Curriculum

Clinical Training

The clinical portion of Mayo Clinic's Female Pelvic Medicine and Reconstructive Surgery Fellowship provides you with extensive surgical and diagnostic training. You will gain hands-on experience diagnosing and managing patients with urinary stress incontinence and pelvic relaxation. You will perform many complex benign gynecological surgical procedures. You also will gain intestinal and urinary tract surgical experience as you manage patients with extensive endometriosis and gynecologic oncology processes.

Additional opportunities available include:

• Anal ultrasound
• Colposcopic evaluation and techniques
• Cystoscopy
• Defocography

At Mayo Clinic, surgical pathologists and the operating teams work closely together, facilitated by the proximity of the pathology laboratory and the operating suites. Many specimens are promptly evaluated via frozen section techniques. You can review the gross and microscopic pathology of a surgical case while the patient is in the operating room.

The faculty members have excellent relationships with other related departments, including general surgery, colorectal surgery, neurology, gastroenterology and urology. This enhances the clinical care of gynecological patients and broadens your medical and surgical exposure.

Rotation
The typical rotation schedule for female pelvic medicine and reconstructive fellows includes:

Pelvic Reconstructive Surgery	3-4 quarters
Radical Pelvic Surgery	2-3 quarters
Urologic/Colorectal Surgery	1 quarter
Research	4 quarters

Rotation Descriptions

Pelvic Reconstructive Surgery
Most of the clinical experiences you will encounter relate to prolapse, urinary incontinence and benign gynecological problems. Procedures on this service include:

• Colporrhaphy
• Fascia lata harvesting
• Hysterectomy
• Laproscopic salpingo-cophorectomy
• Martias flaps
• Mayo culdoplasty
• Mini-incision outpatient Burch urethropaxy
• Overlapping anal sphincteroplasty
• Paravaginal defect repair
• Repair of genital urinary injuries, including fistulas
• Repair or rectro-vaginal fistulas
• Sling procedures
• Urethral diverticulectomy
• Vaginal morcellation of the uterus
• Laparoscopic suspensions
• Sacrocolpopexy

Radical Pelvic Surgery
Your clinical experiences on this service will be a combination of oncologic and benign gynecologic problems. Procedures include:

• Debulking procedures, such as intestinal resection, urinary conduits, CUSA resection of implants and splenectomy
• Exenteration
• Hysterectomy
• Laparoscopic Burch urethropexy
• Laparoscopic radical node dissection
• Laparoscopic salpingo-oophorectomy
• Mayo culdoplasty
• Morcellation of the uterus
• Radical abdominal hysterectomy
• Radical vaginal hysterectomy
• Radical vulvectomy

Urologic/Colorectal Surgery
During this rotation, you will learn about gastrointestinal endoscopy, anal manometry, anal ultrasound and a variety of colorectal operations. The rotation also includes extensive exposure to cystoscopy, urodynamics and a variety of urologic procedures and operations.

Didactic Training
Clinical conferences, seminars, small discussion groups, journal clubs and one-on-one instruction are all an integral part of the Female Pelvic Medicine and Reconstructive Surgery Fellowship. You will attend the following didactic sessions:

• Advanced Gynecological Surgery Fellowship Conference: This conference provides you with didactic training in gynecological operative procedures and medical gynecology.
• Urogynecology/Pelvic Floor Conference: This multispecialty conference gives you additional education in pelvic floor dysfunction.
• Research Conferences: This conference brings together a variety of clinicians and basic scientists to foster pelvic floor research.

During your research year, you are encouraged to take classes in research design, statistics, pelvic anatomy, urodynamics and computer use.

Research Training
Your research opportunities at Mayo Clinic are outstanding. The hands-on clinical experiences in this fellowship, combined with our highly trained laboratory and statistical support teams, create an environment well-suited to scientific investigation.

You will conduct clinical research projects during your fellowship, with assistance and support from the faculty. This research is expected to result in manuscripts suitable for presentation and publication in peer reviewed journals.

You may also have the opportunity to participate in laboratory-based research and to collaborate with academicians in other institutions as part of your research experience.

Call Frequency
Your call schedule will vary by individual rotation. Mayo Clinic follows the recommendations of the Accreditation Council for Graduate Medical Education (ACGME) and complies with ACGME's duty hour requirements.

Off-site Rotations
During the fellowship, you may have the opportunity to rotate to other Mayo Clinic sites to enhance your training. Mayo Clinic funds the authorized additional costs of your travel, housing, auto rental and licensure fees.

Evaluation
To ensure that you acquire adequate knowledge and develop your technical skills, your performance will be monitored carefully during the course of your fellowship. You will be evaluated formally by your supervising faculty member after each clinical rotation. In addition, you will regularly evaluate the faculty and your educational program to ensure that your needs are being met.

Career Development
Fellows will meet periodically with faculty members, administrators and the program director to discuss their career goals. Mayo Clinic recruits many of its staff physicians from its own training programs. Thus, when you successfully complete the Pelvic Reconstructive Surgery Fellowship, job opportunities may be available at one of Mayo Clinic's group practices.

Case Studies
During your fellowship, you will prepare several case study presentations. You will present the pertinent information of an interesting case, conduct an in-depth discussion of that case and create a current bibliography.

Teaching Opportunities
You will have the opportunity to teach residents, Mayo Medical School students and visiting students from other medical schools through bedside instruction and formal didactic lectures.

Cardiac Life Support Certification
Certification in Basic Cardiac Life Support and Advanced Cardiac Life Support (ACLS) is required for all Mayo Clinic residents and fellows. ACLS courses are held during the last week of June, just before the start of the academic year. The ACLS course also is offered evenings every three months during the year to facilitate re-certification.

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