'S GYN-ONC FELLOWSHIP
PROGRAM
ADVANTAGES OF UTMB'S GYN-ONC FELLOWSHIP PROGRAM
FELLOWSHIP REQUIREMENTS AT UTMB
RESEARCH IN THE DEPARTMENT AND DIVISION
RESEARCH OPPORTUNITIES FOR THE FELLOW
GOAL OF UTMB'S GYN-ONC FELLOWSHIP PROGRAM
The goal of the now NEW 3-YEAR FELLOWSHIP PROGRAM (more details coming soon) in Gynecologic Oncology at the University of Texas Medical Branch at Galveston (UTMB) is to offer training and other unique educational opportunities to those Obstetrician/Gynecologists who are committed to a career in academic medicine and the acquisition of excellent skills in clinical care, teaching, and research.
ADVANTAGES OF UTMB'S GYN-ONC FELLOWSHIP PROGRAM
- four faculty mentors who are clinically active at both clinical sites where the fellow will be rotating and who offer a significant diversity of background and experience;
- unique breadth of clinical materials available at two institutions, leading to a sound, comprehensive knowledge of gynecologic malignancies;
- extended number of valuable off-service rotations, to include, among others, breast surgery;
- broad range of research opportunities and facilities to enable the fellow to hone skills in experimental procedures, protocol design, and statistical analysis; and acquire a functional knowledge of carcinogenesis, epidemiology, population statistics, prevention, and genetics of gynecologic malignancies;
- professional training and support in the development of such broad skill bases as literature review, publication, presentation, teaching, and time management/organization.
OVERVIEW OF TRAINING PROGRAM
(See Schedule of Fellowship Program at end of brochure)
MONTHS 1-18, JULY-DEC (UTMB)
The educational program will begin in the laboratory. At this time, the fellow will be enrolled in the Masters of Medical Science Degree Program. During the first few weeks of the fellowship, the fellow will become acquainted with several areas of research in order to feel comfortable with the research area ultimately chosen. In turn, this process will introduce the fellow to several investigators so that the fellow can subsequently, with approval of the Fellowship Director, identify a mentor. To the fullest extent possible, each new fellow will be allowed to choose the particular area of research interest.
MONTHS 19-21, JAN-MARCH (UTMB)
The fellow will spend three months on ancillary rotations (Radiology, Nutrition, Pathology). These rotations are designed to allow time for ongoing research.
Radiology
In January of the second year, the fellow will spend time on the Radiology service at UTMB. This will involve direct teaching and participation in diagnostic radiology with special attention to MRI, CT, and chest and abdominal X-rays. The fellow will participate in interventional radiology procedures including placement of central venous access, gastrostomy tubes, percutaneous nephrostomy tubes, radiographically directed biopsies and radiographically directed drainage of abscesses. Time will also be spent on pelvic ultrasound with special interest in gynecology.
Nutrition Service
In February of the second year, the fellow will participate in the Nutrition service at UTMB. All patients at UTMB hospitals require a consult from the Nutrition service for parenteral nutrition. This service also participates in evaluation of metabolic requirements and various enteral feedings. The fellow will acquire the skills of evaluating nutritional status, assessing surgical risk, and implementing nutritional programs to meet the needs of oncology patients. The gynecologic oncology fellow will function similarly to a senior resident on the nutritional support team. Upon consultation, the fellow will participate in the initial evaluation of the patient, as well as assessment of nutritional needs and available mechanisms of meeting those needs. The fellow will participate in prescribing nutritional support, including both enteral and parenteral formulations, and will follow patients receiving such specialized support.
Pathology
In March of the second year, the fellow will rotate on the Pathology service at UTMB. The fellow will participate in the frozen section, gross examination, prosection, and subsequent microscopic analysis of benign and oncologic gynecologic biopsy and operative specimens. The fellow will be responsible for assigned cases and will follow these through to completion, including special histochemical stains and immunohistochemical or ultrastructural studies.
The fellow will participate in preparation and presentation of cases at the weekly gynecologic oncology tumor treatment conference. During the rotation, the fellow will also review teaching cases with the faculty supervisor.
MONTHS 22-33, APRIL-MARCH (ST. JOSEPH HOSPITAL)
The fellow will spend a 12-month rotation on the Gynecologic Oncology service in the private setting of St. Joseph Hospital in Houston, during which time the fellow will be involved in all aspects of the patient's care under the direct supervision of a faculty member. Daily rounds will be held with the faculty member, the fellow, the residents, and the medical students assigned to the gynecology service. The fellow is expected to have full knowledge of every inpatient and is expected to assess each patient daily and provide a plan of management. This will be presented to the faculty on rounds for further discussion. Teaching on the service will occur through daily rounds, direct supervision in the operating room and clinics, participation in morning report, and formal lectures.
The fellow will also serve as the primary consultant for the St. Joseph Obstetrics and Gynecology Residency program, limited to patients with complicated gynecologic surgery, pre-invasive disease, and invasive or presumed invasive gynecologic diseases.
Additionally, the fellow will participate in weekly Radiation Treatment Planning Conferences and treatment of patients with gynecologic malignancies. There are no residents on the Radiation Oncology service at St. Joseph Hospital; therefore, the fellow will have direct interaction with the two radiation oncologists and the physicist.
MONTHS 34-36 APRIL-JUNE (UTMB)
The fellow will spend 3 months on ancillary services (General Surgery/Breast Service, SICU, Medical Oncology).
Surgical Oncology/Breast Disease
In April of the third year, the fellow will spend 1 month on the General Surgery service with special emphasis on breast diseases, including breast cancer. The overall objective of the rotation is to acquaint the fellow with the evaluation and treatment of benign and malignant breast diseases. The fellow should develop sufficient knowledge of diagnostic techniques and the presentation and staging of breast diseases to participate in the appropriate management of patients with a broad variety of breast diseases. Training will include instruction in history and physical examination, diagnostic techniques, surgical and nonsurgical treatment of breast diseases, staging of breast cancer, and follow-up and long-term management of patients with benign and malignant breast disease.
The majority of instruction will be supervised. This instruction will involve active participation in the various breast clinics (diagnostic breast clinic, breast high-risk clinic, breast cancer multidisciplinary clinic, and breast cancer follow-up clinic), the breast multidisciplinary conference, and management of surgical patients. A portion of the time spent during this rotation will involve a review of breast imaging and image-guided biopsy techniques in the Radiology Department. Review of pertinent breast pathology will be conducted as part of the breast multidisciplinary conference.
Medical Oncology
May of the third year will be spent on the Medical Oncology service. The fellow will participate in the evaluation, diagnosis, and treatment of patients with hematologic and solid tumors. The fellow will be expected to participate in all educational conferences and journal clubs while on the medical oncology service.
Surgical Intensive Care
In June of the third year, the fellow will spend 1 month on the Surgical Intensive Care service. The fellow will participate in the initial evaluation, stabilization, and continuing management of patients admitted to the surgical intensive care unit. The fellow will be involved in all aspects of critical care including ventilatory support, and management of cardiac arrhythmias and heart failure. The fellow will participate in placement and management of invasive monitors.
MONTHS 37-48 JULY-JUNE (UTMB)
The fellow will spend a 12-month rotation on the Gynecologic Oncology service at UTMB where the fellow, in the last year, will have greater autonomy. The fellow will be expected to supervise morning and evening rounds with the residents and medical students, participate actively in teaching, and formulate and prepare treatment plans for presentation to faculty. Additionally, the fellow will be available to instruct and supervise residents and medical students on minor procedures performed on the floor and in the clinics.
FELLOWSHIP REQUIREMENTS AT UTMB
Course Requirements
The American Board of Obstetrics and Gynecology (ABOG) requires two graduate level courses, one in statistics and one in a topic related to the fellow's research. We have required three courses to ensure exposure to all basic science topics included in the ABOG publication "A Guide to Learning in Gynecologic Oncology." The fellow may choose courses from the UTMB graduate school catalogue but is encouraged to take a course in immunology, molecular genetics, and cell and molecular biology. Additional courses may be taken if desired. The fellow will be required to maintain current certification in Basic Cardiac Life Support, Advanced Cardiac Life Support, and Advanced Trauma Life Support.
Evaluation of Fellow's Progress by Gynecologic Oncology Fellowship Committee
The Gynecologic Oncology Fellowship Committee consists of the Fellowship Director, the gynecologic oncology faculty, and the director of the specific laboratory in which the fellow conducts research. This committee evaluates the fellow on a quarterly basis to specifically identify strengths and weakness and modify the educational program to best suit the needs of the fellow. Additionally, evaluation from medical students and residents will be obtained, particularly in regard to teaching skills. The recommendations of the committee will be presented to the fellow by the Fellowship Director.
DESCRIPTION OF INSTITUTIONS
The University of Texas Medical Branch at Galveston
The University of Texas Medical Branch Hospitals are John Sealy Hospital; Children's Hospital; John Sealy Annex; Jennie Sealy Hospital; Rebecca Sealy Hospital; R. Waverley Smith Pavilion; Mary Moody Northen Pavilion; Texas Department of Criminal Justice (TDCJ) Hospital, operated jointly by TDCJ and UTMB. Shriners Burns Hospital, operated by the Shriners of North America, is a UTMB-affiliated center.
The University of Texas Medical Branch operates 928 hospital beds of which 414 are in John Sealy Hospital. There were 36,229 admissions to UTMB in 1997 and 797,846 outpatient visits. There were 88,378 additional emergency room visits.
St. Joseph Hospital
St. Joseph Hospital in downtown Houston is the largest hospital in the Christus Health Care Network, a nonprofit Catholic Health Care System. St. Joseph hospital operates 504 beds with 22,099 annual admissions and 38,488 emergency room visits. Housed within the St. Joseph Hospital complex is the DuBuis Long Term Acute Care Hospital, a skilled nursing facility, a rehabilitation unit, and both inpatient and outpatient hospice programs.
RESEARCH IN THE DEPARTMENT AND DIVISION
Department of Obstetrics & Gynecology
The Department of Obstetrics & Gynecology has laboratory space utilized for basic science research. This research is primarily conducted within the Division of Reproductive Sciences, located on the 11th floor of the Medical Research Building (MRB). The Department of Obstetrics & Gynecology occupies approximately 22,300 square feet within the MRB with a total of 19 laboratories. Fifty employees support the basic science research mission of the department. One current area of emphasis for basic research is uterine contractility, specifically the events that maintain the uterus in a quiescent state and then initiate labor at term. Other areas of focused research include regulation of gene expression by transcription factors and infectious diseases. The department has available within our laboratories all equipment necessary for molecular studies.
Additional assets for obstetrics and gynecologic research include the Chairman's Research Division. The division comprises two units: the Clinical Trials Unit and the Research Laboratory. The units are staffed by a total of nine individuals, including registered nurses, administrative associates, study coordinators, and laboratory technicians.
The Department of Obstetrics & Gynecology also provides investigators with publication and grant application support free of charge. The office of Publication, Grant, & Media Support consists of a director, an editor, a graphic artist, a technical writer, and an editorial assistant.
The services of both the Chairman's Research Division and Publication, Grant, & Media Support will be available to our fellows.
Division of Gynecologic Oncology
The Division of Gynecologic Oncology maintains multiple sites of basic science research both within our Department of Obstetrics & Gynecology, as well as through collaborative efforts with the Departments of Surgery, Microbiology & Immunology, and Dermatology.
The Division of Gynecologic Oncology has laboratory space immediately adjacent to our administrative offices as well as in the Medical Research Building.
RESEARCH OPPORTUNITIES FOR THE FELLOW
After completion of the initial 18 months of dedicated basic science research, the fellow will have approximately 8 hours per week in which to participate in research activities. The fellow will be allowed to participate in any laboratory that is currently collaborating with the Division of Gynecologic Oncology and will be encouraged to work with the clinical faculty on both prospective and retrospective clinical research. The fellow will be required to complete at least one (preferably prospective) clinical project before completing the fellowship.
CONTACT US
Lory LeBlanc
Fellowship Program Coordinator
409-772-7595
lrleblan@utmb.edu