Educational objectives of the program
The targets of our fellowship program have evolved positively to parallel the growth in program maturity, faculty numbers, experience, innovation, and enterprise. We are successfully keeping pace with and contributing to the rapid expansion of concepts, theory, and practice in pelvic floor disorders. Our fellowship program today has surpassed our expectations, reflecting a sustained growth in strength and productivity originally envisioned at its inception more than seven years ago.
Our primary educational objective is to teach and train fellows in the art and science of the subspecialty of Female Pelvic Medicine and Reconstructive surgery. Each faculty member is a dedicated teacher whose basic objective in relationship to the fellows is the creation of a succession of superlative young physicians fully and confidently equipped to meet all the challenges presented by women afflicted with pelvic floor disorders. To meet this goal we seek to provide the fellows with a comprehensive clinical training involving both surgical and non-surgical management of pelvic floor disorders. To balance this and create a complete physician, we provide a comprehensive didactic program with an emphasis on critical evaluation of the existing literature. Research is mandatory and completes the molding of the complete physician.
Goals, strengths and weaknesses
Our program is designed precisely to prepare fellows to be acknowledged as highly competent and well-respected experts in either academia or private practice, or both. We seek to train skilled and caring consultants to OB/GYN generalists and urologists as well as to their colleagues in internal medicine and colorectal surgery. Fellows must be competent researchers, and will understand how to organize, conduct, analyze, and present their research.
The strengths of this program are the dedicated faculty who comprises not only urogynecology, as noted above, but also urology, colorectal surgery, geriatrics, sexology, and physical therapy. A diverse patient mix provides opportunity to explore all diagnostic and therapeutic options. State of the art equipment and commitment to teaching make this a great program. Office based cystometry, urodynamics, biofeedback and functional electrical stimulation, as well as hospital based urodynamics, neurodiagnostic pelvic floor evaluation, physical therapy, colorectal/fecal incontinence screening including anal manometry, along with a vast array of benign pelvic surgery, will increasingly solidify the learning experience.
Perhaps the most gratifying and stimulating element in our program is the increase in numbers and the widening variety of surgical cases from the simple to the complex. Our faculty provides unique services to a very large area extending from Philadelphia to the New Jersey shore, and from Southern to Central New Jersey. This wide area provides ample exposure to patients with both common and rare conditions. Our faculty members, Drs. Adam Holzberg, Ricardo Caraballo and Karolynn Echols treat the complete spectrum of pelvic floor disorders encompassing prolapse, incontinence, pelvic pain, fistulas, and sexual dysfunction. This is complemented by the nationally renowned urologist and fellowship director, Dr. Kristene Whitmore at Hahnemann University Hospital. Our own widely advertised conferences and the steadily increasing involvements of our faculty in national-level meetings and in Grand Rounds appearances across the country are expected to continue our steadily expanding volume of cases, especially such uncommon cases as vesico-vaginal and recto-vaginal fistulas, suburethral diverticulae, chronic fourth degree perineal lacerations, and vaginal agenesis.
Educational operative video production has been initiated and developed as part of the education program. Several video projects have been presented at major national-level conference with acceptance into College libraries. Fellows are intricately involved in both the surgery and the associated narratives of these productions. In an ancillary mode, the fellows themselves are learning how to create educational videos, which is far from a simple task.
Our research arm has been evolving as well. With a robust surgical database upon which to call, there is ample raw material for any research hypothesis. More significantly, we have progressed to prospective trials, initiated by both industry and investigators. The basic science arm of the research division is expanding as well.
Education Program
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Organization of in- and out-patient teaching (by institution)
Fellowship education has been conducted in the usual double manner of on-the-job training in the various clinical settings and in varied formal education formats, including journal clubs, didactic lectures, case reviews and critiques, assigned fellow-led topic presentations, grand rounds attendance, and attendance at major conferences. Interaction with residents and medical students facilitates the opportunity to develop teaching skills. Outpatient experience is fulfilled at the Cooper Health System at Voorhees in a private practice facility which includes four examining rooms, three faculty offices, a fellow’s office, and a urodynamics/office cystoscopy procedure room in addition to the standard spaces for administration, reception, chart and record storage, waiting room, and restrooms. Outpatient experience with Dr. Whitmore occurs at the Pelvic Floor Institute in Philadelphia which is similarly equipped. Rotations in colorectal surgery and geriatrics complete a well rounded curriculum.
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Supervision in ambulatory unit and operating room
Fellowship supervision in the ambulatory surgical unit and in the operating rooms is well established by program faculty for all cases involving pelvic floor disorders.
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Conferences
Meetings and educational sessions are scheduled regularly at both institutions Attendance is mandatory at all of these for both faculty and fellows. Residents and students are included. The agenda includes fellowship journal club on the first Monday of each month, chapter reviews and regular research meetings monthly at both sites. Pelvic floor team meetings and didactics occur on Monday evenings once per month. The topics vary but cover all particular elements of FPM/RS, pertinent areas of other OB/GYN subspecialties and general OB/GYN, urology, colorectal medicine and surgery, pelvic neurology, and geriatrics. In addition, fellows are encouraged to attend residency related conferences which include morning report twice weekly and department grand rounds every Tuesday morning.
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Scientific meetings
Fellows must attend the annual scientific meeting of the American Urogynecological Society and are expected to submit one or more abstracts annually for consideration. Attendance, participation and presentation are encouraged at other scientific meetings, such as that of the Society of Gynecologic Surgeons. Fellows have also attended and presented other national meetings such as: American College of Obstetrics and Gynecology, American Urologic Association, Society of Urodynamics and Female Urology, International Society of Pelvic Neuromodulation and the Interstitial Cystitis Association and the International Continence Society.
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Research activities
A thesis is mandatory for completion of the fellowship. All research is conducted with the aid of a mentor, and multiple projects are encouraged. All modes of research are welcome, ranging from industry-supported to investigator-initiated to basic science.
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Off-service rotations
Off service rotations, as required, have been firmly established into the fellowship agenda in colorectal surgery, geriatrics, and wounds and flaps. The liaison of and integration with these ancillary areas of our fellowship has steadily solidified with expectations for growing strength. Fellows are also given the opportunity to travel abroad for international exposure to medicine in some of the developing countries in Africa and the Caribbean. This includes but is not limited to prevention, and reparation of obstetrical fistulas, urogynecology and benign gynecology.
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Progressive responsibility
Our fellows have matured in their roles as clinical instructors of OB/GYN for both residents and students within the sphere of our medical school. Within the fellowship itself, the third year fellow has become a very effective supervisor of the junior fellows. Progressively increasing autonomy helps facilitate the transition from fellowship to practice.
Responsibilities and activities of fellows in:
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Teaching of residents and students
All of the precise demands of the fellows are in direct integration with their participation in the broad program of education as outlined above. The function of fellows at every level of clinical involvement as instructors for a fully certified residency program containing four residents in each of a total of four years must be re-emphasized. Exactly the same requirements are expected of fellows relevant to medical students, particularly the 6-8 third year student groups who rotate through OB/GYN every six weeks.
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Lectures and presentations
Fellows must respond to their integral functions regarding didactic lectures (five times annually) and core lectures to students (three to six times per year).
Available research space and opportunity for the fellows
Clinical research is conducted at both institutions with ample space for dedicated fellows offices, patient interviews, examination and documentation in accordance with HIPPA regulations and IRB protocols. Our outpatient clinics with over 20,000 patient visits per year in obstetrics and gynecology provide our fellows with a vast source of patients available for recruitment. Interest in basic science research can be accommodated at the Education and Research Building adjacent to Cooper Hospital.
Integration of the fellowship and residency programs
Fellows participate in the training of residents via supervision in clinics and operating rooms. They also provide in-hospital overnight coverage where they directly supervise the residents. This is scheduled within the guidelines of the 80 hour work rule. Fellows also share in the resident educational programs and attend as many resident conferences and meetings as their rotations will allow.
Methods for evaluation of fellow’s progress
Fellows are formally evaluated every 6 months. In addition, they receive immediate positive and negative feedback at the outpatient offices as well as the operating room.
Methods for fellows’ evaluation of faculty
Fellows evaluate the faculty on a yearly basis. This is done in complete anonymity which is assured by having the evaluations typed by a third party. A comprehensive form designed for this purpose is included at the end of this section.
| PLEASE NOTE: This fellowship is accredited through the American Board of Obstetrics and Gynecology (ABOG). |
Available Position: 1
Contact Information
Director: Kristene Whitmore, M.D.
Contact: Rosalind Robinson
Phone: (856) 963-3963
Fax: (856) 365-1967
Email: Robinson-rosalind@cooperhealth.edu
Address: Cooper University Hospital, Department of OB/GYN, Three Cooper Plaza, Suite 221, Camden, New Jersey 08103