Clinical Experience

Trainees will have the opportunity to work within MIS faculty clinics and obtain one-on-one training in the evaluation and management of complex gynecology patients.  Trainees will spend approximately 1 – 1.5 days in the clinic.

The surgical experience during this program is “hands-on,” and trainees actively participate in all surgical cases performed by the MIGS faculty.  Types of procedures that a trainee is expected to master include the following: supracervical and total laparoscopic hysterectomy, robot-assisted hysterectomy, robotic myomectomy, laparoscopic myomectomy, laparoscopic excision of advanced endometriosis, laparoscopic ovarian cystectomy and adnexectomy, laparoscopic trachelectomy, lysis of adhesions, excision of ovarian remnants, and advanced operative hysteroscopy with resection of submucosal fibroids, and intrauterine adhesions.  Mini-laparotomy for abdominal myomectomy, as well as vaginal hysterectomy, are also emphasized. Trainees will spend approximately 2-3 days in the operating room, depending on their rotation schedule.  The MIGS faculty also supervise an outpatient office procedure clinic, with a focus on diagnostic hysteroscopy and operative hysteroscopy (e.g. removal of embedded IUD, polypectomy), and saline-infusion sonohysterography.  This clinic is held weekly.

In addition to time spent in the operating room, trainees will further refine their skills in surgical simulation labs and cadaver labs done jointly with GYN oncology and urogynecology.

All MIGS trainees at Michigan Medicine will have the opportunity to spend one month each year on the gynecologic oncology service within the Department of Obstetrics and Gynecology.  The MIGS trainee will be fully integrated into these off-service rotations.  During these rotations, the MIGS trainee will have the opportunity to participate in the medical and surgical care of patients on these services.  In doing so, MIGS trainees will gain important exposure and experience in the preoperative evaluation, screening, and evaluation of gynecologic malignancies.  The trainees will also operate with this service and will gain valuable experience in radical pelvic surgery and retroperitoneal dissection, including laparoscopic and robotic GYN cancer staging procedures. Additional elective time will be used to rotate in outpatient clinics within urogynecology, vulvar disease, and advanced pain care (including working with pelvic floor physical therapy, and PM&R physicians with expertise in chronic pelvic pain).

• GYN call and UMOG call:  Trainees will participate in the benign gynecology and UMOG call pools.
  • The benign gynecology attending call is taken from home approximately 3 times per month.  This attending is responsible for inpatient and emergency department consultations and admissions and any emergency surgical procedures. 
  • The UMOG attending call is an overnight, in-house obstetrics call that is taken 1 time per month during the first year. The UMOG attending supervises the on-call Ob-Gyn residents on labor and delivery. 
• MIGS service:  MIGS trainees will be available for residents to discuss and evaluate MIGS patients who are admitted to the hospital or present to the ED for evaluation of postoperative complications.  Trainees will share the call responsibility, and the call schedule should be posted to the Obgyn call calendar.  In general, this should be covered by the OR trainee, but can be adjusted according to individual scheduling needs.  If no trainee is available, the MIGS faculty will be called directly.