Clinical Experience

The treatment of gynecologic malignancies includes surgery, chemotherapy and radiation therapy. Our clinical training program will prepare the fellow to provide excellent care to patients with gynecologic cancers. The fellow is given graduated responsibility in surgical and medical management of gynecologic cancer through direct involvement in the care of all patients undergoing evaluation and treatment.

Surgical Experience

The fellow will attain technical skills in the surgical procedures associated with the treatment of gynecologic malignancies. As the fellow gains more technical skills and surgical judgment, graduated responsibility in the operating room is given. Over 500 new patients are seen annually by the gynecologic oncology service, thus providing ample clinical volume. 

The fellow will gain surgical experience related to the following:

• Comprehensive pelvic surgery
• Radical vulvar excisions and reconstruction
• Radical tumor debulking to include bowel and bladder surgery
• Upper abdominal procedures
• Exenterative procedures
• Urinary and fecal diversion
• Minimally invasive procedures (including traditional laparoscopy and the robotic platform)

Robotic Training

The Robotic Surgery Training Room at the University of Iowa is housed adjacent to the Main Operating Suite. One da Vinci Standard robot is dedicated entirely to training. The Robotic Training Room is utilized by residents and fellows from the Departments of General Surgery, Obstetrics and Gynecology, Urology, and Otolaryngology. It is available for use most days; arrangements are made with one of our Robotic Coordinators.

The Residents and Fellows in the Department of Obstetrics and Gynecology are encouraged to use the Robotic Training Room whenever possible to improve their skills. In addition to the Standard robotic training lab, the da Vinci Si robot has a Skills Simulator that can be used when the dual console is not in use. Arrangements are made with our Robotic Coordinators.

Clinics

The fellows will attend one day of clinic per week with faculty. At those clinics they are involved in the management and treatment planning of patients with gynecologic malignancies, including patients with new or recurrent diagnoses. With the guidance of the faculty member, the fellow will formulate a plan and discuss that plan with the patient and her family. The fellow will also see patients undergoing cancer surveillance. The fellow gains expertise in the prescription of chemotherapy and management of complications within the clinical setting.

Our clinics are supported by midlevel providers including, physician assistants, nurse practitioners, and dedicated oncology nurses. Additionally, a nurse clinical care coordinator is available throughout the day to assist with clinical and administrative tasks related to patient care. 

One fellow per week is on call. Call responsibilities include answering outside calls overnight from patients, referring providers, and the emergency department. On weekends, the fellow answers outside calls and makes rounds in the morning with residents and faculty. Call responsibilities rotate weekly between the fellows, who arrange their own schedule.

Clinical Rotations

The fellows rotate through two off-service rotations: Surgical and Neuroscience Intensive Care Unit (SNICU) and Radiation Oncology.

Rotating in the SNICU provides an unparalleled opportunity to care for a diverse set of critically ill patients. Working with critical care specialists trained in surgery, anesthesia, medicine, and pharmacy, fellows are part of a multidisciplinary team managing patients with complex needs.

Fellows will learn:

• Ventilator and vasopressor management
• Vascular access
• Management of critically ill patients.

The Radiation Oncology rotation provides the fellow with hands-on experience in the treatment of gynecologic malignancies with radiation therapy. The basic modalities of radiation therapy and physics are introduced within the clinic and reinforced through didactic sessions. Management of the complications of radiation therapy is covered through didactic lectures and in the clinic. 

Fellows will learn:

• High-dose rate brachytherapy implants
• Interstitial implants
• Planning of external beam radiation 

Departmental Education

The Department of Obstetrics and Gynecology Morbidity and Mortality (M&M) Conference is held on Tuesday mornings. During this time, cases from the preceding week are presented by the residents and discussed by the department. The fellows are encouraged to participate in this learning experience.

The Department of Obstetrics and Gynecology Grand Rounds follows the Morbidity and Mortality conference. Grand Rounds consists of speakers from within the department, as well as invited guests from other medical institutions. Each fellow presents at one Grand Rounds conference per year.

Didactic Sessions

Didactic sessions are held on Tuesdays to systematically review all basic science and clinical aspects of gynecologic oncology as described in the Guide to Learning. These include lectures by the faculty, fellows, and invited guests from other departments. 

Gynecologic Oncology Tumor Board

Gynecologic Oncology Tumor Board is a multidisciplinary conference run by the fellows. Fellows present the clinical scenario, after which the pathology slides are presented and reviewed by the pathology fellow/staff. A robust discussion concerning treatment options is then led by the fellow and finalized by the faculty.

Chemotherapy Rounds

All patients actively undergoing treatment with chemotherapy are reviewed. This includes patients both on and off clinical trials. Fellows are expected to discuss options for patients initiating chemotherapy, as well as provide alternative chemotherapy choices for patients failing current regimens. 

Gynecologic Oncology Journal Club

Gynecologic Oncology Journal Club is a monthly conference where faculty members and fellows alternate the presentation of articles. Fellows are assisted in the choice of articles by any one of the faculty members and typically include current clinical or scientific findings. 

University Lectures

Numerous outstanding University and College of Medicine lectures are available and fellows are encouraged to attend when possible. Opportunities include other departmental grand rounds, invited speakers, and the Holden Comprehensive Cancer Center lecture series. 

Program Accreditation

The Gynecologic Oncology Fellowship Program at University of Iowa Hospitals & Clinics is accredited by the Accreditation Council for Graduate Medical Education.

Information specific to program requirements for a gynecologic oncology fellowship training program and milestones for fellow performance may be found at the ACGME’s Obstetrics and Gynecology Review Committee (RC).

Board Certification

The ABOG-American Board of Obstetrics and Gynecology is an independent, non-profit organization that certifies obstetricians and gynecologists in the United States. Visit the American Board of Obstetrics and Gynecology for information on board certification requirements. 

The fellow will complete one year of research. Opportunities exist for research within a multitude of laboratories throughout the medical and undergraduate campus. The research work is expected to culminate in the production of a thesis, as mandated by the American Board of Obstetrics and Gynecology. Fellows have won national awards for their research from various scientific and professional societies.

The division is also active in clinical research, and fellows have an excellent record of presenting basic, translational and clinical science at national meetings. These works generally result in first author publications for the fellows. 

A valuable resource within the Department of Obstetrics and Gynecology is the divisional tumor tissue bank. It consists of tumor tissue collected from patients undergoing gynecologic surgery. Clinical data is available for all of these patients.

During the research year, didactic coursework is required for fellows. This typically consists of a statistics-related course, as well as a molecular biology course. This is determined in conjunction with the program director. 

Christian M. Pettker, MD
Jennifer R. Niebyl, MD Chair and Department Executive Officer
Department of Obstetrics and Gynecology

Welcome to the website of the University of Iowa Department of Obstetrics and Gynecology. I am proud to lead a talented group of hard-working, creative, and caring faculty and staff that works every day to bring the best healthcare to Iowans and beyond.  The field of medicine is faced with considerable challenges today.  Our team is rising to these challenges to meet the needs of those we serve, while working also to maintain the joy and meaning of being a healthcare provider.  A strength of our department is our interdisciplinary composition, as we comprise a diverse group of physicians, nurse midwives, advanced practice nurses, physician associates, nurses, genetics counselors, sonographers, embryologists, and more.  We also have important collaborative relationships with the School of Nursing and the Departments of Family Medicine and Pediatrics.

Our comprehensive medical, surgical, and nursing services provide the full spectrum of care for patients with normal and complicated pregnancies and for gynecology, including cancer, menopause, female pelvic health, and reproductive endocrinology.  While our care is primarily focused in Iowa City at the University of Iowa Health Care hospitals, we serve all of Iowa, with telehealth and outreach services at sites across the state.  The goal of our department is to serve, educate, and care for Iowans, and exemplify all models of care in women’s and reproductive health for the world to see.

We are a primary care provider for women’s health, serving normal and uncomplicated pregnancies and routine women’s health issues.  In keeping with the institution's quaternary care role, a number of our patients represent complicated or high-risk conditions within all spectrums of obstetric and gynecologic care.  We serve two labor and deliver suites at our two Iowa City hospitals, incorporating both modern technological advances as well as facilities for the family-oriented approach to patient care.  The gynecologic oncology program is an integral unit of the Holden Comprehensive Cancer Center at the University of Iowa. Our in vitro fertilization program is a national leader in outcomes and the latest technologies.  Additional specialty areas include genetics counseling, infertility, in-vitro fertilization, gynecologic urology, menopause, pelvic pain, prenatal diagnostics, and reproductive care. 

Basic and clinical research in reproductive medicine is an important departmental activity and is generously funded by state, federal, and philanthropic support.  Our areas of strength in scholarship include obstetric quality and safety, preeclampsia, ovarian and uterine cancer, female pelvic health, fertility/infertility, and rural women’s health.  Our internationally-recognized Women’s Health Tissue Repository attracts researchers from across the spectrum of pregnancy and reproductive health and is a particularly unique resource used to answer the more important questions in our field.  Important collaborations with state and federal agencies are an critical part of our scholarship and research as well.

We are dedicated to excellence in the education of medical students, residents, and fellows, as reflected by a competency-based curriculum that is designed to provide practitioners with comprehensive knowledge and outstanding skills. The clinical and research efforts of trainees are closely mentored and nurtured by a dedicated research team. Our graduates move on to successful careers in clinical practice and academic obstetrics and gynecology. We have four ACGME-accredited fellowship programs in Female Pelvic Medicine and Reconstructive Surgery, Gynecologic Oncology, Maternal Fetal Medicine and Reproductive Endocrinology and Infertility.  We also support an accredited Clinical Nurse Midwife training program.

Whether you are a patient, student/trainee, researcher, physician, midwife, or other provider, we hope you will have a meaningful and rewarding interaction with our department and that we treat you with our unique ‘Iowa nice’ touch.

Keely Ulmer, MD

Residency: University of Iowa Hospitals & Clinics
Expected Graduation: 2025

Andrew Polio, MD

Residency: Tufts Medical Center, Boston, MA
Expected Graduation: 2026

Katherine B. Sawaya, MD

Residency:  Ochsner Clinic Foundation; New Orleans, LA
Expected Graduation:  2027