Female Pelvic Medicine & Reconstructive Surgery

Female Pelvic Medicine & Reconstructive Surgery

OVERVIEW

The University of Louisville Female Pelvic Medicine and Reconstructive Surgery Fellowship is an accredited three-year program that provides comprehensive training to diagnose and treat conditions of pelvic organ prolapse, urinary and fecal incontinence, voiding and defecatory dysfunctions.  Surgical education includes vaginal, open, laparoscopic, robotic techniques, and training on the DaVinci Robotic Surgical System. 

Unique opportunities include a laparoscopic dry lab and a fresh tissue human cadaver lab with full laparoscopic set-up. Specialty specific and departmental didactics are attended weekly.  Fellows serve as mentors to students, residents and peers during outpatient clinics and surgical procedures. 

Program Aims:

  • Maintain faculty that hone knowledge and skills, are active in research, provide quality mentorship based on current evidence-based practices and model professional behavior. 
  • Develop competent clinicians with the knowledge, clinical and surgical skills necessary to practice independently.
  • Produce academicians who model professional behavior, are able to relay medical knowledge to future learners and serve as mentors during office based clinical practice and surgical procedures.
  • Maintain a culture of inquiry, research, and scholarly activity that prepares fellows to independently design, implement, and analyze research for presentation and publication in peer-reviewed journals.

FACILITIES

The division maintains its major outpatient care facility at the Springs Medical Center and the University of Louisville Health Care Outpatient Center (HCOC) and The Springs Medical Center where the attendings and fellows see their private patients as part of the University of Louisville Physicians (ULP) group. Patient consults and surgeries are performed at University of Louisville Hospital (ULH), Baptist Hospital East (BHE) and hospitals within the Norton Healthcare system.

PATIENTS

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. The division has clinical patient care office hours five days-a-week. Laboratory, urodynamics and ultrasound services are available on site.

CONSULTS

The division receives consults from members of the gynecology generalist division within the department and from physicians throughout the University of Louisville Physician practices and the Kentuckiana region.

Curriculum

PGY5

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.

PGY6

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.

PGY7

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.

Research

Fellows will participate in scholarly activities based on their areas of interest both within the institution and at the national level. Fellows will spend a total of 12 months of protected time for research during fellowship. 

By the end of the fellow’s first year, he/she will have established a mentor, a subject for the  thesis project, and an outline which summarizes the following elements:  Hypothesis, Specific Aims, Study Design, Methods (including primary outcome variables), Analysis Plan, Time Line, Dissemination and Current Status. The fellow will complete HIPAA and other required institutional training/tasks necessary for Institutional Review Board (IRB) participation.

The PGY 5 fellow will participate in and successfully complete the 12-week OB/GYN Fellowship Research and Statistics Course conducted by Jeremy Gaskins, PhD, Biostatistician. Fellow will participate in grant writing as appropriate under the guidance of the research mentor.  Fellows are encouraged to publish at least three times in peer reviewed journals and present their work at scientific meetings. All fellows attend the annual American Urogynecologic Society scientific meeting as well as other scientific meetings throughout the year that they have works accepted to present.

Didactics

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 each academic year and conduct resident didactics during each year of training.

Faculty

Sean Francis, MD, Division and Fellowship Director

Kate Meriwether, MD, Associate Program Director

Other faculty attendings who teach fellows include:

Urology: Murali Ankem, MD, chair, Ryan Malone, MD, Jamie Messer, MD

Colorectal Surgery: Peter Deveaux, MD, Jeffery Jorden, MD, Russell Farmer, MD

Gastroenerology: Thomas Abell, MD, chair

Research: Zhenmin Lei, MD, PhD, Vice Chair of Research, OB/GYN

Bioinformatics and Biostatistics:  Jeremy Gaskins, PhD

Fellows

James "Ryan" Stewart, DO, PGY 7

Ankita Gupta, MD, PGY 6

Olivia Cardenas-Trowers, MD, PGY 5

Zebulon Cope, DO, Incoming Fellow, AY 2019 - 2020

How to Apply

Application Process:

Applications to the University of Louisville Female Pelvic Medicine and Reconstructive Surgery Program will be accepted ONLY through the Association of American Medical College's (AAMC) Electronic Residency Application Service (ERAS). 

Prospective Fellows are invited to interview based on information provided in the personal statement, letters of recommendation, research and scholastic accomplishments and USMLE scores. It is the policy of this program to select the most qualified candidates regardless of gender, race, creed, color, national origin, handicap, age or sexual orientation. All applicants must participate in the National Resident Matching Program (NRMP).

Eligibility Requirements:
  • All required clinical education for entry into ACGME accredited fellowship programs must be completed in an ACGME accredited residency program, or in an RCPSC accredited or CFPC accredited residency program located in Canada.
  • For an international Medical School graduate, verification of Educational Commission for Foreign Medical Graduates (ECFMG) certification will be required.
  • Our program does accept J1 Visa applicants as long as the applicant has three years remaining on their visa in order to complete the fellowship.

Important Dates

December 1, 2019: Application Available in ERAS

April 1, 2019: UofL FPMRS Application Deadline

April 17, 2019 and May 22, 2019: UofL FPMRS Fellowship Interviews

Interview offers will be made via email in March/April. Applicants are invited to attend an informal dinner the night before with our current fellows.  This event is not mandatory but attendance is encouraged.  The interview day usually starts at 7:30 a.m. and lasts through mid afternon.

August 7, 2019: FPMRS Match Announced

Contact Information

Dana Lamon, Fellowship Coordinator

Department of Obstetrics, Gynecology & Women's Health
University of Louisville School of Medicine
550 S. Jackson Street
Louisville, KY 40202
(502) 561-7260