August 4, 2011

New fellowship focuses on female pelvic medicine

New fellowship focuses on female pelvic medicine

It’s not every day a new medical subspecialty comes into existence, but when the American Board of Medical Specialties recognized the new field of Female Pelvic Medicine and Reconstructive Surgery in March, Vanderbilt was ready to hit the ground running with a collaborative training program.

“Not only was this a banner year in terms of recognition as a separate stand-alone subspecialty, but also it was our first year at Vanderbilt to graduate someone from both Gynecology and Urology in this,” said Roger Dmochowski, M.D., professor of Urologic Surgery and director of the new Female Pelvic Medicine and Reconstructive Urology Fellowship.

Roger Dmochowski, M.D.

Roger Dmochowski, M.D.

The new subspecialty integrates two previously separate training programs: gynecologic urology and female urologic surgery.

The Departments of Urologic Surgery and Obstetrics and Gynecology have been collaborating for eight years to bring the training programs together in anticipation of the newly named discipline. The fellowship has been in existence for nine years with a specific urology track, and four years in Ob/Gyn, but now effectively combines both tracks.

Patients are women with complicated conditions that result in incontinence, prolapse of pelvic organs, or benign structural problems that lead to significant pelvic pain or dysfunction.

The aging population creates a greater volume of need for treatment of female pelvic problems, and the complex conditions require a focus on developing new treatments and improving outcomes. This makes the collaborative nature of Vanderbilt’s program critically important.

“One in three women will experience either prolapse or incontinence in her lifetime, plus there is a broad range of women who experience a complicated disorder like damage from prior radiation, a failed surgery or other complicated co-morbidities,” Dmochowski said.

The program would not be possible without dedicated departmental interaction under the supervision of Howard Jones, M.D., chair of Obstetrics and Gynecology, and Jay Smith, M.D., chair of Urologic Surgery. Dedicated contributions of faculty in both departments makes Vanderbilt one of only three academic medical centers in the nation that currently offer a collaborative approach to train fellows to achieve this new certification in both urologic and gynecologic disciplines at once.

The program has a two-year training track for Urology and a three-year track for Gynecology and includes clinical and basic science rotations.

Two Female Pelvic Medicine and Reconstructive Surgery specialists will complete training each year, one from each discipline.

“Vanderbilt’s existing fellowships in Female Urology and Urogynecology are each slightly different in their foundational base,” said Daniel Biller, M.D., assistant professor of Urogynecology and Pelvic Medicine and Reconstructive Surgery.

“Physicians enter a track based on his or her previous residency training. The Departments of Urology and Gynecology work together closely to provide excellent clinical, surgical and research opportunities to all of our fellows. This is an excellent example of how Vanderbilt's collegial atmosphere will benefit both our patients and the future development of our subspecialty.”

The first Female Pelvic Medicine and Reconstructive Surgery fellows to complete Vanderbilt's combined training have each joined the Medical Center faculty. W. Stuart Reynolds, M.D., and Karen Gold, M.D., will begin seeing patients in the fall. Physicians who have been practicing under the original Urologic or Gynecologic subspecialties will be able to apply for the certification exam for the new subspecialty over the next several years.