6 PROGRAM REQUIREMENTS FOR7 FELLOWSHIP IN MINIMALLY ... · page 2 of 22 rev 6 – fmigs board...

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1 Rev 6 – FMIGS Board Approved 4.2.19

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Fellowship in Minimally Invasive Gynecologic Surgery 3

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Effective July 1, 2019 5

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PROGRAM REQUIREMENTS FOR 7

FELLOWSHIP IN MINIMALLY INVASIVE GYNECOLOGIC SURGERY 8

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Direct Correspondence To: 22

6757 Katella Avenue, Cypress, CA 90630-5105, USA 23

Ph: (800) 554-2245 or (714) 503-6200 * Fax: (714) 503-6202 24

E-mail: [email protected]. Website: www.fmigs.org 25

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mailto:[email protected]

http://www.fmigs.org/

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Table of Contents 27

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A. INTRODUCTION 4 29

B. MISSION 4 30

C. GOALS 4 31

D. FELLOWSHIP TRAINING PROGRAM REQUIREMENTS 4 32

1. FELLOWSHIP DIRECTOR 4 33

2. CORE FACULTY 6 34

3. FACILITIES 6 35

E. EDUCATIONAL OBJECTIVES 7 36

F. CURRICULUM 7 37

1. SCHEDULE 8 38

G. RESEARCH 9 39

1. RESEARCH TRAINING 9 40

2. RESEARCH PROJECTS 9 41

H. COMPETENCIES 10 42

I. FELLOWSHIP DATES, LEAVE AND TRANSFER 10 43

J. TRANSFER POLICY 11 44

K. REQUIREMENTS FOR GRADUATION 11 45

L. EVALUATIONS 12 46

1. FELLOW EVALUATIONS 12 47

2. FACULTY EVALUATION 13 48

3. PROGRAM EVALUATION 13 49

M. INSTITUTIONAL COMMITMENT 13 50

N. POLICIES 14 51

1. ANTI-HARASSMENT POLICY 14 52

2. GRIEVANCE POLICY 14 53

O. DISCIPLINARY ACTION / DUE PROCESS 14 54

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P. ACCREDITATION OF FELLOWSHIP PROGRAMS 16 55

Q. DUTY HOURS 17 56

R. STIPEND AND BENEFITS 17 57

S. APPLICATION PROCESS 18 58

T. MATCH 18 59

U. FURTHER INFORMATION 19 60

V. APPENDIX 1: COMPETENCIES 20 61

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REQUIREMENTS FOR A POST-GRADUATE FELLOWSHIP IN THE SUBSPECIALTY AREA OF 64

MINIMALLY INVASIVE GYNECOLOGIC SURGERY 65

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A. Introduction 67

Fellowships in Minimally Invasive Gynecologic Surgery (FMIGS) are intensive 68

training programs preparing the graduate for advanced minimally invasive 69

gynecologic surgery (MIGS) expertise. The FMIGS Board is a Professional Interest 70

Partner under the auspices of the AAGL and accredits all FMIGS programs. 71

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B. Mission 73

The mission of the fellowship is to provide a uniform training program for 74

gynecologists who have completed residency in obstetrics and gynecology and 75

desire to acquire additional knowledge and surgical skills in minimally invasive 76

gynecologic surgery (MIGS) so they may: serve as a scholarly and surgical resource 77

for patients and referring physicians; have the ability to care for patients with 78

complex gynecologic surgical disease via minimally invasive techniques; establish 79

sites that will serve a leadership role in advanced endoscopic and reproductive 80

surgery; and further research in minimally invasive gynecologic surgery. 81

82

C. Goals 83

The overall goal of the fellowship is for the graduate to serve as an independent 84

specialist and consultant in the surgical management and techniques of advanced 85

benign minimally invasive gynecology at a level surpassing competence expected 86

by completion of a categorical residency. 87

88

D. Fellowship Training Program Requirements 89

The MIGS Fellowship consists of a minimum of two years of continuous education, 90

training, and research following completion of an obstetrics and gynecology 91

residency. 92

93

1. Fellowship Program Director 94

The fellowship director is ultimately responsible for the design and 95

implementation of the fellowship-training program. 96

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There must be a single fellowship director with authority and accountability 98

for the operation of the program. The sponsoring institution (e.g. Designated 99

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Institutional Official, department chairperson) and the FMIGS Board must 100

approve the fellowship director. 101

1. The fellowship director must commit to his/her position for a length 102

of time adequate to maintain continuity of leadership and program 103

stability. 104

105

The fellowship director must: 106

1. Have surgical training and clinical experience 107

2. Have documented scholarly expertise in MIGS by: 108

1. publication of at least one original research or review article in a 109

peer-reviewed journal within the past two years and at least of two 110

of the three items within the past two years: 111

a. peer-reviewed funding 112

b. presentation at regional or national professional and 113

scientific society meetings 114

c. serve as a reviewer for a major journal 115

3. Have educational and administrative experience 116

4. Maintain current certification by the American Board of Obstetrics and 117

Gynecology or be a current Fellow of the Royal College of Surgeons in 118

Canada 119

5. Have completed a fellowship in MIGS, Gynecologic Oncology (GO), Female 120

Pelvic Medicine and Reconstructive Surgery (FPMRS) or Reproductive 121

Endocrinology and Infertility (REI) for any new or incoming fellowship 122

director 123

6. Have current medical licensure and appropriate medical staff appointment 124

7. Have a minimum of 4 years’ independent practice post-fellowship 125

experience 126

8. Directly supervise the education and mentoring of fellows to ensure that 127

they receive the appropriate clinical instruction and training to provide 128

safe patient care 129

9. Ensure that each fellow completes the research requirements by assigning 130

a research mentor and monitoring compliance 131

10. Evaluate and document the fellow’s performance as described below 132

11. File an Annual Report with the FMIGS Board 133

12. Respond in a timely fashion (within ten days) to any inquiry made by the 134

FMIGS Board or Site Review and Compliance committee 135

13. Be an active member of the AAGL and in good standing 136

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137

The fellowship director must identify at minimum one Associate Program Director 138

with defined responsibilities that includes acting on behalf of the fellowship 139

director if he/she is not available. If the fellowship director and Associate Program 140

Director(s) are not able to provide training oversight, it will be the responsibility 141

of the sponsoring institution or department to identify a qualified fellowship 142

director who is available and willing to provide the fellow with the required 143

training. Fellowship programs can identify additional Associate Program Directors 144

for oversight at additional training sites (see below). 145

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Fellowship Director Changes 149

The FMIGS Board must approve a change in fellowship director. A letter must be 150

sent electronically to the FMIGS office (within 30 days) and indicate the 151

resignation of the fellowship director and the appointment of an interim 152

fellowship director until the matter has been considered by the Board. The Board 153

reserves the right to require additional information and/or site visit. 154

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2. Core Faculty 156

There must be adequate faculty with special interest, expertise, and scholarly 157

activity related to MIGS that participate in the care of patients and the 158

education of fellows. 159

160

3. Facilities 161

1. All MIGS fellowships (with the exception of military programs) must be 162

affiliated with an accredited training program(s) as required by the 163

National Resident Matching Program (NRMP; www.nrmp.org). The 164

educational program must be sponsored by an ACGME-accredited 165

institution or participating site. 166

2. The primary hospital facilities must be equipped to provide state-of-the-167

art inpatient and outpatient MIGS experiences. Office and ambulatory 168

care facilities must also be appropriately equipped including office 169

hysteroscopy. 170

3. Clinical information systems or libraries and/or online information 171

systems, including those relevant to the subspecialty, must be readily 172

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available as resources for patient care and clinical research at the host 173

institution. 174

4. A breadth of skills and simulation training must be integrated into 175

fellowship instruction. 176

5. Research support must be available. 177

6. Animal and cadaver training experiences are desirable. 178

7. A program may utilize more than one patient–care facility. If more than 179

one site is used, there must be a Program Letter of Agreement (PLA) with 180

the ancillary site(s) and appropriate faculty, updated every 5 years. An 181

Associate Program Director may be designated to oversee fellow training 182

at each ancillary site. The ancillary site(s) will receive the same approval 183

period accredited to the program unless there are changes to the ancillary 184

site. 185

The Program Letter of Agreement (PLA) must: 186

A) Identify the faculty and possibly Associate Program Director who will 187

assume both educational and supervisory responsibilities for fellows 188

B) Specify responsibilities of the above faculty for teaching, supervision, and 189

formal evaluation of fellows 190

C) Specify the duration and content of the educational experience 191

D) Specify the fellow’s responsibilities at the ancillary institution. 192

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E. Educational Objectives 194

All Educational Objectives (https://bit.ly/2IsgtLZ) are directed toward the 195

standardization of training in minimally invasive gynecologic surgery. These 196

objectives must be addressed in a structured and systematic manner during the 197

training period. The fellowship director must ensure that fellows are provided and 198

encouraged to complete the FMIGS Core-Reading List (https://bit.ly/2q2NIec) and 199

surgical video curriculum (https://bit.ly/2IoLPPC). 200

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F. Curriculum 202

1. Didactic. Education of fellows must include structured teaching conferences, 203

seminars, and didactic instruction in both basic science and clinical aspects of 204

the specialty as outlined in the Educational Objectives. The fellow’s schedule 205

and responsibilities must be structured and protected (i.e. free of clinical 206

duties) to allow regular attendance at didactics, simulation training, and 207

national conferences. Fellows must have progressive teaching responsibilities 208

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for resident physicians and ideally with all types of learners (e.g. medical 209

and/or nursing students). 210

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2. Clinical. The clinical experience of inpatient and outpatient care must include 212

a sufficient number and variety of cases to fulfill the Educational Objectives. 213

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A) The fellow must be involved with the preoperative planning and care, the 215

surgical care, and the postoperative management of surgical patients. 216

B) Surgical experience is particularly important and must be carefully 217

organized and supervised by the fellowship director and clinical faculty. 218

The fellow must be capable of performing all appropriate diagnostic and 219

therapeutic procedures relevant to the clinical practice of the subspecialty. 220

During the course of the educational program, the fellow must be 221

supervised in all clinical activities, including surgical procedures. The 222

FMIGS Surgical Competency List (https://bit.ly/2FIXrih) must be used and 223

completed for each fellow by the end of the fellowship training. 224

C) Surgical procedures available for the fellow must include but are not 225

limited to: diagnostic and operative hysteroscopy, diagnostic and 226

operative laparoscopy, laparotomy, robotic surgery, office procedures, 227

and ambulatory procedures. Additionally, the program must ensure fellow 228

competency in vaginal hysterectomy, the management of small and large 229

bowel concerns as it relates to complex gynecologic disease, and 230

gynecologic conditions that may impact fertility (e.g., uterine septum, 231

intrauterine adhesions, and uterine leiomyomas). 232

D) Fellowships must ensure that graduates perform the minimum number 233

and types of surgical cases prior to graduation as specified in the case 234

minimum list (https://bit.ly/2obFmwR). Fellowship leadership must 235

confirm on a weekly basis that cases are being appropriately entered into 236

the case log system. 237

E) The majority of each fellow’s clinical experience must be in benign MIGS. 238

The first-year fellowship surgical experience should be broad based, as 239

outlined in the surgical competency list. 240

F) Programs may emphasize specific areas of specialization within MIGS (such 241

as pelvic pain) as an augmentation to the core curriculum. 242

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1. Schedule 244

The core 2-year fellowship must be structured to show a progression in clinical 245

and teaching responsibilities during the span of the program. A weekly, 246

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monthly and yearly clinical and educational schedule must be prepared for 247

both year -1 and -2. A third year of training can be approved by the FMIGS 248

Board on a case-by-case basis but must contain a unique educational 249

experience with defined goals and objectives. 250

251

G. Research 252

1. Research Training 253

It is required that the fellow complete a minimum of one course in clinical 254

research, research design, biostatistics, or epidemiology unless the fellow has 255

documentation of previous graduate level coursework in one or more of these 256

topics or holds a graduate level degree that documents competence in the 257

required area(s). Ideally, the fellow may be given the opportunity to work 258

towards an advanced degree (e.g. MPH) or certificate in clinical research. This 259

can be accomplished in a classroom setting or through a fellowship director-260

approved online course. The institution must provide financial support for a 261

minimum of one research-related course. 262

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Research training must: 264

A) Provide structured translational, clinical or surgical research as applied to 265

MIGS 266

B) Enhance the fellow’s understanding of the latest scientific surgical 267

techniques 268

C) Promote the fellow’s academic contributions to the specialty 269

D) Further the ability of the fellow to be an independent investigator 270

271

2. Research Projects 272

During training, the fellow will undertake an independent original research 273

project approved by the fellowship director. The sequence in which research 274

experience is integrated with clinical training will vary with each program but 275

should be initiated in the first year of fellowship training. A research mentor 276

who has expertise (i.e. proven track record of hypothesis-based research 277

publications) in clinical research and is available and regularly meets with and 278

mentors the fellow must be appointed. Under the supervision of the research 279

mentor, the fellow must complete, by the end of his/her final academic year, 280

at least one IRB approved (if applicable) research project relevant to minimally 281

invasive gynecologic surgery. This research project must be an original data-282

driven project, meta-analysis or a systematic review that conforms to PRISMA 283

guidelines and ultimately must be submitted for publication to a peer-284

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reviewed journal by the end of fellowship. Writing a textbook chapter, clinical 285

opinion review article, or production of an educational/scientific video does 286

not meet criteria for an approved research project. It is the expectation that 287

most fellow manuscripts will result in publication. 288

H. Competencies 289

The fellowship director will provide training and evaluate the fellow according to 290

the following competencies: patient care-clinical and surgical skills, knowledge 291

base, practice-based learning, communication skills, professionalism, system-292

based practice (see Appendix 1), teaching skills, and scholarly research project 293

development. 294

295

I. FELLOWSHIP DATES, LEAVE AND TRANSFER 296

Each program may be approved for a maximum of 2 fellows unless an increase has 297

been requested and granted by the FMIGS Board. An increase in fellow 298

complement will be considered if there exists adequate surgical volume, clinical 299

experience, and research mentorship to support this expansion and that the 300

current fellow experience will be enhanced. 301

302

START DATE 303

All fellows will be required to start no later than August 1st. Later start date 304

requests will be given individual consideration. An administrative fee will be 305

incurred if the fellowship program is unable to start fellowship training by August 306

1st. If the start date is delayed for any reason, the fellow’s program must still 307

adhere to the minimum 22-month clinical training requirements as described 308

below. 309

310

Leave 311

Leave may be granted to a fellow at the discretion of the Fellowship director in 312

accordance with local policy but cannot exceed the limits listed below. Such leaves 313

include maternity, paternity, sick, medical, vacation, funeral, personal, etc. A 314

Fellow’s travel to regional, national, or international meetings in order to attend 315

or present research conducted during the program or travel to attend other 316

program-approved educational activities should be counted as an educational 317

endeavor and not as a leave. 318

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319

In keeping with the minimum of 22-month clinical training requirement to 320

graduate from the Fellowship Training, a fellow is allowed: 321

• Up to 6 weeks in the first year; 322

• Up to 6 weeks in the second year; 323

• Not to exceed a total of 8 weeks over the entire 2 years. 324

325

If a fellow’s absence from a program exceeds the maximum amount of leave time 326

allowed in any given year or for the entirety of the program, the expected 327

completion date must be extended for the duration of time in excess of the 328

maximum leave. This extension must not detract from the experience of the other 329

fellows in the program. 330

J. Transfer Policy 331

A fellow may transfer from one FMIGS- program to another. To approve the 332

transfer, the FMIGS Board must receive: 333

a) A letter from the fellow requesting the transfer 334

b) A letter from the current Fellowship Director: 335

i. Approving the transfer 336

ii. Outlining the number of months the fellow successfully completed and the 337

date the fellow will leave the program 338

iii. Describing the rotations completed 339

iv. Assessing the level of competency to date 340

c) A letter from the Program Director of the potential (new) program: 341

i. Approving the transfer 342

ii. Outlining the dates the fellow is expected to commence and complete the 343

program 344

The fellow must still meet the 22-month clinical training requirement even if 345

portions of that interval are spent in more than one location. If the approved total 346

fellow positions will be exceeded at any time due to a transfer, an increase must 347

be approved prior to the transfer occurring. 348

349

K. Requirements for Graduation 350

Upon successful completion of the fellowship, each fellow will receive a certificate 351

of completion from the FMIGS Board. If these requirements have not been met 352

by graduation, certification will be withheld until all requirements are fulfilled. 353

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Requirements for graduation will include: 355

1. Satisfactory clinical and surgical training as outlined by the FMIGS Board 356

2. Completion of an original research project as described above. 357

3. Submit a scientific contribution to a national or international meeting. The 358

contribution can be a video, oral or poster presentation. 359

4. Completion of at least twenty-two months of training. 360

5. When available, completion of the AAGL Essentials in Minimally Invasive 361

Gynecology Program. 362

363

L. EVALUATIONS 364

The fellows, faculty, and program must be evaluated. All of the evaluations 365

performed must be documented in writing, and evidence must be available upon 366

request by the FMIGS Board. 367

368

1. Fellow Evaluations 369

The Fellowship Director must formally evaluate a fellow’s progress. 370

Assessment must include the regular and timely feedback to the fellow that 371

includes the evaluations of knowledge, skills, research, and professional 372

growth using appropriate criteria and procedures. 373

374

Formative EvaluationThe supervising faculty must regularly evaluate (i.e. 375

minimum of 5 evaluations/month per fellow) fellow performance in a timely 376

manner after clinical or surgical encounters and document this evaluation using 377

myTIPreport. Additionally, 378

1. The Program Director must perform an evaluation on each fellow at least 379

every six months. The evaluation must: 380

• Provide objective assessments of competence in patient care, medical 381

knowledge, practice-based learning and improvement, interpersonal and 382

communication skills, professionalism, and systems-based practice 383

• Use multiple evaluators (i.e. faculty, patients, self, and other professional 384

staff) 385

• Document progressive fellow performance improvement appropriate to 386

education level 387

2. Summative Evaluation The Program Director must perform a summative 388

evaluation on each fellow at the completion of the fellowship. This may 389

replace the final semi-annual evaluation. The evaluation must: 390

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• Document the fellow’s performance during the final period of education 391

• Verify that the fellow has demonstrated sufficient competence to practice 392

without direct supervision 393

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2. Faculty Evaluation 396

The performance of each faculty member must be evaluated at least annually by: 397

• Each fellow – Must be written (typically electronic) and confidential 398

• The program – Must include a review of the faculty’s clinical teaching 399

abilities, commitment to the educational program, clinical knowledge, 400

professionalism, and scholarly activities. 401

402

3. Program Evaluation 403

A meeting to discuss the educational and research mentoring effectiveness of the 404

program and the curriculum must be held at least annually. The Fellowship 405

Director, program faculty, and at least one fellow must attend the meeting. The 406

discussion of the issues must be documented and the results used to improve the 407

program. 408

During the evaluation process, the attendees must consider: 409

• Written comments by faculty and fellows 410

• Fellow performance 411

• Faculty performance 412

• The most recent GME report of the sponsoring institution (if applicable or 413

available) 414

• Any additional material that can be used to judge the achievement of the 415

program’s educational objectives 416

417

M. INSTITUTIONAL COMMITMENT 418

The fellowship director must provide evidence of institutional commitment to 419

support the fellowship. This is to include financial support, clinical environment 420

for education and adequate research facilities to fulfill FMIGS requirements for a 421

fellowship program in MIGS. 422

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N. POLICIES 424

1. Anti-Harassment Policy 425

All faculty involved with fellowship training must be in compliance with AAGL’s 426

policies to interact with each other for the purposes of professional 427

development and scholarly interchange so that all members may learn, 428

network and enjoy the company of colleagues in a professional atmosphere. 429

Every individual associated with the AAGL has a duty to maintain this 430

environment free of harassment and intimidation. The program director must 431

indicate that they have read and will comply with AAGL’s Anti-Harassment 432

policy in the annual report. If a complaint is made by a trainee, it shall be 433

addressed as set forth in the AAGL Anti-Harassment policy referenced above 434

The complaint will be investigated and adjudicated by a committee appointed 435

according to the Grievance Committee Policy. Any reported allegations of 436

harassment, discrimination, and/or retaliation will be taken seriously and 437

investigated promptly, thoroughly and impartially as outlined in the Anti-438

Harassment policy. 439

440

All program directors and associate program directors must complete 441

sensitivity training every other year and document compliance in the annual 442

report and at the site visit. 443

444

2. FMIGS Grievance Policy (other than anti-harassment) 445

Fellows that are concerned about their training experience may contact the 446

FMIGS grievance committee and are referred to the FMIGS Grievance Policy 447

https://bit.ly/2zHqIUJ. If a formal grievance is waged, it will by pursued and 448

acted by the AAGL Grievance Committee and/or the FMIGS Grievance 449

Committee. 450

O. Disciplinary Action / Due Process 451

452

Types of Disciplinary Actions 453

Official disciplinary actions are probation, non-reappointment, or termination. In 454

general, disciplinary action should follow the due process identified by the primary 455

training site as is commonly distributed by the Department of Graduate Education. 456

If any type of disciplinary action is taken, the FMIGS Board must be notified. The 457

FMIGS Board requires the following sequence: 458

459

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Evaluation and feedback 460

The fellow must be advised about deficiencies and the expectations for 461

improvement must be clearly delineated. This must occur every semi-annual 462

evaluation, but also may occur in an interval meeting if needed. The ability to 463

provide useful feedback is contingent upon regularly completed written 464

evaluations of the trainee. The fellowship director needs to provide clear guidance 465

to the training faculty as to the types and frequencies of evaluations expected 466

from them. Verbal feedback from a faculty member to the fellowship director 467

regarding a trainee, either positive or negative, must be followed up with a written 468

communication for the trainee’s file. 469

470

Warning 471

When a trainee has been advised about deficiencies but fails to make sufficient 472

improvement, he/she may be warned that continued lack of improvement may 473

result in probation. This information must be provided to the trainee in person 474

and in writing. 475

476

Probation 477

Clearly suboptimal academic and/or clinical performance may warrant probation. 478

The action must be explained to the fellow in person and in writing. Expectations 479

for improvement, the methods for evaluating improvement, the anticipated 480

duration of probation, and possible future actions must be delineated. The trainee 481

must be advised that his/her academic file is always available for review and that 482

he/she may appeal the decision. The trainee should be offered counseling. A 483

sample probationary letter is available from the FMIGS Board but is subject to 484

local variation. 485

486

Non-reappointment/Termination 487

A trainee’s failure to remediate suboptimal academic and/or clinical performance 488

may warrant a decision not to reappoint the trainee at the end of the current 489

training year, or, in unusual circumstances, to terminate the contract immediately. 490

The action must be explained to the fellow member in person and in writing. As 491

with a probationary letter, the trainee must be advised that his/her academic file 492

is always available for review and that he/she may appeal the decision. The trainee 493

must be offered counseling. A sample non-reappointment or termination letter is 494

available from the FMIGS Board but is subject to local variation. 495

496

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Termination without an intervening period of probation should be reserved for a 497

serious deviation from acceptable academic and clinical performance (e.g., 498

dereliction of duty) that endangers patient care. 499

500

The Purpose of Disciplinary Actions 501

The objective of academic discipline is remediation. Thus, the terms of probation 502

should always be carefully devised to ensure that the trainee has the opportunity 503

to attain the desired improvement and that methods for evaluating that 504

improvement are robust and as objective as possible. 505

506

Timing issues 507

A probationary period must be long enough to permit a thorough evaluation of 508

progress. Except in unusual circumstances, a period of at least 3-4 months is 509

required. The date on which the trainee’s status will be reconsidered should be 510

picked in light of possible future actions, such as non-reappointment, so that 511

ideally the trainee will have ample opportunity to find a different training program 512

before the end of his/her training year. Alternatively, if a trainee’s lack of progress 513

requires a period of probation late in the training year, there should be 514

consideration of extending the current training year until a decision regarding 515

adequacy of remediation can be made. 516

517

P. Accreditation of Fellowship Programs 518

All new fellowship programs must apply to the FMIGS Board. Programs that have 519

demonstrated compliance with the fellowship standards receive accreditation for 520

one or more years. 521

522

Fellowship programs will be evaluated continuously on their compliance with the 523

program requirements. If a program is found to have areas of non-compliance 524

(deficiencies or areas of concern), the FMIGS Board will list these citations, and 525

expect the program to come into compliance in the time period designated. 526

Based on the number, severity and/or persistence of these citations, a program 527

may be given a warning, placed on probation or accreditation may be withdrawn. 528

Fellowships on probation may not recruit for fellows and must notify the current 529

fellows. Please see the FMIGS Accreditation and Review Policy on the website for 530

more details. 531

532

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If there are any significant or unexpected changes in the program or status of the 533

fellow (e.g. change in the number of fellow positions, fellowship director, key 534

faculty members, patient volume and procedures; changes in clinical sites or 535

closure of major research programs), the FMIGS Board must be notified 536

electronically within 30 days ([email protected]). 537

538

Q. Duty Hours 539

The FMIGS Board expects the ACGME Guidelines regarding Duty Hours to be 540

considered. Detailed information can be accessed at: https://bit.ly/2Jw2zZr. 541

Policies and procedures related to duty hours for fellows must be distributed to 542

the fellows and faculty and the program must: 543

1. Monitor according to the program policy, with a frequency sufficient to 544

ensure compliance 545

2. Monitor the demands of day, night, OB (if applicable), moonlighting and/or 546

at-home call and intervene as necessary to mitigate excessive service 547

and/or fatigue 548

3. Monitor the need for and ensure the provision of back up support systems 549

for patient care 550

R. Stipend and Benefits 551

Fellows must be provided a stipend which must be at the minimum equivalent to 552

a PGY-5 or -6 housestaff officer in the geographic region of the program. 553

Candidates invited for an interview are to be informed, in writing or by electronic 554

means, of the terms, conditions, and benefits of their appointment, including 555

stipend and other financial support; vacations; parental, sick and other leaves of 556

absence. 557

558

The following benefits are required: 559

1. The fellowship must provide fellows with health, disability and professional 560

liability coverage at all sites and all pertinent information regarding this 561

coverage. Liability coverage must include legal defense and protection against 562

awards from claims reported or filed after the completion of the program(s) if 563

the alleged acts or omissions of the fellows are within the scope of the 564

program(s). Specify if liability coverage is provided for external 565

rotations/electives. Research associated costs (IRB, equipment, publication) 566

must be covered. 567

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The program must inform the candidate about whether or not the following 569

recommended benefits are provided: 570

1. Travel to the Global Congress of the AAGL 571

2. Certification as console surgeon for robotically-assisted laparoscopy 572

It is the expectation that programs will not require their fellows to sign a non-573

compete agreement or restrictive covenant. If the program does require a 574

restrictive covenant clause, they must notify both the FMIGS Board and notify (in 575

writing) all applicants before an initial interview is scheduled. 576

S. Application Process 577

The FMIGS Board actively encourages applications from Obstetrician-Gynecologist 578

physicians aspiring to develop their surgical skills in MIGS. The deadline dates for 579

the application process are based upon the National Resident Matching Program 580

(NRMP). Please see our website for details of the deadline dates. Application will 581

be available online at the Fellowship webpage, www.fmigs.org. 582

583

Applications for programs interested in becoming a fellowship training site, are 584

also available on the Fellowship webpage, www.fmigs.org, or by contacting the 585

Fellowship Administrative Assistant at the Fellowship office. 586

587

T. Match 588

The Fellowship match is conducted through an objective computer matching 589

program (NRMP). Programs and applicants are required to use the match 590

process. No candidate at any time can be offered a position outside the NRMP 591

match without prior approval from the FMIGS Board. If a fellowship program 592

intends to accept a specific candidate outside the match (e.g. graduating resident 593

from their program), they must contact the FMIGS NRMP representative 594

(https://bit.ly/2UsP3qW), obtain FMIGS Board approval for the match waiver and 595

avoid subjecting other candidates to the unnecessary burdens of interviewing. 596

597

The match provides a uniform time for both applicants and fellowship programs 598

to make selection decisions without coercion, undue or unwarranted pressure. 599

Both applicants and fellowship programs may express their interest in each other; 600

however, they shall not solicit verbal or written statements implying a 601

commitment. Applicants shall at all times be free to keep confidential the names 602

or identities of programs to which they have or may apply. Any violations will be 603



https://bit.ly/2UsP3qW

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addressed by the FMIGS Board and will be subject to consequences as determined 604

by the FMIGS Board. 605

606

U. Further Information 607

For further inquiries, please contact the FMIGS Administrative Assistant: 608

6757 Katella Avenue, Cypress, CA 90630‐5105 USA. 609

Ph: (800) 554‐2245 or (714) 503‐6200 • Fax: (714) 503‐6202 610

E‐mail: [email protected] • Web Site: www.aagl.org 611

612


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613

V. Appendix 1: Competencies 614

615

1. Patient Care 616

Fellows must be able to provide patient care that is compassionate, 617

appropriate, and effective for the treatment of health problems and the 618

promotion of health. Fellows must demonstrate competence in: 619

A) Evaluating a patient's complaint, providing an accurate examination, 620

employing appropriate diagnostic tests, arriving at a correct diagnosis, and 621

recommending the appropriate treatment 622

B) The essential areas of benign gynecology including: 623

• normal physiology of reproductive tract 624

• gynecologic management during pregnancy 625

• gynecologic surgery and complications management 626

• management of critically ill patients 627

• gynecologic pathology 628

• the full range of commonly employed diagnostic procedures, including 629

ultrasonography, Computed Tomographic (CT) Magnetic Resonance 630

Imaging (MRI) and other relevant imaging techniques 631

632

2. Medical Knowledge 633

Fellows must demonstrate knowledge of established and evolving medical, 634

clinical, epidemiological and social-behavioral sciences, as well as the 635

application of this knowledge to patient care. 636

Fellows must demonstrate knowledge in: 637

A) Reproductive health care, diagnosis, management, consultation, and 638

referral 639

B) The fundamentals of basic science as applied to MIGS 640

C) Applied surgical anatomy and pathology 641

D) Basics of risk-benefit analysis, epidemiology, statistics, data collection and 642

management, and use of medical literature and assessment of its value 643

644

645

646

647

648

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3. Practice-based Learning and Improvement 649

Fellows must demonstrate the ability to investigate and evaluate their care of 650

patients, to appraise and assimilate scientific evidence, and to continuously 651

improve patient care based on constant self-evaluation and life-long learning. 652

Fellows are expected to develop skills and habits to be able to meet the 653

following goals: 654

A) Identify strengths, deficiencies, and limits in one’s knowledge and 655

expertise 656

B) Set learning and improvement goals 657

C) Identify and perform appropriate learning activities 658

D) Systematically analyze practice using quality improvement methods, and 659

implement changes with the goal of practice improvement 660

E) Incorporate formative evaluation feedback into daily practice 661

F) Locate, appraise, and assimilate evidence from scientific studies related to 662

their patient’s health problems 663

G) Use information technology to optimize learning 664

H) Participate in the education of patients, families, students, residents and 665

other health professionals 666

667

4. Interpersonal and Communication Skills 668

Fellows must demonstrate interpersonal and communication skills that result 669

in the effective exchange of information and collaboration with patients, their 670

families, and health professionals. 671

Fellows are expected to: 672

A) Communicate effectively with patients, families, and the public, as 673

appropriate, across a broad range of socioeconomic and cultural 674

backgrounds 675

B) Communicate effectively with physicians, other health professionals, 676

and health related agencies 677

C) Work effectively as a member or leader of a health care team or other 678

professional group 679

D) Act in a consultative role to other physicians and health professionals; 680

E) Maintain comprehensive, timely, and legible medical records, if 681

applicable 682

F) Have the fundamentals of good medical history taking and thoughtful, 683

meticulous physical examination 684

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5. Professionalism 685

Fellows must demonstrate a commitment to carrying out professional 686

responsibilities and an adherence to ethical principles. Fellows are expected 687

to demonstrate: 688

A) Compassion, integrity, and respect for others 689

B) Responsiveness to patient needs that supersedes self-interest 690

C) Respect for patient privacy and autonomy 691

D) Accountability to patients, society and the profession 692

E) Sensitivity and responsiveness to a diverse patient population, 693

including but not limited to diversity in gender, age, culture, race, 694

religion, disabilities, and sexual orientation 695

F) Ethics and medical jurisprudence 696

697

6. Systems-based Practice 698

Fellows must demonstrate an awareness of and responsiveness to the larger 699

context and system of health care, as well as the ability to call effectively on 700

other resources in the system to provide optimal health care. 701

Fellows are expected to: 702

A) Work effectively in various health care delivery settings and systems 703

relevant to their clinical specialty 704

B) Coordinate patient care within the health care system relevant to their 705

clinical specialty 706

C) Incorporate considerations of cost awareness and risk-benefit analysis 707

in patient and/or population-based care as appropriate 708

D) Advocate for quality patient care and optimal patient care systems 709

E) Work in inter-professional teams to enhance patient safety and 710

improve patient care quality 711

F) Participate in identifying system errors and implementing potential 712

systems solutions 713

714

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