Clinical Responsibilities

Overview of Clinical Responsibilities

Fellows 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.  Fellows will spend approximately 1 – 1.5 days in the clinic.

The surgical experience during this fellowship is “hands-on,” and fellows actively participate in all surgical cases performed by the MIS faculty.  Types of procedures that a fellow 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 and robotic 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 and hysterectomy, as well as vaginal hysterectomy, are also emphasized.  Fellows will spend approximately 2-3 days in the operating room, depending on their rotation schedule.  The MIS faculty also supervise an outpatient office procedure clinic, with a focus on office hysteroscopy, office diagnostic and operative hysteroscopy, and saline-infusion sonohysterography.  This clinic is held weekly.

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

All MIS fellows 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 MIS fellow will be fully integrated into these off-service rotations.  During these rotations, the MIS fellow will have the opportunity to participate in the medical and surgical care of patients on these services.  In doing so, MIS fellows will gain important exposure and experience in the preoperative evaluation, screening, and evaluation of gynecologic malignancies.  The fellows 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:  Fellows 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 when the UMOG attending is unavailable and is responsible for any emergency surgical procedures. 
    • The UMOG attending call is an overnight, in-house call that is taken 1 time per month.  The UMOG attending supervises the on-call Ob-Gyn residents in all of their clinical activities, except for emergency gynecologic procedures.  This includes the obstetric service.  Participation in the UMOG call is optional but encouraged.  Faculty will receive an additional stipend for each UMOG call taken.
  • MIS service:  MIS fellows will be available for residents to discuss and evaluate MIS patients who are admitted to the hospital or present to the ED for evaluation of postoperative complications.  Fellows will share the call responsibility, and the call schedule should be posted to the GroupWise Obgyn call calendar.  In general, this should be covered by the OR fellow, but can be adjusted according to individual scheduling needs.  If no fellow is available, notify MIS faculty.