Gynecology

The goals of the fellowship program in pediatric and adolescent gynecology 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; and primary or co-investigators in clinical research projects.

Objectives designed to achieve these goals are to:

1. Communicate effectively with girls of all ages to establish rapport, obtain a reliable medical history, facilitate adherence to medical recommendations and promote healthy lifestyles.
2. Communicate effectively with families to encourage adult involvement while respecting individual patient rights to privacy and confidentiality.
3. Recognize the value of and contribute to an interdisciplinary team approach to adolescent healthcare.
4. Be aware of the medico-legal aspects of pediatric and adolescent gynecology and be able to cite relevant state laws.
5. Understand how psychosocial development during adolescence affects gynecological health and healthcare.
6. Differentiate normal from abnormal sexual development during childhood.
7. Differentiate normal from abnormal female pubertal development.
8. Counsel patients and families about pubertal development, menstrual function, sexual health and sexual risk behaviors.
9. Recognize and manage the childhood antecedents of common adult diseases in females, such as obesity, osteoporosis and polycystic ovary syndrome.
10. Diagnose and manage common gynecologic problems of childhood (vaginal discharge, vulvar rashes, condyloma, labial adhesions, imperforate hymen).
11. Evaluate and manage genital trauma.
12. Screen children and adolescents for sexual, physical and emotional abuse as part of routine gynecologic care and know how to respond if suspected.
13. Know how to manage patients with physical sequelae of past abuse.
14. Recognize and screen for depression, suicidal ideation and other mental health problems and know how to respond if detected.
15. Evaluate an adolescent for abnormalities of pubertal development, including precocious puberty, abnormal bleeding, delayed puberty and primary and secondary amenorrhea.
16. Evaluate and manage congenital anatomic anomalies (imperforate hymen, vaginal septa, uterine duplications, vaginal agenesis).
17. Evaluate and manage hyperandrogenism and its sequelae (hirsutism, acne, abnormal bleeding, insulin resistance, obesity, hypertension).
18. Manage the adolescent with ovarian cysts.
19. Manage the adolescent with chronic pelvic pain and understand the indications for operative intervention.
20. Understand the indications for and the performance of laparoscopy in children and adolescents.
21. Evaluate and manage adolescents with endometriosis.
22. Independently perform common surgical procedures (diagnostic laparoscopy, surgical ablation of genital warts, ovarian cystectomy, management of ovarian torsion).
23. Serve as a consultant to other health professionals, demonstrating appropriate written and verbal communication skills.
24. Guide primary care providers in the care of common menstrual problems during adolescence (primary dysmenorrhea, oligomenorrhea).
25. Manage or provide consultation regarding the diagnosis and management of early pregnancy and its complications.
26. Manage or provide consultation regarding the management of abnormal bleeding.
27. Manage or provide consultation regarding the induction of therapeutic amenorrhea and management of menstrual suppression.
28. Manage or provide consultation regarding gynecologic problems of individuals with physical and mental disabilities and handicaps.
29. Manage or provide consultation regarding gynecologic issues for young women with chronic diseases.
30. Evaluate and manage genital warts, HPV infection, abnormal cervical cytology, including cervical dysplasia in adolescents.
31. Evaluate, manage and counsel patients with sexually transmitted infections, including pelvic inflammatory disease.
32. Participate in the management of patients with gynecologic tumors.
33. Practice in an appropriate and collegial manner as a member of an interdisciplinary team of colleagues.
34. Become familiar with clinical research methodology and be able to develop hypotheses, design a research study, conduct analyses and write a research manuscript.
35. Submit at least one abstract to a national meeting and develop a manuscript for publication in a peer-reviewed journal.
36. Complete at least one review article or chapter for publication.

It is anticipated that applicants will have successfully completed a residency in obstetrics and gynecology. They will have taken the written examination given by the American Board of Obstetrics and Gynecology, given in June of their last year of residency training.

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 60 percent effort for direct patient care and 40 percent for research and other scholarly activities.

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.