Residency Program

Curriculum

Division of GYNECOLOGIC ONCOLOGY

• Knowledge of the diagnostic criteria, pathophysiology, and natural history of female pelvic and breast neoplasms. He/she should be familiar with the various modes of therapy and their applicability to these tumors.
• Knowledge of colposcopy and the theory and techniques for the out?patient management of squamous intraepithelial neoplasia of the lower female genital tract.
• Knowledge and experience in retroperitoneal surgery and operative treatment of malignancies including node biopsy, omentectomy, and recognition and repair of bowel, urinary and vascular injury. Techniques of vulvar surgery are included.
• Basic knowledge of appropriate radiotherapy, immunotherapy, and chemotherapy as they apply to female pelvic malignancy.

FIRST ROTATION - FIRST YEAR RESIDENT (JAR) (7 weeks)
SECOND ROTATION - SECOND YEAR RESIDENT (AR) (7 weeks)
THIRD ROTATION - THIRD YEAR RESIDENT (SAR) (7 weeks)
FOURTH ROTATION - CHIEF RESIDENT (7 weeks)

This rotation, "houseperson", is designed to introduce the new resident to the complexities of care of hospitalized patients on gynecology, oncology and endocrinology. This includes on-ward management of fluids and electrolytes, blood volume management, wound care, introduction and use of venous access lines and aspects of critical care.

SECOND ROTATION - SECOND YEAR RESIDENT (AR) (7 weeks)

1. Fundamentals of Preoperative Care
   • Establishment of accurate diagnosis.
   • Metastatic survey and staging.
   • Preoperative management - stabilization of all intercurrent disease processes and establishment of optimal metabolic condition in all major systems.
2. Fundamentals of Postoperative Care
   • Fluid/electrolyte therapy, and management of renal disease.
   • Cardio-Pulmonary Support.
   • Management of GI Physiology.
     • Cantor tubes
     • NG tubes
   • Management of miscellaneous support
     • Hemovac/J-P drains
     • Arterial lines
     • Dressing/wound care
   • Postoperative stabilization of intercurrent disease.
3. Basic Colposcopy and Outpatient Management of CIN
4. Introductory Operative Gynecologic Oncology
   • Opening/closing abdomen
   • Simple abdominal/vaginal hysterectomy
   • Observation of retroperitoneal anatomy
5. Beginning to Learn Radiotherapeutic Techniques, Indications, and Complications for the Treatment of Gynecologic Cancers.
6. Beginning to Learn Chemotherapeutic Techniques, Indications, and Complications.

 

THIRD ROTATION - THIRD YEAR RESIDENT (SAR) (7 weeks)

1. Advanced Life Support
2. Progressive Surgical Experience
3. Expanded Pelvic Anatomy
   • This is particularly true in learning the retroperitoneal space in order that one can identify the ureter, identify vessels to control hemorrhage, aid in removing disease which extends into this area.
   • Experience will be obtained mainly by involvement in retroperitoneal node dissections, but also in even the routine hysterectomy in which these spaces and anatomy are routinely identified on all procedures.
4. The resident by the completion of the rotation should be acquainted with the manner in which lacerations in the GI or GU tract can be repaired:
   • The techniques for cystotomy done at the time of laparotomy should be well known.
   • It is planned that some of the experience needed to feel comfortable in these areas will be obtained in the dog lab as well as by observation and participation in the operating room.
   
   

 

FOURTH ROTATION - CHIEF RESIDENT (7 weeks)

1. Familiarity with all diagnostic procedures necessary to properly diagnose and evaluate (stage) gynecologic malignancies and establish the diagnosis of gynecologic malignancy.
2. Experience with colposcopy that insures proficiency with this procedure and, therefore, expertise in the management of the patient with cervical intraepithelial neoplasia on an outpatient basis.
3. Ability to manage the patient with an uncomplicated adenocarcinoma of the endometrium, including hysterectomy, bilateral salpingo-oophorectomy, and node sampling if indicated, with proper intraoperative evaluation.
4. Preparation for adequately performing the appropriate surgery on a patient with unexpected ovarian cancer found at the time of laparotomy for an adnexal mass.
5. Possibly, the management of the patient with an early vulvar cancer.
6. Familiarity with the retroperitoneal space that will enable the resident to operate in this area as assistant or primary surgeon.
7. Appropriate management of bowel, urinary tract and vascular injuries.