Program Introduction for Interviewing Urogynecology and Reconstructive Pelvic Surgery Fellows

A Message from Kris Strohbehn, MD – Urogynecology and Reconstructive Pelvic Surgery (URPS) Program Director

Program information

Department of OB/GYN mission

We deliver high-quality, evidence-based care in a respectful, compassionate and caring environment. We are committed to timely access and clear communication with our patients and colleagues. We advance the science of health care delivery through education, research, and continuous quality improvement.

Introduction

The URPS Division is a busy clinical practice; we evaluate and treat the full spectrum of pelvic floor disorders for our patients. Treatment options include conservative and surgical management of pelvic organ prolapse, urinary and fecal incontinence, as well as fistulas and urethral diverticula. With an emphasis on transvaginal approaches, our fellows will become diverse and skilled transvaginal, conventional laparoscopic and robotic surgeons.

Faculty

See our faculty list.

Fellows: Division of Urogynecology and Reconstructive Pelvic Surgery

See our list of fellows.

Other faculty

Colorectal Surgery

View Introduction Video by Lauren Wilson, MD

Image	Sara W. Mayo, MD, MS Division Chief, Colon and Rectal Surgery Assistant Professor of Surgery, Geisel School of Medicine, Dartmouth
Image	Lauren Wilson, MD Clinical Assistant Professor of Surgery, Geisel School of Medicine, Dartmouth
Image	Matthew Wilson, MD Assistant Professor of Medicine, Geisel School of Medicine, Dartmouth

Gastroenterology

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Michael Curley, MD, FRCPC Assistant Professor of Medicine, Geisel School of Medicine, Dartmouth

Urology

View Introduction Video by E. Ann Gormley, MD

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E. Ann Gormley, MD Professor of Surgery, Geisel School of Medicine, Dartmouth

Transgender Medicine Program

Currently, the gynecology department offers a Gynecology Gender Clinic twice per month for routine gynecology care and surgical consults for hysterectomy and oophorectomy for gender diverse patients. This clinic in part of a multidisciplinary transgender clinic at our institution that includes urology, plastic surgery, gynecology, psychiatry, dermatology, and primary care. Through this collaborate group, we offer combined procedures and all stages of our newly launched surgical program in phalloplasty, metoidioplasty, and vaginoplasty.

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Ella Damiano, MD  Obstetrics & Gynecology

Physical Therapy

Rotation schedule

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Fellows rotate in one-month blocks.

• Urogyn
  We have divided Urogynecology rotations into an “Urogyn A” and “Urogyn B”.
  • Urogyn A Fellow fellow spends much of their rotation at the main campus, Dartmouth Hitchcock Medical Center in Lebanon, New Hampshire. Their rotations include rotating in clinic, urodynamics, inpatient consults, the main operating room, the outpatient surgery center. They may cover Bedford / Manchester once per week.
  • Urogyn B fellow will do outreach clinics in Keene, Bedford / Manchester, and the operating room at Cheshire Medical Center. They will also fill in for OR coverage at the main campus. They rotate with Dr. Catherine Dubeau, a gerontology expert, ½ day per week to see Geriatric Medicine patients with urinary incontinence. They will rotate with physical therapy intermittently in year 1.
• Research
  The Research rotation is at least two consecutive months per rotation, with four months of research every year of the fellowship, totaling 12 months during the fellowship. The time is dedicated to research only, with the only clinical responsibilities being a ½ day continuity clinic at least twice monthly. The fellows will develop a hypothesis-driven thesis, which is defended at the end of the fellowship.
• Urology
  During the second year, fellows rotate with Dr. Ann Gormley and the Urology Department for a two-month block.
• Gastroenterology/ Colorectal Surgery
  During the third year, the fellow rotates in Gastroenterology with Dr. Eric Shah, and the motility lab; and with Colorectal Surgery, focusing on anoscopy, fistula repairs, rectopexy, common colorectal disorders.

Continuity clinic is scheduled weekly, ½ day per week, except twice monthly during research blocks.

Working at Dartmouth Hitchcock Medical Center

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We offer benefits, including stipends, insurance, and assistance programs.

See also important/required GME policies to read prior to your interview:

• Eligibility requirements (PDF)
• Selection process
• Visa policy
• Example agreement of appointment (PDF)

View all of our GME policies

Supplemental funding

In addition to the benefits outlined on the page above, URPS also provides a $1000/annum for program use and department supplemental funding for additional expenses.

Conferences

There are formal didactic lectures for URPS fellows on Thursday morning, in addition to journal club. There is a joint conference with Urology quarterly on Friday, which provides an opportunity for review of topics of interest and complex cases with our Urology colleagues. There is also a joint conference with Gastroenterology, Colorectal Surgery and Radiology monthly to review complex pelvic floor cases.

• Urology urodynamics conference - monthly
• GI Radiology conference - monthly
• URPS didactics - twice a month
• Colorectal Surgery conference - monthly
• URPS Journal club - twice a month
• Didactic teaching for residents - monthly
• Research meeting - monthly
• Preop conference - monthly
• Departmental grand rounds, M & M’s - weekly
• Combined Urology / Urogynecology rounds - quarterly

Fellow research

• PGY-5
  • White Belt training, Human subjects research training (orientation)
  • Literature review
  • Identify scholarly project
  • Mentor
  • Study plan
  • Yellow Belt training
  • Scholarly activity project proposal
  • Begin data collection
• PGY-6
  • Project development and data acquisition, data analysis
• PGY-7
  • Complete data analysis, present at annual meeting
  • Write publishable scientific thesis

There are 12 months of protected time for research in the 3-year URPS Fellowship. The timeline for completing research projects is outlined in the slide.

Research opportunities include:

1. Outcomes Research
   The Division of URPS has collected almost 15 years of questionnaire data with the validated Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire. This data could be used for exploring many aspects of care in retrospective analysis.
2. The Value Institute Learning Center
   First-year fellows will have training White Belt training with orientation. To develop training ranging “From basic awareness and skills for all employees, to a tiered curriculum to develop process improvement leaders.”
   For more information, visit the Value Institute Learning Center website.
3. The Dartmouth Institute (TDI) of Health Care Policy and Clinical Practice
   There are many resources available for research and some collaborative projects have been done with TDI students, including cost effectiveness analysis, Systematic Reviews. Dr. Jack Wennberg was the founder of TDI and the origin for Outcomes Research and variations in healthcare. TDI is the home of the Dartmouth Atlas project and Shared Decision Making. For more information, visit the TDI website. 

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1. The Center for Shared Decision Making at Dartmouth Hitchcock Medical Center
2. Thayer School of Engineering
   Dr. Hanissian and Dr. Shaw have both worked with Thayer graduate students for several projects, including autologous graft tissue harvesting and modeling, pessary design:
3. Tuck School of Business at Dartmouth
4. Opiate and Addition Related Research
5. Rural Healthcare Research

All clinical research at Dartmouth Hitchcock Medical Center is overseen through the Clinical Trials Office.

There is departmental funding allocated to foster residents and fellows research projects, including some help with statistical analysis. There is also a commitment to help fund residents and fellows who are first author for regional and national scientific meetings.

The Clinical Research Unit is available to assist with patient recruitment and trials.

Procedure Case Logs – Fellow and 2020 Chief Residents

This table (PDF) summarizes the cases for Dr. Gerjevic and Dr. Schrum in their fellowship. Please note that the volume is less than anticipated due to the cancellation of all elective cases after the COVID-19 pandemic.

Current fellows photos

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OB/GYN Residency Program

Leadership Preventive Medicine Residency

Combined training in Preventive Medicine and Ob-Gyn.

• Builds on TDI strengths in outcomes research, improvement, population health and institutional commitment to quality, safety, and value
• MPH degree from TDI – tuition paid by program!
• Opportunity to lead change and improvement at Dartmouth Hitchcock Medical Center
• Two-month governmental public health experience
• Dedicated faculty coach; teaching opportunities; unique multi-specialty resident/fellow/faculty group
• May incorporate research in one year of program (3 + 1)
  • Continue clinical work (app.20% time) in OB/GYN
  • Moonlighting allowed
• Graduates are in demand and employers are very interested in their mix of clinical skills plus improvement and change knowledge and experience
• Visit the LPMR web page, email tina.c.foster@hitchcock.org or contact an alum to learn more!

Electives and global health

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The URPS faculty have several connections for global health opportunities. Dr. Strohbehn has traveled to the Hospital de Familia, in Nuevo Progreso, Guatemala every other year. This hospital caters to under-resourced individuals in the mountains of northwest Guatemala. He has been with a team three times and Dr. Gerjevic traveled with him as a Dartmouth Hitchcock Medical Center OB/GYN resident in 2017. Dr. Jonathan Shaw served as a Consultant Urogynecologist at the Tenwek Hospital, in Kenya for two years, after completing his fellowship in 2016. He has traveled annually to Kenya since starting at Dartmouth Hitchcock Medical Center and has been coordinating with Tenwyk Hospital to start a Kenya-based residency there. He will continue trips to Kenya annually. He was planning to travel to Kenya with the OB/GYN Residency Program Director, Dr. Fisher, as well as Dr. Gerjevic and a 3rd year OB/GYN resident. Unfortunately, this trip was cancelled due to the COVID-19 pandemic.

Note: Opportunity to travel depends on the current state (safety) of the country for travel.

Other OB/GYN department divisions and colleagues

• General OB/GYN

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• Reproductive Endocrinology and Infertility
  • Human Embryology and Andrology Laboratory:
    Navid Esfandiari, PhD
  • Boston IVF Bedford (PGY-2 rotation)
    Kristen Wright, MD
• Division of Gynecologic Oncology
• Certified Nurse Midwives

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Orientation, simulation and skills labs

Dartmouth Hitchcock Medical Center has a Patient Safety Training Center, also known as the "Sim Center."

There are skills labs, including suturing, laparoscopic and robotics training. The department participates in simulation and also has annual anatomic dissection at the cadaver lab at the Geisel School of Medicine at Dartmouth.

Match communication code of conduct

We follow the NRMP guidelines for the Match process. We will not contact you but are happy to hear from you and to answer questions you may have that are not answered during the application and interview process.

Life in the Upper Valley

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The Upper Connecticut River Valley area of central New Hampshire and Vermont includes the towns of Hanover and Lebanon, New Hampshire. Known as "The Upper Valley," this region attracts people from around the world for its scenic beauty.

The Upper Valley area offers a wide variety of cultural and recreational activities for people of all ages.

Learn more about Upper Valley life