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