Fellowship Program Director: Veronica Gomez-Lobo, M.D.
Overview
The Pediatric and Adolescent Gynecology (PAG) Fellowship is a two-year fellowship program comprised of faculty from the National Institute of Child Health and Human Development (NICHD), and Children's National Hospital (CNH). The fellowship is housed within NICHD at NIH, and the care of patients will take place at NIH and CHN.
The goal of this fellowship is to train graduates of an ACGME accredited Obstetrics and Gynecology Residency in the gynecologic care of patients between birth and age 21. The fellow will learn the diagnosis and management of common problems in pediatric gynecology as well as uncommon and more complex conditions, such as congenital reproductive anomalies and anorectal malformations, variations in sex characteristics (VSC), pediatric and adolescent pelvic masses and gynecologic malignancies, gynecologic disorders in medically complicated children, reproductive endocrinopathies, fertility preservation, sexual abuse and vulvar conditions. The fellows will also receive extensive surgical training and will perform complex gynecologic surgeries in children of all ages including pelvic masses (benign and malignant), congenital anomalies of the reproductive system including those with anorectal malformations in collaboration with the colorectal team and variations in sex characteristics with the VSC team urologist. In addition, fellows will receive training and support for research development. Our goal is that graduates will pursue careers that advance the field of pediatric and adolescent gynecology forward in all areas including research, education, and patient care.
Our fellows will interact with fellows in reproductive endocrinology and infertility and pediatric endocrinology within NICHD as well as pediatric surgery, pediatric urology, and adolescent medicine fellows at Children's National. Opportunities for collaboration with Women and Infant Services fellows at MedStar Washington Hospital Center are also available. This interaction nurtures a rich academic environment which promotes excellence in clinical care, education and research. Furthermore, our location is in the nation's capital which houses the American College of Obstetrics and Gynecology (ACOG).
Pediatric and Adolescent Gynecology fellowship graduates will have expertise in the following areas:
- Congenital: anomalies of the reproductive tract including variations in sex characteristics (VSC).
- Oncology: pelvic masses, pediatric and adolescent cancers of the genital tract as well as risks for adult cancers which begin in childhood and adolescence (such as human papilloma exposure and endocrine exposures).
- Fertility: impact of exposures in the adolescent period on fertility such as ovarian torsion, exposure to gonadotoxic therapy and exposure to infectious agents which cause infertility (such as Chlamydia).
- Medical/endocrine conditions: evaluation and management of reproductive endocrine conditions such as precocious and delayed puberty, polycystic ovary syndrome, premature ovarian insufficiency and hirsutism.
- Structural: structural gynecologic conditions including vulvar and vaginal conditions, pre-pubertal bleeding, management of conditions which can cause vaginal stenosis such as radiation, and autoimmune reactions.
Program Structure
The Fellowship in Pediatric and Adolescent Gynecology at National Institutes of Health/ and Children's National Hospital will entail 70% clinical work and 30% research with rotational blocks dedicated to fellow research time. During clinical time at CNH, fellows will participate in general pediatric gynecology clinics as well as a variety of specialty clinics staffed by the PAG team. Fellows will also participate in emergency surgeries and those generated by the general and specialty clinics. Multidisciplinary clinics include those that care for patients with fertility preservation and survivorship, heavy menstrual bleeding, variations in sex characteristics, colorectal anomalies, Turner syndrome, anorectal malformations, complex endocrinology conditions, and rheumatologic conditions. In addition, fellows will have opportunities to rotate with providers specializing in eating disorders and child abuse. At the NIH, fellows will participate in the consult service and assist in the gynecologic care and research for studies in McCune-Albright, congenital adrenal hyperplasia, Turner syndrome, Mullerian agenesis (MRKH), fertility preservation and androgen insensitivity syndrome (AIS).
For successful completion of this training program, the fellow will design, implement, complete, describe and report at least one research study. A second multicenter project is to be designed and submitted or collaboration with a project submitted to the Fellows Research Network at North American Society for Pediatric and Adolescent Gynecology (NASPAG) will be required. During the fellowship, fellows will have thirty percent of their time protected for clinical research. This time will take place throughout the 2 years mostly during the NIH rotations.
Structured training includes a series of introductory seminars geared to the first-year fellows that takes place from July to September of the first year. These introductory seminars provide a historical perspective and basic understanding of the practice of Pediatric and Adolescent Gynecology and Reproductive Endocrinology as well as statistics. Fellows are required to attend a weekly colorectal conference, a monthly VSC clinic conference and a monthly Turner's clinic conference, PAG Journal Club/research meeting and lectures. In addition, fellows are encouraged to attend the monthly Reproductive Endocrine Journal Club and VSC-TRN case conference. In addition, the North American Society for Pediatric and Adolescent Gynecology (NASPAG) has developed a research and journal club curriculum for fellows.
In addition to informal mentoring by the PAG team faculty bi-annual mentorship meetings will allow the fellow to present and obtain feedback regarding their research and career development progress. Fellows are welcome to attend all lab meetings to learn about other research within the department as well as brainstorm ideas. Furthermore, fellows are encouraged to participate in didactic training offered at national meetings, such as the North American Society for Pediatric and Adolescent Gynecology, the American Society for Reproductive Medicine, the Society for Gynecologic Investigation and the Pediatric Endocrine Society. Moreover, fellows are encouraged to attend specialty meetings in their chosen interest areas, such as the Oncofertility Consortium and Differences in Sex Development-Androgen Insensitivity annual meetings.
Major Clinical and Research Interests of the Faculty
NIH/NICHD
- Veronica Gomez-Lobo, M.D., General PAG, Surgery including pelvic masses and anomalies; fertility preservation in special populations, androgen insensitivity syndrome, and reproductive endocrinology
- Jacqueline Maher, M.D.- Follicle activation and fertility preservation
- Micah Hill, M.D., Reproductive Endocrinology and Infertility
- Lisa Halvorson, M.D., Reproductive Endocrinology and Infertility
- Catherine Gordon, M.D., Pediatric Endocrinology and Adolescent Medicine
- Stephanie Chung, M.D., Pediatric Endocrinology, Type II diabetes
- Alison Boyce, M.D., Pediatric Endocrinology, McCune Albright Syndrome, fibrous dysplasia
- Marissa Lightbourne, M.D., Pediatric and Adult Endocrinology, Turner Syndrome, lipodystrophies
Children's National Hospital
- Lauren Damle, M.D., General PAG, (MedStar and Children's National)
- Allison Mayhew, M.D., General PAG, congenital anomalies, colorectal anomalies
- Ariel Cohen, M.D., General PAG (Kaiser Permanente and Children's National)
- Swetha Naroji, M.D., General PAG
- Rebecca Persky, M.D., Pediatric Endocrinology
- Kim Shimy, M.D., Pediatric Endocrinology, Reproductive Endocrinology, Variations in Sex Characteristics
- Roopa Kanakatti Shankar, M.D., Pediatric Endocrinology, Turner Syndrome
- Marc Levitt, M.D., Colorectal Surgery
- Christina Feng, M.D., Colorectal Surgery
- Andrea Badillo, M.D., Colorectal Surgery
- Erin Teeple, M.D., Colorectal Surgery
- Allison Jackson, M.D., Child Protection Services
- Daniel Casella, M.D., Pediatric Urology, Variations in Sex Characteristics
- Christina Ho, M.D., Urology
- Briony Varda, M.D., Urology
- Sharyn Malcolm, M.D., Adolescent Medicine
- Anisha Abraham, M.D., Adolescent Medicine, Eating Disorders
- Tucker Pyle, M.D., Genetics, Variations in Sex Characteristics
- Anna Yasmine Kirkorian, M.D., Dermatology
- AeRang Kim, M.D., Hematology/Oncology
- Hyojeong Han, M.D., Hematology/Oncology
Research in Pediatric and Adolescent Gynecology
In addition, the Pediatric and Adolescent Gynecology Program at NIH has a basic science laboratory.
Application Information
Applications should be submitted using the common application form on NASPAG. Applications are accepted in July before the anticipated start date and interviews are typically held in August or September before the start date. Qualified candidates must be U.S. Citizens or Green Card holders and have completed an accredited residency in Obstetrics and Gynecology in the United States and be board eligible in this specialty. Selection of candidates is processed through the National Resident Matching Program. One to two positions are available alternating years.
The Pediatric and Adolescent Gynecology training program is not an Accreditation Council for Graduate Medical Education (ACGME) accredited specialty. Upon completion of the program, fellows may obtain special certification for Pediatric and Adolescent Gynecology through the American Board of Obstetrics and Gynecology.
Qualified fellowship candidates must be U.S. citizens or Green Card holders who have completed a U.S. approved four-year residency in Obstetrics and Gynecology (PGY-4) and must be eligible for board certification by the American Board of Obstetrics and Gynecology. Due to the nature of the training program and rotations, this requirement cannot be waived. The program accepts civilian and military graduates of U.S. residencies in Obstetrics and Gynecology.
Questions regarding the application and status of applications may be addressed to Sofia Getachew.