Research Programs

Gynecologic Oncology Fellowship Research Rotation, Year 1

One year of the three-year fellowship is protected time for research and academic development in which there will be minimal interruption from clinical duties related to the fellowship. The training of gynecologic oncology fellows will be individualized based on the fellows’ previous training, skills, research interests and other aspirations. The educational process will be formally structured with an Individual Development Plan (IDP) that is constructed within three months of entering the program by the fellow and an advisory committee comprised of:

Their chosen research mentor
Kristine Zanotti, MD

The IDP will enumerate goals for academic and professional development encouraged by the program and will provide a framework to address progression towards these stated goals. However, it will be considered a flexible blueprint that can be modified in response to the fellow’s achievements, difficulties or redirection of interests. The IDP will be reviewed twice a year by the fellow and their advisory committee.

Download IDP Form (Word document)

Our program is designed to foster the desire and opportunity to pursue a more expanded mentored and collaborative investigational experience that has the ultimate goal of training interested fellows to become productive junior faculty investigators who are poised to initiate collaborative investigative experiences and funding after their fellowship.

During their first year, fellows will develop and initiate new research projects with their chosen thesis mentor(s). For their thesis mentor, fellows may select from a variety of potential research mentors within the department and institution and will formally interview among select potential mentor candidates in the basic sciences, clinical sciences, epidemiology or biostatics during their first month. An interview with Stefanie Avril, MD PhD, will be arranged as a standard interview. Dr. Avril is a translational research scientist, she is Chair of the multidisciplinary Gynecologic Oncology Translational Research Working Group.

Additional interviews will be selected by the fellow from the candidates delineated in the application based on their individual interests, typically within the Clinical Research Scholars Program at Case Western Reserve School of Medicine. Fellows with specific interests that are outside the faculty areas of interest may contact additional faculty. To be approved as a fellow’s primary research mentor, a faculty member must have evidence of prior productive mentoring experiences and have adequate funding, facilities and space. Moreover, oversight for progress assessments within our division is required and will take place during scheduled research meetings.

Select Research Programs

Gynecologic fellows have been involved in many academic projects throughout the cancer center, including educational research, quality research, and translational research including the following select programs:

Coursework

Thesis

All fellows formally defend their thesis to their thesis committee at the end of their third year of fellowship. Ideally, the fellow thesis is also submitted for peer-review publication.

A Note about ABOG Certification Thesis Requirement: A thesis is required by the American Board of Obstetrics and Gynecology (ABOG) Division of Gynecologic Oncology and must according to the guidelines for preparation listed in the ABOG Bulletin for Subspecialty Certification in Gynecologic Oncology. The work must have been undertaken during their fellowship. Ideally, the thesis will be a scientific worked published in a peer reviewed publication but publication by a refereed journal does not guarantee acceptance of the thesis for the Certifying Examination. Moreover, it is not essential for the thesis to have been published.

Hypothesis: The thesis must clearly have a hypothesis to be tested.

Unacceptable Papers: The following are not acceptable for a Fellow’s thesis:

Book chapters
Case reports
Case series

Potentially Acceptable Papers: Any thesis submitted must be the product of a significantly thoughtful and robust research effort. The following types of clinical research would be considered acceptable for a thesis:

Randomized controlled trial: The report must represent subject matter that is of significant importance to the field, and must adhere to the CONSORT guidelines.
Meta-analysis and systemic review: The report must represent subject matter that is of significant importance to the field, and must adhere to the PRISMA or MOOSE guidelines.
Cost-effective analysis: The study must represent subject matter that is of significant importance to the field, and must conform with the principles set forth in the “WHO guide to Cost-Effective Analysis.
Case-control study: If there is a well-defined objective with a specific hypothesis to be tested, and if the subject matter is of significant importance to the field, the thesis will be reviewed by the subspecialty division for possible acceptance. The submitted thesis must conform to the STROBE guidelines for observational studies.
Cohort study: The subspecialty division will review the thesis for possible acceptability if (a) the candidate developed the cohort [i.e., data-mining of established datasets is rarely acceptable], (b) there is a well-defined hypothesis to be tested, and (c) the subject matter is of significant importance to the field. The submitted thesis must conform to the STROBE guidelines for observational studies.
Survey-collected data: The subspecialty division will review the thesis for possible acceptability if (a) the candidate developed the questionnaire or used a previously validated questionnaire, (b) the subject matter is of significant importance to the field, (c) there is a well-defined hypothesis to be tested, (d) the recipients of the questionnaire 26 are selected to avoid bias, and (e) there is at least 50 percent return and completion of the questionnaire. The submitted thesis must conform to the STROBE guidelines for observational studies.

Other Activities During 1st Year

Formal coursework and instruction: Formalized instruction in research is an essential component of your Gynecologic Oncology fellowship training experience. At least two courses in quantitative methods will be completed during the research year through the Clinical Research Scholars Program. An additional week long seminar in Comparative and Cost-Effectiveness in Health Care is required in our fellowship program. Fellows are also encouraged to take additional courses within Case Western Reserve University in their first year, depending on their career and academic interests.

Clinical Research Scholars Program (CRSP)

Fellows will take advantage of the Clinical Research Scholars Program at Case Western Reserve University School of Medicine by completing coursework in clinical research. Case Western Reserve University offers training in clinical research and career development via the Clinical Research Scholars Program.

CRSP 401: We require first year fellows to take CRSP 401, Introduction to Clinical Research, that is offered every summer. Admission to other courses within the CRSP program is not possible until completion of CRSP 401.

EPBI/MPHP 467: We also believe that cost awareness is an essential part of your fellowship training. Moreover, understanding and performing cost effectiveness analyses is a valuable skill for the academic gynecologic oncologist. For this reason, we also require you to take EPBI/MPHP 467, Comparative and Cost Effectiveness Research. This is a five-day intensive seminar given every May that has two components:

Understanding Comparative Effectiveness Research
- Implications for healthcare practice, management and policy
- Ethical, legal and social issues

Cost Effectiveness Analysis – Methods and Software
- How to evaluate a cost-effectiveness paper
- How to build and analyze a cost-effectiveness model
- Intro to TreeAge software for CEA

Other coursework is encouraged during your research year and can be undertaken based on your individual interest and with approval of your program director. Learn more about CRSP courses offered.

Quality Improvement Projects

We also require fellows to initiate one or more quality improvement (QI) projects during the first year of their fellowship and to complete this project prior to fellowship completion. We define QI projects for our fellows as systematic, data-guided analyses and activities that are designed to bring about immediate actionable improvements in health delivery to our gynecologic oncology patients at University Hospitals Cleveland Medical Center. Importantly, to make improvements, fellows will need to gain an understanding of our healthcare organization and our immediate gynecologic oncology multidisciplinary healthcare delivery system and key processes within this system. The primary mentor chosen for this project will be from among the Gynecologic Oncology faculty, however, a multidisciplinary team approach to these investigations will be essential to its success.

The UH Rainbow/UH MacDonald Quality Curriculum is an optional course provided by UH Cleveland Medical Center that is available every winter and is available to Gynecologic Oncology fellows during their first year of fellowship. It is a practical set of two-hour educational seminars occurring over a four-month period that instructs on understanding the practical elements of Quality Improvement Science and applying one’s learnings to a performance improvement project of the participant’s choosing. Over the course of the sessions, a project is outlined and refinements occur based on mentorship and feedback. Course Director: Joyce Deptola (Director of Quality and Organizational Readiness, UH Rainbow Babies & Children’s and UH MacDonald Women’s Hospital)

Outreach and Advocacy Projects

“Health care does not exist in a vacuum.” We all participate in a complex healthcare system and achieving optimal health outcomes can be viewed on several levels: 1) the individual, 2) the community, and 3) the population. Fellows will participate in outreach and/or advocacy activities of their choosing to gain a better understanding of the social, political and economic determinants of health that ultimately influence the outcomes and well-being of their patients.

Outreach is the activity of providing services to populations who might not otherwise have access to those services. We are strengthened when we develop a deeper understanding of the community that we serve and being an engaged community member means reaching out beyond the hospital campus.

Advocacy is defined as any action that works in favor of individuals or groups. We are all advocates to our patients, but advocacy may also involve collaboration with others to achieve influence within varied institutional, political, economic and social systems. Advocacy may take the form of organizing, educating the public or legislators, undertaking relevant research, working with agencies, litigation or lobbying.