Two clinical years immerse fellows in a diverse and high-volume clinical and surgical experience that provides exposure to complex gynecologic pathology.
Rotations focus on four main surgical approaches: laparoscopy, hysteroscopy, vaginal, and robotic surgery. In all four areas, emphasis is on the mastery of the pelvic anatomy so that fellows are confident in navigating all spaces encountered in simple and complex pathology. A hands-on laparoscopic workshop using the cadaveric model is held annually to gain skills in opening the retroperitoneal lateral and presacral spaces, ureterolysis, and isolation of the uterine arteries. An established dry-lab curriculum using laparoscopic pelvic trainers and robotic simulation ensures competency in laparoscopic suturing and mastery of the robotic system.
During rotations in laparoscopy and robotics, trainees demonstrate understanding of the principles of different energy modalities, show familiarity with safe techniques for peritoneal access and specimen removal, demonstrate competency in handling of tissue and use of available instrumentation, and show knowledge and skills for prevention and management of complications.
The hysteroscopy rotation emphasizes surgical principles, mastery of skills, and handling of equipment. In addition, fellows provide knowledge of the indications, options, and considerations necessary in the treatment of patients with infertility and adolescents with mullerian abnormalities.
During the vaginal surgery rotation, the trainee is equipped with skills to become proficient in vaginal hysterectomy. Fellows learn to articulate the specific challenges encountered during the vaginal approach and know the different techniques and devices available to overcome these challenges. By the end of the program, fellows will be comfortable with the vaginal approach for large uteri and non-prolapsed conditions. Fellows also rotate through the Pelvic Floor Clinic and become familiar with diagnosis and treatment options for pelvic organ prolapse and incontinence. The use of cystoscopy for identification of ureteral and bladder injuries during surgery is also emphasized.
Fellows have intermittent practice and emergency room call responsibilities, as well as attending weekly service commitments, but no obstetric duties.
The fellowship includes a one-year rotation in research with Roger Smith, PhD, a world-renowned expert in robotics, simulation, and surgical innovation. This dedicated research year takes place at the Nicholson Center in Celebration, FL, which features a 50,000 square-foot surgical training facility that possesses state-of-the-art surgical and simulation technology (e.g. six training robots), as well as cadaveric and vivarium facilities.
During this year, fellows will be guided through the scholarly rigors of design and implementation of scientific experiments, interpretation of data, and manuscript writing. Fellows are required develop and implement research protocols and present their work at national/international meetings with the ultimate goal being publication of research in peer-reviewed journals.
Research activities are also available during clinical rotations. Fellows are required to present a major thesis subject to jury defense at the end of the three-year program for graduation.
Conferences and Didactics
Morbidity and Mortality Conference
Thursday is the academic day for the entire Department of Obstetrics and Gynecology at Columbia University Medical Center. The day begins with the Morbidity and Mortality (M&M) Conference, in which interesting cases from each service are presented by members of the house staff and are followed by lively and thoughtful discussion from the faculty and other members of the department.
Weekly Grand Rounds follow the M&M Conference and feature presentations from within our faculty, as well as many distinguished visiting guest speakers.
Fellow Lecture Series
A core MIGS Lecture Series Schedule supplements the experience gained on clinical rotations to round out the comprehensive post-graduate curriculum.
A Gyn Journal Club is held every month with the presentation of an interesting paper by a fellow and a critical discussion and review of the topic led by a faculty member.
A TGIF conference is held every other Friday morning. Preoperative cases are discussed with supervising faculty, and often an ACOG practice bulletin or a review of recent literature on a particular gynecologic topic will be presented by a resident with discussion facilitated by a rotating faculty preceptor.
A research meeting is held weekly on Friday mornings during which our faculty and fellows discuss ongoing research projects within the division.