CU PAG Fellowship Program Highlights

In 2021, the CU PAG Section had a total of 359 cases. Of those cases:

• 141 were contraception management
• 218 were surgical cases

The mission of the Fertility Preservation and Reproductive Late Effects Program at the University of Colorado Cancer Center and Children’s Hospital Colorado is to optimize the reproductive health of patients receiving fertility compromising treatments by providing fertility-preservation therapies and evidence-based reproductive care from diagnosis through survivorship. Fellows in our program will serve as medical and surgical consultants, providing patients and families with a detailed discussion of fertility preservation options, contraceptive management, menstrual suppression treatments available and surgical management strategies for fertility preservation. Fellows training in our program will have a broad exposure to pediatric, adolescent and adult fertility preservation and reproductive late effects and will develop necessary medical knowledge to provide consultative services, manage reproductive late effects and develop surgical skills to perform ovarian transposition and ovarian tissue cryopreservation and transplantation.

The mission of the Spots and Dots Clinic, located at Children’s Hospital Colorado, is to provide comprehensive gynecologic and hematologic care to adolescents and young adults with heavy menstrual bleeding with or without an underlying blood disorder.  Dr. Tricia Huguelet serves as the Medical Director, along with Dr. Genevieve Moyer in Hematology, and manages a team of providers including physical therapy, psychiatry and social work.  The clinic is recognized as a Clinic of Excellence within the Foundation for Women and Girls with Blood Disorders (FWGBD) and is aligned with the foundation’s Learning Action Network.  This clinic and our collaboration with FWGBD will provide fellows with exposure to the adolescent and young adults with heavy menstrual bleeding and blood disorders, access to clinical experts in the field, and create regional and national research opportunities.

This multidisciplinary program, led by world renowned experts, is dedicated to the management of patients with complex colorectal conditions like cloaca. Gynecology provides care to these patients from infancy to adulthood. In 2020, Gynecology participated in 31 cases with Colorectal surgery and/or Urology.  The PAG fellow will be actively involved in evaluating and managing these patients in outpatient and inpatient settings and will actively participate in complex surgical planning and training in these surgeries.  A specific surgical rotation is designated to this training program.

 

In addition to the above nationally recognized programs, we have several other multi-disciplinary clinics that are led by faculty within the Section of Pediatric and Adolescent Gynecology and other medical and surgical specialties.  The fellow will rotate through these clinics on a regular basis as part of their routine and subspeciality training in PAG.  These clinics include the following:

• Adolescent Polycystic Ovary Syndrome Clinic with specialists in endocrinology, gynecology, nutrition, dermatology, exercise physiology and psychology. 
• Adolescent Complex Pelvic Pain with specialists in gynecology, physical therapy, psychology and anesthesiology.  Dr. Steve Scott, within the Section of PAG, is the Medical Director of the Complex Pelvic Pain clinic and provides clinical and research expertise in this area.
• Differences in Sexual Development Clinic (SOAR, Sex Development Outcomes – Achieving Results) with specialists in endocrinology, gynecology, urology, genetics, and psychology.  Dr. Veronica Alaniz providers expert gynecologic care in this clinic.
• Bariatric Clinic with specialists in pediatric surgery, endocrinology, gynecology, lifestyle medicine, nutrition and psychology.  Carri Holton, WHNP provides contraceptive consultative services in this clinic.
• Special Care Clinic with specialists in primary care, gynecology, neurology, nutrition and respiratory therapy.  Carri Holton, WHNP provides consultative services in contraception and menstrual suppression in this clinic.

In conjunction with clinical programming, the PAG fellow will also obtain skills necessary to perform clinical outcomes-based research in Pediatric and Adolescent Gynecology. The Children’s Hospital Colorado and the University of Colorado-Department of OB-GYN are committed to providing the essential foundation to successfully complete a novel project during fellowship and continue successful research production after graduation. Our Director for Research, Stephen Scott MD, MPH, and Associate Director for Research, Karen Hampanda, PhD, will provide mentorship in generating research ideas and developing study designs. Dr. Kendra Hutchens, PhD is a Senior Instructor in our PAG Section and works exclusively with the PAG Department and will guide fellows through the logistics of clinical research including IRB protocol completion, study coordination, patient recruitment, data collection, statistical analysis, along with poster and manuscript writing. In addition to Dr. Hampanda’s statistical and teaching expertise, the PAG fellow will also have access to hospital-wide supports for research. Children’s Hospital Center for Surgery was established to support all surgical subspecialties and has developed the Research Outcomes in Children’s Surgery (ROCS) Team. ROCS can assist the PAG fellow from idea inception to project completion, with additional support in research education, methodology review, complex statistical analysis, and editing. As part of our research program, fellows will be expected to develop a novel project, with the goal of submission for national or international presentation and manuscript submission to a peer-reviewed journal. Our long-term goal is to see rigorous and well-designed research production expanding nationally to all institutions that our fellows choose to join upon fellowship completion.

The Section of Pediatric and Adolescent Gynecology is also dedicated to the education of medical students and residents, as well as our future fellows.  We currently have a dedicated 6-week rotation in PAG, with one PGY-2 resident splitting their rotation between the PAG and Reproductive Endocrinology services.  The resident becomes an integral member of our team, seeing patients in general PAG and subspecialty clinics, rounding on ED and Inpatient consults, scrubbing on OR cases, and actively participating in didactics and educational conferences.  We are proud of our educational mission and expect that our fellows will also participate in the education of our trainees.

PAG was one of my favorite rotations of second year. All of the attendings are amazing to work with and the pathology you see at Children's Hospital Colorado is an unparalleled experience.

OB-GYN Resident, Class of 2023

PAG is a rotation where we finally get to learn how to best take care of our child and young adult patients, in a way that is sensitive and comprehensive. On our PAG rotation, we get excellent training in discussing difficult topics with our teenage patients, and how to make them feel most comfortable. PAG offers experience in such a variety of topics - bleeding disorders, Mullerian anomalies, vulvovaginitis in children - we get to see everything, common and rare. Kids and teens need different care than our typical adult OB-GYN population - it’s so important to learn the best way to take care of them.”

OB-GYN Resident, Class of 2023

The Section of Pediatric and Adolescent Gynecology at Children’s Hospital Colorado is comprised of a large and diverse faculty group, including 5 physicians and two women’s health nurse practitioners.   All of our physicians have a Focused Practice Designation in Pediatric and Adolescent Gynecology by the American Board of Obstetricians and Gynecologists and two faculty have fellowship training in Pediatric and Adolescent Gynecology.  Our faculty group have a wide variety of clinical and research interests, including heavy menstrual bleeding and blood disorders, congenital anomalies of the reproductive tract, fertility preservation and reproductive late effects, adolescent chronic pelvic pain and mood disorders, polycystic ovary syndrome and complex contraception.  

As Chief of Pediatric and Adolescent Gynecology, Dr. Tricia Huguelet is passionate about remaining committed to the mission of the section and expanding our national and international reputation for patients with pediatric and adolescent gynecologic conditions.  Our team is also dedicated to advocacy and community engagement, working to promote the health and well-being of our patients both inside and outside of the hospital.  In order to maintain that enthusiasm and engagement, she has developed biannual treats for the PAG team.  Each year, one retreat is held to further develop the clinical, educational, research and advocacy mission of the section.  One additional retreat is held annually to reengage the team in a fun and relaxed environment outside of the hospital.  Throughout the year, the team also gets together for social hours, dinners, journal clubs and much, much more!