University of California Irvine

Job Address: Dept of Urology 101 The City Drive Bldg 55 Room 304 Orange, CA 92868-3298

Contact Name: David I. Lee, M.D.

Type/Focus: Laparoscopy & Robotics

Duration: 1 Year

Phone: 714-456-6782

Fax: 714-456-5062

Region: North America

Contact Email: [email protected]

The newly created lap/robotic one year fellowship at UC Irvine is designed to provide the motivated candidate an outstanding experience in robotic surgery and scholarly activity.  The primary preceptor, Dr. David Lee, had been the director of the robotic fellowship at Penn for 16 years and brings a wealth of experience to UC Irvine where he completed his fellowship with Dr. Tom Ahlering and Dr. Ralph Clayman.  The UC Irvine minimally invasive program is one of the most advanced in the world.  The training will involve practice-based learning as well as the opportunity for cutting edge research.  Additionally, the fellow will participate in the education and training of our residents and medical students.  This experience will prepare the fellow to be a leader in either an academic or community setting for a practice specialized in robotic surgery.

The fellow will be working with Dr. David Lee in the operating room 1-2 days per week and in clinic 1-2 days per week.  The fellow will also spend time with Dr. Tom Ahlering in the OR 1 day every other week.  The fellow will also spend time with another one of our attendings for robot upper tract experience another 1 day every other week.  There will be a dedicated academic day per week. 

The fellow will primarily have console time as the primary table side assistants are dedicated PA’s.  Minimal table side assisting will be performed at the outset of the fellowship training to ensure competency. 

The fellow will also work closely with Dr. Ahlering and his team on outcomes research for robot prostatectomy patients.  His and Dr. Lee’s database of patients are a wonderful starting point for many clinical research projects focused on functional and oncological outcomes, in addition to novel technique modifications.

The principal preceptor is David I. Lee, MD. Dr. Lee completed his fellowship with Dr. Ralph Clayman and Dr. Tom Ahlering where he was involved with one of the pioneering experiences of robotic prostatectomy at UCI Medical Center. He was Chief of Urology at Penn Presbyterian Medical Center and Director of the Robotic Urologic Fellowship at Penn Urology. He now returns to UCI as Professor of Urology and Director of the Comprehensive Prostate Cancer Program.  He has performed more than 6000 robotic prostatectomy cases and routinely performs around 400 prostatectomy cases per academic year. 

Materials Required for Application

 The applicant will provide:

1.     A current Curriculum Vitae

2.     Chief year residency case log

3.     A total of 3 letters of recommendation with 1 from your Program Director

These materials can be sent electronically in a single PDF or Word document to David I. Lee This email address is being protected from spambots. You need JavaScript enabled to view it.

Chattanooga, TN

Job Address: Department of Urology, Erlanger Medical Center 979 East 3rd Street Suite C-925 Chattanooga, TN 37403

Contact Name: Program Director: Benjamin Waldorf, M.D. Affiliated Faculty: Amar Singh, MD., Department Chairman; Henry Okafor, M.D.

Type/Focus: Laparoscopy & Robotics

Duration: 1 Year

Country: United States

Phone: 423-778-4691

Fax: 423-778-3375

Region: North America

Contact Email: [email protected] Applications to sent to Fellowship Coordinator: [email protected]

Clinical Training:

 The Department of Urology at the University of Tennessee Chattanooga College of Medicine is proud to offer a 1-year advanced clinical training program in robotics and laparoscopy that is recognized by the Endourological Society. The goal of our program is to provide the fellow with extensive training in advanced robotic and laparoscopic surgery. The clinical training program has a focus on robotic urologic oncology, with exposure to a full breadth of robotic oncologic cases, including: radical prostatectomy, radical/partial nephrectomy, adrenalectomy, nephroureterectomy, and radical cystectomy with urinary diversion. The trainee will also be exposed to the newest techniques in robotic urologic reconstruction, including: buccal ureteroplasty, pyeloplasty, and ureteral reimplantation. Surgical volume is excellent, with over 250 robotic urologic procedures performed annually.  

Applicants must have completed an ACGME accredited urology residency and be board-eligible/board-certified at the start of the 1-year program. The applicant must also be eligible for a full Tennessee medical license. The trainee is involved in all aspects of clinical care for patients undergoing robotic surgery, and will operate daily with one of the three attending physicians listed above. The trainee will also have clinical training responsibilities in the education of our urology residents. A goal of the training program is for the fellow to attain a comfort level with robotic/laparoscopic procedures that enables them to function in a teaching role, instructing residents in the basics of robotic/laparoscopic surgery.

The trainee is recognized by the Erlanger hospital system as an attending physician with the ability to admit patients, independently schedule and perform general (non-robotic/laparoscopic) surgical procedures. The trainee participates in the attending call rotation, with similar responsibilities as other members of the department. The trainee also supervises residents in our indigent care clinic, in which the urology residents see uninsured patients one morning per week

Hospital Overview:

The Department of Urology is affiliated with the University of Tennessee College of Medicine and provides urologic care through Erlanger Medical System. Erlanger is the region’s only academic teaching hospital and level 1 trauma center, and is the major tertiary referral center for our region. Erlanger is also the only provider of indigent care in our region. The trainee in our advanced clinical training program in robotics and laparoscopy has clinical responsibilities at two Erlanger hospitals.

Erlanger Baroness Hospital is the flagship institution of Erlanger Medical Center and the site at which most of our major robotic and laparoscopic operations are performed. Typically, Drs. Singh and Waldorf each perform 4-6 major robotic procedures per week at the Baroness Hospital, where we have access to three DaVinci Xi robots (all with dual consoles). We are also one of the few institutions with access to a DaVinci SP robot system. We perform a full range of major robotic procedures at Erlanger Baroness, including the majority of our oncologic surgery.

Erlanger East Hospital is a comprehensive community hospital located east of downtown Chattanooga, and has recently upgraded to a DaVinci Xi robot. Drs. Waldorf and Okafor each typically perform 1-2 robotic procedures per week at Erlanger East.

Research and Academic Responsibilities:

Throughout the 1-year clinical training program, the trainee participates in clinical research and quality improvement projects. All clinical faculty are involved in clinical research, which is supported by the University of Tennessee College of Medicine. Funds are available to facilitate trainee travel to academic conferences, including the national AUA meeting, the World Congress of Endourology, the North American Robotic Urologic Symposium (NARUS), and the southeastern AUA sectional meeting.

Trainee participation in department academic conferences is also expected. Conferences include a weekly indications and morbidity and mortality conference, as well as monthly tumor board, journal club, and grand rounds.

Maywood, New Jersey

Job Address: 255 W. Spring Valley Ave Suite 101 Maywood, NJ 07607

Contact Name: Mutahar Ahmed, M.D./Gregory Lovallo, M.D.

Type/Focus: Laparoscopy & Robotics

Duration: 1 Year

Country: United States

Phone: 201-342-6600 Ext. 1636

Region: North America

Contact Email: [email protected]

This one-year combined private and academic practice fellowship is accredited by the Endourological Society. It is designed to prepare fellows for a career in urologic and laparoscopic surgery, with its main focus on robotic surgery. You will have tremendous all-around exposure as well as firsthand experience of the private practice side. The program will provide the candidate with a high-volume, high-quality training that will enable them to do robotic work at the most advanced level.

Clinical Experience: Our physicians have been leaders in robotic surgery since its inception in 2000 in the Northeast region. We do over 400 cases per year and are pioneers in various robotic surgeries. These include prostatectomy, cystectomy, partial nephrectomy, intracorporeal diversions, intracorporeal neobladder, all types of reconstructive surgery, IVC thrombectomy, UPJ, and of course, stones. Ninety nine percent of our cases are done robotically, including oncology cases. Our practice is always eager to take on new technology as this has been in our DNA. Keeping with tradition, we have started using the Single Port daVinci Robot since January 2019. Dr. Ahmed has personally done over 350 cases. Our physicians routinely perform RALP in under an hour and radical cystectomy with intracorporeal diversion in under three hours. We are successfully performing all types of cases in single port fashion. You will become proficient at doing these cases well. We will be teaching you our system that always looks for ways to cut costs and make the surgical process efficient.

Research Experience:  For those that are interested in research, there is an opportunity to work with the Hackensack University Medical Center department of urology research team. In addition, NJU has its own clinical trial and ongoing large scale research projects with a very busy radiation and oncology department. We also have ongoing randomized trials on regenerative tissue use. You will gain a myriad of academic experience, as well as exposure to the private practice side. 

Present position and future prospects: We work at several hospitals including Hackensack University Medical Center, where you will spend the lion share of your time and two other local community hospitals, Holy Name Medical Center and Mountainside Hospital. We perform a variety of all types of robotic cases, including oncology and benign disease. This will provide you with a wide range of experience. You will be working with our team and top hospitals, which strive to work with the most advanced equipment. We led the way 20 years ago when we started to use the da Vinci robot, and we are now once again paving the way with Single Port robotic surgery. It allows the surgeon to perform even more minimally invasive surgeries. Hackensack/ Maywood is also a 15-minute drive from New York City, which provides convenience to partake in leisurely activities during the fellowship. 

The fellowship is directed by Dr. Mutahar Ahmed, who is an innovator in robotic surgery and has over 20 years of teaching experience. Board-certified urologist and diplomat of the American Board of Urology, Dr. Mutahar Ahmed is the Director of the Center for Bladder Cancer at Hackensack University Medical Center and is also a specialist in oncology, laparoscopic / robotic surgery, cryo-surgery, and reconstructive urological surgery. He has a special interest in minimally invasive approaches to treating prostate, bladder, and kidney cancer. He continues to teach this exciting technology to other urologists globally. He has been invited to national and international seminars and conferences and continues to play a major part in teaching state of art robotic techniques. Dr. Ahmed leads laparoscopic surgical workshops in Bangladesh and other LDC countries to help expand minimal surgical technique. Fellows may have the opportunity to join in this type of international trip, which can be a rewarding and tremendously unique learning experience. He is continuously recognized nationally; featured in New York/New Jersey Top Doctors by New York Magazine, New Jersey Magazine, and Castle Connolly Top Doctors.  He has co-authored numerous articles and abstracts in peer reviewed publications. 

The fellowship is co-directed by Dr. Gregory Lovallo, a practicing Urologist in New Jersey since 2007; specializing in minimally invasive and robotic urologic surgery for disorders of the prostate, kidneys, and bladder. He was trained under Dr. Ahmed, and they have been practicing partners for over 15 years. Dr. Lovallo has co-authored multiple articles and abstracts in peer-reviewed publications. As the son of educators, Dr. Lovallo takes great pride in teaching medical students and residents. He has presented and lectured at Society meetings locally, nationally, and abroad. Dr. Lovallo received his Medical Degree from Rutgers-New Jersey Medical School, where he also completed his Surgical and Urologic Residency Training. He has consistently been recognized by New Jersey Magazine Top Doctors, Castle Connolly Top Doctors for New York/New Jersey, as well as in the “Top Doctors” issue of New York Magazine.

Application Process:

Candidates must have completed an ACGME-accredited urology residency in the United States or Canada and be board eligible. One fellow is accepted each year.

Prospective fellows must register through the Endourological Society and apply for the Match through AUA at https://internal.auanet.org/secured/endourology/applicant_RF.cfm. After registration, application materials should be forwarded to:

Dr. Mutahar Ahmed, MD

Dr. Gregory Lovallo, MD

Program Manager

Department of Urology

New Jersey Urology

255 W. Spring Valley Ave Suite 101

Maywood, NJ 07607

Phone: 201-342-6600 Ext 1636

Fax:

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Buenos Aires, Argentina

Job Address: Hospital de Clinicas Jose de San Martin

Contact Name: Norberto Bernardo, M.D.

Type/Focus: Endourology

Duration: 1 Year

Region: South America

Contact Email: [email protected]

Endourology Post-basic Training Program Hospital de Clínicas José de San Martín

Justification of Endourology Specialization

Urology, as all the medical specialties, has been organized into different sub specialties. This vectorizing has caused an enormous development on diagnosis methods and therapeutic procedures. Among the sub specialties mentioned, there is Endourology.

From its emergence at the end of the 1970´s and beginning of the 1980´s, Endourology has progressed on its field in order to solve cases of increasing complexity with minimally invasive procedures, becoming –at present– the gold standard to solve most urinary stone cases and towards the treatment of other diseases, such as upper track urinary cancers.

Training and the correct handling of this kind of procedures is essential for a better patients assistance. However, a low number of hospitals –as the Hospital de Clínicas José de San Martín– currently count with a vast casuistry and the technology needed.

The Urology Career at the Hospital de Clínicas José de San Martín from the Buenos Aires University is turning 122 years since it was founded in 1898 by Federico Texo, MD. The Endourology Fellowship program was created by Professor Norberto Bernardo in year 2001, after returning from New York where he completed his Fellowship with Prof. Arthur Smith at Long Island Jewish Medical Center in 1999. The Hospital de Clinicas from the University of Buenos Aires is the first in the country offering applicants the possibility of being trained on this specialty.

The wide volume of information and the need of a training on specific procedures are the reasons why Endourology training cannot be completed during the Basic Urology Internal Medical Residency, thus a specific training to complete the academic training is required. That is why there are numerous Fellowship Programs worldwide.

Endourology Division of the Urology Service at the Hospital de Clínicas José de San Martín develops daily a prominent clinical and surgical activity in a university hospital environment. Each week, approximately 60 patients are tended on outpatient clinics, and around 250 surgeries are performed annually.

In the teaching activity, staff doctors participate delivering classes on subjects related to the specialty for students of Urology at the Medicine Career from the University of Buenos Aires and of the Specialty Training in Urology.

Endourology Training Objectives

General Objectives

Upon completing the training program, the fellow will be able to:

• Have the knowledge, and the clinical and theoretical experience to provide a comprehensive assistance of those pathologies that require an endourologic approach or extracorporeal lithotripsy for their resolution, and of the stone disease in general.
• Interpret image studies related to the pathology, such as ultrasonography, computed tomography, MRI, angiography and nuclear medicine, among others.
• Resolve the severity degree and need of resolution of different cases of stone disease, as well as surgical treatment options –if needed–, at the moment of diagnosis and during the illness progress.

 Research and Education Activity

• To identify the design and implementation of a prospective database.
• To prepare and make prospective clinical trials.
• To identify interface between basic science and clinical care.
• To analyze statistic methods to test research studies results published properly.
• To recognize search methodology, analysis and selection of scientific journals.
• To train students and residents in the multidisciplinary handling of patients with diseases of endourology approach.
• To train no medical staff (medical assistants, nurses, etc.) in specialized endourology pathology assistance.

Specific Objectives

• To gain technical skills in performing complex endourology procedures to solve lithiasis pathology and other cases that require an endourology approach for its resolution.
• To acquire technical skills needed for performing Extracorporeal Shockwave Lithotripsy [ESWL].
• To have knowledge on metabolic aspects of the stone disease and its utility in prevention of its recurrence.

Requirements to Enter the Fellow Program

- To have at least 3 (three) full years of Urology residency in a Urology Service with a residence system approved by the national or international health agencies, regardless of race, color, sex, language, politics bias, national or social origin, economic status, birth or any other condition. Furthermore, there will be no distinctions based on political, legal or international condition of the country or territory of whose jurisdiction a person depend on.

- To have National License for medical practice. Those that had performed their residence period abroad must have their National License effective in accordance with the Ministry of Health [Ministerio de Salud de la Nación] regulations.

- To submit a research project that shall be assessed by the persons responsible for the Fellow Program and the Teaching and Research area, and shall be approved by the ethic and medical advisory committee, and, when your advanced training is completed, you shall submit the complete project.

- To pass an interview –that shall include a suitability and backgrounds assessment– coordinated by the persons responsible for the training program and by a representative of the Teaching and Research area. Subsequently, the chosen candidate shall be appointed.

Program Contents

Theoretical Contents

Through different aid and scientific activities (outpatient clinics, surgeries, research works, etc.), this program’s objective is to train doctors so that they know the handling of the endourology pathology and can practice surgeries, with criteria and suitability.

By the end of the program, the doctor shall:

• Identify the urological anatomy and pathophysiology.
• Identify the natural evolution of the stone disease.
• Analyze the handling of the stone disease in outpatient clinics.

Acquisition of skills on:

• Anamnesis.
• Physical Examination.
• Requirement and interpretation of the complementary studies.
• Indications and contraindications of surgical procedures.

The instructional strategy is divided into three areas:

Cognitive Area

• Clinical Panel (weekly)
• Panel on Morbidity and Mortality (monthly)
• Bibliographic Panel (weekly)
• Attendance to the Sociedad Argentina de Urología sessions (monthly)

Skills and Capabilities Area

• Permanent supervision over the different practices developed in the office, admission and at the OR.

Attitude and Behavior Area

• Permanent supervision and accompaniment emphasizing on communication and the patient care, interrelationship with colleagues, responsible update of the medical knowledge.

All the teachers are responsible for the compliance of the strategies mentioned.

Practical Contents

Procedures that the doctor must perform autonomously:

• Stone Disease
• Extracorporeal Shockwave Lithotripsy [ESWL]
• Semi Rigid Ureteroscopy
• Pneumatic Intracorporeal Lithotripsy
• Laser Intracorporeal Lithotripsy
• Ultrasonic Intracorporeal Lithotripsy
• Retrograde Intrarenal Surgery (RIRS)
• Percutaneous Nephrolithotripsy (PCNL)
• Endoscopic Combined Intrarenal Surgery (ECIRS)

Procedures in which Endourology acts as secondary procedures:

• RIRS for the conservative treatment of upper track urinary cancers
• Percutaneous Renal Access for the conservative treatment of upper track urinary cancers

Assessment

The assessment shall be based on the compliance of the objectives set on the Fellow Program, and on the passing and compliance of the research project.

Assessment by Performance

Performance of the daily health-care activity on outpatient clinics, compliance with the health-care requirements, bibliography handling, performance on academic programs, skills to acquire new knowledge.

Assessment by Procedures

Development of the surgical procedures set as part of the practical contents as 1^st Assistant and as Principal Surgeon.

A point-to-point evaluation of the steps of each surgical procedure set will be performed.

Length and Vacancy

One (1) vacancy shall be appointed for the one year Clinical Advanced Program on Endourology, within the framework of a pre-established study program, which shall last one (1) year, to allow the chosen candidate the opportunity of study and improve on endourologic techniques on the Urology Division of the Hospital de Clínicas José de San Martín and other institutions that are dependent on the Buenos Aires University.

Hourly Load

The 1-year program comprises approximately 2000 hours of training (40 hours weekly).

The working hours inside the Institution shall follow a timeline (see chart) which will allow Endourology Fellows to participate in academic activities in and out the Hospital de Clínicas premises, such as teaching lectures, local, regional and national meetings. Each Fellow shall have a daily time dedication of approximately 8 hours inside the hospital. 

The Fellow shall have an annual recess of 30 (thirty) consecutive days.

Weekly Schedule

Staff

Directors:

Prof. Norberto Bernardo (MD, Chief of Urology Service)

Horacio Sanguinetti (MD, Chief of Endourology Section)

Medical Team:

Jorge Aguilar (MD, Endourology Staff)

Maximiliano López Silva (MD, Endourology Staff)

Raul Montiel Romero (MD, Endourology Staff)

Nicolás Rosenfeld (MD, Endourology Staff)     

Assistants:

Mrs. Lorena Gancedo       This email address is being protected from spambots. You need JavaScript enabled to view it.

Mrs. Florencia Azarola      This email address is being protected from spambots. You need JavaScript enabled to view it. / This email address is being protected from spambots. You need JavaScript enabled to view it. 

Resources

Program’s Learning Areas

Outpatient Clinics: the fellows learn about outpatient diseases, prevalent pathology and diagnosis methodology of patients with surgical conditions. They also learn about the monitoring methodology of surgical patients.

Admission Room: the fellows learn about the clinical surgical handling of diseases that require this therapy.

OR: fellows acquire the skills and technical concepts of the treated pathologies.

ESWL Room: fellows acquire the skills and technical concepts of Extracorporeal Lithotripsy.

Animal Lab Training Center (in an Associate institution).

Training center with simulators: in which courses are given, and where fellows as well as basic Urology residents are trained regularly.

The Hospital de Clínicas has a state-of-the-art infrastructure to develop its health-care and teaching activities properly. To highlight: modern surgical instrument, state-of-the-art 100 watts Holmium laser device, CT scan, etc.

The Fellow is already an especialist in Urology whose main goal is the acquisition of knowledge in a branch of the specialty such as Endourology is. It has a wide activity in the clinical, diagnosis and therapeutic fields in which it is included in the surgical treatment.

The Fellow participates in all the activities. He enters the hospital at 7 AM and ends his shift at 3 PM approximately. The aim is that, in that period of time and under permanent supervision, he improves his performance in all the activities mentioned until he can perform most of them autonomously and in a responsible manner. His participation progresses on liability and complexity as he acquires knowledge and capabilities to perform them by himself. Fellows have a Residents and Fellows Room and a Doctors Room with desks, chairs and computers with Internet access, audiovisual technology where they can consult medical histories and studies as well as making presentations.