Gynecologic Oncology Fellowship - Obstetrics & Gynecology

The Fellowship in Gynecologic Oncology is an ACGME-accredited, three-year, post-residency program offered by the Division of Gynecologic Oncology. Our well-established Fellowship Program at Washington University in St. Louis prepares graduates for careers as future leaders in gynecologic oncology, physician-scientists, or academic clinician-researchers.

How to apply

The fellowship is conducted under the auspices of the Division of Gynecologic Oncology. The fellowship program director is Carolyn McCourt, MD, Associate Professor of Obstetrics and Gynecology.

Meet our faculty

Training sites

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Program format and objectives

Research training

The first year of our three year fellowship is dedicated to research. Prior to starting the program, incoming fellows will meet with program leadership to discuss their research goals and identify potential mentors and research opportunities. Following interviews with research faculty, the fellow, along with program leadership, will determine the most appropriate research path and outline a plan for the upcoming year. Faculty mentors may be part of the Department of Obstetrics and Gynecology or may be associated with one of many departments across the institution, including Radiation Oncology, Medical Oncology, or Surgical Oncology to name a few.  Fellows are encouraged to submit and present their research at national meetings and publish their findings in peer reviewed journals. The department provides support for scientific writing to include manuscript editing as well as assistance with grantsmanship. Fellows also take at least one graduate-level course during their research year and are fully supported by the division.  Many choose courses offered through our Clinical Research Training Center in the Institute of Clinical and Translational Sciences. Courses in biostatistics, dissemination and implementation science, and designing outcomes and clinical research are just a few of the offerings.

Didactics and Teaching

The trainee is also expected to attend a number of weekly seminars, conferences, and lectures, given within the department, as well as the medical center. There is dedicated, protected didactic time weekly on Wednesday mornings. Interactive sessions are facilitated by a variety of expert faculty and ancillary staff; the curriculum spans three years and encompasses the objectives of the ACGME and ABOG learning guide. We conduct a monthly journal club led by research fellows under the mentorship of the division’s faculty. There is also a weekly multidisciplinary Tumor conference led by a clinical fellow and resident wherein surgical cases are reviewed and evidence based treatment decisions are discussed and debated in a format similar to the ABOG certifying oral exam. In collaboration with the division of Medical Oncology, fellows are also invited to various applicable medical oncology fellow didactics. In addition, the Ob/Gyn department recently launched a Professional Development Series tailored to fellows’ career development needs, with topics such as leadership competency training and negotiation skills. Finally, the School of Medicine and Siteman Cancer Center offer a plethora of research related programming on a daily basis across campus. Opportunities abound for learning, engagement, and collaboration.

Clinical training

Following the research year, the subsequent two years of fellowship are spent in clinical gynecologic oncology, under the guidance of ten faculty members who have appointments at the Washington University School of Medicine. The team consists of the four clinical fellows (two senior and two junior clinical fellows), one fourth-year resident, two third-year residents, one second-year resident and one first-year resident. Fellows participate in both inpatient and ambulatory care and are responsible for evaluating new and established patients, those undergoing chemotherapy as well as cancer surveillance. Fellows participate in oncologic and complex pelvic surgery under faculty supervision with graduated autonomy. The fellow also directs a colposcopy clinic, evaluating and managing pre-invasive disease.

To provide a comprehensive educational experience, the fellow will also interrelate with the Division of Radiation Oncology (in the Mallinckrodt Institute of Radiology), Division of Palliative Care, Department of Surgery, and of Division of Medical Oncology (in the John T. Milliken Department of Internal Medicine) on various rotations.

Objectives

It is expected that each fellow will acquire the expertise to meet the following objectives:

Gain the understanding, skill and capability to perform radical pelvic surgery independent of supervision.
Manage intestinal, urologic and vascular problems caused by gynecologic malignancies or their treatments.
Manage operative and post-operative care of patients with critical medical conditions and co-morbidities Handle non-operative management of associated conditions and disorders of the intestinal and urinary tract
Participate as a member of the a team which plans and applies all forms of radiotherapy
Be able to evaluate patients with gynecologic malignancies, choose appropriate drugs, administer therapy and care for the toxic side effects of chemotherapy in these patients

Clinical research

The division actively participates in clinical research studies, including investigator-initiated and industry-sponsored studies as well as studies from national cooperative groups such as NRG Oncology and the GOG Foundation. We also collaborate with our Developmental Therapeutics and Phase I program to provide expanded opportunities for our patients. Our program strongly supports fellows who are interested in developing clinical research ideas with full-time research staff and our department’s Division of Clinical Research is available to assist and mentor fellows through the trial design and institutional approval process.

Clinical gynecologic oncology rotation

The fellow’s weekly service rotations include surgeries related to gynecologic malignancies, as well as complex pelvic surgeries. The fellow must participate in all surgical procedures in the categories defined by the American Board of Obstetrics and Gynecology. Periodic meetings with the program director will assure the fellow’s active participation in the training program.

One afternoon a week is reserved for ambulatory service patients, many of whom will be pre-operative, post-operative, undergoing current therapy, or follow-up patients. This is a fellow-driven clinic, with oversight by our faculty. Over 450 new gynecologic cancer patients are seen by the faculty and fellows of the division at the medical center each year. Another afternoon a week is reserved for Colposcopy Clinic and approximately 15-20 patients are scheduled each week, with referrals coming from within the institution as well as from outside providers.

Off-service rotations

Gynecologic oncologists within the division have managed and performed intestinal and urologic surgery related to gynecologic malignancies for well over thirty-five years. However, in order to provide the fellow with a concentrated experience in the care of seriously ill patients, a four-week rotation in the Surgical Intensive Care Unit is provided under the supervision of the Departments of Surgery and of Anesthesia. All aspects of critical patient care including respiratory, cardiovascular, hemodynamics, electrolyte, and fluid balance are taught by direct bedside teaching.

The Division of Gynecologic Oncology has a long-established tradition of cooperation with the Division of Radiation Oncology. In addition to a joint weekly conference, fellows have a two-week rotation on the radiation therapy service during the second and third year. During this rotation, fellows are required to attend didactic lectures in radiation physics and radiation biology given by the Division of Radiation Oncology.

Fellows will also spend a two-week rotation on the Palliative Care service during their first clinical year.  During this rotation fellows are supervised by the Palliative Care Service faculty, all of whom have extensive clinical experience and board certification in Hospice and Palliative Medicine.   Fellows are introduced to all aspects of Palliative Care and are expected to work together with all members of the Interdisciplinary Palliative Care Team.

New to our curriculum is a four-week rotation with the Division of Colorectal Surgery during the final year of fellowship. During this rotation fellows are supervised by the colorectal surgery faculty and work with fellows and residents on the surgical team, performing complex bowel surgery. We believe this experience will augment the already solid foundation they have developed during their surgical cases on our gynecologic oncology service.