Obstetrics and Gynecology

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Female Pelvic Medicine and Reconstructive Surgery Fellowship

The Female Pelvic Medicine and Reconstructive Surgery Fellowship training program is designed to train physicians to provide consultative services and comprehensive management including preventive, diagnostic and therapeutic procedures for women with the following pelvic floor disorders: urinary incontinence, lower urinary tract disorders, pelvic organ prolapse, defecatory dysfunction, and childbirth-related injuries.

Fellows interact with patients under the guidance and supervision of faculty members who provide context to those interactions. Supervision assures the provision of safe and effective care to patients while assuring that each fellow develops the skills, knowledge and attitudes required for proficiency in the six domains of clinical competency required to enter the unsupervised practice of medicine.

As the fellow gains experience and demonstrates growth in their ability to care for patients over the 36 months of training, the fellow assumes roles that permit the fellow to use these skills, knowledge and attitudes with greater independence. Patient interactions occur at three clinical sites within the IU Health care delivery system, including IU Health Methodist Hospital, IU Health North Hospital, and IU Health Saxony Hospital.

Accreditation

This fellowship program, established in 1988, was the first in the United States to be officially accredited by the American Board of Obstetrics and Gynecology in 1996; it is now jointly certified by the American Board of Obstetrics and Gynecology and the American Board of Urology. Effective July 1, 2012, the Accreditation Council for Graduate Medical Education (ACGME) fully accredited the training program for three fellows (one fellow/year). In April 2016, the Accreditation Council for Graduate Medical Education (ACGME) re-accredited the training program for three fellows (one fellow/year) until 2019. This means that the fellowship training program and its sponsoring institution meet an accepted set of educational standards.

Program Faculty

The Female Pelvic Medicine and Reconstructive Surgery Fellowship faculty fulfill their supervisory and teaching responsibilities in an environment conducive to educating fellows in each of the six ACGME competency areas. The core program faculty consist of two fellowship-trained urogynecologists who are board certified in FPMRS by the American Board of Obstetrics and Gynecology (ABOG) and one fellowship-trained urologist certified by the American Board of Urology (ABU). Other physician faculty members include qualified colorectal surgeons and gastroenterologists who possess qualifications that are acceptable to the ACGME review committee. Non physician faculty include physical therapists and a board-certified clinical nurse specialist (CNS) who provides administrative support as program coordinator. All program faculty encourage and support fellows in scholarly activities by maintaining an environment of inquiry with an active research component.

Michael H. Heit, MD, PhD,  MD,  BS

Michael H. Heit, MD, PhD, MD, BS

Volunteer Clinical Associate Professor of Obstetrics & Gynecology
Douglass S. Hale, MD

Douglass S. Hale, MD

Volunteer Clinical Professor of Obstetrics & Gynecology
Charles R. Powell, MD

Charles R. Powell, MD

Associate Professor of Urology
Bruce W. Robb, MD

Bruce W. Robb, MD

Associate Professor of Clinical Surgery
Toyia N. James-Stevenson, MD

Toyia N. James-Stevenson, MD

Assistant Professor of Clinical Medicine

Non-Physician Faculty include Elizabeth Fuller RN, MSN, CNS, and Kaylene Hernandez, DPT.

Curriculum

The educational objectives of the Female Pelvic Medicine and Reconstructive Surgery Fellowship program are accomplished through an appropriate blend of supervised patient care responsibilities, clinical teaching and didactic conferences. The program does not rely on fellows to fulfill non-physician service, moonlighting, or general obstetrics and gynecology night call to cover salaries.

Twenty four of the thirty six months of training is devoted to female pelvic medicine and reconstructive surgery. According to American Board of Obstetrics and Gynecology, beginning academic year 2017, Female Pelvic Medicine and Reconstructive Surgery fellows who were Ob/Gyn-trained are required to have at least 12 months of research completed in 12 one-month blocks with no more than four hours per week (averaged over four weeks) spent in non-research activities; this includes all non-research related clinical activities. Therefore, each fellow has eight months of clinical service and four months of research time for each of three consecutive academic years as outlined in the table below.

Female Pelvic Medicine Reconstructive Surgery

Didactic Sessions

The Female Pelvic Medicine and Reconstructive Surgery Fellowship training program includes regularly scheduled journal clubs, case/urodynamic/ surgical video seminars, didactic lectures, and morbidity/mortality conferences consistent with ACGME program requirements as follows.

WeekDayConferenceDescription
1MondayDidactic Lecture PGY5PGY5 is responsible for a Powerpoint presentation of 11 of the 22 learning objectives outlined in the ABOG Guide to Learning for FPMRS. Therefore the entire guide is covered by didactic lectures as part of the curricula over a two-year cycle.
Monthly AuditAudit of Learning Module, Learning Portfolio, and Case Log completion
2MondayCase/Urodyn/VideoInteresting patient cases, urodynamic or cystoscopic evaluations are reviewed to supplement didactic education. Surgical videos are reviewed to expand the breadth of experience guided by ACGME general competencies.
3MondayResearch MeetingForum for discussion of new, innovative research ideas, progress reports for ongoing industry and investigator initiated research projects and advisory consultations for research design, IRB submission, and data collection/analysis.
4MondayJournal ClubPGY5 is responsible for a Powerpoint presentation of 11 of the 22 learning objectives outlined in the ABOG Guide to Learning for FPMRS. Therefore the entire guide is covered by didactic lectures as part of the curricula over a two-year cycle.
WednesdayPelvic Floor ConferenceMultidisciplinary conference attended by urologists, gastroenterologists, colorectal surgeons, urogynecologists and radiologists. Cases of women with known pelvic floor disorders are reviewed by the team interested in providing comprehensive care for the patient.
5MondayMorbidity/MortalityReview of patient cases associated with complications related primarily to surgical intervention.

Scholarly Activity

The fellowship training program allocates adequate educational resources to facilitate fellows’ involvement in scholarly activity. According to ACGME program requirements for the Female Pelvic Medicine and Reconstructive Surgery Fellowship, each fellow, under the direction of a faculty mentor, must complete a comprehensive written scholarly paper or quality improvement project (thesis) during the program that demonstrates utilization of advanced research methodology and techniques, including research design and quantitative analysis; collection and statistical analysis of information obtained from a structured basic laboratory and/or clinical research setting; and synthesis of the scientific literature, hypothesis testing, and description of findings and results. Each PGY 7 fellow must give an oral presentation of his or her scholarly project (thesis), which is formally assessed by the faculty, including a written evaluation.

According to the American Board of Obstetrics and Gynecology Bulletin for Subspecialty Certification in Female Pelvic Medicine and Reconstructive Surgery, documentation of publication or acceptance for publication by a referred journal must be submitted with the scholarly project (thesis) to meet the requirements for application to the oral board examination. Publication or acceptance of a thesis for publication by a refereed journal does not guaranteed acceptance of the thesis for the oral examination.

Research Training

The Department of Obstetrics and Gynecology is committed to developing well-educated clinical investigators with the knowledge of the basic principles of research, including how research is conducted, evaluated, explained to patients and applied to patient care. This fund of knowledge is developed by each fellow’s participation in the Clinical Investigation and Translational Education (CITE) Program in anticipation of graduation with a Master of Science in Clinical Research degree. Coursework is begins in the PGY 6 year.

This program has clinical and laboratory research facilities equipped to allow fellows to engage in scholarly activities of their choosing.

 Local ResourceLocationDescription
 Indiana Clinical and Translational Sciences Institute (ICTSI)Indiana University/Purdue University/Indianapolis NIH- and state-funded collaboration between IU, PU and ND to facilitate the translation of scientific discoveries in the lab into clinical trials and new patient treatments. Strategic goals include support for pilot projects by providing investigators with mentorship to identify, evaluate, and support innovative pilot research through their project development teams. They train new clinical investigators in scientific research methodology through their CITE program
 Regenstrief Institute Indiana University/Purdue University/Indianapolis Internationally respected informatics and healthcare research organization affiliated with Indiana University School of Medicine, recognized for its role in improving quality of care, increasing efficiency of healthcare delivery, preventing medical errors and enhancing patient safety.  They are dedicated to the improvement of health through research that enhances the quality and cost-effectiveness of health care through the following three organizations: (1) Biomedical informatics, (2) Health Services Research, (3) IU Center for Aging Research
 Kinsey Institute for Research in Sex, Gender, and Reproduction Indiana University/Bloomington Promotes interdisciplinary research and scholarship in the fields of human sex, gender, and reproduction including sexual decision making, women’s sexuality and well- being, mood and sexual arousal, intimate relationships and couples, condom use research, cross-cultural studies in reproductive health and behavior neuroscience and sexuality
Weldon School of Biomedical Engineering – Engineered Biomaterials and Tissue Systems Purdue University/West Lafayette Engineered Biomaterial research focuses on a wide range of natural and synthetic components that might be used to design novel devices to replace diseased or damaged tissues or create artificial joints. A good example is nano-structured artificial materials that can be used to replace portions of the human bladder. Tissue Engineering research focuses on techniques to provide replacement tissues and/or the construction of scaffolds that can allow the body to heal itself. A prime example of this would be the use of naturally-derived extracellular matrix to provide a rejection-resistant scaffold that the body can use to form its own replacement tissue.