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Curriculum

The first year of Mayo's Gynecologic Oncology Fellowship Program consists primarily of gynecologic-related basic science research. Basic science programs currently are available in the departments of biochemistry, experimental biology, pharmacology and cell biology. Designated basic scientists in each of these areas allocate space and serve as mentors.

This experience in laboratory research will teach you how to recognize significant oncologic processes worthy of investigation, generate a testable hypothesis and coordinate the technology necessary to test your hypothesis.

In addition to the basic science research you conduct during your first year, you will complete a clinical investigation project. Ideally, this project should be coordinated with your basic science research.

During the final two years, you will receive training in clinical gynecologic oncology, advanced gynecologic surgical oncology, radiotherapy and chemotherapy. Gynecologic oncology surgical rotations occur quarterly. You will be assigned to a preceptor with a specific interest in gynecologic oncology, but you also will have the opportunity to work with all of Mayo's gynecologic surgeons.

Rotations

Fellows Summer Quarter Fall Quarter Winter Quarter Spring Quarter
1st Year-A Research Research Research Research
1st Year-B Research Research Research Research
2nd Year-A GYN Surgery/Med Onc/Rad Onc GYN Surgery**/Critical Care Service^^ GYN Surgery**/Colon & Rectal Surgery GYN Surgery**
2nd Year-B Med Onc/Rad Onc/ GYN Surgery Critical Care Service^^/ GYN Surgery** GYN Surgery** C&RS/GYN Surgery**
3rd Year-A GYN Surgery** GYN Surgery** GYN Surgery** GYN Surgery**
3rd Year-B GYN Surgery** GYN Surgery** GYN Surgery** GYN Surgery**

**Gynecology Oncology fellows see patients with a medical oncologist one afternoon every other week they are on a GYN Surgery quarter.

^^Fellows will function as a junior resident when on the Critical Care Service (CCS) rotation and will be responsible for having Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) certification up to date prior to this rotation.

Clinical Training

Most inpatient and outpatient activities and related clinical instruction occur on alternate weekdays at Mayo Clinic. The chart below shows a typical week.

Typical Weekly Schedule

Nonsurgical Days

  • Hospital work rounds (a.m.)
  • Staff teaching rounds
  • Outpatient services
  • Chemotherapy clinic
  • Hospital work rounds (p.m.)

Surgical Days

  • Hospital work rounds (a.m.)
  • Gynecologic surgery
  • Pathology and tumor board reviews
  • Brachytherapy (O.R. insertion)
  • Intraoperative irradiation
  • Hospital work rounds (p.m.)

On nonsurgical days, you will conduct early morning hospital work rounds at Rochester Methodist Hospital, evaluating the pre- and post-operative status of patients and formulating management plans. Then you will join a consulting staff member and revisit all inpatients for teaching rounds. During these rounds you will discuss the patients' conditions and modify your management plans if necessary. You will go to Mayo Clinic for the balance of the day -- seeing and evaluating new, returning and post-operative patients. This includes afternoon consultations for patients returning to the Gynecologic Chemotherapy Unit. You will complete the day with final hospital work rounds.

On surgical days, you will conduct early morning and late afternoon hospital work rounds, as described above. You will begin surgery at 7:45 a.m., working one-on-one with the surgical consultant who will give you intraoperative instruction.

On an ongoing basis, you will receive clinical training in pretreatment exploratory laparotomy, intraoperative radiation therapy, brachytherapy and the surgical management of complications resulting from radiotherapy.

Assignments

You will be assigned to a staff gynecologic oncologist for each three-month rotation in the program. During each rotation you will consult with that staff member and serve as one of three individuals on the surgical team (staff consultant, fellow and operating technician) on operating days.

The degree of independence you have in any given case will be determined by your experience and surgical expertise as well as the complexity of the surgery required to care for the patient. However, your overall responsibility will increase commensurate with your professional growth. For example, during the first three to six months after you begin your fellowship, you will function as an assistant to the staff surgeon until you are familiar with Mayo's approach and techniques. By the time you have reached the last six months of training, it is expected that these roles will be reversed. This same process should also occur in your work with patients in both the outpatient and inpatient postoperative settings.

The staff gynecologic oncologists at Mayo perform both benign and oncologic surgical procedures, so you will be exposed to many different types of gynecologic procedures during your assignments. To ensure that you have the opportunity to gain superior surgical skills, you will have experience with:

  • Rectovaginal, vesicovaginal and colovaginal fistulas
  • Vaginal and perineal reconstructive procedures
  • Advanced urogynecologic procedures
  • Repair of posthysterectomy vault prolapses
  • Abdominal and vaginal hysterectomies

Didactic Training

You will be required to apply to and complete the Master’s of Biomedical Science degree program through the Mayo Graduate School. Didactic courses including biostatistics, cancer biology and pelvic anatomy are completed during the first year of training. Courses in colposcopy, gross pelvic anatomy, gynecologic pathology, and radiophysics and biology are completed during the two clinical years. A thesis, written examination and successful completion of an oral examination are required to complete the master’s program.

You will attend the annual meeting of the Society of Gynecologic Oncologists while you are in this training program. In addition, you will attend other annual scientific meetings if you have an abstract or manuscript for oral or poster presentation accepted for presentation.

Conferences

The complete conference, seminar and lecture schedule at Mayo Medical Center include approximately 100 presentations or discussions per week. Staff, fellows and residents are encouraged to attend as many of these as appropriate, keeping in mind their commitments to course work, patient care, research, family life and outside interests.

You are encouraged to attend the following presentations:

  • Gynecologic Oncology Division Conference (weekly September through June)
  • General Surgical Grand Rounds
  • Radiation Oncology Conference
  • Mayo Oncology Society Lecture
  • Weekly Gynecologic Oncology Fellowship Conference
  • Any other basic science presentation related to your research interests.

You will present several formal lectures throughout the academic year to groups within the department and to interdepartmental meetings. For example, you will make a quarterly presentation during Gynecologic Oncology Division Conference on a current, relevant topic in oncology. In addition, you will be responsible for selecting timely cases and leading tumor conferences that include representatives from gynecologic pathology, therapeutic radiology, medical oncology and gynecologic oncology.

You may receive requests from other departments to present lectures about pertinent issues in gynecologic oncology. You are encouraged to accept these invitations.

Also see:

  • May 9, 2012
  • ART803658