University of Virginia Oncology Fellowship Program

University of Virginia Oncology Fellowship Program

 

The primary objective and goal of the Gynecologic Oncology Fellowship Training Program at the University of Virginia Health System is to train Physicians who will pursue an academic career in Gynecologic Oncology. The program is designed as a three-year fellowship, with one trainee per year. The fellowship at the University of Virginia Health System will be based upon a well-established history of both clinical and research excellence in the discipline of gynecologic oncology. Our relationships with the Departments of Surgery, Urology, Plastic Surgery, Medical Oncology, and Radiation Oncology allow for a more expansive clinical development of the Gynecologic Oncology Fellow, with a central focus on the delivery of excellent clinical care to women with gynecologic malignancies.

The Division of Gynecologic Oncology and the Fellowship Program, under the leadership of Linda R. Duska, M.D., presently includes five full-time, board-certified Gynecologic Oncologists:

Academic interests of the faculty include clinical research with a strong laboratory emphasis.

The Division of Gynecologic Oncology is an integral part of the University of Virginia Cancer Center. The Cancer Center is one of only 12 NCI-Designated Clinical Cancer Centers and is directed by Michael Weber, PhD, an internationally known scientist in Cell-Signaling.

The Cancer Center has 10 basic research core laboratories and 202 competitively funded investigators organized around the following programmatic themes: Cell Signaling, Metastasis, Invasion and Cell Surfaces, Structural Biology, Immunology, and Endocrinology. These investigators [who were awarded more than 45 million dollars in extra-mural funding last year] are potential scientific mentors for the Fellows.

The clinical program of the Cancer Center provides a large number of patients for clinical care and clinical research. More than 2000 new and analytic cancer cases are seen each year. The clinical programs are organized around multidisciplinary care teams, divided by cancer site, each with participation by specialists from diagnostic imaging, the specific surgical discipline, radiation oncology, medical oncology, pathology, and specialty nurse coordinators. In addition, the Division of Gynecologic Oncology is a full member of the Gynecologic Oncology Group, the most prestigious cancer research group dealing with gynecological malignancies.

Laboratory research and research training of Gynecologic Oncology Fellows will be under the direction of Linda Duska, M.D.  All training is conducted within the collaborative laboratory efforts of the Gynecologic Oncology Laboratory and the Women's Cancer Group.

All inpatient and outpatient clinical care is provided at the University of Virginia ’s Hospital and Comprehensive Cancer Center , both of which are located at the same site. All Fellowship Training will be conducted at the University of Virginia Medical Center. The Fellow will be supervised and advised by a Faculty Member at all times, allowing for progressively increasing responsibility and independence. Inpatient ward rounds will be carried out as a whole group, led by Fellows in the morning and FFaculty every evening. Medical students, Obstetrics and Gynecology Residents, and Fellows will all participate in rounds, with teaching directed at specific issues of patient management. All surgical aspects of gynecoSogic oncology will be taught by the Gynecologic Oncology Faculty. All radical, intestinal, and urinary tract surgery will be performed by the Fellow with Faculty supervision.

Outpatient teaching is similarly accomplished with direct patient care. With Faculty Supervision, each Fellow will manage new patient evaluations and follow-ups. The Fellows will be actively involved in the assessment and supervision of patients receiving chemotherapy. The entire team of Faculty, Fellows, Residents, and Medical Students will be simultaneously seeing patients in the Cancer Center Surgical Oncology Clinics.

For further information regarding our Fellowships please contact:

Linda Duska, M.D.
c/o Mrs. Tammy Lull, Education Coordinator
University of Virginia Medical Center Department of Obstetrics and Gynecology
P.O. Box 800712 Charlottesville, Va 22908

Phone: 434-924-9930  
Fax: 434-924-9180
email: tl5s@virginia.edu

Progressive Responsibility

At the completion of the Fellowship, the Fellow will be able to function independently as a Gynecologic Oncologist. Continuous evaluation of the Fellow’s competence by all Faculty Members will dictate the level of responsibility and independence that will be provided to each Fellow. The fellow will progress at his/her own pace. The Fellow will not be placed in a situatiFn where skills are required that he/she have not mastered. The faculty is responsible for insuring the Fellow’s maturity from a clinical prospective over the two years. With the daily exposure provided by the Fellow’s schedule, the Faculty will be able to competently assess the Fellow’s progress. Longitudinal patient care will be a key component to our Fellowship Program.

Training is continuously given to both clinical Fellows in Radical Pelvic Surgery, Radiation Therapy, Chemotherapy, and Immunotherapy. The Fellows will coordinate all aspects of patient care that our subspecialty entails. We do feel that the four weeks off-service during the two-year clinical portion of the Fellowship will provide specialized, in-depth training from other clinicians.

The Fellow will be allowed to supervise non-radical surgery performed by the Resident Staff, with Faculty present in the room. Pelvic Surgery for malignant disease will be the sole responsibility of the Fellows with Supervision by the Faculty. The Division of Gynecologic Oncology maintains the responsibility for managing all urinary and bowel complications that may result from the malignancy or from treatment complications.

All patients receiving radiation therapy for gynecologic malignancies at the University of Virginia Health System are co-managed by the Department of Radiation Oncology and the Division of Gynecologic Oncology. All inpatients are on the Gynecologic Oncology Service. The Fellows will be responsible for all care associated with brachytherapy, concurrent chemotherapy, and complications of therapy. All brachytherapy applications will involve fellow participation. The weekly Gynecologic Oncology Tumor Board conference does include all patients treated primarily or secondarily with radiation therapy for pelvic malignancies. This is an interdisciplinary conference and dosimetry will be discussed.

Chemotherapy will be a primary responsibility for the Fellows under the supervision of the Faculty. As stated, we are active members of the Gynecologic Oncology Group. The Fellows will first evaluate all toxicity and complications that may arise with direct supervision by an attending. Four gynecologic oncology nurse clinicians are presently working in the practice and will work closely with the Fellows.

Teaching of Residents and Students

The Fellows, Residents, and Medical Students interact throughout the day, beginning with rounds in the morning. A vast majority of the teaching will be done in the clinical setting. Morning rounds will be led by the Senior Fellow, who will supervise and teach the Residents and Medical Students on the service. In the operating room, the Fellow will supervise the Residents in performing non-radical surgery for gynecologic malignancy.

There will be active participation by the Fellow in the Resident’s Gynecologic Didactic Series. This series will review all topics in Gynecologic Oncology and will require that the Fellow give several lectures to Residents each year. In addition, less formal teaching conferences will be established by the Fellows for the Residents and Medical Students as clinical responsibilities and time allow. The Faculty and Fellow will review the critiques of the Fellow by the Residents and Medical Students at the completion of their rotation.

Benign Gynecology

The Fellows will have no formal responsibility to the benign Gynecology service or the Obstetric service.

Lectures

Fellows will be assigned to give approximately ten lectures and attend multiple educational conferences as listed in Section A.2.c. We will also request that the Fellows present CME lectures (approximately two per year) to Community Obstetric and Gynecology Physicians. These lectures are given under the auspices of arrangements between the University of Virginia Health System and selected Community Hospitals in Lynchburg , Fishersville, and Harrisonburg.

Fellows will present talks at Obstetrics and Gynecology Grand Rounds yearly, and the Senior Fellow will present a paper at Departmental Research Day each June.

Monthly Fellow Rotations

The First Fellowship year is devoted completely to either Laboratory Research or a Master's Degree. The Fellow will work closely with a member of the Clinical Faculty and the Basic Science Faculty in developing and executing a thesis research project. The Fellow’s project will be continued into the clinical portion of the Fellowship (years two and three). Furthermore, Clinical Research projects may be initiated during the research year. During the first year, the Fellow will take required Graduate Level Courses in Statistics and Basic Science.

The second and third years of the Fellowship are devoted to Clinical Training and Clinical Research on the Gynecologic Oncology Service of the Department of Obstetrics and Gynecology as well as Urology, Colorectal Surgery, Radiation Therapy, and Pathology. There is a progression in responsibility, teaching, and leadership in the two years as discussed above.