During the clinical years, technical skills learned include performance of all radical surgery including radical hysterectomy and pelvic lymphadenectomy, exenteration, radical vulvectomy with inguinal lymphadenectomy, and tumor debulking of ovarian cancer; bowel and urinary tract surgery necessary for management of gynecologic cancer and its complications including urinary and fecal diversion; management of postoperative complications and seriously ill cancer patients; central catheter and port placements, understanding of the technique of placement of percutaneous nephrostomies and transcutaneous biopsy of deep structures including lymph nodes; performance of complex colposcopy; planning intracavitary cesium application and interstitial brachytherapy; administration of cytotoxic drugs with knowledge of their pharmacology and side effects; and understanding the management of breast cancer.  There are rotations in surgical intensive care and in radiation oncology. Minimally invasive surgery, including robotic surgery, is performed, and the fellows will increasingly participate in these procedures under the guidance of Drs Bender and Buekers.

The fellow is given graduated responsibility in surgical and medical management of gynecologic cancer through direct involvement in the care of all patients undergoing surgical, radiotherapeutic, or chemotherapeutic treatment for gynecologic cancer.  Emphasis is placed on understanding psychosocial issues and rehabilitation, functioning in resident and postgraduate education programs as a teacher and as a resource; and acquisition of basic skills enabling understanding and conduct of clinical research in gynecologic oncology.

The senior clinical fellow supervises the junior clinical fellow and residents' management of all inpatients with guidance from the attending faculty.  As clinical skills and judgment are acquired, greater responsibility in the management of these patients is given.  The fellow is expected to become increasingly involved in direct supervision of the residents in performance of non-radical procedures.  Toward the final months of clinical rotation, the fellow is given more independence with continued close faculty supervision of clinical and surgical judgments.