Minimally Invasive Gynecologic Surgery Fellowship
The Northwestern University Fellowship in Minimally Invasive Gynecologic Surgery is an AAGL/SRS accredited two-year program for those seeking subspecialty training in advanced endoscopic procedures in gynecology. Our goal is to train surgeon scientists to provide excellent clinical and surgical care to women with complex gynecologic disorders as well as to become independent investigators. Our fellowship was established in 2014 and became accredited through AAGL in 2016.
Our Program
Objectives
While acting as Gynecologic Service attending on the inpatient gynecology service, fellows will have teaching responsibilities within the residency program regarding patient care, clinical decision-making and resident physician management. Fellows will run morning teaching rounds, staff inpatient consults and function as junior attendings for emergent surgeries and surgical consults allowing them to gain independence in their clinical training. Weekly Gynecology Endoscopy Rounds, curriculum containing a variety of simulation and didactic activities, is primarily created and run by the fellows. Within the residency programs, fellows participate in and assist in teaching various conferences, including Fibroids conference and Pre-Operative conferences, gynecology simulations and anatomy labs. Our fellows also attend weekly Grand Rounds and Mortality/Morbidity Conferences within the department and participate in monthly journal clubs with residents and attendings.
Our fellows also have access to Northwestern University’s Simulation Center NCASE (Northwestern Center for Advanced Surgical Education), a state-of-the-art facility with both low and high-fidelity simulators to practice minimally invasive procedures and skills prior to the operating room.
All fellows give one Grand Rounds lecture at Northwestern on a MIGS topic of their choice and present at our Annual Resident and Fellow Research Day. This gives them education on how to give large group lectures at an academic institution.
All fellows attend the Annual Clinical and Surgical Updates in Gynecology course created and run by our MIGS faculty at Northwestern. This course is designed for the education of the Chicago community ob-gyns, and our fellows attend lectures by world-class faculty and also participate as lab faculty in the simulation portion of the course.
All fellows are required to attend FMIGS Boot Camp and encouraged to attend and present research at a variety of courses, including Advanced Fellow Robotics courses, AAGL, SGS, APGO/CREOG and ASRM.
In addition, our fellows have the wider opportunities of being at a large academic institution. There are numerous Feinberg-wide educational programs for attendings, residents and fellows in the arenas of medical education, quality improvement, patient safety and global health. There are opportunities to attend university-wide educational experiences on diversity and inclusion and a wide breadth of topics. Our fellows have junior attending status, and as Instructors at Northwestern, receive tuition discounts for classes through a variety of schools at Northwestern.
Conferences
Morbidity & Mortality Conference
Friday is the academic day for the entire Department of Obstetrics & Gynecology at Northwestern University. The day begins with the Morbidity & Mortality (M&M) Conference, in which interesting cases from each service are presented by members of the housestaff and are followed by lively and thoughtful discussion from faculty, other members of the department, as well as consulting services.
Grand Rounds
Weekly Grand Rounds follow the M&M Conference and feature presentations from within our faculty, as well as many distinguished visiting guest speakers.
MIGS Fellow Lecture Series
A core MIGS Lecture Series Schedule supplements the experience gained on clinical rotations to round out the comprehensive post-graduate curriculum.
Indications/Preop Conference
The gynecology service meets weekly to discuss planned surgical procedures from the MIGS division as well as resident scheduled cases. This is an opportunity to review the cases to ensure proper preoperative evaluation either with imaging and or needed pathology.
Fibroid Conference
This monthly conference is solely dedicated to fibroids. Attendees of the conference include Interventional Radiology, MIGS attendings, fellows, MIGS resident and the gynecology service. Interesting cases whether surgical or candidates scheduled for UFE are discussed extensively.
Ob-Gyn Fellows Lecture Series
All obstetrics and gynecology fellows participate in quarterly lectures on statistics for research to better understand and assist in their research projects.
Ob-Gyn Summer Series
Our obstetrics and gynecology residents organize a series of lectures every summer themed around non-clinical topics often addressing diversity/inclusion, ethics and wellness, and lecturers are drawn from Northwestern and the larger Chicago community. Our fellows are encouraged to attend and participate in these lectures.
Activity | Scheduled | Frequency |
Grand Rounds | Required | 4/month |
Morbidity & Mortality Conference | Required | 4/month |
Gynecology Laparoscopy/Endoscopy Rounds | Required | 4/month |
Gynecology Indications Conference | Required | 4/month |
Inpatient Gynecology Teaching Rounds | Service | Daily |
Rotations
Rotation Schedule:
Monthly
Level PGY-5 | (10 Months) | May-June |
---|---|---|
Assignment | MIGS Clinic | Colorectal |
Location | Northwestern Memorial Hospital | Northwestern Memorial Hospital |
Level PGY-6 | July-August | Sept-Oct | (8 months) |
Assignment | MIGS Clinic | GynOnc / UroGyn | MIGS Clinic |
Location | Northwestern Memorial Hospital | Northwestern Lake Forest Hospital | Northwestern Memorial Hospital |
Weekly - MIGS Clinic
MON | TUES | WED | THURS | FRI | |
AM | Clinic/O.R. | Clinic/O.R. | Clinic/O.R. | Clinic/O.R. |
Scheduled Educational Sessions 7 - 9 AM O.R. Robotic Cases (or research if none scheduled) |
PM | Clinic/O.R. | Clinic/O.R. | Clinic/O.R. | Clinic/O.R. |
Clinic (2x Month) Research Time |
Patient Care
While on clinical rotations, fellows will obtain experience in evaluation and appropriate selection of medical or surgical treatment for complex, benign gynecologic conditions. These conditions include abnormal uterine bleeding, symptomatic fibroids, endometriosis, benign ovarian neoplasms, chronic pelvic pain and infertility. Fellows will be exposed to a large volume of simple and advanced endoscopic surgical cases in benign gynecology, reproductive surgery, urogynecology and oncology under direct faculty supervision. These experiences focus on laparoscopy, hysteroscopy, vaginal and robotic surgery for the treatment of uterine fibroids, advanced endometriosis, benign ovarian neoplasms, ovarian remnants, mullerian abnormalities and infertility. Fellows will also have the opportunity to become proficient in office procedures such as in office hysteroscopy, sonohysterography, colposcopy and cervical excision procedures.
Fellows also have the opportunity to rotate with Physical Medicine and Rehabilitation and physical therapists in the evaluation and treatment of chronic pelvic pain. With our PMR physician, various treatment options with compounded medications or injections will be discussed and utilized for the treatment of chronic pelvic pain.
Secondary to some of the surgeries being performed, patients may experience hormonal imbalances. Through the Center for Sexual Medicine and Menopause, fellows have the opportunity to learn various treatment modalities depending on patient symptoms.
Our first-year fellow spends 10 months at Prentice Women’s Hospital, the main women’s teaching hospital at the Northwestern Memorial Hospital, located in the Streeterville neighborhood of Chicago working with our core program MIGS faculty. The remainder of the year is spent at Northwestern Lake Forest Hospital located in the northern suburbs of Chicago. Here, they work with our Lake Forest divisions of FPRMS, Gynecologic Oncology and MIGS performing pelvic floor reconstructive procedures, malignancy and other benign gynecology surgical cases. Second-year fellows spend an additional three months at Lake Forest Hospital in order to give them a breadth of education with a variety of surgical faculty.
Fellows have both MIGS practice group night call and emergency room call responsibilities intermittently throughout the year. They also have the opportunity to act as Gynecologic Service attending in weeklong stints throughout their fellowship where they care for all patients on the resident gynecologic service and perform ER and hospital consultations during the day. In addition, our fellows take call in our OB triage unit where they care for women with obstetric-related complaints.
Robotics
A substantial portion of laparoscopic hysterectomies, myomectomies and lysis of adhesions/endometriosis surgeries are performed robotically. Approximately 25 percent of these procedures are performed using robotic assistance and fellows will be able to participate in nearly all of these cases.
Surgical Profile
NMH | NLFH | Total | |
1. Hospital-Based Endometrial Ablasion | 83 | 83 | |
2. Office-Based Endometrial Ablation | 12 | 12 | |
3. Hospital-Based Hysteroscopic Myomectomy | 248 | 248 | |
4. Office-Based Hysteroscopic Myomectomy | 0 | 0 | |
5. Hospital Based Hysteroscopic Polypectomy, sterilization, Lysis of adhesions or septoplasty |
485 | 485 | |
6. Office-Based Hysteroscopic Polypectomy, sertilizatoin, lysis of adhesions or septoplasty |
23 | 23 | |
7. Hospital-Based Diagnostic hysteroscopy | 432 | 432 | |
8. Office-Based Diagnostic Hysteroscopy | 1 | 1 | |
9. Laparoscopic myomectomy | 964 | 17 | 981 |
10. Laparoscopic myomectomy | 87 | 87 | |
11. Laparoscopic adnexal surgery | 305 | 305 | |
12. Laparoscopic retroperitoneal dissection including ureterolysis |
126 | 18 | 144 |
13. Laparoscopic management of Stage III/IV endometriosis |
85 | 85 | |
14. Pelvic Floor reconstructive procedures | 30 | 30 | |
15. Cystoscopy (diagnostic and/or operative) | 60 | 60 | |
16. Vaginal hysterectomy | 70 | 47 | 117 |
Resources
The Northwestern Center for Advanced Surgical Education (NCASE) is a comprehensive, quality simulation center geared toward surgical training of residents and fellows. The center includes computerized laparoscopic simulators and a high-fidelity robotic stimulator. These tools are open to our fellows 24 hours a day, seven days a week. Additionally, the center includes equipment for a clinical case simulation and the capacity for animal and cadaver labs.
The Feinberg School of Medicine's Galter Health Sciences Library has a vast array of online and in-house resources, including textbooks, journals, search tools, computer software, conference space and certified staff librarians. Fellows have full access to innumerable resources for education, simulation, research and teaching.
Finally, fellows have the option of enrollment in numerous courses in the two campuses of Northwestern University. If desired, fellows have the option of pursing MPH, MA or MBA degrees during the course of their fellowship. These courses are easily integrated in to the fellow's block schedule and are able to supplement a fellow's education in a unique way.
Facilities
The fellows will be based out of Prentice Women's Hospital, which is part of Northwestern Memorial Hospital located in the Streeterville neighborhood of Chicago. During their second year, fellows will complete a two-month rotation at Northwestern Lake Forest Hospital in the northern suburbs of Chicago.
Research
As part of the fellowship, fellows are required to complete an independent research project with MIGS faculty and/or faculty within Northwestern University Feinberg School of Medicine. The research project should result in presentation at a national meeting as well as publication in a peer-reviewed journal. Time for research will be weekly and allocated based on the surgical and rotation schedule. The MIGS division has a dedicated research coordinator to aid with the research process, including grant applications, IRB applications and research design. Regular meetings occur as a division to discuss and improve current and future research projects.
The fellows attend a quarterly fellows research lecture series to address research design and statistics education.
Fellows are also required to enroll in one of numerous statistical/research design courses at Northwestern University. If desired, fellows have the option of also pursuing an MPH, MA, MBA or MSCI (Master of Science in Clinical Investigation) during their fellowship. Tuition defrayment is available through university benefits. These courses are integrated into the fellows' block schedule with reading and coursework performed outside regular work hours.
Application & Interview
The program accepts one fellow per year. Applications for fellowship will be available in January and must be submitted via the AAGL website by June. Interviews are held in August and September to invited applicants.
Our selected pool of applicants will be contacted for interviews on Northwestern University downtown medical campus and will be scheduled utilizing FMIGS Board Guidelines.
Interviews will be held designated Fridays from 10 a.m. to 4 p.m., allowing for a morning arrival and evening departure if desired. There will be no evening event scheduled the evening before. Candidates will have the opportunity to meet a variety of faculty and fellows throughout the day and will tour the downtown medical campus and the facilities of the Comprehensive Center for Gynecology.
Northwestern University does not discriminate or permit discrimination by any member of its community against any individual on the basis of race, color, religion, national origin, sex, pregnancy, sexual orientation, gender identity, gender expression, parental status, marital status, age, disability, citizenship status, veteran status, genetic information or any other classification protected by law in matters of admissions, employment, housing or services or in the educational programs or activities it operates.
Why Northwestern?
Housestaff training through McGaw Medical Center of Northwestern University provides diverse and challenging clinical experiences and world-class education located in the heart of the beautiful city of Chicago. Learn more via the links to the McGaw website below.
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Meet Our Team
For more information, contact our Fellowship Coordinator Cindy Fuentes at cindy.fuentes@nm.org.
Physician-Scientist Training & Resources
We offer a wide range of resources, mentorship opportunities and training to help our residents and fellows excel as physician-scientists. Explore all of the resources and hear from housestaff who are making research a major part of their career development plans.