Houston Methodist Graduate Medical Education
Urology Female Medicine and Pelvic Reconstructive Surgery Fellowship Program
Urology Female Medicine and Pelvic Reconstructive Surgery Fellowship Program To promote the quality of women’s healthcare, our mission is to educate and produce outstanding clinician-scientists by providing comprehensive multidisciplinary education and research at multiple, renowned institutions in the Texas Medical Center, as well as providing in-depth education of health disparities and financial limitations that effect a large number of individuals in the Houston community.
Welcome to Our Future Fellows We appreciate your interest in the Houston Methodist Urology Female Pelvic Medicine and Reconstructive Surgery Fellowship Program! As an established fellowship program for over 30 years, we are pleased to be a newly ACGMEaccredited two-year program. Based at Houston Methodist—ranked as the #1 hospital in the state of Texas by U.S. News and World Report—we are leading in medicine by offering the latest and most advanced technology and treatment options. We combine the highest level of medical expertise with an unparalleled commitment to patient safety and compassionate care. Our program consists of four core faculty members, each specializing in a specific subset of FPMRS. Each subspecialty offers varied experiences in the FPMRS field, including running a subspecialty transitional urology clinic with Rose Khavari, MD, a neurourology expert who heads one of the few clinics in the country for helping young adults with neurourological congenital defects transition to adulthood. Other opportunities include managing a FPMRS community outreach clinic for women without insurance. Our trainees also will acquire and demonstrate medical knowledge of neurologic and idiopathic disorders of the bladder and pelvic floor leading to incontinence, voiding dysfunction and pelvic organ prolapse. Incorporating the most current studies and standards of practice, our fellowship provides education from multiple renowned institutions and faculty from Departments of Obstetrics and Gynecology, Plastic Surgery, Colorectal Surgery and Neurology from Houston Methodist Hospital, MD Anderson Cancer Center and The University of Texas Health Science Center at Houston. Fellows receive extensive training in prosthetics, soft tissue reconstruction and bowel reconstruction led by accomplished faculty who are leaders in their field, with experience in colorectal, urogynecology, neurourology, plastics and reconstructive surgery. I encourage you to explore our website and view our video tour for a first glimpse of the impressive culture we commit to in our fellowship and at Houston Methodist. If you have any questions or concerns, you are welcome to contact me directly. We look forward to seeing you in Houston!
Ricardo R. Gonzalez, MD Associate Professor of Urology Program Director, Urology Female Pelvic Medicine and Reconstructive Surgery Fellowship Program Houston Urology Associates, Houston Methodist
1
Overall Goals & Objectives
The Houston Methodist Hospital Urology Fellowship in Female Pelvic Medicine and Reconstructive Surgery is a multi-disciplinary training program with seven fellowship-trained faculty from both the Departments of Urology and Gynecology. It is part of Houston Methodist’s Center for Restorative Pelvic Medicine.
Fellows primarily divide time between urology and urogynecology during their clinical rotations at Houston Methodist
“
Hospital and MD Anderson Cancer
my fellowship training at Houston
Center in the world-renowned Texas
Methodist Hospital. My training was
Medical Center. This training offers a diverse range of clinical
a perfect balance of both autonomy and support
experiences, including evaluation and
in the operating room, in clinic, and with regard to
management of urinary and fecal incontinence,
research endeavors. Each faculty member exhibited
pelvic organ prolapse, cancer survivorship, voiding and storage dysfunction, pelvic pain, congenital anomalies, neurourology and
unparalleled surgical skill, clinical acumen and mentorship. I still reach out to each of them for
urogenital fistulae. Fellows obtain an extensive
advice as I am starting my own practice. I feel
amount of surgical experience, with large
incredibly lucky to have been afforded the
surgical volumes at both sites, focusing on complex reconstructive surgery with a balance of vaginal, abdominal and minimally invasive laparoscopic and robotic techniques. 2
I could not be more grateful for
opportunity to train with wonderful urologists and people.
”
– Rachel Sosland, MD
FPMRS Opportunities
Clinical and basic science research opportunities with various mentors Multidisciplinary rotations in pelvic floor reconstruction World-class simulation in MITIE surgical facilities
“
Although
our FPMRS fellowship is recently ACGME accredited, it is not a new program. Drs. Timothy Boone and Rodney Appell started this fellowship many years ago and have trained both urologists and gynecologists.
While working with colorectal surgery, plastic surgery and physical therapy, fellows learn integrated approaches to women’s care. The curriculum has
Later, it was modified and included Drs. Timothy Boone
interactive, didactic and multidisciplinary instruction
and Sophie Fletcher. I am
in clinical patient evaluation, pelvic reconstructive
proud to say that I am
surgery, urogynecology, female urology, neurourology
the first graduate of this
and pelvic pain. Additionally, participation in a well-established, comprehensive multidisciplinary
modified track in 2012.
Transitional Urology Clinic supports fellows in
Personally, I love seeing
becoming familiar with the complex care required
how this program has
for patients with congenital genitourinary anomalies
constantly evolved and
when transitioning to adulthood.
progressed to adapt to
Fellows gain robust experience in prosthetic urology, neuromodulation and urinary diversions.
the times and needs of the trainees. Houston Methodist Urology FPMRS Program is a well-rooted
Fellows are involved with continuous scholarly research activity in clinical outcomes or translational research in either urology or urogynecology. The program’s goal is to train graduates of ACGME-accredited urology residency programs with the most advanced clinical education and surgical training in FPMRS to provide the highest standards of care in treating genitourinary and pelvic conditions in women.
fellowship with a strong and solid past and a vision to grow and lead.
”
– R ose Khavari, MD Associate Professor of Urology and Program Director, Urology Residency, Department of Urology Houston Methodist
3
Training the Next Generation of Caregivers & Innovators Houston Methodist faculty trained 41,344 learners in 2020. Our modern interdisciplinary GME and educational programs have access to advanced resources like the MITIESM virtual hospital and procedural skills labs that support evidence-based practice.
1.38M
PATIENT ENCOUNTERS
8,268
775
PHYSICIANS
1,554
PEER-REVIEWED PUBLICATIONS
26,098
FACULTY
136
COLLABORATING COUNTRIES
41,344
EMPLOYEES
920
LEARNERS
1,470
TRAINEES IN RESIDENCE
CLINICAL PROTOCOLS
GRADUATE MEDICAL EDUCATION
336
59
41,344
LEARNERS
RESIDENTS/FELLOWS
4
RESEARCH
GRADUATE MEDICAL EDUCATION PROGRAMS
ALLIED HEALTH
PHYSICIAN NURSING
45
ACGME ACCREDITED
+
14
NON-ACGME ACCREDITED
399 494
PHARMACY
HEALTH CARE
=
303 2,863
4,154 8,474 12, 483 11,898
13,461
HOUSTON, TX
Houston Methodist is based in the heart of the Texas Medical Center, the largest medical center in the U.S.—just a short walk from the city’s museum and art district, zoo and midtown attractions, and a few miles from Houston’s downtown and sports arenas. Houston is a vibrant city comprised of diverse communities that reflect global influences, who enjoy a great variety of cultural amenities, world-class restaurants and a low cost of living. In Houston, more than 145 languages are spoken and one in four residents was born abroad.
“
My fellowship at Houston Methodist under the tutelage of Drs.
Boone, Gonzalez, Khavari, and Stewart was easily the best part of my entire surgical training. During this fellowship, I learned how to perform complex reconstructive surgeries that I had no experience with prior to my fellowship, and this has proven invaluable in my career thus far. I also learned how to work-up aforementioned patients for surgery, perform and read video urodynamics, conduct translational research projects, and manage complicated neuro-urological cases as well as voiding dysfunction. I will forever be grateful for the dedication and teaching of my mentors in this program.
”
– Sanchita Bose, MD
Rotation Sites 1
Our FPMRS program is based at HOUSTON METHODIST HOSPITAL, the flagship facility of the Houston Methodist system, which includes an academic research institute and seven satellite hospitals. Ranked as the #1 hospital in the state of Texas by U.S. News and World Report, Houston Methodist is leading medicine by offering the latest and most advanced technology and treatment options.
2
UT PHYSICIANS SPECIALTY CLINICS During the UT Physician Specialty Clinic Colorectal Surgery (CRS) clinic rotation, fellows work closely with two colorectal surgeons who specialize in pelvic floor dysfunction and fecal incontinence. They work in both the clinical setting and the operating room. The goal of the rotation is to train fellows how to evaluate and treat defecatory dysfunction and conditions such as hemorrhoids, rectovaginal fistula, anal prolapse, anal cancers and other conditions. During the rotation, clinical and surgical supervision will be provided by the CRS faculty, Marianne Cusick, MD, and Michael Snyder, MD, at the University of Texas Health Science Center at Houston.
6
3
EL CENTRO DE CORAZON CLINIC Houston Methodist Urology launched the “Female Urology” Clinic at El Centro de Corazon’s Magnolia Clinic on November 2019, by working in conjunction with the Houston Methodist Scholars Program. The clinic is run by the urology fellow and supervising faculty members Ricardo Gonzalez, MD, Julie Stewart, MD, and Rose Khavari, MD. All three physicians specialize in neurourology, voiding dysfunction, and female urology. The conditions treated at this free community outreach clinic are urinary incontinence, urinary infections, sexually transmitted infections, prolapse, and pain with intercourse. This clinic is scheduled for the first Friday morning of each month.
4
UNIVERSITY OF TEXAS MD ANDERSON CANCER CENTER Trainees are taught the pre-operative evaluation, surgical planning and technical skills to comprehensively manage and correct the functional genitourinary problems of patients with pelvic malignancies—urologic, colorectal, gynecologic and pelvic sarcoma. A special emphasis is placed on the complexities of reconstructing structural and functional urinary tract disorders after surgery and radiation. Endoscopic evaluation, prosthetic urology (artificial sphincter), abdominal and pelvic surgical approaches for urinary reconstruction and diversion are covered by Ouida Westney, MD, in Urologic Oncology at MD Anderson Cancer Center. Fellows work with Thomas Smith, MD, at MD Anderson Cancer Center to gain experience with treating urethral strictures, including urethroplasty. This variety of exposure helps fellows learn how to manage and improve the quality of life of patients with cancer.
UT P SP HY S CL ECIA ICIA IN LT N IC Y S S
Fellows will not have call responsibility at MD Anderson during these rotations.
2
HOUSTON ZOO
3
LVD .
MA IN
ST .
IVE RS ITY B
UTHEALTH MEDICAL SCHOOL
H M OUS O ETH TO CA UTP ODIS N RE ATIE T CE NT NT ER
RICE UNIVERSITY
UN
EL CENTRO DE CORAZON CLINIC
MEMORIAL HERMANN
ST . IN FA NN
HOUSTON METHODIST
1
TEXAS CHILDREN’S PAVILION FOR WOMEN TEXAS CHILDREN’S HOSPITAL TEXAS WOMAN’S UNIVERSITY
HERMA GOLF
BEN TAUB GENERAL HOSPITAL
BAYLOR COLLEGE OF MEDICINE
TIRR MEMORIAL HERMANN
4 CHI ST. LUKE’S HEALTH BAYLOR ST. LUKE’S MEDICAL CENTER
TEXAS HEART INSTITUTE
DB OO SW AE BR
MD ANDERSON CANCER CENTER
. LVD
BAT ES S T.
RONALD MCDONALD HOUSE OF HOUSTON
HOUSTON HOSPICE
HOLCOMBE BLVD.
7 ST.
UTHEALTH SCHOOL OF NURSING
U
W. HOLCOMBE BLVD.
Conferences for Continuing Education & Collaboration
To support continuing education, advance the most innovative treatments, collaborate across institutions and develop leadership opportunities, the Female Medicine and Pelvic Reconstructive Surgery Fellowship regularly participates in the following conferences. INSTITUTIONAL CONFERENCES
NATIONAL CONFERENCES
• Urology Grand Rounds – Once per month
• American Urological Association (AUA)
• Urogynecology Didactics – Twice per month • Urology Journal Club – Once per month • Urogynecology Journal Club – Once per month • Urology Morbidity and Mortality – Once per month • Urogynecology Morbidity and Mortality – Once per Quarter • Urology Research Meeting – Semi Annual • Urogynecology Labs – Annual • TX/OK/NM Fellow Meeting - Once per month
Annual Meetings • Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) Annual Meetings • American Urogynecologic Society (AUGS) Annual Meetings
Houston Methodist Urology Associates Department Faculty Timothy B. Boone, MD, PhD
Brian J. Miles, MD
Professor and Department Chair Chief Education Officer, Houston Methodist Neurourology, Pelvic Reconstructive Surgery, Female Urology
Professor and Department Vice Chair Laparoscopic and Robotic Fellowship Program Director Associate Residency Program Director Oncology, Men’s Health
Rose Khavari, MD
Ricardo R. Gonzalez, MD
Associate Professor Residency Program Director Neurourology, Pelvic Reconstructive Surgery, Female Urology
Adjunct Associate Professor Urology FPMRS Program Director Neurourology, Pelvic Reconstructive Surgery, Female Urology
Julie N. Stewart, MD
Monica Morgan, MD
Assistant Professor Urology FPMRS Fellowship Associate Program Director Neurourology, Pelvic Reconstructive Surgery, Female Urology
Assistant Professor Medical Clerkship Director Oncology, Endourology, Transplant Surgery, Kidney Stones
Raj Satkunasivam, MD
Nery Flores-Sandoval, MD
Assistant Professor Associate Director, Laparoscopic and Robotic Fellowship Program Oncology
Men’s Health, Kidney Stones Neurourology, Pelvic Reconstructive Surgery, Female Urology
Nathan R. Starke, MD Director Men’s Health Center Houston Methodist Urology Associates
Urology Female Medicine and Pelvic Reconstructive Surgery Fellowship Program Houston Methodist Department of Urology 6560 Fannin Street, Suite 2100, Houston, TX 77030 713.441.5861 Meggan Miller, Program Coordinator Mmiller4@houstonmethodist.org
houstonmethodist.org/urology-fpmrs-fellowship
Ranked in 11 Specialties: Cancer Cardiology/Heart Surgery Diabetes & Endocrinology Ear, Nose & Throat Gastroenterology/GI Surgery Geriatrics Gynecology Neurology/Neurosurgery Nephrology Orthopedics Pulmonology/Lung Surgery
HMRI Office of Communications & External Relations | DPT-UR-20-00673 | LC | DH | 02.2021