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Curriculum and Research

Clinical

The goal of our training is to produce highly skilled and knowledgeable clinician-surgeons who are able to care for women with complex pelvic floor disorders. The clinical curriculum reflects a multidisciplinary approach, with FPMRS rotations supplemented by exposure to subspecialty training in pelvic pain, colorectal and GI disorders, pelvic floor physical therapy, general urology, and transgender care.  The clinical hubs are Kaiser Permanente East Bay and UCSF.

KP East Bay boasts one of the most culturally and socioeconomically diverse patient populations in the United States, and care is provided within a truly integrated system that places high value on efficiency, innovation, consistency of clinical outcomes, and patients’ ease of access to care. While at KP East Bay, you will work with two fellowship-trained faculty from Urogynecology, one fellowship-trained faculty from Female Urology, three fellowship-trained faculty in Colorectal Surgery, and a fellowship-trained Chronic Pelvic Pain specialist. Clinical training will enable you to perform simple and multichannel urodynamics, diagnostic and operative cystoscopy, and preoperative evaluation and counseling of patients with pelvic floor disorders amenable to surgical treatment, a variety of surgical approaches to the correction of urinary incontinence and pelvic organ prolapse, evaluation and treatment of fistulas, urethral diverticulae, chronic obstetrical lacerations, and GU anomalies. Importantly, we value a surgeon’s ability to perform both vaginal and abdominal (laparoscopic) pelvic reconstructive surgeries, as we believe this is essential to providing high quality, patient-centered care. Fellows are also trained to perform endo-urologic procedures (retrograde pyelograms and stent placement) and ureteral reimplantation with an opportunity to participate in complex urinary reconstructive procedures, including urinary diversions.

UCSF, as a National Center of Excellence in Women’s Health, is recognized internationally for its expertise in understanding women’s health needs, teaching evidence-based medicine, and improving patient care. As a tertiary care referral center in Northern California, UCSF serves as a crucial site for patients with complex pelvic floor disorders and surgical complications. You will work with one fellowship-trained faculty from Urogynecology, one fellowship-trained faculty from Female Urology, and one board-certified FPMRS faculty. You will be well versed in vaginal, laparoscopic, and robotic approaches. You will also have the opportunity to participate in vesicovaginal and colovaginal fistulae repairs that involve multidisciplinary surgical teams.

Kaiser Permanente San Francisco serves as the hub for multidisciplinary care for transgender patients. While on rotation, you will work in the Gender Pathways Clinic, where transgender and gender-expansive patients receive integrated care in a comfortable, supportive setting. Clinical care includes hormone therapy, metal health services, surgical evaluations, and gender reaffirming and reconstructive surgery.

Research

We strongly believe that training skilled surgeon-scientists is essential to ensuring high-quality care for women with pelvic floor disorders and place a high priority on our fellows’ research education.

As a concentrated introduction to clinical research methods, each fellow will spend 6 weeks during the summer of the first year in the Training in Clinical Research seminar at UCSF. Additionally, we have a longitudinal didactic and practical research curriculum that calls on each fellow to present research proposals, develop them into study designs, and carry out the studies. It is our expectation that each fellow will lead and participate in multiple high-quality research studies that result in presentations and publications. The fellow, together with the research mentor, will identify the study that will serve as the research thesis for the oral board examination in FPMRS.

Extensive research mentorship and support is available to our fellows, both through the research infrastructure of UCSF, as well as through Kaiser Permantente’s Division of Research.

Education

The program’s educational curriculum reflects a commitment to the interdisciplinary, team-based approach. In addition to close collaboration in the clinics and operating room, faculty, fellows, residents, and other pelvic floor health care providers meet weekly for academic conferences that follow a longitudinal didactic curriculum in FPMRS and incorporate case-based learning, journal club, scientific writing, and research works-in-progress.

Fellowship Didactics:

Every Tuesday afternoon fellows are expected to participate in fellow-level conferences that include lecture, preoperative case-based conference, and either journal club, research work-in-progress, or a multidisciplinary roundtable discussion.

Departmental Conferences:

Every week participate in departmental M&M and Grand Rounds at KPEB or UCSF, depending on their rotation.

Teaching Conferences:

To develop their own teaching skills, the fellows participate in resident core lecture program in FPMRS both within the departments of OB/Gyn and Urology.  Fellows also serve as teachers during simulation and skills labs. These programs are offered throughout the academic year.

Scientific Meetings:

Our fellows take part in the Annual Resident Research Symposium for Kaiser Permanente Northern California as well as the UCSF Fellows Research Day. Fellows are financially supported to attend at least one national meeting per year (more, depending on research presentations and committee service).

Community and Global Health

Our program exists within two organizations that are committed to reducing healthcare disparities locally and globally. During training, each fellow will be encouraged to participate in a quality improvement that reflects the fellow’s personal interests and/or the priorities of the department. Fellows will also have opportunities for global health work and medical Spanish workshops.

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