The first 10 months of the Urogynecology and Reconstructive Pelvic Surgery (URPS) Fellowship at Mayo Clinic in Rochester, Minnesota, are dedicated to research and graduate courses with no clinical responsibilities. There are two additional research rotations in the second and third years to complete the required 12 months of research.

As a fellow, you will enroll in Mayo Clinic Graduate School to pursue a Master of Biomedical Sciences in urogynecology and reconstructive pelvic surgery program. The master’s degree course will focus on research and protocol development, statistics, and epidemiology. Optional elective courses in healthcare disparities, survey research, and advanced statistical analysis (logistic regression, survival analysis) are offered. Workshops focused on grant writing and publishing in scientific journals are also part of the degree program. The master's degree program is designed to prepare you to lead and participate in research teams conducting effective patient-oriented research.

Whether pursuing clinical or basic science research, the research rotations are organized to teach you how to generate a hypothesis and coordinate the necessary hypothesis testing. In addition to the thesis project generated during protected research rotations, you have the opportunity to participate in a wide variety of additional research endeavors, often yielding several additional manuscripts or book chapters during the 36 months of training.

Clinical training

The Urogynecology and Reconstructive Pelvic Surgery Fellowship offers:

• A broad spectrum of experience in pelvic surgery, with an emphasis on urogynecology and reconstructive pelvic surgery, as well as experience in radical pelvic surgery, complex abdominal surgery, and colorectal surgery
• A multispecialty approach to the evaluation and management of urinary incontinence and pelvic floor disorders that includes specialists from gastroenterology, urology, neurology, colorectal surgery, and physical medicine and rehabilitation
• Training that emphasizes clinical evaluation, including urodynamics and cystoscopy, as well as nonsurgical treatments for a wide range of urogynecologic and pelvic floor dysfunctions
• The opportunity to obtain a Master of Biomedical Science degree in urogynecology and reconstructive pelvic surgery
• An extensive conference and didactic schedule focused on urogynecology and reconstructive pelvic surgery, pelvic floor dysfunction, congenital anomalies, neuro-urology, and general gynecologic surgery
• Five fellowship-trained urogynecologists as primary faculty
• Two advanced-practice providers focusing on nonsurgical management of pelvic organ prolapse

Simulation

Fellows participate in multiple simulation activities annually. This includes cadaveric labs focusing on advanced pelvic surgery techniques. The fellowship hosts multiple simulation labs annually. These include ureteral stent placement, vaginal surgery techniques, periurethral bulking/injection, and sacral neuromodulation.

Didactic training

Clinical conferences, seminars, small discussion groups, journal clubs, and one-on-one instruction are all integral parts of the fellowship. As a fellow, you will attend one of these didactic sessions every Tuesday morning:

• URPS Fellowship Research Conference
• URPS  Fellowship Journal Club
• URPS Fellowship Conference
• URPS  Fellowship Quality Improvement (M&M) Conference

Fellows also participate in:

• Multidisciplinary Conference (MDC) including urogynecology, colon and rectal surgery, and GI
• Adult Transgender Intersex Specialty Care Clinic (TISCC) Conference

Fellows attend the conferences noted above in addition to the didactic training in pursuit of the Master of Biomedical Sciences in urogynecology and reconstructive pelvic surgery. In addition, you will participate in an annual six-week graduate-level pelvic anatomy course. As a fellow, you may participate in many other conferences, including the Department of Obstetrics and Gynecology conference, general surgery conference, and OB/GYN journal club.

Fellows attend the annual meeting of the American Urogynecologic Society (AUGS) at least once during fellowship and may attend each year if an abstract is accepted for presentation at the conference. You may attend other scientific meetings if an abstract is accepted for presentation. Fellows are able to attend up to five conferences annually to present their research, each with travel time and financial support provided by the training program.

Research training

The research opportunities at Mayo Clinic are significant. The urogynecology team focuses on epidemiology, retrospective and prospective analysis of surgical outcomes, imaging modalities of the pelvic floor, and basic science research.

An extensive support team facilitates investigation in a variety of areas. This includes a dedicated department statistician for complex statistics, access to study coordinators, and a survey research facility to assist with the creation and distribution of study surveys. As a fellow, you are expected to generate research projects resulting in manuscripts suitable for presentation and publication in peer-reviewed journals.

The Scientific Publications department at Mayo Clinic's campus in Rochester, Minnesota, is the largest in-house publication service of any academic center in the United States. You may utilize this service for proofing, formatting, and submission of manuscripts.

Rotation schedule

During the clinical and surgical rotations, fellows receive extensive medical, surgical, and diagnostic training in urogynecology and reconstructive pelvic surgery with hands-on experience in evaluating, diagnosing, and managing patients with urinary incontinence, pelvic relaxation, and other disorders of the female reproductive tract.

An example of the fellowship rotations:

Call frequency

Fellows' call schedules vary by individual rotation. Fellows are on pager call one to two nights during the workweek. Weekend call is rotated and averages approximately eight weekends per year. Fellows function as junior faculty supervising the resident call team and working with the faculty covering call. Fellows have no in-house call responsibilities and no obstetric coverage requirements.

Mayo Clinic complies with the Accreditation Council for Graduate Medical Education (ACGME) work hour requirements.

Moonlighting

Moonlighting is not required. Moonlighting is allowed with the permission of the program director and must comply with ACGME work-hour requirements. Moonlighting must not interfere with any fellowship responsibilities.

Evaluation

To ensure that fellows acquire adequate knowledge and development of technical skills, performance is monitored carefully during the course of the Urogynecology and Reconstructive Pelvic Surgery Fellowship at Mayo Clinic in Rochester, Minnesota. Fellows are evaluated formally by their supervising faculty member on a quarterly basis, and these evaluations are shared with each fellow by the program director.

In addition, fellows regularly evaluate the faculty, rotations, and fellowship to ensure fellows' needs are being met.

Certification

After successfully completing the program:

• Obstetrics and gynecology physicians will be eligible to take the Urogynecology and Reconstructive Pelvic Surgery subspecialty qualifying and certifying exams offered by the American Board of Obstetrics and Gynecology.
• Urology physicians will be eligible to take the Urogynecology and Reconstructive Pelvic Surgery subspecialty certifying exams offered by the American Board of Urology.