Training Structure

The first-year fellow is not assigned any clinical responsibilities and participates in the clinical call schedule only for weekend call every third week. The fellow will select a thesis and thesis advisor. The project must lead to the completion of a thesis suitable for subspecialty board examination. This project may be laboratory-based basic or translational science or non-laboratory-based epidemiology or outcomes-research. The educational objectives of the research year include many, but not necessarily all, the following:

1. The division objective for basic and translational science research activity focuses on the molecular biology of gynecologic neoplasms, specifically ovarian, and to a lesser extent, endometrial and cervical cancers. a) Mastery of basic laboratory techniques used in molecular biology such as DNA/RNA extraction, DNA analysis (Southern blotting and sequencing), RNA analysis (Northern blotting), PCR, and immunohistochemistry, b) An understanding of the basic concepts of molecular biology,
2. The division objective for epidemiology and outcomes-based research activity focuses on gynecologic neoplasms. a) Mastery of clinical trial design, b) Preparation of IRB applications, c) Understanding of basic concepts of epidemiology, population-based statistics, outcome measures, and interpretation of data.
3. All fellows will be expected to learn the following during their research experience: a) Improvement of skills related to the critical analysis of published data, b) An understanding of why collaborative research is important and how to establish these interactions, c) The development of manuscript writing skills and exposure to grant preparation
4. These educational objectives are accomplished by providing a structured research experience in which the fellow is expected to devise and implement a research plan, interpret the results, troubleshoot experimental failures, and prepare a manuscript describing the work.
5. The selection of the thesis research project is based upon input from the prospective fellow, the program director, and the project director (if different from the program director). Upon notification of matching and acceptance of the fellowship training offer, the fellow is provided a list of potential mentors and projects. The fellow can choose from this list or suggest his or her own project after discussing the options with the Program Director. If the fellow has a specific project in mind, every effort will be made to accommodate that interest. In special circumstances, clinical research projects will be considered acceptable. Examples include projects related to epidemiology or outcomes research that involve significant participation with the School of Public Health. The project that is selected must have scientific merit, be related to some aspect of gynecologic oncology, and have achievable goals. The activities of the research year are expected to result in at least one peer-review publication.
6. Fellows may establish mentor relationships with distinguished researchers in other departments when the program director feels it best suits the particular research interests of the fellow.
7. Clinical research activities include institutional studies, quality improvement studies, and participation with two national collaborative groups. The division enrolls patients in NRG/Gynecologic Oncology Group (GOG) protocols and institutional protocols. An important ancillary goal of the two years of clinical training is to provide a framework in which the fellow can learn to balance the demands of clinical care with those of scholarly pursuits, including ongoing laboratory research and manuscript preparation.

Fellows actively participate in all aspects of in-patient and out-patient care of patients with known or suspected gynecologic cancer, including evaluation, planning, treatment and follow-up at both the University of Michigan Hospital and Saint Joseph Mercy Hospital in Ann Arbor. Structured in-patient and out-patient services incorporate the participation of gynecologic oncology fellows in all patient care activities. Faculty consultation is available to the fellows at all times. Formal teaching rounds at UMMC are conducted regularly by the faculty. The attending faculty agree that day-to-day patient care decisions will be left to the fellow as appropriate for the individual fellow’s level of training and experience.

Gynecologic Oncology is a multidisciplinary specialty where the provider is expected to be able to perform a wide variety of surgical procedures including bowel surgery and urologic surgery in addition to gynecologic procedures. The University of Michigan strictly follows the ABOG Guide to Learning in Gynecologic Oncology. The fellows gain experience on all of these procedures while on the gynecologic oncology service at the University of Michigan because bowel and urologic procedures comprise a significant portion of our routine clinical services.

The fellow obtains Advanced Cardiac Life Support (ACLS) certification before beginning the clinical portion of the fellowship program. On the surgical oncology/breast care center rotation, the fellow participates in the capacity of a senior-level house officer.

Fellows are not recalled to the gynecologic oncology service when on an off-service rotation unless a rare procedure such as a pelvic exenteration is to be performed. This minimizes disruption to both services and permits the fellow to take on a greater level of responsibility on the off-service rotation. Fellows continue to share weekend rounds when the off-service rotation does not involve weekend clinical duties.