MCh in Gynaecological Oncology: Admissions, Medical Colleges, Fees, Eligibility criteria details
MCh Gynaecological Oncology or Master of Chirurgiae in Gynaecological Oncology also known as MCh in Gynaecological Oncology is a super specialty level course for doctors in India that is done by them after completion of their postgraduate medical degree course. The duration of this super specialty course is 3 years, and it focuses on the diagnosis and management of cancers of the female reproductive system, including ovarian cancer, uterine cancer, vaginal cancer, cervical cancer, and vulvar cancer.
The course is a full-time course pursued at various recognized medical colleges across the country. Some of the top medical colleges offering this course include Dr. B. Borooah Cancer Institute (Regional Cancer Centre), Guwahati, Assam, Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna, Bihar, B J Medical College, Ahmedabad, Gujarat.
Admission to this course is done through the NEET-SS Entrance exam conducted by the National Board of Examinations, followed by counseling based on the scores of the exam that is conducted by DGHS/MCC/State Authorities.
The fee for pursuing MCh (Gynaecological Oncology) varies from college to college and may range from Rs. 6,900 to Rs.3,50,000 in government college per year and from Rs.2,07,000 to Rs.28,00,000 per year in private medical colleges.
After completion of their respective course, doctors can either join the job market or can pursue certificate courses and Fellowship programs recognized by NMC and NBE. Candidates can take reputed jobs at positions as Senior residents, Consultants, etc. with an approximate salary range of Rs 26,00,000 to Rs.50,00,000 per annum.
What is MCh in Gynaecological Oncology?
Master of Chirurgiae in Gynaecological Oncology, also known as MCh (Gynaecological Oncology) or MCh in (Gynaecological Oncology) is a three-year super specialty program that candidates can pursue after completing a postgraduate degree.
Gynaecological Oncology is the branch of medical science dealing with the diagnosis and management of cancers of the female reproductive system, including ovarian cancer, uterine cancer, vaginal cancer, cervical cancer, and vulvar cancer.
National Medical Commission (NMC), the apex medical regulator, has released a Guidelines for Competency-Based Postgraduate Training Programme for MCh in Gynaecological Oncology.
The Competency-Based Postgraduate Training Programme governs the education and training of MChs in Gynaecological Oncology.
The postgraduate students must gain ample knowledge and experience in the diagnosis, and treatment of patients with acute, serious, and life-threatening medical and surgical diseases.
PG education intends to create specialists who can contribute to high-quality health care and advances in science through research and training.
The required training done by a postgraduate specialist in the field of Gynaecological Oncology would help the specialist to recognize the health needs of the community. The student should be competent to handle medical problems effectively and should be aware of the recent advances in their specialty.
The candidate is also expected to know the principles of research methodology and modes of the consulting library. The candidate should regularly attend conferences, workshops, and CMEs to upgrade her/ his knowledge.
Course Highlights
Here are some of the course highlights of MCh in Gynaecological Oncology
Name of Course | MCh in Gynaecological Oncology |
Level | Doctorate |
Duration of Course | Three years |
Course Mode | Full Time |
Minimum Academic Requirement | Candidates must have a postgraduate medical Degree in MD/MS/DNB (Obst. & Gynae) obtained from any college/university recognized by the Medical Council of India (Now NMC)/NBE, this feeder qualification mentioned here is as of 2022. For any further changes to the prerequisite requirement please refer to the NBE website. |
Admission Process / Entrance Process / Entrance Modalities | Entrance Exam (NEET-SS) INI CET for various AIIMS, PGIMER Chandigarh, JIPMER Puducherry, NIMHANS Bengaluru Counseling by DGHS/MCC/State Authorities |
Course Fees | Rs. 6,900 to Rs.3,50,000 per year in Government medical colleges Rs.2,07,000 to Rs.28,00,000 per year in Private medical colleges |
Average Salary | Rs.26,00,000 to Rs.50,00,000 per annum |
The eligibility criteria for MCh in Gynaecological Oncology are defined as the set of rules or minimum prerequisites that aspirants must meet to be eligible for admission, which includes:
Name of Super Specialty course | Course Type | Prior Eligibility Requirement |
Gynaecological Oncology | MCh | MD/MS/DNB (Obst. & Gynae) |
Note:
· The feeder qualification for MCh Gynaecological Oncology is MD/MS/DNB (Obst. & Gynae) is defined by the NBE and is subject to changes by the NBE.
· The feeder qualification mentioned here is as of 2022.
· For any changes, please refer to the NBE website.
- The prior entry qualifications shall be strictly by Post Graduate Medical Education Regulations, 2000, and its amendments notified by the NMC and any clarification issued from NMC in this regard.
- The candidate must have obtained permanent registration with any State Medical Council to be eligible for admission.
- The medical college's recognition cut-off dates for the Postgraduate Degree courses shall be as prescribed by the Medical Council of India (now NMC).
Admission Process
The admission process contains a few steps to be followed in order by the candidates for admission to MCh in Gynaecological Oncology. Candidates can view the complete admission process for MCh in Gynaecological Oncology mentioned below:
- The NEET-SS or National Eligibility Entrance Test for Super specialty courses is a national-level master's level examination conducted by the NBE for admission to DM/MCh/DrNB Courses.
- Qualifying Criteria-Candidates placed at the 50th percentile or above shall be declared as qualified in the NEET-SS in their respective specialty.
- The following Medical institutions are not covered under centralized admissions for DM/MCh courses through NEET-SS:
1. AIIMS, New Delhi, and other AIIMS
2. PGIMER, Chandigarh
3. JIPMER, Puducherry
4. NIMHANS, Bengaluru
- Candidates from all eligible feeder specialty subjects shall be required to appear in the question paper of the respective group if they are willing to opt for a super specialty course in any of the super specialty courses covered in that group.
- A candidate can opt for appearing in the question papers of as many groups for which his/her Postgraduate specialty qualification is an eligible feeder qualification.
- By appearing in the question paper of a group and on qualifying for the examination, a candidate shall be eligible to exercise his/her choices in the counseling only for those super specialty subjects covered in the said group for which his/ her broad specialty is an eligible feeder qualification.
Fees Structure
The fee structure for MCh in Gynaecological Oncology varies from college to college. The fee is generally less for Government Institutes and more for private institutes. The average fee structure for MCh in Gynaecological Oncology is around Rs. 6,900 to Rs.3,50,000 per year in government colleges and from Rs.2,07,000 to Rs.28,00,000 per year in private medical colleges.
Colleges offering MCh in Gynaecological Oncology
Various medical colleges across India offer courses for pursuing MCh in (Gynaecological Oncology).
As per National Medical Commission (NMC) website, the following medical colleges are offering MCh in (Gynaecological Oncology) courses for the academic year 2022-23.
Sl.No. | Course Name | State | Name and Address of Medical College / Medical Institution | Annual Intake (Seats) |
1 | M.Ch - Gynaecological Oncology | Assam | Dr. B. Borooah Cancer Institute (Regional Cancer Centre), Guwahati | 2 |
2 | M.Ch - Gynaecological Oncology | Bihar | Indira Gandhi Institute of Medical Sciences, Sheikhpura, Patna | 1 |
3 | M.Ch - Gynaecological Oncology | Gujarat | B J Medical College, Ahmedabad | 4 |
4 | M.Ch - Gynaecological Oncology | Karnataka | Kidwai Memorial Institute of Oncology, Bangalore | 3 |
5 | M.Ch - Gynaecological Oncology | Karnataka | St. Johns Medical College, Bangalore | 1 |
6 | M.Ch - Gynaecological Oncology | Kerala | Regional Cancer Centre, Thiruvanthapuram | 2 |
7 | M.Ch - Gynaecological Oncology | Kerala | Amrita School of Medicine, Elamkara, Kochi | 2 |
8 | M.Ch - Gynaecological Oncology | Maharashtra | Tata Memorial Centre, Mumbai | 2 |
9 | M.Ch - Gynaecological Oncology | Orissa | Acharya Harihar Regional Cancer Centre, Cuttack | 2 |
10 | M.Ch - Gynaecological Oncology | Tamil Nadu | Christian Medical College, Vellore | 2 |
11 | M.Ch - Gynaecological Oncology | Uttarakhand | All India Institute of Medical Sciences, Rishikesh | 21 |
An MCh in Gynaecological Oncology is a three years specialization course that provides training in the stream of Gynaecology and Oncology.
Syllabus
Course contents:
At the end of a three-year course in Gynaecological Oncology, the post-graduate student should have acquired the following theoretical, clinical skills and research knowledge.
• Diagnostic techniques and staging of gynecological cancers
• Surgery for gynecological cancers
• Principles of radiation therapy for gynecological malignancies
• Chemotherapy, targeted therapy, and Immuno-therapy for gynecological cancers
• Palliative care for advanced and recurrent cancers
• Pathology of common gynecological cancers
• Research methodology for clinical trials and statistics
• Writing original papers in reputed national & International scientific journals
• Knowledge related to epidemiology and preventive oncology as applied to Gynaecological Oncology
1. Diagnostic techniques and staging
Objectives :
• The trainee should be able to:-
Identify the appropriate diagnostic techniques needed to:-
- establish the diagnosis
- establish the extent of the disease
- evaluate co-existing diseases which may have an important bearing on the selection of and response to treatment
- evaluate the response of cancer to treatment
- Stage cancer according to the current F.I.G.O. classification for gynecological cancers and the corresponding TNM classification.
- have sufficient knowledge in colposcopy and have expert knowledge of the colposcopic evaluation of abnormal cervical or vaginal cytology and vulval neoplasia and identify abnormal epithelial and vascular patterns involving the cervix, vagina, and vulva with the colposcope
- perform cystoscopy
- perform proctosigmoidoscopy
- perform hysteroscopy
- understand the indications for gastrointestinal endoscopy
- he expert in directed cervical biopsies, cone biopsy, LEEP biopsy of the cervix, endocervical curettage, endometrial biopsy and curettage, vulval and nodal biopsies of pelvic, abdominal, and other nodal sites
- understand the indications and techniques for open and percutaneous biopsies
- of possible metastatic sites such as lung, liver, and spine
- understand the indications for and be able to carry out trans-vaginal and trans-abdominal needle biopsy for the diagnosis or evaluation of the extent of pelvic cancers understand the use and limitations of cytology in the detection of cancer and know how to obtain the necessary samples
• The trainee should know the indications for the relative value and interpretation of values and limitations of the techniques such as:-
- Radiographic diagnosis:
- Standard plain film evaluation of heart, abdomen, and skeletal system
- CT Scan and MRI
- Angiography, pulmonary, renal, pelvic
- Intravenous and retrograde urography
- Gastrointestinal and colonic radiography
- Mammography
- Radioisotope scanning:
- PET/CT scanning
-liver-spleen
- bone
- brain
- kidneys
- lungs
- peripheral vascular system
- Ultrasonography
- Measurement of tumor markers and other humoral markers of cancer and benign tumors
- serum HCG and beta-HCG
- serum Alpha fetoprotein
- Carcinoembryonic antigen
- Serum CA125
- Ectopic hormone production (for example-growth hormone, HCG, parathormone)
- Steroid hormones (estrogen/androgens/corticosteroids)
- Biochemistry
- liver function tests
- renal function tests
- carbohydrate tolerance tests
- inappropriate ADH secretion
Blood coagulation
- tests for coagulopathies
- monitoring of anticoagulant therapy
- the prophylactic and therapeutic use of anticoagulants
Pulmonary function tests (PFT)
Perioperative monitoring
- central venous pressure and CVP lines
- pulmonary wedge pressure and Swann Ganz catheters
- arterial lines
- ECG
- the role of HDU/ITU
2. Surgery for gynecological cancers
• Objectives
• The trainee should gain expertise in:-
preoperative evaluation
pre-operative preparation
- bowel
- position of ostomy sites
- fluid restriction
- pulmonary – when indicated
- thromboprophylaxis
- counseling the patient and the family
- obtaining informed consent
- choice of treatment – surgical and non-surgical treatment
- surgical anatomy comprising detailed knowledge of the abdominal pelvic anatomy, including genital, urinary, and G.I tracts and other areas of relevance, e.g., thigh and neck
- management of complications- To be familiar with common complications associated with commonly performed surgical procedures for gynecological cancers.
- intraoperative
1. transfusion reaction
2. cardiac arrest
3. injury to the bladder, bowel, ureters, and major blood vessels
- postoperative
a. atelectasis, other pulmonary complications
b. intra-abdominal bleeding
c. DVT and pulmonary embolus
d. vesicovaginal fistula
e. ureterovaginal fistula
f. rectovaginal fistula
g. renal failure
h. congestive heart failure
i. jaundice
j. pyrexia and sepsis
k. respiratory insufficiency
l. wound problems – infection, dehiscence, evisceration
m. paralytic ileus
n. bowel obstruction
• The trainee should have sufficient training and experience so that the following procedures may be independently and competently performed and their aftercare managed by the completion of the training period.
Primary procedures
- hysterectomy – (a) radical, (b) total abdominal, (c) vaginal
- pelvic lymphadenectomy
- para-aortic lymphadenectomy
- radical vulvectomy
- inguinal and femoral lymphadenectomy
- debulking surgery for stage III and IV ovarian cancer, fertility-sparing surgery for early-stage ovarian cancer
- conservative surgery for early-stage ovarian and cervical carcinoma in young patients
- laparoscopic surgery for carcinoma endometrium, carcinoma cervix
- Exenteration procedures
Gastrointestinal procedures related to gynecological malignancy in collaboration with colorectal surgeons where necessary :
- small intestine : (a) resection and reanastamosis
(b) bypass procedures
(c) ileostomy
- large intestine : (a) resection
(b) colostomies
Urinary tract procedures related to gynecological malignancy in collaboration with urological surgeons where necessary :
- bladder : (a) partial cystectomy
(b) cystotomy
- ureter : (a) ureteroneocystostomy
(b) end-to-end ureteral reanastomosis
(c) ileal conduit
Evaluation procedures
- cystoscopy
- laparoscopy
- colposcopy
- Upper GI endoscopy
- sigmoidoscopy/colonoscopy
• The trainee should at least understand the place of:-
- pelvic exenteration
- primary colonic anastomosis
- continent urinary conduits
- vaginal reconstruction
- plastic reconstruction of the vulva
- laparoscopic lymph node dissection
- laparoscopic surgical staging
- laparoscopic prophylactic salpingo-oophorectomy
- radical vaginal surgery for cervical cancer
- insertion of intracavitary radiation applicators
- feeding jejeunostomy/gastrostomy
- repair of vesicovaginal fistulae
- primary closure
- bulbocavernosus interposition
• Over 30 months it is expected that a candidate enrolled for an MCh course in Gynaecological Oncology will perform the following number of procedures:-
Complete pelvic and para-aortic node dissection - 15
Complete ureteric dissections - 12
Radical abdominal hysterectomy - 12
-Radical excisions of vulval cancer including
Groin dissection - 05
-Laparotomies for stage III and IV ovarian cancer - 25
-Fertility-sparing surgery for early gynecological - 05
cancers
-Type I hysterectomies for carcinoma endometrium - 10
-Exposure to newer surgical techniques such as
HIPEC, robotic surgery
• To allow assessment of training, the trainee should keep a logbook of cases for discussion at assessment. Suggested minimum data comprises
- Patient Id (WITHOUT NAME)
- Date
- Main, Co-Surgeon or assistant surgeon
- Tumour and stage
- Procedure
- Complications
- Special features
3. Principles of radiation therapy for gynecological malignancies
Objectives
The trainee should have sufficient familiarity with the principles and practice of Radiation Oncology in treatment planning, in the execution of intracavitary applications, and the management of irradiation-induced complications.
• Radiobiology and Cell biology
General principles of Radiobiology
- The cell cycle, basic cell kinetics, tumor vasculature, and angiogenesis.
- Cellular systems and their response to radiation
- Radiation biology models radiation damage at the cellular level.
Techniques in molecular biology
- Nucleic acid analysis including electrophoresis, hybridization, blotting, PCR, sequencing, transfection
- Microarray techniques
- Transgenic models
The genetics of normal and malignant cells
- Normal chromosomal structure and function, normal gene transcription
- Normal DNA repair mechanisms
- Polymorphisms, mini and microsatellites
- Chromosomal and genetic changes in malignancy, point mutations, translocations, deletions, gene amplification, and over-expression
- Oncogenes, proto-oncogenes, tumor suppressor genes.
Normal tissue radiobiology
- Normal tissue damage & concepts of normal tissue tolerance
- The concept of damage (lethal, sub-lethal, potentially lethal) & Repair
- The cell survival curve as a basis for fractionation
- Hyper fractionation, accelerated fractionation, and hypo fractionation
- Hypoxic cell sensitizers and protectors
• Radiotherapy treatment planning
Alpha, beta, and gamma rays
Inverse square law
Immobilization (techniques and accuracy)
Tumor localization: direct visual, simulator, CT, MRI, USG, PET
Principles of conformal therapy and intensity modulated radiation therapy (IMRT)
• Radiotherapy Treatment
External Beam Therapy & equipment
- Principles of superficial, orthovoltage, and megavoltage
- Principles of the Linear Accelerator & Telecobalt machines
- Radiation Doses; Radical & Palliative
- Radiotherapy Techniques: Conventional, 3D-CRT, IMRT & IGRT
Brachytherapy
- Types of sources & their construction
- Principles of clinical use
- Gynaecological intracavitary brachytherapy systems, source, and dose distributions and dose specification, dose to point A & B
- Principles of after-loading (manual, remote, low, medium, and high dose rate)
- Image-guided Brachytherapy
Radiotherapy at gynecological sites
- Uterine Cervix
- Corpus Uteri
- Vagina
- Vulva
- Ovaries
- Fallopian Tube
- Radiotherapy at uncommon sites
Radiation protection
- Radiation risk & Radiation limits
- Protection mechanisms: time, distance, shielding
- Monitoring of personnel
- Dose reporting mechanisms and dose level
Early radiation reactions
- Bowel, Bladder, Vaginal & Skin reactions
• Late Complications
- Factors affecting late complications
- A complication to GI Tract, Urinary tract, Skin, Bone Marrow, etc.
- Managing complications
- Late radiation-induced malignancies
• Combination of chemotherapy and radiation therapy (neoadjuvant, concurrent, and adjuvant)
• To allow assessment of training, the trainee should keep a logbook of cases for discussion at assessment. Suggested minimum data comprises
Patient id (WITHOUT NAME)
- Date
- Tumour and stage
- Procedure (e.g. radiotherapy planning or insertion)
- Complications
- Special features
4. Chemotherapy for gynecological cancers
1. Objectives
The trainee should understand the pharmacology of the major drugs used in cancer chemotherapy and be able to use them.
• Cell biology including:
cell cycle kinetics
log kill hypothesis
cycle and phase specificity
• Classes of chemotherapeutic agents :
Taxanes
alkylating agents
antimetabolites
antibiotics
vinca alkaloids
hormones
miscellaneous agents
• Targeted therapy
• Immunotherapy
• Mechanism of action
• Pharmacology of specific agents
- routes of administration and absorption
- distribution
- biotransformation
- excretion
- drug interactions
- pharmacokinetics
- Benefits and limitations of combination chemotherapy
- Intraperitoneal chemotherapy
- High dose chemotherapy
- General guidelines for clinical evaluation include the definitions of complete or partial responses, the concept of phase I, II, and III drug trials, and adjuvant therapy.
- Toxicity including :
- general effects on rapidly proliferating epithelium such as bone marrow, G.I.
- tract and hair follicles
- drug-specific toxicity
- management
• Trophoblastic disease
• Palliative Chemotherapy
To allow assessment of training, the trainee should keep a personal logbook of cases for discussion at assessment. Suggested minimum data comprises
- Patient Id (without a name)
- Date
- Tumour and stage
- Procedure (e.g. chemotherapy planning or prescription)
- Complications
- Special features
5. Palliative care for advanced and recurrent cancers
1. Objectives:
The trainee should be able to contribute to palliative care including:-
• Pain relief:
- non-narcotic analgesics
- narcotic analgesics
- co-analgesics
- WHO ladder
- understanding the role of anesthetist – (a) pain clinics, (b) neural blocks
• Anxiety relief :
Sedatives and tranquilizers
counseling (patient and family)
Home care
• nausea and vomiting relief:
- antiemetics
- dietary measures
• Community support roles:
- General Practitioner
- district nurse
- family
- religion
- community services, e.g., laundry, social services
- cancer help groups
• The trainee should have received practical exposure to hospice care.
• The trainee should have been taught and have experience in breaking bad news to patients and relatives.
6. Pathology of common gynecological cancers
1. Objectives:
• The trainee should be able to identify, based on direct visual and microscopic evaluation, lesions that are pre-malignant or malignant and distinguish them from benign disorders. She/he should know what histopathological features are important in disease progression i.e. tumor margins, depth of invasion, lymphovascular space involvement, grade, and node metastases. The candidate should be familiar with immunohistochemistry stains and immunophenotyping, receptor studies as applied to gynecological tumors
Vulva including:
- neoplastic and non-neoplastic disorders
- warts
- intraepithelial neoplasia
- carcinoma
- sarcoma
Vagina including:
- adenosis
- warts
- intraepithelial neoplasia
- carcinoma
- sarcoma
Cervix including:
- intraepithelial neoplasia
- microinvasion
- carcinoma
- sarcoma
- neuroendocrine tumors
Uterine body including:
- cystic hyperplasia
- adenomatous hyperplasia
- carcinoma
- sarcoma
- trophoblastic hyperplasia
- carcinosarcoma
Fallopian tube:
- carcinoma
Ovary including:
- functional cysts
- serous cystadenoma and carcinoma
- mucinous cystadenoma and carcinoma
- Brenner tumor
- granulosa-theca cell tumor
- Sertoli-Leydig cell tumor
- gynandroblastoma
- cystic teratoma
- mixed germ cell and gonadal stromal tumors
- embryonal carcinoma
- choriocarcinoma
- endometrioid carcinoma
- metastatic carcinoma
- gonadoblastoma
- mesonephros
SUBJECT-SPECIFIC THEORETICAL COMPETENCIES
Cognitive domain (Knowledge Domain)
At the end of the course, the student should have acquired the following skills and knowledge in the following:
1. Female pelvic anatomy.
2. Vascular supply of pelvis
3. Anatomy of female ureter and bladder.
4. Lymphatic drainage of the female pelvis including the vulva.
5. Pathology of premalignant and malignant lesions of the female genital tract.
6. FIGO and other international staging systems for various gynecological cancers.
7. Surgical principles in the management of various gynecological cancers.
8. Postoperative care, including fluid and electrolyte management.
9. Surgical management in case of the small intestine or large bowel involvement by gynae cancer.
10. Surgical management in case of ureter or bladder involvement or injury during surgery.
11. Prophylaxis against venous thromboembolism.
12. Management of suspected and established cases of venous thromboembolism.
13. Concept of Medical and Radiation Oncology management of these cases.
The affective domain (Attitudes including Communication and Professionalism)
At the end of three years course in Gynaecological Oncology, a candidate should be able to -
1. Effectively communicate to the patient and her relatives the nature of the disease, the extent of the disease, the treatment options available, and the expected outcome following management of the disease.
2. execute the planned treatment with the help of other colleagues in the specialty of Gynaecological Oncology.
3. maintain the highest degree of professionalism in executing treatment of the disease and communication with the patient and relatives.
SUBJECT-SPECIFIC PRACTICAL COMPETENCIES
Diagnostic techniques and staging
1. Objectives :
• The trainee should be able to:-
Identify the appropriate diagnostic techniques needed to:-
- establish the diagnosis
- establish the extent of the disease
- evaluate co-existing diseases which may have an important bearing on the selection of and response to treatment
- evaluate the response of cancer to treatment
• stage cancer according to the current F.I.G.O. classification for gynecological cancers and the corresponding TNM classification.
• have sufficient knowledge in colposcopy and have expert knowledge of the colposcopic evaluation of abnormal cervical or vaginal cytology and vulval neoplasia and identify abnormal epithelial and vascular patterns involving the cervix, vagina, and vulva with the colposcope
• perform cystoscopy
• perform proctosigmoidoscopy
• perform hysteroscopy
• understand the indications for gastrointestinal endoscopy
• be an expert in directed cervical biopsies, cone biopsy, LEEP biopsy of the cervix, endocervical curettage, endometrial biopsy and curettage, vulval and nodal biopsies of pelvic, abdominal, and other nodal sites
• understand the indications and techniques for open and percutaneous biopsies of possible metastatic sites such as lung, liver, and spine, and lymph nodes.
• understand the indications for and be able to carry out transvaginal and transabdominal needle biopsies for the diagnosis or evaluation of the extent of pelvic cancers
• understand the use and limitations of cytology in the detection of cancer, and know how to obtain the necessary samples
• The trainee should know the indications for the relative value and interpretation of values and limitations of the techniques such as:-
Radiographic diagnosis:
- Standard plain film evaluation of heart, abdomen, and skeletal system
- CT Scan and MRI
- Angiography, pulmonary, renal, pelvic
- Intravenous and retrograde urography
- Gastrointestinal and colonic radiography
- Mammography
Radioisotope scanning:
- PET-CT scanning
- liver-spleen
- bone
- brain
- kidneys
- lungs
- peripheral vascular system
Ultrasonography
Measurement of tumor markers and other humoral markers of cancer and benign tumors
- serum HCG and beta-HCG
- serum Alpha fetoprotein
- Carcinoembryonic antigen
- Serum CA125
- Ectopic hormone production (for example-growth hormone, HCG, parathormone)
- Steroid hormones (estrogen/androgens/corticosteroids)
Biochemistry
- liver function tests
- renal function tests - including, creatinine clearance, GFR, urine electrolytes, osmolality, serum electrolytes, osmolality and pH
- carbohydrate tolerance tests
- inappropriate ADH secretion
Blood coagulation
- tests for coagulopathies
- monitoring of anticoagulant therapy
- the prophylactic and therapeutic use of anticoagulants
-Pulmonary function tests (PFT)
-Perioperative monitoring
- central venous pressure and CVP lines
- pulmonary wedge pressure and Swann Ganz catheters
- arterial lines
- ECG
- the role of HDU/ITU
2. Surgery for gynecological cancers
1. Objectives
• The trainee should gain expertise in:-
- Preoperative evaluation
- Pre-operative preparation
- bowel
- position of ostomy sites
- fluid restriction
- pulmonary – when indicated
- thromboprophylaxis
- counseling the patient and the family
- obtaining informed consent
- Choice of treatment – surgical and non-surgical treatment
- Surgical anatomy comprising detailed knowledge of the abdominal pelvic anatomy, including genital, urinary, and G.I tracts and other areas of relevance, e.g., thigh and neck
- Management of complications-To To be familiar with common complications associated with commonly performed surgical procedures for gynecological cancers.
- Intraoperative
* transfusion reaction
*cardiac arrest
*injury to bladder, bowel, ureters, major blood vessels
- Postoperative
a. atelectasis, other pulmonary complications
b. *intra-abdominal bleeding
c. *DVT and pulmonary embolus
d. *vesicovaginal fistula
e. *ureterovaginal fistula
f. *rectovaginal fistula
g. *renal failure
h. *congestive heart failure
i. *jaundice
j. *pyrexia and sepsis
k. *respiratory insufficiency
l. *wound problems – infection, dehiscence, evisceration
m. *paralytic ileus
n. *bowel obstruction
• The trainee should have sufficient training and experience so that the following procedures may be independently and competently performed and their aftercare managed by the completion of the training period
Primary procedures
- hysterectomy – (a) radical, (b) total abdominal, (c) vaginal
- pelvic lymphadenectomy
- para-aortic lymphadenectomy
- radical vulvectomy
- inguinal and femoral lymphadenectomy
- debulking surgery for stage III and IV ovarian cancer, fertility-sparing surgery for early-stage ovarian cancer
- conservative surgery for early-stage ovarian carcinoma in young patients
- laparoscopic surgery for carcinoma endometrium, carcinoma cervix
- Exenteration procedures
Gastrointestinal procedures related to gynecological malignancy in collaboration with colorectal surgeons where necessary :
- small intestine : (a) resection and re-anastomosis.
(b) bypass procedures
(c) ileostomy
- large intestine : (a) resection
(b) colostomies
Urinary tract procedures related to gynecological malignancy in collaboration with urological surgeons where necessary :
- bladder (a) partial cystectomy
(b) cystotomy
- ureter (a) ureteroneocystostomy
(b) end-to-end ureteral reanastomosis
(c) ileal conduit
Evaluation procedures
- cystoscopy
- laparoscopy
- colposcopy
-Upper GI endoscopy
- sigmoidoscopy/colonoscopy
• The trainee should understand the place of:-
- Pelvic exenteration
- Primary colonic anastomosis
- Continent urinary conduits
- Vaginal reconstruction
- Plastic reconstruction of the vulva
- Laparoscopic lymph node dissection
- Laparoscopic surgical staging
- Laparoscopic prophylactic salpingo-oophorectomy
- Radical vaginal surgery for cervical cancer
- Insertion of intracavitary radiation applicators
- Feeding jejeunostomy/gastrostomy
- Repair of vesicovaginal fistulae
- primary closure
- bulbocavernosus interposition
Career Options
After completing an MCh in Gynaecological Oncology, candidates will get employment opportunities in Government as well as in the Private sector.
In the Government sector, candidates have various options to choose from which include Registrar, Senior Resident, Demonstrator, Tutor, etc.
While in the Private sector, the options include Resident Doctor, Consultant, Visiting Consultant (Gynae oncology), Junior Consultant, and Senior Consultant (Gynae oncology).
Courses After MCh in Gynaecological Oncology Course
MCh in Gynaecological Oncology is a specialization course that can be pursued after finishing a Postgraduate medical course. After pursuing a specialization in MCh in Gynaecological Oncology, a candidate could also pursue certificate courses and Fellowship programs recognized by NMC and NBE, where MCh in Gynaecological Oncology is a feeder qualification.
Frequently Asked Questions (FAQs) –MCh in Gynaecological Oncology Course
- Question: What is the full form of an MCh?
Answer: The full form of an MCh is Master of Chirurgiae.
- Question: What is an MCh in Gynaecological Oncology?
Answer: MCh Gynaecological Oncology or Master of Chirurgiae in Gynaecological Oncology also known as MCh in Gynaecological Oncology is a super specialty level course for doctors in India that is done by them after completion of their postgraduate medical degree course.
- Question: What is the duration of an MCh in Gynaecological Oncology?
Answer: MCh in Gynaecological Oncology is a super specialty program of three years.
- Question: What is the eligibility of an MCh in Gynaecological Oncology?
Answer: Candidates must have a postgraduate medical Degree in MD/MS/DNB (Obst. & Gynae) obtained from any college/university recognized by the Medical Council of India (Now NMC)/NBE., this feeder qualification is mentioned here as of 2022. For any further changes to the prerequisite requirement please refer to the NBE website.
- Question: What is the scope of an MCh in Gynaecological Oncology?
Answer: MCh in Gynaecological Oncology offers candidates various employment opportunities and career prospects.
- Question: What is the average salary for an MCh in Gynaecological Oncology candidate?
Answer: The MCh in Gynaecological Oncology candidate's average salary is between Rs. 26 lakhs to Rs. 50 lakh per annum depending on the experience.
- Question: Can you teach after completing an MCh Course?
Answer: Yes, the candidate can teach in a medical college/hospital after completing an MCh course.
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