Goals, Objectives and Training
Goals | Objectives | Training Duration
Yearly Number of Trainees | Funding Sources | Program Impact
The goals of the Pediatric and Adolescent Gynecology Fellowship Program at Cincinnati Children's Hospital Medical Center are to prepare its graduates to serve as:
- Expert clinical consultants in the management of children and adolescents with gynecological problems
- Educational leaders in the field of pediatric and adolescent gynecology
- Advocates for the provision of high quality, accessible gynecological services to all children, adolescents and adult women
- Primary or co-investigators in clinical research projects
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Specific objectives designed to achieve these goals are as follows:
- Communicate effectively with girls of all ages to establish rapport, obtain a reliable medical history, facilitate adherence to medical recommendations and promote healthy lifestyles.
- Communicate effectively with families to encourage adult involvement while respecting individual patient rights to privacy and confidentiality.
- Recognize the value of and contribute to an interdisciplinary team approach to adolescent healthcare.
- Be aware of the medico-legal aspects of pediatric and adolescent gynecology and be able to cite relevant state laws.
- Understand how psychosocial development during adolescence affects gynecological health and healthcare.
- Differentiate normal from abnormal sexual development during childhood.
- Differentiate normal from abnormal female pubertal development.
- Counsel patients and families about pubertal development, menstrual function, sexual health, and sexual risk behaviors.
- Recognize and manage the childhood antecedents of common adult diseases in females, such as obesity, osteoporosis and polycystic ovary syndrome.
- Diagnose and manage common gynecologic problems of childhood (e.g., vaginal discharge, vulvar rashes, condyloma, labial adhesions, imperforate hymen).
- Evaluate and manage genital trauma.
- Screen children and adolescents for sexual, physical and emotional abuse as part of routine gynecologic care and know how to respond if suspected.
- Know how to manage patients with physical sequelae of past abuse.
- Recognize and screen for depression, suicidal ideation and other mental health problems and know how to respond if detected.
- Evaluate an adolescent for abnormalities of pubertal development, including precocious puberty, abnormal bleeding, delayed puberty, primary and secondary amenorrhea.
- Evaluate and manage congenital anatomic anomalies (e.g., imperforate hymen, vaginal septa, uterine duplications, vaginal agenesis).
- Evaluate and manage hyperandrogenism and its sequelae (hirsutism, acne, abnormal bleeding, insulin resistance, obesity, hypertension).
- Manage the adolescent with ovarian cyst(s).
- Manage the adolescent with chronic pelvic pain and understand the indications for operative intervention.
- Understand the indications for and the performance of laparoscopy in children and adolescents.
- Evaluate and manage adolescents with endometriosis.
- Independently perform common surgical procedures (e.g., diagnostic laparoscopy, surgical ablation of genital warts, ovarian cystectomy, management of ovarian torsion).
- Serve as a consultant to other health professionals, demonstrating appropriate written and verbal communication skills.
- Guide primary care providers in the care of common menstrual problems during adolescence (e.g., primary dysmenorrhea, oligomenorrhea).
- Manage or provide consultation regarding the diagnosis and management of early pregnancy and its complications.
- Manage or provide consultation regarding the management of abnormal bleeding.
- Manage or provide consultation regarding the induction of therapeutic amenorrhea and management of menstrual suppression.
- Manage or provide consultation regarding gynecologic problems of individuals with physical and mental disabilities and handicaps.
- Manage or provide consultation regarding gynecologic issues for young women with chronic diseases.
- Evaluate and manage genital warts, HPV infection, abnormal cervical cytology, including cervical dysplasia in adolescents.
- Evaluate, manage, and counsel patients with sexually transmitted infections, including pelvic inflammatory disease.
- Participate in the management of patients with gynecologic tumors.
- Practice in an appropriate and collegial manner as a member of an interdisciplinary team of colleagues.
- Become familiar with clinical research methodology and be able to develop hypotheses, design a research study, conduct analyses, and write a research manuscript.
- Submit at least one abstract to a national meeting and develop a manuscript for publication in a peer-reviewed journal.
- Complete at least one review article or chapter for publication.
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The duration of the fellowship in Pediatric and Adolescent Gynecology is two years, starting in July and continuing for two academic years. In general, the fellow will be expected to devote 70% percent effort for direct patient care, 10% for teaching and 20% for research and other scholarly activities.
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The number of fellows per year will depend on two factors: clinical volume and applicant strength. Initially, we anticipate only one new fellow per year, with an overlap during the second year.
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The goals and objectives of the fellowship center on clinical experience as a gynecology member of a health professional team. The fellow provides direct clinical services to patients and, as a board-eligible or board-certified obstetrician-gynecologist in a field that does not hold sub-certification, can bill for the services provided. The clinical revenues generated from these clinical activities support 65% of the fellow's salary and benefits. The remaining 35% is supported through the standard allocation to all fellows in the Department of Pediatrics from the Chairman. Candidates who are accepted into the Pediatric and Adolescent Gynecology Fellowship Program will be required to complete the Cincinnati Children's Medical Staff credentialing processes to achieve hospital privileges, maintain eligibility for professional liability insurance, successfully complete the on-line compliance training tool and tests and be enrolled as a provider in third-party payer plans.
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In the past, the Division of Adolescent Medicine has had funding from the Maternal and Child Health Bureau, which has an interdisciplinary team of fellows from the disciplines of:
- Pediatrics
- Nursing (Nurse Practitioner)
- Nutrition
- Psychology
- Social Work
Currently, the Division of Adolescent Medicine has physician fellows. While the interdisciplinary fellowship funding is no longer in place, a well-developed, well-established, nationally recognized curriculum for fellows has been developed as a result of the division's strength and history in these areas, and the addition of a fellow in Pediatric and Adolescent Gynecology will strengthen the interdisciplinary nature of interactions with fellows in Adolescent Medicine.
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