Minimally Invasive Gynecologic Surgery Fellowship

Department Chairman: Richard Leach, M.D.
Program Director: Joelle Aoun-Abood, MD
Associate Program Director: Annmarie Vilkins, DO
Fellowship Coordinator: Rosalind Gerich (313) 916-1023
Training Sites: Henry Ford West Bloomfield Hospital, Henry Ford Hospital
Accreditation: AAGL
Program Length: 2 years

Program Overview

The Henry Ford Health fellowship in Minimally Invasive Gynecologic Surgery is an AAGL accredited two-year program for those seeking subspecialty training in advanced endoscopic procedures in gynecology that benefits from the clinical volume and breadth of an urban-based integrated health system.

Our MIGS division was established in 2003, and accompanies subspecialty divisions in urogynecology, oncology, reproductive medicine, and maternal fetal medicine. The training takes place at the Henry Ford Hospital and Henry Ford West Bloomfield Hospital, where the fellow performs a full range of minimally invasive services including robotic, straight laparoscopic and vaginal surgeries. Each surgical facility includes devoted robotic procedure rooms and a sophisticated medical simulation center, in which the fellow will both receive and give training.
The clinical focus of the fellowship is benign surgical gynecology, and is dense with fibroid management, endometriosis, pelvic pain, and menstrual disorders. The Fellow operates at least three full days a week and attends clinics for chronic pelvic pain and surgical referrals. In addition to achieving excellence in advanced gynecologic surgery, one of the major tenets of the Fellow’s training is thoughtful and comprehensive perioperative management. By leading the department’s weekly benign gynecology preoperative conference, the Fellow becomes well-versed in medical optimization, strategic intraoperative planning, and postoperative care. The gynecology department overall depends on the MIGS division to support best practices in ensuring patients achieve optimal surgical outcomes. The Fellow also becomes an expert in collaboration, aiding the MIGS faculty as both the intraoperative consult and as a resource for preoperative planning for the generalist group.

In order to further expand the Fellow’s advanced gynecologic exposure, off-service rotations include urogynecology, colorectal surgery, and gynecologic oncology. This allows for a deeper understanding of pelvic anatomy and the creation of an expansive surgical toolkit ensuring the Fellow graduates with the confidence to tackle the toughest of cases. The Fellow will also spend substantial time in the Clinic for Chronic Pelvic Pain and Endometriosis, which is a multi-disciplinary clinic staffed by a physician, psychologists specializing in chronic pain, and physical therapists trained in pelvic floor therapy. Many of our conservative and extirpative procedures for endometriosis originate in this clinic. Robotic-assisted laparoscopy is also a priority in our program and the fellowship program will graduate individuals ready to develop robotic programs at their future home institutions. The division currently utilizes six robotic platforms at two campuses.

Teaching is integral to the fellowship, and the Fellow will become an expert in the use of the educational resources in our institution, both in their own training, and in training residents. The department of Women’s Health provides training for five residents per year, as well as rotating students from Wayne State University School of Medicine. The Fellow will participate fully in the organization and implementation of our curriculum in minimally invasive surgery and will gradually assume more responsibility as a teacher throughout the two years. From being responsible for resident surgical education in the first year to transitioning to a consultant under the responsibility of the director in the second year, the Fellow will graduate with the skill set to be an expert in all areas of gynecologic care. The department has committed itself to graduating residents who have proven competencies in laparoscopic surgery both in the simulation lab and in the operating room and the Fellow is integral in assisting in the growth of resident surgical skills. Women’s Health has certified our residents in the Fundamentals of Laparoscopic Surgery (FLS) course for many years, and the fellow does much of the proctoring of residents during their preparation for the exam. Residents staff most surgeries, and fellows are expected to lead the case as soon as they are ready, typically within the first few months of fellowship.

The Fellow has twenty percent protected time for research, where the emphasis is on designing and implementing comparative studies. The fellow participates in clinical research protocols ongoing in the department, leading to papers submitted to peer-reviewed journal and presented at AAGL and other national conferences. Research time is also used to contribute to the division’s surgical video library. The Fellow receives compensation and benefits standard in the institution for the PGY-5/6 level. The Fellow is designated as junior faculty, and receives hourly moonlighting pay for any in-house hospital coverage, typically twice monthly. The benefits package includes paid vacation and support for attendance at AAGL, with additional support for travel for all major presentations at other conferences.

Didactics & Teaching Program

The Department of Obstetrics and Gynecology provides a rigorous educational program for the residents, students, and faculty. The fellow is provided with protected teaching time every Monday, including monthly grand rounds incorporating teaching cases, journal club and M & M conference.

Additional regularly scheduled conferences include:

• DEI Conference (monthly)
• Benign Pre-Op Conference (weekly, Mondays)
• Grand Rounds (monthly)
• Journal Club(monthly)
• Morbidity & Mortality Conference (4th & 5th Wednesdays)
• MIGS Fellow Lecture Series

Unique Programs

System-wide Healthcare Equity Campaign, focused on raising awareness, improving cross cultural communication, and integrating changes into system policies.

Institute on Multicultural Health (IOMH) is working to develop effective and innovative approaches to providing quality healthcare to underrepresented racial and ethnic populations who are disproportionately affected by serious and chronic medical conditions

Multiple training opportunities for health system leaders and team members in health care equity, culturally appropriate care, and diversity and inclusion topics including Unconscious Bias training.

Employee Resource Groups (ERGs) for women, veterans, caregivers, individuals living with a disability, Hispanic/Latino, Middle Eastern, African American, Millennials, and LGBTQ team members.

A supplier diversity program nationally recognized for fostering the growth of small, women-owned, and minority-owned businesses

Academic Conferences

Fellows receive support to attend academic conferences if they are presenting a paper or an abstract in which they are listed as the first author.

• AAGL
• other national conferences

Research

Henry Ford Health is nationally-recognized for both clinical and basic research. Our academic health center is the leading non-university recipient of research funding ($80 million) in Michigan and is in the top 20% of NIH-funded institutions nationally. Hands-on research experience complements resident education in Women’s Health; thus, every resident is expected to finalize one resident research project with a manuscript and oral presentation. Mentorship, protected time on selected rotations during the PGY-5 & 6 years, and both funding- and biostatistician-support are available through GME.

As part of the fellowship, fellows are required to complete an independent research project with MIGS faculty and/or faculty. The fellow will be assigned a primary research mentor during their first year. Each fellow is encouraged to design and conduct at least one randomized-controlled clinical trial and one quality improvement project during their training.

Fellow Wellness

With the leadership of Dr. Lisa MacLean, past Program Director for Psychiatry and Assistant Dean for Students, Wayne State University School of Medicine, Henry Ford is using a The Physician Well-being Index, developed by the Mayo Clinic, to allow physicians to self-monitor themselves. This is being complemented by monthly “Wellness Rounds”. The “We Care” program is intended to help physicians and physicians in training is to maintain optimal health and well-being through education (strategies to maintain health and wellness), peer support, timely assessment of needs, and resources for healing.

The “We Care” Physician Wellness Program demonstrates a commitment to the well-being of our physicians in helping them achieve greater satisfaction in their careers and in their personal lives.