Minimally Invasive Gynecologic Surgery
Overview
The fellowship in Minimally Invasive Gynecologic Surgery (MIGS) at the Univeristy of Louisville was first established in 2001 under the direction of Drs. Ronald Levine and Resad Pasic. The Division of MIGS has a rich history of pioneering gynecologic laparoscopy: The first laparoscopic bilateral oophorectomy in the U.S. was performed at the University of Louisville by Dr. Ronald Levine in 1984. The first endoscopic course in the U.S. was conducted by Drs. Levine and Pasic in 2001. The division later partnered with AAGL in 2001 to establish the first endoscopic cadaver course in the U.S. This cadaver course has served many physicians both nationally and internationally in honing their knowledge and skills in gynecologic anatomy and laparoscopic techniques.
In 2021, Dr. Pasic and the MIGS Fellow Dr. Megan Cesta performed the total laparoscopic hysterectomy on a 7.4 Kg uterus that turned out to be world's largest uterus taken out laparoscopically.
The MIGS program is a two year program which utilizes academic and private clinical settings to train fellows in gynecologic operative laparoscopy, hysteroscopy, endoscopy, and robotics. Since its inception, the program has graduated 20 fellows who now hold positions in both academic and private practice settings. Past graduates have won prestigious awards such as the AAGL 2008 and 2010 Jay M. Cooper Endowed Award; the 2010, 2011 and 2012 IRCAD, and AAGL Excellence in Suturing awards. Our faculty and fellows have also authored or coauthored 75 peer-reviewed publications in major journals and books.
Fellows are designated departmental “instructors” who serve as attendings with periodic service and call responsibilities. Fellows have unrestricted access to the fresh tissue human cadaver laboratory, learning and teaching pelvic anatomy and various surgical techniques to residents and medical students. In addition, each fellow participates in post-graduate courses in anatomy and advanced endoscopy held at the University of Louisville.
The fellows have the opportunity to learn robotic surgery on a dual console Intuitive daVinci Si unit that offers practice in refining clinical robotic endoscopic procedures. Upon completion of the program, the fellow will be able to confidently perform most advanced laparoscopic and hysteroscopic procedures and be eminently qualified to continue as an academic clinician in a supervisory position.
Facilities
The division maintains its major outpatient care facility at the University of Louisville HealthCare Outpatient Center (HCOC) where the MIGS attending and fellows see their private patients as part of the University of Louisville Physicians (ULP) group. This facility also provides access to a self-contained outpatient operating room.
A resident and faculty clinic is also housed within the Department of Ob-Gyn-Women’s Health office suite in the UofL Ambulatory Care Building (ACB).
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 hour’s five days per week with laboratory and ultrasound services on site.
Consults
The division receives consults from members of the gynecology generalist division within the department and from physicians throughout the region.
Research
Basic science research is conducted with departmental faculty members and Zhenmin Lei, MD, PhD. The following techniques are available in these investigator’s laboratories: Northern, Southern, Western and ligand blotting, covalent receptor cross linking, nested RT-PCR, cell transfections, antisense gene expression, gel mobility shift, cloning cDNAs, light and transmission electron microscopy, immunocytochemistry, immunoassays, cell and tissue culture, and in situ hybridization.
Curriculum
PGY5
The fellow’s time during the first year is spent with the division’s faculty attendings in direct preceptorship with an emphasis on learning anatomy, surgical instruments, preoperative preparation and postoperative management for outpatient surgery, diagnostic and operative hysteroscopy and laparoscopy, allowing for increased responsibility as the fellow’s skill level increases. Fellows also participate in a bi monthly cadaveric dissection in the laboratory.
Through guided experience by attendings, fellows learn diagnoses and treatments for patients with conditions that can be successfully managed with minimally invasive surgical techniques.
A portion of time is devoted to the development of a clinical, basic science, or video research project.
PGY6
Time is devoted to mastering the skills of myomectomy, hysterectomy, appendectomy, endometriosis, pelvic sidewall dissection, enterolysis, bowel repair, herniorrhaphy.
Fellows learn gynecologic urinary tract procedures and tubal reconstructive surgery. Procedural skills learned during the first year are honed during the second year, when the fellow assumes increased responsibility for the patient’s management care plan.
Each fellow is expected to have completed a research or video project by the end of the second year, which culminates in the annual research day presentation.
Didactics
The fellowship is a cornerstone of the gynecology 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 patient care conference to review previous / upcoming surgeries, including video review of previous surgeries
- weekly seminar/didactic courses where fellows present assigned textbook chapters and preselected articles under the direction of a faculty mentor, as per the core reading assignments set forth by the AAGL
- weekly pre-operative conference regarding all upcoming resident surgeries
- laparoscopic surgery and dissection on minimally embalmed cadavers performed every other month with a second and third year resident
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 several resident didactics during each year of training.
Faculty
Link to Minimally Invasive Gynecologic Surgery Faculty
Fellows
Shivani Parikh, MD, PGY 5
Rebecca Barbaresso, MD, PGY 5
Suporting Faculty
Jonathan Reinstine, MD, Fellowship Co-Director, private practitioner, Associates in OB/GYN
Research
Zhenmin Lei, MD, PhD, Professor and Interim Director of Research
Jeremy Gaskins, PhD, Biostatistician
Female Pelvic Medicine
Sean Francis, MD
Stacy Lenger, MD
How to Apply
IMPORTANT DATES
December 2023: Applications Open through AAGL
May 1, 2024: Deadline to Submit Applications
May 8, 2024: Application Distribution to Programs
May 24, 2024: First Wave of Interview Notifications
June 1, 2024: Deadline for Candidates to Accept/Decline Interview Invitation
June 3, 2024: Second Wave of Interview Notifications
August 23, 2024: UofL MIGS Interview Day
September 2024: Match Day
The MIGS candidate must have completed one of the following:
- Graduate of a medical school in the United States or Canada accredited by the Liaison Committee on Medical Education (LCME).
- Graduate of a college of osteopathic medicine in the United States accredited by the American Osteopathic Association (AOA).
- Graduate of a medical schools outside the United States and Canada who meet, as of the date of graduation therefrom, meet all of the following qualifications:
- Received a currently valid certificate from the Educational Commission for Foreign Medical Graduates (ECFMG);
- Be eligible for an unrestricted license to practice medicine in a U.S. licensing jurisdiction;
- Complete an RRC approved obstetrics and gynecology residency or the equivalent.
The following documents must be included to complete your application:
December 2023: Applications Open through AAGL
May 1, 2024: Deadline to Submit Applications
May 8, 2024: Application Distribution to Programs
May 24, 2024: First Wave of Interview Notifications
June 1, 2024: Deadline for Candidates to Accept/Decline Interview Invitation
June 3, 2024: Second Wave of Interview Notifications
August 23, 2024: UofL MIGS Interview Day
September 2024: Match Day
The FMIGS match is conducted through the National Residency Matching Program (NRMP). You will be required to register for the match on the NRMP website (www.nrmp.org).
Why Louisville?
Click the links below for more information about the great places and events in Kentucky
City of Louisville- Louisville is a progressive community of nearly 1 million people. Many residents live in areas that have the feel of a neighborhood but are conveniently located very close by the hospitals where they work. Situated on the banks of the Ohio River, America's 17th largest city boasts a cost of living that is substantially lower than the national average, with a broad range of affordable housing options from high-rise apartments and historic Victorian homes to suburban communities and rural farms.
Louisville is best known for a variety of things including the world-famous Kentucky Derby, bourbon and its diverse dining options. In fact, there are so many great places in Louisville to grab a meal from, Travel and Leisure magazine recently ranked the Derby City as one of the top 10 destinations in the United States for foodies! Professional opera? Check. Professional ballet? Sure. Professional orchestra? Yep. Professional theatre? Sure. Children’s theatre? Of course. Rounding out this list is a fabulous fact for art lovers: Louisville is not only one of a handful of cities in the country with all of the aforementioned resident performing arts groups, but also has many renowned visual arts outlets as well, including the 21c Museum Hotel and Speed Art Museum. There are wonderful theaters, music, and galleries and festivals that occur throughout the year.
Those who love playing outdoors should feel at home in Louisville, which has some of the most parkland per capita in the country. The city’s parks system comprises more than 15,000 acres, and it’s especially attractive since much of it was designed and planned by the Father of American Landscape Architecture, Frederick Law Olmsted. The system is one of only four Olmsted designed (he also designed New York’s Central Park) and includes a total of 18 parks and six parkways that he and his successor firm developed. There are many more public recreation spaces beyond these, as well, including many miles of paved trails for biking, walking and running.
Louisville was one of the first city in the South to pass a LGBTQ+ Fairness Ordinance, and Louisville Metro Government was one of the first Southern cities to extends benefits to employee's domestic partners. The University of Louisville maintains five stars in the Campus Pride Index and was the first public university in the South ranked among the “Best of the Best.” Our medical school also piloted the first medical student training for targeted LGBTQ healthcare needs, and it was the first university in the country to offer a LGBTQ+ Studies minor.
Louisville offers the amenities of a city but with the welcoming atmosphere of a town.
If questions, please contact our Fellowship Administrator:
Phone: 502-561-7260
Fax: 502-561-8684