The first nine months of the Mayo Clinic Female Pelvic Medicine and Reconstructive Surgery (FPMRS) Fellowship is dedicated to research with no clinical responsibilities. There are two additional six-week research rotations in the second and third years to complete the required 12 months of research.

Fellows enroll in Mayo Clinic Graduate School of Biomedical Sciences' Master of Biomedical Sciences in female pelvic medicine and reconstructive surgery program, as well as the Center for Clinical and Translational Science (CCaTS) diploma program. The master's degree and CCaTS diploma programs are designed to prepare fellows to lead and participate in research teams conducting effective patient-oriented research.

Master's degree minimum credit requirements

Fellows must complete 16 credits of required didactic courses, with a minimum GPA of 3.0 on a 4.0 scale. Fellows earn 24 credits toward the master's degree for participating in structured research activities and 28 credits for participating in departmental clinical and surgical training.

Fellows may enroll in additional elective courses offered by Mayo Clinic Graduate School of Biomedical Sciences after discussion and approval by the graduate program director. Completion of the master's degree requires successful completion of a thesis manuscript, written examination and oral defense of the thesis.

Whether pursuing clinical or basic science research, the research rotations are organized to teach fellows how to generate a hypothesis and coordinate the necessary hypothesis testing. In addition to the thesis project generated during protected research rotations, fellows have the opportunity to participate in a wide variety of additional research endeavors, often yielding several additional manuscripts or book chapters during the 36 months of training.

Rotation schedule

During the clinical and surgical rotations, fellows receive extensive medical, surgical and diagnostic training in female pelvic medicine and reconstructive surgery with hands-on experience in evaluating, diagnosing and managing patients with urinary incontinence, pelvic relaxation and other disorders of the female reproductive tract.

An example of the fellowship rotations:

Year 1
Quarter Rotation
Summer Research
Fall Research
Winter Research; BLS and ACLS certification
Spring Gynecologic surgery and Urogynecology Clinic
Year 2
Quarter Rotation
Summer Gynecologic surgery and Urogynecology Clinic
Fall Gynecologic surgery and Urogynecology Clinic
Winter Gynecologic surgery and Urogynecology Clinic
  • GI/manometry (2 weeks)
  • Research (6 weeks)
  • Gynecologic surgery and Urogynecology Clinic (4 weeks)
Year 3
Quarter Rotation
Summer Gynecologic surgery and Urogynecology Clinic
  • Female urology off campus at Metro Urology in Woodbury, Minn. (8 weeks; required)
  • Colon and rectal surgery (4 weeks)
Winter Gynecologic surgery and Urogynecology Clinic
  • Gynecologic surgery and Urogynecology Clinic (6 weeks)
  • Research (6 weeks)

Clinical training

The FPMRS faculty and fellows participate in both outpatient clinical evaluation and surgery each week during their fellowship. Oftentimes, this occurs on alternating weekdays. For example, outpatient clinic one day followed by surgery the next day, in an alternating manner. The list below shows a typical week.

Fellows are assigned to work one-on-one with one of four board-certified FPMRS faculty for 12-week blocks, though some blocks are shorter due to off-service rotations (urology, colorectal surgery). During this time, the fellow works directly with this faculty member in the outpatient clinic, in the operating room and managing postoperative patients. This offers a unique continuity not often found in other training centers.

Nonsurgical days:

  • Hospital work rounds (morning)
  • Staff teaching rounds
  • Urogynecology Clinic
  • Hospital work rounds (afternoon)

Surgical days:

  • Hospital work rounds (morning)
  • Gynecologic surgery
  • Hospital work rounds (afternoon)

On nonsurgical days, fellows conduct morning hospital rounds at Mayo Clinic Hospital, Methodist Campus, evaluating the postoperative status of patients and formulating management plans. Fellows then join a supervising faculty member and revisit all inpatients for morning teaching rounds. During these rounds, fellows discuss the patients' conditions and modify management plans if necessary. Fellows and faculty then proceed to the Urogynecology Clinic for the balance of the day, seeing and evaluating new and returning patients as well as postoperative patients. During that clinic day, fellows evaluate patients with pelvic floor disorders, interpret urodynamic tests and perform cystoscopic patient evaluations, and then complete the day with final hospital work rounds.

On surgical days, fellows conduct morning and late afternoon hospital work rounds as described above. Fellows begin surgery at 7:45 a.m., working with their assigned surgeon.

The faculty members maintain excellent working relationships with other departments, including general surgery, colorectal surgery, neurology, plastic surgery, gastroenterology and urology, enhancing clinical care of gynecologic patients and broadening fellows' medical and surgical exposure.

During the clinical and surgical rotations, fellows rotate in gastroenterology (two weeks), colon and rectal surgery (four weeks), and female urology (required eight-week off-campus rotation at Metro Urology in Woodbury, Minnesota).

The urogynecologic surgeons focus on prolapse, urinary incontinence and complex benign gynecologic problems. Fellows participate in procedures that include:

  • Hysterectomy
  • Bilateral salpingo-oophorectomy
  • Modified McCall culdoplasty for vaginal vault prolapse
  • Anterior and posterior colporrhaphy
  • Urethral diverticulectomy
  • Synthetic midurethral sling placement
  • Autologous pubovaginal sling procedures
  • Burch retropubic urethropexy
  • Abdominal sacrocolpopexy
  • Repair of genitourinary injuries including fistula
  • Repair of rectovaginal, vesicovaginal and urethrovaginal fistulas
  • Cystoscopy
  • Ureteral stent placement
  • Ureteroneocystostomy, along with repair of other injuries to the urinary tract
  • Anal sphincteroplasty
  • A variety of plastic surgery procedures, including McIndoe procedures for creation of a neovagina as well as various rotational flaps for reconstructive surgery

In addition, fellows perform intraoperative cystoscopy for surveillance of the urinary tract as well as for placement of intraoperative ureteral stents and Botox injection. Fellows are trained in sacral nerve stimulation.

In addition to the operative procedures, fellows are trained in diagnostic procedures in the clinical setting, including:

  • Urodynamics
  • Cystoscopy
  • Anorectal manometry
  • EMG
  • Endorectal ultrasound
  • Defecography/dynamic MRI
  • Pelvic floor biofeedback
  • Pessary fitting

The degree of independence fellows have in performing any of the above procedures is determined by clinical and surgical experience as well as the complexity of the surgery required to care for the patient. However, overall fellow responsibility will increase commensurate with professional growth. For example, during the first month after beginning the clinical rotations, the fellow functions as an assistant to the faculty surgeon until familiar with Mayo Clinic's approach and techniques. These roles are reversed as the fellow progresses through training. This same process occurs in both the outpatient and the inpatient postoperative settings.

In addition, the Mayo Clinic gynecologic surgical staff includes several gynecologic oncologists who perform both benign and oncologic surgical procedures. Fellows are exposed to many different types of gynecologic procedures and approaches during assignments. This ensures that fellows have the opportunity to gain superior surgical skills not only in urogynecology and reconstructive pelvic surgery but also with gynecologic oncology cases that have relevance to female pelvic medicine and reconstructive surgery.

Didactic training

Clinical conferences, seminars, small discussion groups, journal clubs and one-on-one instruction are all integral parts of the fellowship. Fellows attend one of these didactic sessions every Tuesday morning:

  • Urogynecology Fellowship Research Conference
  • Urogynecology Fellowship Journal Club
  • Urogynecology Fellowship Conference
  • Urogynecology Fellowship Quality Improvement (M&M) Conference

Fellows attend the conferences noted above in addition to the didactic training in pursuit of the Master of Biomedical Sciences in female pelvic medicine and reconstructive surgery. In addition, fellows participate in an annual six-week graduate-level pelvic anatomy course. Fellows may participate in many other conferences, including the Department of Obstetrics and Gynecology conference, general surgery conference, and OB/GYN journal club.

Fellows attend the annual meeting of the American Urogynecologic Society (AUGS) at least once during fellowship and may attend each year if an abstract is accepted for presentation at the conference. Fellows may attend other scientific meetings if an abstract is accepted for presentation.

Research training

The research opportunities at Mayo Clinic are significant. The urogynecology team focuses on epidemiology, retrospective and prospective analysis of surgical outcomes, imaging modalities of the pelvic floor, and basic science research.

An extensive support team facilitates investigation in a variety of areas. This includes a dedicated department statistician for complex statistics, access to study coordinators, and a survey research facility to assist with creation and distribution of study surveys. Fellows are expected to generate research projects resulting in manuscripts suitable for presentation and publication in peer-reviewed journals.

The Scientific Publications department at Mayo Clinic's campus in Rochester, Minnesota, is the largest in-house publication service of any academic center in the United States. Fellows may utilize this service for proofing, formatting and submission of manuscripts.

Call frequency

Fellows' call schedules vary by individual rotation. Fellows are on pager call one to two nights during the workweek. Weekend call is rotated and averages once a month. Fellows have no in-house call responsibilities and no obstetric coverage requirements.

Mayo Clinic complies with the Accreditation Council for Graduate Medical Education (ACGME) duty-hour requirements.


Moonlighting is not required. Moonlighting is allowed with permission of the program director and must comply with ACGME duty-hour requirements. Moonlighting must not interfere with any fellowship responsibilities.


To ensure that fellows acquire adequate knowledge and development of technical skills, performance is monitored carefully during the course of the Mayo Clinic Female Pelvic Medicine and Reconstructive Surgery Fellowship. Fellows are evaluated formally by their supervising faculty member on a quarterly basis, and these evaluations are shared with each fellow by the program director.

In addition, fellows regularly evaluate the faculty, rotations and fellowship to ensure fellows' needs are being met.

Dec. 17, 2015