Gynecologic Oncology Fellowship
Our ACGME-approved fellowship program in gynecologic oncology is a three-year fellowship. Typically two three-year fellows are accepted into the program each year.
Our clinical facilities include the primary facility of Barnes-Jewish Hospital, a greater than 1200-bed hospital at Washington University Medical Center. The medical center is a major tertiary care center and receives referrals from all parts of Missouri, southern Illinois and other neighboring midwestern states. Our program also utilizes Missouri Baptist Medical Center, a facility located just west of the city of St. Louis, thus drawing in patients who live in the suburban St. Louis County area.
Program format and objectives
Fellows who are accepted into the program spend their first year in research. Fellows in their research year of training are paired with one of the many full-time faculty in the medical center who will mentor them, along with the Gynecologic Oncology faculty, to ensure that their research produces publishable results. Faculty mentors may be part of the Department of Obstetrics or Gynecology or may be associated with one of many departments with the medical center and Siteman Cancer Center, an NCI Comprehensive Cancer Center located on campus.
The subsequent two years of fellowship will be spent in clinical gynecologic oncology, under the guidance of eight faculty members who have appointments at the Washington University School of Medicine. Each faculty member rotates as an attending for the Gynecologic Oncology service. A faculty member oversees surgeries scheduled as fellow cases. The clinical fellows also scrub on all cases scheduled by the faculty as well. 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. Each faculty member is always ready to assist the fellow in obtaining the knowledge, skill and capability to manage all gynecologic oncology patients.
The fellow will also interrelate with the medical school’s Division of Radiation Oncology (in the Mallinckrodt Institute of Radiology), Division of Palliative Care, and of Division of Medical Oncology (in the John T. Milliken Department of Internal Medicine).
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
Didactics and scientific meetings
Fellows are asked to take two graduate level courses during their research year. These courses are fully supported by the division. In the past, these have included courses in biostatistics and molecular biology. 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. The fellow will be encouraged to attend regional or national scientific meetings which are pertinent to the field of gynecologic oncology, and funding is available for such meetings. Presentations at such meetings are strongly encouraged as well.
The gynecologic oncology fellow will also be responsible for giving several formal lectures within the Department of Ob/Gyn, as well as other departments. Student lectures will also be the responsibility of the fellow as scheduled. The second-year clinical fellow is responsible for the weekly Tumor Conference, held jointly with the Division of Radiation Oncology and the Department of Pathology. The research year fellows are responsible for choosing relevant and recent publications for the monthly journal club.
Clinical trial development
The division actively participates in clinical research studies, including investigator-initiated studies, industry-sponsored studies as well as studies from national cooperative groups such as the Gynecologic Oncology Group and the Radiation Therapy Oncology Group (NRG Oncology). Our program strongly supports fellows who are interested in developing prospective clinical trials, as well as retrospective chart reviews, and there is a full-time research staff of 8 with extensive expertise to assist and mentor the fellows through the institutional approval process.
Clinical gynecologic oncology rotation
The fellow’s weekly service rotations include surgeries related to gynecologic malignancies, as well as difficult pelvic surgeries not related to cancer diagnoses. The fellow must participate in all surgical procedures in the categories defined by the American Board of Obstetrics and Gynecology, depending upon the type of surgery being performed, the level of the fellow’s proficiency and the year of training. 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 one of the full-time 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 outside.
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 a mandatory rotation during training. The rotation is 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 is a long-established tradition of cooperation with the Division of Radiation Oncology. In addition to a joint weekly conference, fellows have a four-week rotation on the radiation therapy service. 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.
The ultimate goal of the Division of Gynecologic Oncology is to train physicians who are capable of functioning as independent gynecologic oncologists. That is why all aspects of patient management are equally emphasized.
In order to achieve this goal, fellows are given progressive clinical responsibilities during the two years of clinical training. Since it is recognized that different fellows may possess different backgrounds, knowledge, skill and learning ability, this progression in responsibility cannot be set by a fixed schedule. It can only be accomplished by ongoing evaluations on an individual basis. Through daily contact, close interactions and direct supervision by faculty members, each fellow is evaluated for his or her initiative, knowledge, competency and skills in the operating room, at the bedside and in the ambulatory care clinics. These evaluations are performed on a quarterly basis. Appropriate responsibilities are then given the fellow and increased in proportion to the individual fellow’s progress. The amount of clinical material and total commitment of faculty members assure the maturity of our fellows in their clinical years.
Applications are accepted in ERAS December through May. Interviews are typically held in July and/or August. All completed applications will be considered for interview. The program coordinator will send interview invitations directly to candidates via email. If you have any questions about the application process please contact the program coordinator.
Apply to the program through ERAS®.
Go to ERAS »
Upload the following to your ERAS application:
- Personal statement
- Medical Student Performance Evaluation (MSPE)
- USMLE Step 1 and Step 2
- Three Letters of Recommendation (one of which is from your residency director or department chair)
Fellowship Program Director:
David G. Mutch, MD
Fellowship Program Coordinator: