Female Pelvic Medicine & Reconstructive Surgery
Female Pelvic Medicine & Reconstructive Surgery
The three-year accredited ACGME fellowship program offers clinical, teaching and research experience while providing comprehensive training to diagnose and treat conditions of pelvic organ prolapse and urinary and fecal incontinence including voiding and defecatory dysfunction.
Surgical education includes a balance of vaginal, open, laparoscopic, and robotic techniques, including opportunities to train on the dual console Intuitive daVinci Si unit.
Unique opportunities include a laparoscopic dry lab dedicated to fellowship training and a fresh tissue human cadaver lab with full laparoscopic set-up. Fellows participate in mentored basic science and clinical research with either a division or departmental faculty member or faculty in the divisions of colorectal, urology, gastroenterology, geriatric medicine, or school of engineering.
Fellows prepare for careers in private practice and academic careers.
The division maintains its major outpatient care facility at the University of Louisville HealthCare Outpatient Center (HCOC) where the attendings and fellows see their private patients as part of the University of Louisville Physicians (ULP) group.
The practice has a wide referral base, accepting patients from Kentucky, Indiana, Ohio, and West Virginia. In the immediate Louisville metropolitan area, the division draws from a geographical area of 1.3 million people within a 50-mile radius.
Patients have a wide range of medical conditions including infertility, amenorrhea, hirsutism, abnormal sexual development, premenstrual syndrome, and symptoms of the menopausal period.
The division has clinical patient care hour’s five-days-a-week and has an in-house laboratory and ultrasound services on site.
The division receives consults from members of the gynecology generalist division within the department and from physicians throughout the region.
Fellows participate in mentored basic science and clinical research with either a division or department faculty member or faculty in the divisions of colorectal, urology, gastroenterology, or geriatric medicine. In addition, the division has a relationship with the school of engineering to collaborate in research.
A human cadaver laboratory and a dual console Intuitive daVinci Si unit enhance learning and allow fellows to refine clinical robotic endoscopic skills, as well as conduct research.
20 days + 10 Continuing Health Science Education days
Training during the first year of fellowship consists of developing a comprehensive knowledge base of the subspecialty, specifically learning technical skills in the office setting, operating room, and inpatient unit at University Hospital.
Fellows work under direct supervision of faculty attendings in completing history and physical examinations with attention to pelvic floor defects, urinary and fecal incontinence, and other benign gynecologic pathology, and providing pre- and post-operative surgical care. Fellows focus on acquiring good surgical technique.
Time is devoted to developing a research proposal with IRB approval.
With increasing proficiency, the second year fellow effectively manages more complex cases of prolapse and incontinence, coordinates patient care, and continues to develop the necessary skills to function as an effective subspecialist.
The fellow gains knowledge in the initial evaluation of patients presenting with fecal incontinence and various forms of colon and rectal problems. S/he participates in pre-operative evaluations, completion of history and physical examinations with attention to rectovaginal fistulas, hemorrhoids, bowel anastomosis, rectal prolapse and other pathology related to the colon and rectum. Under direct supervision, the fellow participates in surgery and rounds on post-operative patients on the service.
The PGY-6 fellow becomes more proficient with technical skills acquired during the previous year of training and expands clinical experience in pre- and post-operative care of patients with pelvic organ prolapse.
Time is devoted to the development of research skills and a project that will be completed during the final year of fellowship.
All training in the previous two years culminates in the final year of competence and responsibility, thus demonstrating the knowledge and skills necessary to practice independently upon completion of the program.
The PGY-7 fellow is primarily responsible for diagnosis and development of a care plan for each patient; s/he manages the treatment and performs as primary surgeon with faculty attendings in the assistant’s role in FPMRS surgeries for pelvic floor defects, urinary and fecal incontinence, and other benign gynecologic pathology. Fellows perform non-surgical techniques to treat different anomalies, perform surgical techniques (including Vecchieti procedure) to treat urogenital anomalies, and know appropriate timing and indications for gonadectomy. The fellow also becomes proficient on neuro-urology and neuromodulation and develops competency in advanced laparoscopy and robotic surgical technique.
The PGY-7 demonstrates competence in research through the submission of a research manuscript for publication in the peer-reviewed literature. On site, the research is presented at the departmental annual Research Day.
The fellow demonstrates a level of competence in cadaveric dissection and subspecialty whereas s/he can now teach independently. The PGY-7 functions at the level of an attending in Female Pelvic Medicine and Reconstructive Surgery.
The fellowship is the cornerstone of the Female Pelvic Medicine and Reconstructive Surgery division, which is committed to a strong teaching curriculum for members of the department and school of medicine, including faculty, residents, and medical students.
As part of our educational mission, the division conducts:
- weekly didactic course based on objectives outlined in the Guide to Learning in Female Pelvic Medicine and Reconstructive Surgery, American Board of Obstetrics and Gynecology (ABOG)
- weekly pre- and post-operative conferences
- monthly subspecialty journal club
- bi-monthly colorectal conference
- bi-monthly urodynamics conference
At the weekly seminar/didactic courses, fellows present assigned textbook chapters and preselected articles under the direction of a faculty mentor.
Fellows attend the department’s weekly Grand Rounds presentations, pertinent weekly Continuous Quality Improvement, preoperative gynecology conferences, morbidity and mortality conference, and Journal Club, all held within protected educational time.
Fellows present a Grand Rounds topic during the final year and conduct a resident didactic during each year of training.
How to Apply
Application Process: ERAS
If you have additional questions, please contact:
Sean Francis, MD, associate professor, is division and fellowship director.
Other faculty attendings who teach fellows include: Murali Ankem, MD, chair, urology; Jeffery Jorden, MD, colorectal surgery; Thomas Abell, MD, chair, gastroenterology; and Luis Marsano-Obando, MD, gastroenterology.
Research members of the department who have direct contact with the fellows through laboratory studies include Jacek Jasinski, PhD, research engineering scientist; and Zhenmin Lei, MD, PhD, professor.