|Title||University of California Irvine|
A Two-Year Post Graduate Training in Endourology
(robotics, laparoscopy, percutaneous surgery, ureteroscopy, image-guided therapy)
Basic and Translational Science
Innovations in Education
Ralph V. Clayman, MD Jaime Landman, MD
Professor of Urology Professor of Urology and Radiology
Dean (emeritus) Chair, Department of Urology
Thomas E. Ahlering, MD
Professor of Urology
Vice Chair, Department of Urology
Edward Uchio, MD
Associate Professor of Urology
Director of Urologic Oncology
Ramy Yaacoub, MD
Assistant Professor of Urology
Kam Kaler, MD
Assistant Professor of Urology
Kari Nelson, MD
Associate Professor of Radiology and Urology
Chief, Interventional Radiology
The Endourology Fellowship at the University of California, Irvine is an Endourology Society approved training program specifically designed to train future academic leaders in all aspects of minimally invasive and noninvasive urology: robotic, laparoscopic, ureteroscopic, percutaneous, and image-guided. The directors of this program were responsible for creating the first Endourology fellowship in 1982. Graduates of the program include some of the most well-known and respected endourologists in the country1, among whom seven have become Chairs of Urology.* While many endourology fellowship programs have gone to a one-year experience, we have maintained a 2-year program as it is our firm belief that academic urology is becoming, more, rather than less complicated. As such the skill set provided in the UCI Endourology fellowship includes a firm grounding in education and leadership as well as extensive research and clinical training.
With an academic future in mind for each fellow, the UCI Endourology fellowship includes an optional one year “masters” curriculum in Biomedical and Clinical Translational Science which can be completed during the initial year of the fellowship; this degree program is directed by world renowned leaders in Health Policy Research, Dr. Sherri Kaplan and Dr. Shelly Greenfield. Also, available to the fellow is an optional leadership training program through the Merage School of Business at UC Irvine. This program is designed to provide additional administrative leadership abilities to better equip each enrollee with tools/knowledge to further enhance a career in academia.
1(Howard Winfield, Peter Bub, Elspeth McDougall, John Denstedt*, Shimon Meretyk*, David Albala, Paramjit Chandhoke, Kevin Anderson, Peggy Pearle, Steve Nakada*, Stuart Wolf*, David Hoenig, Arieh Shalhav*, Matt Dunn, Jaime Landman*, Jamil Rehman, David Lee, Issac Kim, James Borin, Leslie Deane, Geoff Box, Michael Louie, Phil Mucksavage, Sean Collins*, Zhamshid Okhunov, Kara Babaian, Kam Kaler)
The UC Irvine Endourology Fellowship is unique in the depth and breadth of the dedicated faculty. The training program is directed by Dr. Ralph Clayman and Dr. Jaime Landman. In addition, the fellow works closely with Dr. Edward Uchio and Dr. Thomas Ahlering, world class oncologists, for minimally invasive urological oncology training, and with Dr. Ramy Yaacoub and Dr. Kam Kaler who are both fellowship trained in minimally invasive urology. We also collaborate very closely with Dr. Kari Nelson, our chief of interventional radiology, with regard to image guided ablation techniques. The laboratory also includes Dr. Xiaolin Zi, PhD, who runs an NIH and Department of Defense supported basic science laboratory through the Department of Urology.
The two-year fellowship is divided such that the first year is 80% laboratory based and 20% clinical while the second year is 20% laboratory based and 80% clinical. As a clinical instructor the fellow is part of a one in six-week faculty call rotation during both years.
In the laboratory, the first year fellow is considered the team leader for all laboratory and clinical research and directly manages/organizes the work of the undergraduate students, medical students, as well as international visiting scholars. Experience with submitting IRB and IACUC protocols is also obtained during this year along with grant writing capabilities.
The endourology laboratory is well-established and includes both basic and translational science opportunities. Urology staff dedicated to the minimally invasive urology team includes a full time research coordinator, a full time laboratory director, and the services of a statistician. UCI is a highly collaborative campus and the endourology laboratories have ongoing projects with the departments of interventional radiology and nephrology as well as with the Beckman Laser Institute, the School of Engineering and with innovators at the UC Irvine California Institute for Telecommunication and Information Technology (Cal IT2).
The laboratory incorporates four distinct training facilities: a survival operative suite and animal vivarium (i.e. 6 operative stations), a non-survival operative suite, an education suite (i.e. robot and laparoscopic VR trainers, percutaneous and ureteroscopic simulator, and 6 laparoscopic trainers), and a fresh tissue laboratory (i.e. 4 operative stations with cadaver resources). In addition, the program is one of the few in the country with a laboratory based da Vinci (Si) surgical robot for both training and for perfecting new procedures.
In general, at any given time there are upwards of 30 clinical trials, 10 laboratory studies and 5 educational projects. We encourage the fellow to also personally develop projects that stimulate his/her interest and expand her/his technical skill sets in order to create an extremely productive and broad scientific experience. Recent projects include: surgical education and training, surgical simulation, development of novel minimally invasive surgical energy technologies, innovative anastomotic techniques and devices, new applications of surgical pharmaceuticals, detailed mapping of the nerves of the urinary tract, materials development for use within the urinary tract, advances in ablation technologies, improved radiographic targeting and imaging for endourological procedures, virtual reality modeling of renal tumors, and crowd-sourcing for evaluation of skills development.
Of note, there is a weekly laboratory meeting held by Drs. Clayman and Landman from 7:00–8:30AM every Thursday. There are also scheduled weekly one-on-one sessions with Dr. Clayman and Dr. Landman to specifically review the fellow’s progress.
Research training is focused on creative and dynamic innovation, study design, execution, and proper presentation. In addition, the administration of the laboratory is an important part of the training of the fellow. In sum, the laboratory experience is designed to provide the fellow with the knowledge and skills necessary to one day develop their own university-based laboratory.
In year two, the majority of time is spent mastering all clinical aspects of endourological skills. The fellow works at UC Irvine Douglas Hospital as well as the Long Beach Veterans Administration Hospital and Long Beach Memorial Hospital. The fellow has her/his own set of office hours for one half day per week and is able to generate his/her own cases as well as be very involved with the cases of the Endourology and oncology attendings.
During this year the fellow works extensively with Drs. Clayman and Landman learning GU ultrasonography, especially as it applies to in–office ultrasound guided biopsy of renal masses, laparoscopic surgery, ureteroscopy, and percutaneous nephrostolithomy, especially nephrostomy tract development. The fellow also works closely with Dr. Tom Ahlering learning robotic prostatectomy as well as with Dr. Ed Uchio, in urologic oncology. Robotic surgery is currently strongly emphasized in the UC Irvine minimally invasive urology program; there are three dedicated clinical robotic systems, two da Vinci-S robots and a da Vinci Si. Over 200 robotic urology cases are performed annually. Dr. Thomas Ahlering, one of the most experienced robotic surgeons in the world, dedicates significant time to assisting the fellow in perfecting his/her robotic skills. Also during the second year, the fellow participates in the design and implementation of clinical trials under the tutelage of our experienced clinical trials team directed by Dr. Uchio.
Needle ablative therapy is an important evolving aspect of minimally invasive urology. The minimally invasive urology team has one of the world’s leading clinical and research programs in cryoablation. As such, the fellow works with Dr. Kari Nelson, Chief of Interventional Radiology and Dr. Jaime Landman, the director of the UCI Ablation Center. This is one of the only multi-disciplinary ablation programs in the nation. The ablation center incorporates all ablative technologies which allows for a remarkable range of academic and clinical innovative opportunities.
Also during this year, an executive coaching experience is made available to the fellow; the experience includes a 360° evaluation. There is a scheduled weekly one-on-one meeting with Dr. Clayman and Dr. Landman which focuses on manuscript preparation, research progress, and leadership topics.
During both years, great focus is placed on the development of presentation skills so that the fellow will become an effective communicator and speaker. Slide creation, poise at the podium, and timeliness are stressed; indeed, ALL presentations are carefully reviewed and rehearsed with Drs. Clayman and Landman. Also during the course of the fellowship, the fellow will typically participate as faculty in a significant number of national and international level courses such as the UC Irvine Vista course as well as the AUA sponsored Advanced PCNL course which is given annually at UC Irvine.
Upon the initiation of the training program the fellow is granted full attending privileges and is given the academic title of Clinical Instructor. Significant time during this year is spent doing translational and clinical research in minimally invasive urology. Each fellow “inherits” a series of ongoing projects. Typically, one major project and several minor projects are in progress. In addition, the fellow is encouraged to provide a research project prior to his/her arrival which incorporates the fellow’s particular area of interest; this project is designed and prepared such that it can be completed during the training program with a goal of providing data worthy of presentation and publication by the second year of the fellowship. It is typical for the fellow to be primary author or co-author on between 5 and 10 peer reviewed publications annually. Of note, a favorably reviewed manuscript submitted for the annual World Congress of Endourology essay contest is a mandatory requirement for graduation as specified by the Endourology Society.
All laboratory projects are closely supervised by Drs. Landman and Clayman. Laboratory meetings occur on a weekly basis (7:00-8:30AM Thursday mornings) to review progress and future directions. The fellow’s primary responsibility is to become familiar with all ongoing projects. Each member of the laboratory is a lead on a project; all the other members of the laboratory comprise the team whose job it is to help the project leader be successful. In this manner, all of the people in the laboratory are interconnected and attuned to the collective success of the group which translates into the success of each individual in the laboratory. The fellow participates as a major proponent/supporter of this culture of collaboration.
Clinical Component of Training Program:
The major focus during the second year is the clinical care of minimally invasive surgery patients at UC Irvine Medical Center with additional responsibilities at the Long Beach VA as well as Long Beach Memorial Hospital. The fellow has active involvement in a wide range of laparoscopic, robotic, ablative, ureteroscopic, and percutaneous procedures. The fellow will also have his/her own set of office hours one half day per week at the UCI urology patient care center. Historically, the fellow has been able to generate a significant number of minimally invasive urology cases through his/her own office; faculty discussion/support are available as needed. Later in the year, it is expected that the fellow will be able to perform the cases generated from his/her own office practice independently while also training residents in these endourological procedures. The fellow will be on the faculty call rotation, usually 1 in 6 weeks. During this year, it is anticipated that the fellow will be preparing manuscripts regarding the basic/animal/translational/clinical research completed during the initial year of the program and will still attend the weekly Thursday laboratory meeting from 7-8:30AM.
It is anticipated that the first year fellow will attend the AUA annual meeting and that the second year fellow will attend the AUA annual meeting and the World Congress of Endourology in order to present their accepted abstracts.
Endourology Society Requirements:
The fellow must fulfill all of the responsibilities of the Endourological Society fellowship including, but not limited to, preparation of a clinical case log and preparation of a manuscript for submission to the essay contest. The latter must be graded as suitable for review for possible publication in order for the fellow to receive an official diploma from the Endourology Society. Graduation from the UC Irvine minimally invasive urology training program is contingent on obtaining Endourological Society approval.
Training, Education, Experience, and Other Requirements:
Candidates must be board eligible urologists or have recently passed the FLEX exam with application made for Urology Board eligibility. They must also have a valid California medical license prior to beginning the fellowship.
Administrative support is available to the fellow via Dr. Landman’s and Dr. Clayman’s administrative assistant and from the department personnel analyst.
Must be able to assist in patient handling during emergencies and fulfill all of the duties outlined above.
Vacation and Educational Leave Policy:
The fellow is required to notify Dr. Landman, in written form, for any period of absence whether due to vacation or educational leave. This is essential to insure the smooth operation of the UC Irvine minimally invasive urology team. The fellow should make arrangements to have all of his/her responsibilities covered (e.g. clinic, call schedule, laboratory meeting presentation, OR, and laboratory responsibilities). Educational leave shall be granted and not be counted as vacation if the fellow is either presenting the results of research or if he/she is undergoing clinical training as part of an education program. All other time away (i.e. job interviews, etc.) will be counted in the three weeks that are available for personal vacation.
The UC Irvine minimally invasive urology team will fund reasonable expenses for the World Congress of Endourology during the clinical training program year and for the annual AUA meeting assuming the fellow has abstracts accepted for presentation.
The fellows are paid through UC Irvine as per their policies. The annual training program salary is $60,000 per year. All fellows are employees of University of California, Irvine with benefits provided through UC Irvine.
Interested Parties Should Contact:
Ralph V. Clayman, MD Jaime Landman, MD
Professor / Dean (emeritus) Professor and Chair of Urology
Department of Urology Department of Urology
Office: 714 456 6567 Office: 714 456 3330
Email: firstname.lastname@example.org Email: email@example.com
|Contact Name||Ralph V. Clayman, M.D., Jaime Landman, MD|
|Contact Emailfirstname.lastname@example.org, email@example.com|
University of California Irvine
Contact name(s): Ralph V. Clayman, M.D., Jaime Landman, MD
Email: firstname.lastname@example.org, email@example.com