Gynaecologic Specialties

Division Head Introduction

A message from Dr. Catherine Allaire, Interim Head of the Division of Gynaecologic Specialties.

Catherine Allaire

Catherine Allaire

The Division of Gynaecologic Specialties was created in 2012 in recognition of the diversity of academic activities among faculty who do not fall into one of the traditional streams of the existing divisional structure. The goal in bringing these diverse academicians together into one division was to capitalize on opportunities for mutual collaboration, shared academic motivation, and to create a social presence within the Department.

For a complete list of the Department’s programs, visit the Education section.

Undergraduate & Postgraduate

Our members are actively involved in all aspects of teaching undergraduate (medical students) and postgraduate (residents).

Advanced Training Programs

The Division offers two advanced training programs:

Continuing Professional Development

We believe in continuing professional development and implementation of nationally and internationally approved clinical guidelines. Mentorship is offered to our members who wish to offer new surgical procedures to their patients while maintaining the highest level of patient safety.

For a list of research areas in the Division, visit the Research by Division page.

Currently, there is no nation-wide procedure-specific curriculum for standard training of gynaecologic surgeons. Teaching and assessment of surgical skills continues to occur by random opportunity and subjective evaluation. The Royal College of Physicians and Surgeons of Canada has recently identified competency-based education as a priority and has awarded a team, led by division member Dr. Roxana Geoffrion, a 3-year medical education research grant to apply competency-based principles in surgical education. The PROMOTE trial investigates whether procedure specific standardized training results in improved surgical skill in the operating room. Led by Dr. Geoffrion and facilitated by Dr. Nicole Todd, a fellow, OB/GYN residents, a team of research assistants, and involving collaborations with the Universities of Alberta and Calgary, the trial involves randomization of junior gynaecology residents to intervention or control groups. The intervention residents progress through a series of didactic exercises with an online procedure-specific module and surgical skills training on a low-fidelity simulator to the real OR, where they are evaluated via performance scales and compared to controls. The six procedures taught to residents are anterior repair, posterior repair, anal sphincteroplasty, cystoscopy, vaginal hysterectomy and tension-free vaginal tape. The findings from the PROMOTE study will facilitate standard training for gynaecologic surgeons across Canada in the near future.

Dr. Lori Brotto and a team of a dozen fellows and junior researchers are actively involved in grant-funded research evaluating psychological and mindfulness-based treatment for sexual dysfunction and genital pain; online treatment of sexual dysfunction in cancer survivors; psychophysiological assessment of sexual response; ethnic minority issues in reproductive health; mood, stress, and androgens in sexual dysfunction; and asexuality. 2015 saw the publication of 10 manuscripts, 5 new grants, and over two dozen conference presentations, invited talks, and workshops. This research group is also heavily involved in media outreach and knowledge translation activities aimed to improve the sexual well-being of Canadian women.
You can follow us on twitter as well at @DrLoriBrotto
Website - http://www.brottolab.com

Learn about some of the excellent clinical programs, academic programs, and services carried out by members of the Division of Gynaecologic Specialties.

Drs. Catherine Allaire, Christina Williams, and Paul Yong are actively engaged in research on endovaginal ultrasound for pain mapping, understanding provider needs around chronic pelvic pain, and evaluating health outcomes and predictors of outcomes following interdisciplinary treatment. In addition, the team benefits from collaborations with the BC OvCaRe group, which involves surgical endometriosis banking to study genomic determinants for the malignant transformation of endometriosis to ovarian cancer and deeply infiltrating endometriosis.
Website - http://www.womenspelvicpainendo.com/

Drs. Debra Millar and Ellen Giesbrecht, who offer a referral service for patients in pediatric and adolescent gynaecology at B.C. Children’s Hospital in Vancouver, B.C. Patients are referred by primary care and subspecialty pediatricians as well as by other gynecologists and primary care physicians. Dr. Joelle Dennie is the third member of the U.B.C. group of pediatric and adolescent gynaecologists with subspecialty fellowship training. Dr. Dennie provides referral service in Victoria, B.C. To advance the academic objectives of this subspecialty, the PAG Practice Announcement group has just recruited Dr. Nicole Todd as the fourth member of the group.

Patients with gynaecologic concerns in adolescence and childhood often have complex concerns that benefit from multidisciplinary collaboration. As such, both Drs. Millar and Giesbrecht participate on the Gender Assessment Committee at B.C. Children’s Hospital, which provides a forum for multidisciplinary input for patients with medical concerns involving medical genetics, paediatric endocrinology, paediatric urology and gynecology and psychiatry.

We enjoy active involvement in the North American Society for Paediatric and Adolescent Gynecology as well as the Canadian Paediatric and Adolescent Gynecologists and Obstetricians – our representation to SOGC (Society of Obstetricians and Gynecologists of Canada).

Because Pediatric and Adolescent Gynaecology requires collaboration with our surgical subspecialists across the country due to the unique and varied nature of many of these conditions, collaboration is key. In the last two years Dr. Millar and Dr. Philippa Brain (University of Calgary) have been collaborating surgically on such cases. It is intended that ongoing surgical liaison between Vancouver and Calgary will build strength in both centers in areas of treatment of rare complex cases.

The pelvic floor is an integrated system where dysfunction of one aspect can negatively impact others. From this perspective, accurate diagnosis is the initial step to successful treatment. Therapeutic goals should focus on the relief of patient symptoms that will allow women to achieve normal activities, but should also offer a spectrum of treatment options that include non-surgical therapies.

The Centre for Pelvic Competence, based at St. Paul’s Hospital, brings together expertise in the diagnosis and management of pelvic floor disorders to address the concerns of women who suffer from these disorders. Under the leadership of Dr. Geoffrey Cundiff and Dr. Roxana Geoffrion, the Centre coordinates a multidisciplinary nexus of nurses, nurse continence advisors, pelvic physiotherapists, gastrointestinal tract specialists, pelvic floor surgeons and researchers. Each of these health care professionals brings a wealth of expertise from different backgrounds and contributes to the well-being of patients referred with pelvic floor concerns. Pelvic organ prolapse, urinary and fecal incontinence, sexual dysfunction, pelvic pain and pelvic floor fistulas are within the wide spectrum of pelvic floor conditions we treat.

We have an active fellowship program in reconstructive pelvic surgery and take pride in our teaching activities. Our research projects are varied and address patient education in pelvic floor disorders, surgical outcomes of prolapse surgery, the impact of benign pelvic floor conditions (such as uterine fibroids) on pelvic floor function, as well as resident surgical training.
Website - http://www.centreforpelvicfloor.ca

Dr. Deborah Money’s study of qHPV vaccine in HIV positive girls and women across 13 Canadian sites reached enrolment of over 400. This CIHR and Canadian HIV Trials Network supported study, based at UBC and at the Oak Tree Clinic, also involves the BC Cancer Agency and many members of the BC HPV research group, is in final analysis stages and has the potential to inform HPV vaccine policy for HIV positive persons in developed nations and in HIV endemic regions. Amongst other research within the successful Reproductive Infectious Diseases Research Group is the VoGUE study, a Vaginal Microbiome Research Group funded by CIHR and Genome BC. This novel metagenomics study of the population of microorganisms associated with health and disease for women is part of the new advances in personalized medicine. Lead by UBC and Dr. Money, collaborators cross a variety of disciplines and Canadian universities. The findings from this study, which is actively recruiting, have implications for the development of novel diagnostics. The research group, under Dr. Money’s leadership, produced 11 peer reviewed publications in 2012 and significant knowledge translation activities are expected to emerge in the year ahead. The Oak Tree Clinic research team hosted by the Women’s Health Research Institute remains active and successful having recently concluded the first 5 years of the CARMA study on the clinical and molecular impacts of HIV and HAART on aging (led by Dr. Helene Cote).

With generous funds provided by Mrs. Leslie Diamond, Drs. Lori Brotto, Sydney Thomson, and Leslie Sadownik established North America’s first Multidisciplinary Vulvodynia Program (MVP). The program integrates care from gynaecologists, psychologists, a pelvic floor physiotherapist, and researchers, is led by Program Director, Dr. Carolin Klein, and provides comprehensive treatment to women suffering from Provoked Vestibulodynia -- a condition with prevalence ranging from 12-20%. The MVP has also provided a model for the development of 4 new similar programs across North America. National data suggest that the annual burden of chronic provoked genital pain is approximately $17,000/patient and an analysis of the MVP suggests that effective multidisciplinary care can be provided for less than 10% of this cost. 2012 saw the publication of 3 papers for the MVP, 11 conference presentations, 4 CME events, 7 works in public media, and a free public forum (available now at www.mvprogram.org). 2013 will focus on publishing treatment outcomes, knowledge translation activities, providing services to postmenopausal women with secondary PVD, and development of an online platform for women in geographically remote areas suffering in silence.
Website - http://mvprogram.org/

Dr. van Schalkwyk has been involved in collaborative research in HIV, HPV, GBS, and the vaginal microbiome in both health and disease and currently leads this research group, which involves a multidisciplinary team investigating the current risk of transmission, prophylaxis failure, and definition of those who may benefit from antenatal antiviral therapy.

Led by Dr. Darren Lazare, who completed fellowship training in Urogynaecology at the University of Alberta in 2011, the urogynaecology program at Cross Roads Clinics continues to evolve in great ways. We have hired a Nurse Continence Advisor and will be expanding our female pelvic floor medicine and reconstructive surgery program in several key areas, including:

  1. Integrating specialized nursing care for patients with all types of urinary incontinence and pelvic organ prolapse
  2. Developing a collaborative, multidisciplinary program involving urogynaecology, a nurse continence advisor and pelvic floor physiotherapy for antenatal and postnatal obstetric patients
  3. Increasing pelvic medicine and reconstructive surgery clinical exposure and research opportunities for UBC learners
  4. Establishing a Perineal Injury referral service for women in the Lower Mainland with obstetric anal sphincter injuries
  5. Expanding the Pessary Clinic in order to shorten wait times for both new referrals and patients who currently require pessary maintenance
  6. Improving the quality of our urodynamics lab.

Dr. Lazare also has academic interests in the management of pelvic floor dysfunction.
Website - http://www.crossroadsbladderhealth.com

The UBC Department of Obstetrics and Gynaecology is improving the quality of life of women suffering from pelvic floor disorders by conducting research aimed developing new prevention and treatment strategies and by training the next generation of specialists to provide exemplary care to patients.

If you are interested in supporting this initiative please click here.