Female Pelvic Medicine, Reconstructive Surgery, and Neurourology Fellowship

Program Description

The Fellowship Program in Female Pelvic Medicine and Reconstructive Surgery (FPMRS) in UT Southwestern’s Department of Urology is directed by Gary Lemack, M.D.

The Program is offered to U.S. residents completing their training who seek additional specialized training in both the clinical and research aspects in the field. This includes female pelvic disorders, incontinence, pelvic organ prolapse, and voiding dysfunction. In addition, this fellowship features clinical and research experience with a variety of genitourinary disorders in neurologic disease, focusing on patients with spinal cord injury and multiple sclerosis.

The Program, an accredited ACGME fellowship, offers a single two-year position each year.

Faculty

The core faculty includes Philippe Zimmern, M.D., founder of the fellowship and Professor of Urology, Gary Lemack, M.D., Professor of Urology and Program Director of the Urology Residency and FPMRS, and Maude Carmel, M.D., Assistant Professor of Urology, and Director of FPMRS/Urodynamics at Parkland Memorial Hospital.

Other faculty members include Urogynecology (Joseph Schaffer, M.D.Clifford Wai, M.D.Marlene Corton, M.D., and David Rahn, M.D.), Colorectal (Craig Olson, M.D., and Farshid Aragizadeh), and Physical Medicine and Rehabilitation (Kelly Scott, M.D.).

Conferences

The fellow participates in weekly FPMRS conference/lecture series/research updates, as well as journal clubs monthly. In addition, there are quarterly journal clubs with the Colorectal service and Urogynecology, as well as quarterly multidisciplinary meetings of the Comprehensive Pelvic Floor Team, including Urogynecology, Urology, Colorectal, and Physical Medicine Services.

Year One

The fellow works with Drs. Lemack, Carmel, and Zimmern in the clinic and operating room. During this first year, the fellow gains vast experience performing and interpreting urodynamics, learning indications and techniques for the use of neuromodulation and botulinum treatments, and performing surgical repair for other more common pelvic floor disorders (midurethral slings, vaginal, and abdominal approaches to pelvic prolapse). The fellow also spends one month on the Urogynecology service. The remainder of the time (50%) is spent in research activities.

The first-year fellow audits a course on clinical trial design taught at UT Southwestern, and begins the process or selecting his/her thesis. By the conclusion of the year, he/she initiates the research project under the supervision of a FPMRS mentor.

Year Two

The second year is devoted to more advanced female pelvic medicine disorders, with emphasis on treatment of complex female incontinence cases, advanced pelvic prolapse conditions (including open and robotic-assisted laparoscopic sacrocolpopexy), and other unusual disorders, such as vesico-vaginal fistula and urethral diverticulum.

During this year, as in the first year, 50 percent of time is spent in research activities; the remainder of time is spent in the clinic and operating room with Drs. Zimmern, Carmel, and Lemack. The fellow also spends additional time during this year rotating on urogynecology and does a one-month rotation on colorectal surgery services.

Research Program

Research is carried out during both the first and second years. The direction of the research is largely dictated by the fellow's interest. Past research projects have been of both basic science and clinical research types. For example, past bench research projects have focused on detrusor smooth muscle responses to bladder outlet obstruction in spinal cord injury. Clinical research projects have examined the Department’s extensive urodynamics, prolapse/incontinence, and neurourology databases in order to answer research questions regarding a variety of clinical disorders, from neurogenic bladder to voiding dysfunction in pelvic organ prolapse.

The fellow is tasked with identifying a research question in their area of interest during the first year, developing an IRB-approved study, carrying out the study, and ultimately presenting their findings to the group and research mentor prior to graduating.