Curriculum/Schedule

Since 1988, the division has had a fellowship in Reproductive Endocrinology and Infertility (REI). The fellowship has been accredited on a 3-5 year renewal since its inception and is one of 42 REI training around the country.

Michael Thomas, MD, has been the program director of the fellowship program since 2001. Approximately, 100 applicants apply each year for the one fellowship position available at our institution. We interview 12-20 applicants during the interview season that runs from July to October.

The REI program participates in the NRMP Match Program and usually matches its first, second or third choices. The three-year fellowship program is divided into 18 months of clinical service and 18 months of concentrated basic science research.

When the first year fellow starts in July, this individual spends time rotating on the REI clinical service learning the basic work up of new patients and spending time performing many pelvic ultrasounds. Also during the first six months, the fellow rotates through medical endocrinology, pediatric endocrinology and genetics.

Starting in January of the first year, the fellow starts as the IVF fellow for 12 months. In this role, the fellow is responsible for the 225 fresh and frozen IVF cycles that are conducted.

The fellow works closely with the IVF Director to also present at the Tuesday noon IVF educational conference where either patients are discussed or journal articles are presented.

After the 12 month tenure as IVF fellow, the fellow then starts the basic science basic science laboratory experience in January of their second year.

During the 18 months of laboratory experience, the fellow will spend 90 percent of their time in a laboratory of their predetermined research mentors.

The REI Division is responsible for the monies to pay for the materials and reagents needed for the fellow to start and complete their projects. Current and past research mentors include, Stuart Handwerger, Shuk-Mei Ho, S. K. Dey, and Nelson Horseman.

During this research time frame, the fellows learn basic science techniques, hypothesis driven experimental design, statistical analysis, and manuscript preparation. The REI Division has committed $9000 for monies to cover lab expenses and another $5000 annually to send fellows to meeting.

Currently, these monies come from divisional clinical trial income. However, if when these funds are exhausted, the fellowship will need to find funding from other sources.

The fellows participate in the education of the medical students and residents on the REI rotation or through their efforts when presenting during classroom sessions. The fellows also participate in Grand Rounds and help the residents during their Morbidity and Mortality conferences.

The faculty responsibility includes the teaching of pelvic ultrasound, robotic and non-robotic laparoscopic procedures, exploratory laparotomies, myomectomy, IVF and ovulation induction techniques, and clinical research projects. There are two mandatory conferences each week. Monday evening is a reproductive endocrine journal club and chapter review and Tuesday afternoon is an infertility conference.

The faculty and fellows participate in the departmental grand rounds and conferences. There are also monthly conferences with medical and pediatric endocrinology.

Fellowship Year One:

During the first year, each fellow will become proficient in the pelvic ultrasound monitoring of follicle growth under the direction of Drs. Thomas, Lindheim and DiPaola. Daily ultrasound monitoring for gonadotropin ovulation induction is carried out seven days/week by the first-year fellow. The trainee will also be expected to spend one-half day each week attending the pediatric endocrine clinic, medical endocrine clinic, and participate in human genetics rounds.

We believe that the clinical exposure afforded the fellows will be more than sufficient to permit them to develop into well trained consultants and specialists in this field. We are committed to the training of academic reproductive endocrinologists. The required graduate course work (biostatistics) will be completed during the first year as well.

Fellowship Year Two:

During the second year of training, clinical activities of the trainees will increase, but research endeavors will continue. Daily ultrasound monitoring of IVF patients and IVF oocyte retrievals (approximately 100 cycles/year) are performed by the second-year trainee.

In collaboration with the designated preceptor, a research grant proposal similar to the NIH format will be initiated. On the basis of the numbers of patients seen by the five clinical faculty, there will be over 10,000 patient visits per year. Microsurgical cases will also be performed at The Christ Hospital with two board-certified REI private practice faculty. We anticipate a continuing increase in the number of patient visits.

Fellowship Year Three:

The major goal of the third year of fellowship training will be to provide an uninterrupted and intense research experience so that the trainee can design and carry out a detailed research project proposed during the second year. This research project proposal, presented in the NIH format, will be reviewed by the Research Committee of the Department of Obstetrics and Gynecology. After committee’s approval of the budget, the department will provide sufficient funding for this endeavor.

Trainees will also be expected to submit this proposal for funding from extramural sources such as the SREI T32 training grant as well as the Mead Johnson/ACOG fellowship grants during their first or second year of fellowship. Over the past five years, trainees have received training grants from the SREI as well as grants from the North American Menopausal Society and Merck/ACOG.

During this time, the trainee will have daily interaction with the preceptor and essentially be working on a 1:1 basis in the laboratory of the preceptor. This working relationship will be analogous to that of a postdoctoral candidate. The trainee will be required to hone his/her manuscript preparation and grant writing skills.

It is expected that research from the previous two years will be presented at national meetings such as the Society for Gynecologic Investigation or the Endocrine Society and summarized in submitted manuscripts before completion of the third year.