The Goals of the UCI Endourology Fellowship Program are:

• Provide experience in research and state-of-the-art clinical endourology, laparoscopic urology, and robot-assisted surgery.



• Foster an environment of learning new concepts in surgical education and developing teaching skills in an interactive format encompassing all aspects of endourology, laparoscopic urology and robot-assisted surgery techniques.



• Provide to each fellow, continued mentoring and guidance as they establish their own academic careers in minimally invasive urologic surgery.

Description of Program
The Department of Urology at University of California, Irvine offers a two-year endourology fellowship. The fellowship is focused only on individuals interested in a career in academic urology. The fellowship is fully approved by the Endourological Society fellowship matching program. Applicants must be American Board of Urology eligible and within two years of completing their urology residency training. The fellowship includes a junior faculty appointment as a Clinical Instructor in the UCI Department of Urology with clinical, research and teaching responsibilities, plus full hospital privileges. The fellow has designated desk space in the laboratory, laboratory personnel, computer supplies, and secretarial assistance to aid every aspect of his/her productivity.

During the first year of the fellowship program, the fellow serves as the endourology research team leader participating primarily in laboratory research projects. During that time the fellow spends 80% time in the laboratory and 20% time in clinical work. All laboratory efforts are under the guidance of the laboratory director, Dr. Darren Tyson in collaboration with Drs. Clayman and McDougall. To this end, there are biweekly laboratory meetings during which all projects are discussed and reviewed. In the laboratory, there is a full-time laboratory technician/animal care person to aid the fellow along with UCI students interested in independent studies and other post-graduate urologists interested in endourological research. The fellow is the team leader for the laboratory and thus becomes proficient at preparing submissions to the Animal Care Committee. The goal is to enable the fellow to develop a line of independent research that will transfer to their next University place of employment after the fellowship.

The second year, the fellow serves as the endourology clinical fellow assisting in the operating room in robotic, laparoscopic, percutaneous, and ureteroscopic procedures performed at UCI and the Veterans’ Hospital while pursuing clinical research projects. Clinical activities include working with Drs. Ahlering and Ornstein in the area of laparoscopic robotic radial prostatectomy, Dr. Shanberg with regard to laparoscopic hand-assisted cystectomy and diversion, Drs. McDougall and Clayman with respect to standard laparoscopic renal and ureteral surgery, percutaneous renal surgery, ureteroscopy, and needle ablative therapy. The fellow works very closely also with the residents and will often staff endourology cases at the Veterans Administration Hospital. During this year, the fellow will also be encouraged to publish his/her work, prepare lectures for teaching the residents and will participate in the annual New Frontiers in Endourology course at UCI. The fellow will also become proficient at writing clinical protocols for Institutional Review Board approval. The goals during this year are to develop both the fellow’s clinical endourological skills and academic abilities (i.e. grant preparation, manuscript writing and lecturing).

The fellow is included in the faculty call rotation which entails a one-in-nine-call schedule. First call is managed by the junior and senior resident with the fellow as the faculty call advisor.

The expressed goal of this two-year fellowship is to train future academicians in endourology and laparoscopic surgery. This goal has remained unchanged since the initiation of the first endourology fellowship program in 1984, by Dr. Clayman at Washington University. Since that time, 15 fellows have gone on to develop successful academic careers throughout the United States, Canada, and Israel. For an individual interested in pursuing a career in academics in endourology and laparoscopy, this two-year program is designed to provide a solid foundation with which an excellent opportunity in one of the major teaching institutions in the United States can be secured.


Clinical Volume

Research and Animal Laboratory Facilities
The bench laboratory space and animal laboratory research facilities are all housed within Building 55 on the University of California, Irvine Medical Center campus, such that the research facility and hospital are each within 200 yards of each other. The vivarium for UCIMC is housed in the basement of Building 55. On the third floor of Building 55, there is 1600 square feet of space for basic science bench research. These efforts are directed at prostate and bladder cancer, stem cell research, and tissue bioengineering. In addition, the Astellas Education Center in the basement of Building 55, includes 586 square feet of dedicated skills training and assessment materials, including a variety of training models, virtual-reality simulators in both endourology and laparoscopic surgery and a dedicated minimally invasive surgery text and video library. Adjacent to this area is an additional 974 square feet of animal surgery space including six anesthesia bays, a Storz OR1 facility and a four-armed da Vinci® Robotic Surgical System used for training and research. In addition, there is a 327 square foot survival surgery suite for large and small animal work. The animal facility includes all support surgical devices including harmonic scapel, C-arm fluoroscopy unit, argon-beam coagulator, and a laser-generating unit.

Fellowship Faculty

Ralph V. Clayman, M.D.
Professor and Chair, Department of Urology
Endourology Fellowship Director

Training

	Undergraduate:	Grinnell College
	Medical School:	University of California, San Diego
	Residency:	University of Minnesota
	Postgraduate Studies:	Endourology and Laparoscopic Surgery

Dr. Clayman is world renowned for his expertise in minimally invasive surgery for kidney stone disease, kidney cancer, and strictures of the ureter and is named as one of America's Best Doctors. Following his general surgery and urology training at the University of Minnesota, he spent two years at Southwestern Medical School in Dallas pursuing his interests in renal cancer research, kidney stone disease, and minimally invasive urology. Dr. Clayman spent 17 years at Washington University School of Medicine in St. Louis, rising to the positions of Professor of Urology and Radiology, Director of the Midwest Stone Institute, and Co-director of the Division of Minimally Invasive Surgery. In January 2002, he was appointed chair of the newly formed Department of Urology at UCI Medical Center. Dr. Clayman and his associates performed the world's first laparoscopic removal of a kidney for benign disease and for cancer, as well as the first laparoscopic removal of a kidney and ureter to treat cancer. He helped develop a balloon catheter to treat obstruction of the ureter and performed pioneering work on percutaneous and endoscopic therapy for ureteral and kidney stones.

Dr. Clayman established the first fellowship program in minimally invasive urology, and trainees of his program now occupy academic positions at universities throughout the United States, Canada, and Israel. Dr. Clayman is the author of textbooks on laparoscopic and percutaneous urologic surgery, and has published more than 300 peer-reviewed papers and book chapters. He is co-founder and co-editor of the Journal of Endourology and is a member of the editorial board of the Journal of Urology and Urology. He has seven, minimally invasive surgical instrumentation patents to his name. He was recently named to the American Board of Urology, a position he will hold through 2011. Dr. Clayman's patient care, teaching, and research efforts are focused on developing a kinder, gentler surgery in which incisions are either reduced in size or eliminated all together. In order to accomplish this goal, he and his team continue to explore a broad range of minimally invasive and noninvasive surgical techniques to bring up-to-the-moment technology into the operating room.


Elspeth M. McDougall, M.D., FRCSC
Professor of Urology
Director, Astellas Center for Urological Education

Training

	Undergraduate:	University of Alberta
	Medical School:	University of Calgary
	Residency:	Holy Cross Hospital Ottawa Civic and Ottawa General Hospitals
	Fellowship Training:	Endourology / Washington University, St. Louis, MO Learning and Teaching / University of Southern California, Los Angeles, CA

Dr. McDougall joined the UCI faculty in 2002 to continue her clinical and research work in minimally invasive urologic surgery and assist in the development of a minimally invasive surgery education center. She is internationally recognized for her laboratory and clinical research in urologic laparoscopic surgery and for teaching courses on fundamental and advanced endourological and laparoscopic techniques, and is named as one of America's Best Doctors.

Dr. McDougall completed her medical training at the University of Calgary and the University of Ottawa in Canada, and then undertook a fellowship in endourology and extracorporeal shock wave lithotripsy (ESWL) with Dr. Clayman at Washington University School of Medicine. She joined the faculty at Washington University Medical School in 1991, where she spent nine years in academic urology. Subsequently, she developed the Endourology/Laparoscopic Urology Program at Vanderbilt University in Nashville, Tennessee, during her tenure there as Professor of Urologic Surgery. She is a Fellow of the Royal College of Surgeons of Canada (Urology) and certified with the American Board of Urology. Dr. McDougall has published more than 175 peer-reviewed journal articles and numerous book chapters. She is the co-editor of two textbooks on laparoscopic surgery.

Dr. McDougall is a member of the Surgical Simulation Committee of the Society of Laparoendoscopic Surgeons and a member of the Laparoscopic Training Committee of the American Urological Association. She is on the editorial boards of the Journal of Endourology and the Journal of the Society of Laparoendoscopic Surgeons. She is Past-President of the Society of Laparoendoscopic Surgeons and a member of the World Congress of Endourology's Scientific Meeting Advisory Committee. She was recently elected to the prestigious American Association of Genitourinary Surgeons.

Dr. McDougall is the Director of the Astellas Center for Urological Education at UCI and developed the ongoing, five-day mini-residency training program in minimally invasive urologic surgery training academic and community urologists. She recently completed a Teaching and Learning Fellowship at the University of Southern California. She also is co-director of the annual New Frontiers in Endourology course at UCI.


Darren R. Tyson, Ph.D.
Assistant Researcher
Director of Research

Training

	Undergraduate:	University of Illinois
	Graduate School:	Saint Louis University
	Postdoctoral Training:	University of California, Irvine

Darren R. Tyson was recruited to the Department in July 2003 as an Assistant Researcher and Director of Urologic Research. His experience in cellular and molecular biology has aided in establishing a basic science research laboratory for the Department. His extensive knowledge in the field of bone biology will be used to investigate the predisposition of prostate cancer cells to metastasize to bone. As a new investigator in the Department, he will provide his experience in growth factor receptor biology, especially epidermal growth factor (EGF) receptor, and his extensive experience with cells in culture to establish a program of urologic tissue engineering. In conjunction with Drs. Borin and Kim, Dr. Tyson will provide the expertise to isolate cells from urinary bladders, grow them in culture and assemble them onto a preformed matrix (generating a replacement bladder or "neobladder") with the ultimate goal of replacing a cancerous bladder with a newly formed bladder using a patient's own cells.

Dr. Tyson received his B.S. in Microbiology from the University of Illinois in Urbana in 1990. He obtained an M.S. degree in Pathology from Saint Louis University in 1995 and a Ph.D. in Cell and Molecular Biology from the same institution in 1998. He went on to do his postdoctoral training in the Department of Physiology & Biophysics at UCI under the mentorship of Dr. Ralph A. Bradshaw. He obtained a Postdoctoral Fellowship from the National Institutes of Health from 1999 to 2002 to study the effects of mutation of the carboxyl terminus of the EGF receptor in PC12 cells. He has published over a dozen scientific manuscripts, including scientific journal articles and book chapters, and has served as an ad hoc manuscript reviewer for journals such as The Journal of Biological Chemistry. Dr. Tyson has received a postdoctoral fellowship from the NIH to investigate the signal transduction mechanisms of the epidermal growth factor receptor (EGFR) in a rat pheochromocytoma cell line. His work in this area will be expanded to include studies of the EGFR in bladder and prostate cancer. Dr. Tyson is responsible for directing the basic research laboratory in the Department of Urology, providing his expertise to the medical faculty, assisting in training the urology residents, and maintaining his own research projects.


David K. Ornstein, M.D.
Assistant Professor

Training

	Undergraduate:	University of Pennsylvania
	Medical School:	Washington University
	Residency:	Washington University
	Fellowship Training:	National Cancer Institute

Dr. David K. Ornstein joined the Department of Urology at UCI in July 2003 after serving on the faculty at the University of North Carolina, specializing in urologic cancer. Dr. Ornstein has experience in all areas of urologic oncology with particular expertise in potency and continence- sparing surgical procedures for prostate and bladder cancer, laparoscopic surgery for kidney cancer, newer methods for early prostate cancer detection, and advanced medical/surgical therapies for the management of metastatic kidney cancer. Dr. Ornstein plans to utilize new surgical technologies, in particular laparoscopy and robotic prostatectomy, to improve the care of patients with urologic cancers. In the laboratory, Dr. Ornstein is very involved with translational research to develop new molecular and proteomic technologies for the early detection of prostate cancer and for targeted therapy for patients with kidney, bladder and prostate cancer.

Dr. Ornstein's career has already been highlighted by the receipt of numerous awards in recognition of his clinical and academic excellence. In 1996, he received first place in the clinical category for the resident essay contest at the annual South Central Section meeting of the American Urological Association. As an oncology fellow, Dr. Ornstein was awarded first prize for his research paper at the Clinical Sciences Fellows Symposium 2000. He has received a Young Investigator Award from CaPCURE, and the Edwin Beer Award from the New York Academy of Medicine. Presently, Dr. Ornstein is the principal investigator on prostate cancer research studies funded by the National Cancer Institute and the Department of Defense.

At the 2001 meeting of the American Urological Association, Dr. Ornstein was awarded the Best Abstract Prize in the prostate cancer category. Dr. Ornstein has authored more than 50 scientific manuscripts, review articles and book chapters. He is an active member of the American Urological Association, American Association of Cancer Research, Society of Basic Urologic Research and The Society of Urologic Oncology. He is on the editorial board for Investigative Urology and Clinical Proteomics and has served as an ad-hoc reviewer for multiple medical and scientific journals. In addition, Dr. Ornstein serves on a review panel for the Department of Defense Prostate Cancer Research Program.


Thomas E. Ahlering, M.D.
Professor of Urology
Chief, Division of Urological Oncology

Training

	Undergraduate:	University of California, Berkeley
	Medical School:	Saint Louis University School of Medicine
	Residency:	Los Angeles County/University of Southern California
	Fellowship Training:	Urologic Oncology / University of Southern California

Dr. Ahlering is a highly regarded surgeon in urologic oncology. His years of experience in treatment of prostate, bladder, kidney and testicular cancers has placed him as one of the original America's Best Doctors since his membership in 1994. He trained under Dr. Donald G. Skinner at USC in urinary diversion and reconstruction, and has continued to pioneer innovation to the Indiana pouch, and Ileal Neo-bladder reconstructions.

Formerly the Chief of the Division of Urology (1991-2002) after his arrival at UCI from the City of Hope, Dr. Ahlering became Chief of the Division of Urologic Oncology until the new Department of Urology was established in 2002. He majored in chemistry as an undergraduate at the University of California, Berkeley, then received his medical degree at St. Louis University School of Medicine, followed by a residency in urology at the University of Southern California in Los Angeles. He then completed a two-year fellowship in urologic oncology under the clinical training of Dr. Donald G. Skinner and laboratory training under Peter Jones, Ph.D. Dr. Ahlering became a member of the Society of Urologic Oncology in 1988; his clinical practice is devoted to urologic cancer. He has received local, national, and international recognition for his expertise in urologic oncology, in particular continent urinary diversion. His research focuses on the invasion and metastasis of prostate cancer, and development of minimally invasive radical prostatectomy assisted by the da Vinci® Surgical System. He has performed more than 275 such robotic surgeries, including the first robotic prostatectomies in Denmark, Canada and Australia.

Dr. Ahlering has active research projects in prostate and bladder cancer, and has produced over 85 publications of journal articles and book chapters. He is a reviewer for the journals: Urology, Journal of Endourology, and the Journal of Urology, and a member of several of the Societies of the American Urological Association, and serves as its Western Section Treasurer.

As a commitment to public service, he has lectured at the American Cancer Society's Prostate Cancer Awareness Forum in Southern California for the last four years. He was also an invited speaker at Senator Barbara Boxer's Prostate Cancer Forum in 1996.


Allan M. Shanberg, M.D., F.A.C.S., F.A.A.P.
Health Sciences Clinical Professor
Chief of Pediatric Urology, Director of the Antoci Center
Co-director of the Astellas Center for Urological Education

Training

	Undergraduate:	Washington and Jefferson University
	Medical School:	Chicago Medical School
	Residency:	(General Surgery)   Albert Einstein College of Medicine (Urology)   Philadelphia General Hospital- University of Pennsylvania

Dr. Shanberg is a Fellow of both the American College of Surgeons and the American Academy of Pediatrics, as well as the prestigious Society of Pediatric Urologists. For two consecutive years, Dr. Shanberg has been listed as one of America's Best Doctors. Dr. Shanberg's research and clinical activities have included pioneering the use of lasers in the treatment of congenital obstruction of the urinary tract and, more recently, the extensive use of minimally invasive laparoscopic surgery in children. He was among the first surgeons to use this new technology to bring down undescended testicles and remove diseased kidneys in an outpatient setting. Also, Dr. Shanberg has one of the largest series on bladder cancer laparoscopic radical cystectomies in the U.S., and his paper on this series will be published in the Journal of Urology, August 2004. Dr. Shanberg has published over 60 articles in major medical journals and written ten chapters in various urology and surgery textbooks. He has lectured both nationally and internationally in such diverse locales as Saudi Arabia, the Mayo Clinic, and the University of Pennsylvania. Dr. Shanberg serves on the editorial boards of two distinguished peer-review journals, the Journal of Urology and Urology.

At the 1997 annual meeting of the American Academy of Pediatrics-Urology Division, Dr. Shanberg chaired the session on Laparoscopic Surgery in Children. Dr. Kobashi, urology resident, and Dr. Shanberg presented a movie entitled "Laparoscopic Orchiopexy in Children" at the annual meeting of the American Urological Association. This movie was selected to the teaching library of the American Urological Association. In 2004, he published the first case ever reported of robotic-assisted closure of a vesicovaginal fistula. In 2005, Dr. Shanberg reported one of the largest series in the U.S. of robotic-assisted laparoscopic repair of UPJ obstructions in children.

With a generous gift from the Antoci Family in Orange County, Dr. Shanberg has been instrumental in developing the Antoci Family Center for Children with Kidney Disorders at UC Irvine Medical Center. This gift creates the first facility in Orange County devoted exclusively to the care of children with diseases of the genitourinary system. The Center is equipped to diagnose and treat the full spectrum of kidney, bladder and genital system disorders seen in children, from newborns to adolescents. The Center's physicians include two pediatric urologists experienced in the care of functional and anatomic genitourinary problems in children, and a pediatric nephrologist.

Past and Present Fellows


David Lee, MD
Endourology Fellow, 2002-2003
Research Activity:
    He participated in tissue engineering, bladder replacement, hemostatic agents in the urinary tract, autosomal polycystic kidney disease and new technologies in minimally invasive urologic surgery.
Current position:
    Assistant Professor of Surgery
    University of Pennsylvania School of Medicine
    Chief of Urology, Penn Presbyterian Medical Center


Louis Eichel, MD
Endourology Fellow, 2002-2004
Research Activity:
     - Comparison of radical nephrectomy, laparoscopic microwave thermotherapy, cryotherapy, and radiofrequency ablation for destruction of experimental vx-2 renal tumors in rabbits.
     - Technique for tubeless percutaneous nephrolithotomy using hemostatic gelatin matrix.
Current position:
    Director of Minimally Invasive Surgery
    Center for Urology
    Rochester, NY


Isaac Y. Kim, MD, PhD
Endourology Fellow, 2003-2005
Research Activity:
     - Comparison of laparoscopic microwave thermotherapy, radiofrequency ablation, and cryoablation.
     - Comparison of hemostatic agents in the pig urinary collecting system.
     - TGF-beta-based immunogene therapy for prostate cancer.
Current position:
    Assistant Professor
    The Cancer Institute of New Jersey
    Division of Urologic Oncology
    New Brunswick, NJ


James Borin, MD
Endourology Fellow, 2004-2006
Research Activity:
     We have recently investigated:
     - Use of surgical glues and sealants in the collecting system and lower urinary tract
     - Materials for bladder replacement
     - Stent biomaterials
     - Renal cooling during laparoscopic partial nephrectomy
Current position:
    Clinical Instructor, Endourology Clinical Fellow
    University of California, Irvine, Department of Urology
    Orange, CA


Leslie Deane, MD
Endourology Fellow, 2005-2007
Research Activity:
     At present there are many ongoing protocols which include:
     - Trialing of novel stent designs
     - New laparoscopic and urologic instrument testing
     - Investigating various approaches to urinary bladder replacement
     - Assessing the degree of encrustation of numerous materials in the bladder and
     - Applications of cryosurgical energy
Current position:
    Endourology Research Fellow
    University of California, Irvine, Department of Urology
    Orange, CA

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