This fellowship is a four-year program designed to provide comprehensive training for future leaders in academic gynecologic oncology.  Two years of the fellowship involve clinical training - including:

          14 months of gynecologic oncology at UT Southwestern Medical Center
                  (Parkland Memorial Hospital and University Hospital - St. Paul)
          one month of Radiation Oncology/Pathology
          two months of Surgical Critical Care at Parkland Memorial Hospital
          five months of gynecologic oncology at Medical City Dallas Hospital
          two months of gynecologic oncology at Presbyterian Hospital of Dallas

Two years are devoted to acquiring research skills in the Laboratory of Gynecologic Oncology or via a structured clinical research curriculum within the Department of Clinical Sciences.  The clinical and research components are integrated to provide a dynamic setting for successful preparation of an academic career.

Every 6 months each fellow is evaluated by the faculty using the E*Value Evaluation System.  Feedback is formally provided at a semi-annual review with the Program Director to facilitate academic career guidance and determine progress toward accomplishing the terminal objectives described in the "Guide to Learning in Gynecologic Oncology" of The Division of Gynecologic Oncology of the American Board of Obstetrics and Gynecology.

Prerequisites:   Eligibility for this fellowship requires satisfactory completion of an
                            A.C.G.M.E. or R.C.P.S.C. approved residency in Obstetrics and Gynecology,
                            successful completion of the written examination of The American Board
                            of Obstetrics and Gynecology and eligibility for a license to practice
                            medicine from the Texas Medical Board.

Deadline for Applications is May 31, 2008.

UT Southwestern Gynecologic Oncology Faculty:

          David Scott Miller, M.D., F.A.C.O.G., F.A.C.S., Division Chief
          John O. Schorge, M.D.
          Jayanthi S. Lea, M.D.
         

Additional Program Faculty:

          Raheela Ashfaq, M.D., Pathology
          Steven G. Bernstein, M.D., and Samuel Lifshitz, M.D., Presbyterian
                  Hospital of Dallas
          Bruce A. Fine, M.D. and Alan K. Munoz, M.D., Medical City Dallas Hospital
          John D. Minna, M.D., Director, Hamon Center for Therapeutic Oncology Research 
          Phuc Nguyen, M.D., Radiation Oncology
 

Recent Fellow Graduates:

          Jayanthi S. Lea, M.D. - 2004
                   Current position: UT Southwestern Faculty
          Gautam G. Rao, M.D. - 2005
                   Current position: Vanderbilt University Faculty
          Richard D. Drake, M.D. - 2006
                   Current position: Cleveland Clinic Foundation Faculty
          Lynne M. Knowles, M.D. - 2007
                   Current position: Ohio State University - 2003

Current Fellows:

         Shawna L. Bull, M.D. - 2008
                    University of Miami - 2004
         Tomas Heffernan, M.D. - 2009
                    Akron General Medical Center - 2005
         Shana N. Wingo, M.D. - 2010
                    UT Southwestern - 2006
         Scott Purinton, M.D. - 2011
                   University of Miami School of Medicine - 2003

Recent Fellow Publications/Presentations [CLICK HERE]  

CLINICAL EXPERIENCE

Training will be provided in the comprehensive screening, diagnosis, and treatment of cancers of the female genital tract and their complications.  This includes radical pelvic and reconstructive surgery, chemotherapy, and radiation therapy.  Particular emphasis is placed on surgical techniques, critical care, clinical trials and investigational agents.

The clinical aspect of the program is remarkable for its diversity, exposing the fellows to the care of indigent and private patients, as well as university-based and private practice faculty.

Fellows in this program acquire experience in the comprehensive management of gynecologic cancer and its complications: radical operations performed on the reproductive organs, resection/anastomosis/bypass of the gastrointestinal and urinary tracts, and other pelvic surgery techniques.

Fellows also develop skills in dissection of inguinal, pelvic, para-aortic lymph nodes and gain experience with plastic reconstructive operations required for restoration of function in women treated for gynecologic malignancy.

Fellows perform adjunctive procedures required in these patients such as cystoscopy, sigmoidoscopy, insertion of central venous catheters and placement of thoracic cavity drainage tubes.

CLINICAL FACILITIES

The UT Southwestern Medical District includes Parkland Memorial Hospital, University Hospital - St. Paul, and the Harold C. Simmons Comprehensive Cancer Center - all of which are contiguous or adjacent to the UT Southwestern Medical School.  This multifaceted academic medical institution is nationally recognized for excellence in educating physicians, biomedical scientists and other health care professionals.  Facilities encompass 5.5 million square feet in 20 buildings on 150 acres.  Its faculty includes four Nobel Laureates, 15 members of the National Academy of Sciences and 17 members of the Institute of Medicine.

       Parkland Memorial Hospital, founded in 1894, is a 990-bed public hospital that
       ensures healthcare is available to all Dallas County residents. Parkland ranked
       #15 in the nation for Gynecology in 2007 [U.S. News World Report] and is the
       primary teaching hospital for UT Southwestern Medical School.  The emergency,
       trauma and burn centers are world-renowned. The Parkland Obstetrics service
       accounts for 16,000 births annually - making it the nation's largest single-site
       delivery facility.

       University Hospital - St. Paul is a 300-bed facility purchased by UT
       Southwestern in 2000 to facilitate private practice care by University physicians.  
       The Division of Gynecologic Oncology faculty have a busy service that is
       comparable to the Parkland clinical experience.

       The Harold C. Simmons Comprehensive Cancer Center is housed on the
       second floor of the NC Building on the North Campus, which is contiguous
       to the state-of-the-art laboratories used for basic and translational
       research.  This newly furnished facility houses 12 exam room and 17
       chemotherapy infusion rooms.

       Presbyterian Hospital of Dallas is an 897-bed facility located in north Dallas.
       Linked to UT Southwestern via an affiliation training agreement, Ob/Gyn
       residents and fellows participate in clinical rotations at Presbyterian.
       Drs. Berstein and Lifshitz see patients in the adjacent Margot Perot
       Women's and Children's Hospital.

       Medical City Dallas Hospital is a 598-bed facility in north Dallas that is
       also an affiliated training site for UT Southwestern Ob/Gyn residents
       and fellows.  Drs. Munoz and Fine see patients in offices off-site and
       utilize the state-of-art Medical City operating rooms.

RESEARCH EXPERIENCE

Basic and clinical research experience is provided to allow fellows to design, develop, and obtain support for their own studies as well as direct the efforts of others.  It is expected that graduating fellows will be excellent candidates for NIH or other society-supported career development awards.

Fellows will learn the basics of hypothesis-driven research, grant preparation, and peer review presentations and publication skills.  Our fellows have attended and/or presented at SGO, SGI, ASCO, AACR, ACOG, GOG, NEAGO and WAGO in recent years.  In addition, the current fellows have each attended all of the SGO meetings during their years of training.

First year fellows spend their initial three months in the laboratory to become familiar with research techniques and generate data for a possible hypothesis pursuant to their thesis project.  This strategy has been very successful, resulting in 1st year fellows presenting their data at the SGO meeting in four of the last five years.  Fellows then have the opportunity to establish a dialogue with faculty to help guide their long-term research plan within the division.

The 2nd year of the program includes 12 uninterrupted months of research time to generate a thesis project.

The 3rd and 4th years of the program enable the fellow to establish a niche and concentrate on the writing, revising and submission of research papers.

Basic Science:  Fellows will be involved in some of the many laboratory research projects.  With faculty supervision, they will be encouraged to develop their own projects that will typically serve as the basis for their thesis. 

Mentoring of fellows in the laboratory has resulted in two ACOG-Ortho-McNeil grants (1999, 2004), an American Cancer Society-Institutional Research Grant (2003), Society of Gynecologic Oncologists; GCF Award for Best Presentation (2005), an ACOG/3M Pharmaceuticals Research Award (2006) and numerous presentations and publications in recent years.

Clinical Research:  Fellows desiring to pursue a rigorous clinical research curriculum may obtain a Basic Certificate, Graduate Certificate or Master's Degree in Clinical Science through the UT Health Sciences Center-Dallas Campus Site within the medical complex.

Trainees may successfully complete the program by completing the core and elective didactics curriculum, achieving commendable feedback from mentors, attending the clinical science lectures and workshops and demonstrating effective completion of their respective clinical science projects.  This degree is excellent preparation for those fellows desiring an academic career in clinical trial design and protocol development.

The mission of the Department of Clinical Sciences is to accelerate and enhance the training and career development of clinical investigators and provide a formal mechanism of institutional recognition for clinical scientists.

The Division develops its own clinical protocols, conducts industry sponsored studies, and is a full member institution (037) of the Gynecologic Oncology Group (GOG).  Fellows pursing a certificate or degree in Clinical Science are encouraged to submit concepts and be active in the GOG and/or investigator-initiated studies.

The Division of Gynecologic Oncology installed the SGO database in June 1993 to organize the fellows' clinical experience and facilitate research opportunities.  In the past 13 years (effective May 2006), 8,817 patients, 5,289 tumors, 8,790 procedures and 9,055 admission have been entered.  Division faculty also facilitate clinical collaborations with colleagues at other institutions.  Fellows learn the basics of identifying a clinically interesting research question, data retrieval and analysis, draft preparation, submission, manuscript revision and ultimately publication.  Clinical studies culminating in a thesis may be developed with faculty guidance.

RESEARCH FACILITIES

Basic Science Facilities:  The laboratory of Gynecologic Oncology (NB8.222) has 500 square feet of space and an adjoining office for research activities.  The lab is dedicated to the study of the molecular biology of gynecologic cancers under the guidance of division faculty.  It is located within the Hamon Center for Therapeutic Oncology Research in the Simmons Biomedical Research building on the North Campus.

The center is an integral component of a Lung Cancer SPORE and maintains national and international collaborative efforts for all tumor sites. The Hamon Center is completely equipped for modern molecular and cell biologic research and has access to the extensive core facilities.

The laboratory is focused primarily on translational research, has the facilities for tissue culture, in vitro and in vivo tumor growth assays and also houses the NIH-funded gynecologic oncology tumor bank.

Clinical Research Facilities:  The UT Health Science Center School of Public Health-Dallas Campus Site  [CLICK HERE] is located at the medical complex within the Department of Clinical Sciences (E5.506).  This facility provides an academic, educational, and cultural home for clinical investigators across all departments and disciplines at UT Southwestern.  

DIDACTICS

        Gynecologic Oncology Fellow lectures occur monthly.  They are chiefly presented
        by the faculty and are targeted to fellows to prepare them for their written and
        oral board examinations.  Topics for 2006-07 include:

                  Gestational trophoblastic neoplasia
                  Endometrial cancer
                  Surgery for ovarian cancer
                  Chemotherapy for ovarian cancer
                  Vulva cancer
                  Clinical pharmacology
                  Cervix cancer
                  Total parenteral nutrition
                  Pathology of gynecologic cancers
                  Principles of radiation oncology
                  Uterine sarcoma
                  Principles of minimally invasive surgery

        Gynecologic Oncology Grand Rounds occur every six weeks and are presented
        by fellows, faculty and visiting professors.

        Introductory Oncology Fellows lectures are provided each year by the Division
        of Medical Oncology and represent core topics in chemotherapy management
        and oncology emergencies.

        Other Didactic lectures/conferences:
                  Morbidity and Mortality Conference (monthly)
                  Journal Club (monthly)
                  Divisional Research Meeting (monthly)
                  Hamon Center Research Conference (weekly)
                  University Lecture Series
                  Multi-Disciplinary Breast Conference
                  Parkland Patient Care Conference
                  Protocol and Chemotherapy Monitoring Conference (weekly)
                  Gynecologic Oncology Tumor Board (weekly)
                  Hamon Center for Therapeutic Oncology Research Meeting (weekly)
                  Laboratory of Gynecologic Oncology Research Meeting (weekly)
                  Simmons Cancer Center Combined Modality Treatment Conference (weekly)

UNIQUE FEATURES OF THE PROGRAM

Progressive responsibility:  The program provides escalating responsibilities in all areas of training. Close supervision and effective teaching in investigation, clinical activities and teaching capacity will allow progressive development and confidence in analysis of problems, surgical skills and academic progression. The progressive responsibility culminates in the senior fellow serving as unofficial attending ('pretending') for the final two months of the fellowship.

Pelvic anatomy training:  Off-service fellows may participate in an ongoing cadaver pelvic anatomy and dissection course facilitated by faculty members in the divisions of Gynecology, Urogynecology and Gynecologic Oncology within the Department of Anatomy.

Relationship with Departments of Surgery, Urology and Medical Oncology: Intestinal surgical procedures, mediport catheter placement, urinary surgical procedures and management of chemotherapy as they relate to the treatment of gynecologic malignancies are the responsibility of the Division of Gynecologic Oncology. There is an open dialogue with other departments for facilitation of patient care when circumstances arise.

Clinical responsibilities during research years: Fellows have greater than 90% protected time for their two years designated for research training. There are no assigned clinical duties. Fellows have the option to assist the faculty at University Hospital-St. Paul when a major gynecologic oncology surgical case (i.e., radical hysterectomy, ovarian debulking, exenteration) cannot be scrubbed by the clinical service fellow due to scheduling conflicts. Research takes priority over any clinical duty during the week and fellow participation is optional.

Benign gynecology experience: Fellows and supervising faculty are frequently requested as intra-operative consultants for complicated surgical procedures or inadvertent diagnoses of neoplastic diseases. Fellows serve pre-operatively as primary consultants for the Parkland benign gynecology teams evaluating management plans for adnexal masses or other potentially maligant scenarios. Fellows determine which patients would be more appropriate for primary management by the gynecologic oncology service. Faculty coverage for other less suspicious cases is provided as a 'standby' service without fellow coverage. The fellow is not primarily involved in the management of uncomplicated patients with benign gynecologic diseases.

Obstetrical complications: Occasionally, the fellow will be emergently consulted with faculty supervision for an unanticipated obstetrical catastrophe (i.e., massive retroperitoneal hemorrhage, peripartum hemorrhage, ureteral transection at the time of gravid hysterectomy), inadvertent cancer diagnosis, difficulty dissection or anticipated combined care (i.e., cervix cancer during pregnancy for cesarean-radical hysterectomy). The large Parkland obstetrical volume provides a unique aspect to the gynecologic oncology fellow experience.

OTHER INFORMATION

Texas Medical License:   Application for a Texas medical license should be instituted immediately after a fellow is accepted into the program.  The licensing process in Texas is cumbersome and time consuming.  If not begun well in advance, obtaining a license prior to the beginning of the program will be difficult.  The Texas Medical Board (TMB) accepts applications on line.  Their web site is http://www.tmb.state.tx.us/.  For more information, please see Getting Your Texas Medical License.

Personal Time Off:   Personal time off must be approved by the program director and coverage by other clinical fellows must be obtained.  For department guidelines, please see the Personal Time Off section of Fellowships in Obstetrics and Gynecology.  

Compensation and Benefits:  Please see the Compensation and Benefits section of Fellowships in Obstetrics and Gynecology. 

Clinical Service Opportunities Outside Gynecologic Oncology:    Off-service fellows have the option of taking in-house night call on the Ob/Gyn service at University Hospital - St. Paul.  This clinical service is not associated with the fellowship training program.  A permanent Texas Medical License is required to participate.  See also the Compensation and Benefits section of Fellowships in Obstetrics and Gynecology.