Urogynecology & Reconstructive Pelvic Surgery Fellowship

The Urogynecology & Reconstructive Pelvic Surgery Fellowship at Massachusetts General Hospital aims to train female pelvic medicine and reconstructive surgery (URPS) leaders in an environment that maximizes everyone’s potential and leverages available opportunities within our clinically and academically rich institution, providing broad and balanced training. This allows our graduates to be:

• Excellent clinicians capable of practicing independently as consultants and subspecialists in a variety of clinical practice models
• Experts in complex pelvic surgeries

We aim to support a collaborative and multidisciplinary environment where fellows participate in level-appropriate experiences and sharpen their teaching and mentoring skills by working with students and residents.

We promote lifelong scholarly practices through a year-long basic science training that includes all aspects of designing, executing, analyzing and presenting a hypothesis-driven research project.

We aim to establish lifelong evidence-based clinical practices through teaching system-based analysis and quality improvement, critical thinking, and research interpretation.

We strive for an environment that promotes diversity, wellness, resiliency, and the achievement of personal goals through mentoring.

The Urogynecology & Reconstructive Pelvic Surgery Fellowship is an ACGME-accredited program that started in 2012.

The program structure includes:

• One year of dedicated research
• Two years of clinical experience

One position is offered each year. We accept urology and gynecology resident applicants.

Location

The primary site of the fellowship is Massachusetts General Hospital's main campus in Boston, MA. Mass General is a tertiary care center with approximately 1,000 beds and more than 1,000 physicians. Fellows will evaluate and manage patients in the outpatient setting on the main campus, as well as Newton-Wellesley Hospital. Major surgical cases and same-day surgical cases are performed on the main campus. Same-day surgical cases can also be performed at Newton-Wellesley Hospital.

Clinical Experience

As a fellow, you will learn how to evaluate, manage, and treat patients with primary pelvic organ prolapse and bladder control problems as well as complex pelvic floor disorders, including urethral diverticulum, vesicovaginal or rectovaginal fistula, and pelvic floor myofascial pain.

Fellows are trained to perform the full scope of surgical procedures, including:

• Laparoscopic & robotic sacrocolpopexy
• Vaginal hysterectomy
• Vaginal apical suspension procedures
• Slings
• Bulking injection procedures
• Sacral neuromodulation
• Peripheral nerve stimulation
• Fistula repair
• Vaginal laser therapy

In addition, we perform concomitant surgical procedures with our colorectal colleagues, such as laparoscopic sacrocolpopexy with rectopexy.

Fellows will also work within our active Center for Pelvic Floors Disorders, which is a multidisciplinary service composed of URPS, colorectal, urology, and gastroenterology faculty and physical therapists. We work closely with our colleagues to manage patients who have complex pelvic floor disorders. We meet monthly to discuss the evaluation and management of patients with complex pelvic floor disorders.

During the third year of fellowship, fellows rotate through colorectal, urology, and physiatry electives. Fellows can also spend time with pelvic floor physical therapists.

Call

Fellows take home pager calls, covering the URPS service only. Call is split between the three fellows with a faculty member also assigned to the call. Fellows do not have any in-house call, and do not do any obstetrics.

Mass General complies with the Accreditation Council for Graduate Medical Education (ACGME) duty-hour requirements.

Moonlighting

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

Research Experience, Courses and Conferences

Fellows spend 12 consecutive months in research during their 2^nd year of fellowship. While on this rotation, the fellow’s time is protected for research but he or she may be available for up to 4 hours of clinical duties weekly to maintain surgical skills and continued clinical learning. Fellows are also given research time while on clinical rotations, on average a half day weekly. In accordance with guidelines from ABOG and ACGME, all fellows develop a thesis project, which they defend in their third year of fellowship.

In these dedicated 12 months of research, fellows conduct basic science research with Dr. Caroline Mitchell within the Vincent Center for Reproductive Biology. As part of this lab, they contribute to the ongoing understanding of interactions between the human microbiome and reproductive health. They receive personalized mentorship to develop skills in reading and writing basic science literature and pursue their own projects while also being an active part of the lab. In addition to bench research, fellows also have access to a multitude of courses and conferences through Massachusetts General Hospital’s Clinical and Translational Research Institute, which they have ample opportunity to explore during these protected 12 months.

Fellows are supported to present their scholarly work at conferences, including the American Urogynecologic Society (AUGS), International Urogynecological Association (IUGA), and other appropriate conferences. In addition, each fellow is given a stipend to fund the purchase of textbooks, research software programs, society memberships, and travel to meetings upon pre-approval of the Program Director.

Catalyst

Fellows complete an applied biostatistics course through Harvard Catalyst during their research year. They also have the opportunity to take courses at the Harvard T. H. Chan School of Public Health, the Mass General Research Institute/Division of Clinical Research, and other entities throughout the Mass General Brigham system.

Harvard Catalyst/The Harvard Clinical and Translational Science Center is dedicated to improving human health by enabling collaboration and providing tools, training, and technologies to clinical and translational investigators. Harvard Catalyst is a shared enterprise of Harvard University, its 10 schools, and its 17 Academic Healthcare Centers (AHC), as well as the Boston College School of Nursing, MIT, Harvard Pilgrim Health Care, and numerous community partners. Harvard Catalyst offers more than a dozen courses and training programs, ranging from short courses on translational and clinical research to degree-granting multi-year advanced education and training programs.

Mass General Clinical Research Program

The Mass General Clinical Research Program (CRP) provides support for investigators and study teams and education for all involved in clinical research to ensure the best clinical research practices. Courses ranging from hour-long seminars to semester-long commitments are available on a wide range of topics such as IRB submission, obtaining informed consent, basic biostatistics, human genetics, clinical trial design, grant writing and research budget management. Most of these courses are free of charge, but for those with fees, the fellowship will provide tuition on a case-by-case basis.

CPIP: Clinical Process Improvement Leadership Program

All fellows are required to complete a quality improvement project prior to graduation. Mass General is a part of Mass General Brigham enterprise that offers training in CPIP: Clinical Process Improvement Leadership Program. Fellows are encouraged to participate in this program which gives them tools to evaluate and improve processes as part of a team over four months.

Libraries/Online Journals

The Treadwell Library, health sciences library for the Mass General community, is easily accessible through its vast electronic resource center. In addition, fellows have access to Harvard Medical School’s Countway Library, which offers major journals from all medical specialties, as well as specialty-specific journals including the International Urogynecology Journal, Urology, the Journal of Urology, and Neurourology and Urodynamics.

For fellows interested in retrospective reviews, our electronic medical records provide ample opportunity for this type of research, as well as the available staff at the Medical Records offices.

Didactics

Fellows attend a comprehensive schedule of didactic lectures, including:

• Weekly URPS-specific didactics, which include multi-disciplinary faculty presentations and fellow-led chapter reviews
• Grand rounds
• M&Ms
• URPS city-wide quarterly journal club meetings
• URPS region-wide biannual meetings (very complex URPS patients are discussed)
• Pelvic Floor Disorder Center conference

Applicant Requirements

Applicants must have satisfactorily completed either an:

• Obstetrics and gynecology or urology residency accredited by the ACGME
• Obstetrics and gynecology or urology program located in Canada and accredited by the Royal College of Physicians and Surgeons of Canada (RCPSC) (ACGME URPS Requirement III.A.1.)

How to Apply

The program will adhere to the AUGS Fellowship Training Committee’s standardized process for interviews with dates updated in accordance with the AUGS Fellowship Application calendar:

• November 13, 2024: ERAS opens for application submission
• January 21, 2025: Application deadline for consideration of first round of interview offers
• February 10, 2025: First round of interview offers delivered electronically by 9:00 pm ET
• February 13, 2025: Deadline to accept/decline first round interview offers by 9:00 pm ET. Failure to respond will be considered declining the invitation. Subsequent interview offers may then be extended to candidates who are waitlisted or submitted applications after the January deadline
• May 2, 2025 and May 16, 2025: Virtual interviews
• August 1, 2026: Fellowship position begins

Candidates should apply through the ERAS Fellowships online application service. All applications through ERAS Fellowships must include:

• ERAS Common Application Form: professional societies, publications, and other relevant information about your education or experience. Any information you put on your curriculum vitae should be included
• Personal statement of professional goals
• Official transcripts: Each graduate school and/or medical school you attended. Please provide certified or notarized English translations of documents if the documents are not written in English. We do not need undergraduate transcripts
• Dean's letter/Medical School Performance Evaluation (MSPE)
• Official test transcripts for all applicable examinations (USMLE, LMCC, COMLEX, NBOME, FMGEMS, FLEX, or NBME)
• Valid ECFMG certificate. Required if you graduated from a medical school outside the United States or Canada
• Three original letters of recommendation from physicians or faculty members who are familiar with your work. One letter must be from your residency program director. You may submit more than three letters of recommendation if you wish

The following items should be sent via email to Jessica RoySmith (jroysmith@mgh.harvard.edu), to be added to your ERAS Fellowship Application locally, as they are not accepted by ERAS for scanning:

• Copy of completion certificate(s) from each of your prior residency and/or fellowship training programs. Required if you have completed a residency and/or fellowship program previously.
• CREOG annual examination scores. Include score reports from PGY 1-3 if you are still in residency and PGY 1-4 if you have completed residency training

Experienced Leadership

Mentoring partnerships with an experienced faculty offer our fellows the opportunity to learn how to evaluate, manage and treat patients a variety of pelvic issues.

Urogynecology & Reconstructive Pelvic Surgery Faculty

Milena Weinstein, MD
Division Chief, Urogynecology and Reconstructive Pelvic Surgery

Emily Von Bargen, DO
Program Director, Fellowship in Urogynecology and Reconstructive Pelvic Surgery

Youngwu Kim, MD
Associate Program Director, Fellowship in Urogynecology and Reconstructive Pelvic Surgery

May Wakamatsu, MD
Vice Chair, Gynecology, OB/GYN

Kristin Hung, MD

Marcus Ortega, MD

Lori Berkowitz, MD
Vice Chair, Education & Wellbeing, OB/GYN

Research Faculty

Caroline Mitchell, MD
Director, Vulvovaginal Disorders Program, OB/GYN, Mass General

Urology Faculty

Lori Jones, MD

Colorectal Surgery Faculty

Liliana Bordeianou, MD, MPH
Chief, Colorectal Surgery Program
Co-Director, Pelvic Floor Disorders Center

Hiroko Kunitake, MD, MPH