Northwestern University Feinberg School of Medicine

Department of Obstetrics and Gynecology

Minimally Invasive Gynecologic Surgery Curriculum

Educational Objectives, Curriculum and Schedule

Educational/Rotation Objectives:

  1. While rotating on the inpatient gynecology service, fellows will act in a supervisory role in patient care, clinical decision making, and resident physician management. Fellows will run morning teaching rounds on a daily basis and will actively supervise and contribute to patient management. On this service, fellows will also staff inpatient consults as well as preoperative and postoperative care under attending supervision. Fellows will help with frequent, active educational activities for residents and students. Fellows will be primarily responsible for weekly Gynecology Endoscopy Rounds, which will involve a curriculum containing a variety of simulation, didactic, and journal club activities.
  2. While on clinical rotations, fellow will obtain experience treating complex gynecologic problems in a nonsurgical manner including refractory abnormal uterine bleeding, cervical dysplasia, endometrial pathology, adnexal masses, and chronic pelvic pain. Fellows will become comfortable with office procedures included simple and complex hysteroscopy. Fellow will also obtain ample experience with preoperative counseling and preoperative decision making. They will gain experience in surgical aspects of reproductive endocrinology, including complex uterine pathology and Mullerian anomalies.
  3. During each rotation, fellows will have approximately two days each week dedicated to operative experience. Fellow will obtain sufficient breadth and depth of gynecologic cases to encompass a wide array of pathology, operative techniques and clinical competencies. Fellows will also obtain experience in teaching residents and students appropriate surgical skills based on the level and experience of the resident. 
  4. While rotating to Northwestern Lake Forest Hospital, fellows will have the opportunity to evaluate and help manage complex benign gynecologic surgery patients in addition to those with malignancy and pelvic floor disorders. Patients will be seen longitudinally both preoperatively and postoperatively. Surgical experiences will include retroperitoneal dissection, ureterolysis, advanced laparoscopic surgeries, cystoscopy and vaginal surgeries. 

Scheduled Educational Sessions:

ActivityScheduledFrequency
Grand RoundsRequired4/month
Morbidity and Mortality ConferenceRequired4/month
Gynecology Laparoscopy/Endoscopy RoundsRequired4/month
Gynecology Indications ConferenceRequired4/month
Inpatient Gynecology Teaching RoundsServiceDaily
Gynecology Imaging ConferenceService1/month
Gynecology Pathology RoundsService4/month


Rotation Schedule: 

Monthly

Level OBG-1(10 Months)May-June
AssignmentMIGS/Clinic/PAC/REIColon/Rectal
Location Northwestern Memorial Hospital Northwestern Lake Forest Hospital
Level OGB-2July-AugustSept-Oct(8 months)
AssignmentMIGS/Clinic/PAC/REIGynOnc / UroGynMIGS / Clinic /PAC / REI 
LocationNorthwestern Memorial HospitalNorthwestern Lake Forest HospitalNorthwestern Memorial Hospital

Weekly - MIGS / Clinic / PAC / REI

MONTUESWEDTHURSFRI
AMClinic O.R.ClinicO.R.

Scheduled Educational Sessions 7 - 9 AM

O.R. Robotic Cases (or research if none scheduled)

PM

Clinic

O.R.Clinic

Clinic

PAC Clinic (2x Month)

Research Time

Clinical Experience

Surgical Experiences Available:

  1. Fellows will be able to fully participate in a wide variety of hysteroscopic, vaginal, laparoscopic, and robotics procedures. In the office setting, fellows will perform diagnostic and operative hysteroscopy under attending supervision. These cases occur 5-10 times weekly and are performed by both general and subspecialty divisions. These experiences will encompass both standard hysteroscopic polypectomy/myomectomy and more complex cases involving lysis of adhesions. Hysteroscopic cases in the hospital setting occur 10-20 times weekly and include complex myomectomy via the resectoscope, ablation, lysis of adhesions, and resection of retain products of conception.
  2. Fellows will participate in laparoscopic hysterectomies performed for a variety of conditions. These cases will occur 5 - 10 times weekly. Cases will include standard laparoscopic hysterectomy for abnormal uterine bleeding, fibroids, or adenomyosis, but will also include complex hysterectomies with concurrent adhesive disease, endometriosis, and rare pathology. Laparoscopic myomectomies occur approximately 3-5 times weekly and will be performed using both standard laparoscopy and robotic assistant. These cases range from simple to very complex myomectomies. 
  3. Pelvic floor reconstructive procedures are performed under a wide variety of circumstances and for a wide variety of conditions by the Center for Pelvic Medicine and Reconstruction. Robotic-assisted sacrocolpopexy procedures occur several times monthly and will sometimes be available for MIGS fellow participation. Vaginal hysterectomies are performed several times monthly both by general and subspecialty divisions, and reveal a wide array of complexity and pathology. Finally, cystoscopy procedures are abundant amongst all providers and division and will provide the fellow with the opportunity to perfect this procedure under a wide array of conditions.

Robotics

A substantial portion of laparoscopic hysterectomies, myomectomies, and lysis of adhesions/endometriosis surgeries are performed robotically. Approximately 25% of these procedures are performed using robotic assistance and fellows will be able to participate in nearly all of these cases.

Surgical Profile

NMH NLFHTotal 
1. Hospital-Based Endometrial Ablasion8383
2. Office-Based Endometrial Ablation1212
3. Hospital-Based Hysteroscopic Myomectomy248248
4. Office-Based Hysteroscopic Myomectomy00

5. Hospital Based Hysteroscopic Polypectomy, 

sterilization, Lysis of adhesions or septoplasty

485485

6. Office-Based Hysteropscopic Polypectomy,

sertilizatoin, lysis of adhesions or septoplasty

2323
7. Hospital-Based Diagnostic hysteroscopy432432
8. Office-Based Diagnostic Hysteroscopy11
9. Laparoscopic myomectomy96417981
10. Lapraroscopic myomectomy8787
11. Laparoscopic adnexal surgery305305

12. Laparoscopic retroperitoneal dissection

including ureterolysis

12618144

13. Laparoscopic management of Stage III/IV 

endometriosis

8585
14. Pelvic Floor reconstructive procedures3030
15. Cystoscopy (diagnostic and/or operative)6060
16. Vaginal hysterectomy7047117

Quick links:

Benefits, Stipends and Resources for Northwestern Fellows

Apply for a FMIGS fellowship

Diversity and Inclusions Statement