The University of California, Irvine Fellowship in Endourology: A Two-Year Training Program (robotics, laparoscopy, percutaneous surgery, ureteroscopy, HoLEP)
Basic and Translational Science: protocol design, developing IRB and IACUC submissions
Grant preparation
Manuscript writing and presentation skills
Innovations in Education
Leadership Training
Creative Thinking and Methods of Innovation
Co-Directors:
Ralph V. Clayman, MD Jaime Landman, MD
Distinguished Professor Professor of Urology and Radiology
Dept. of Urology Chair, Department of Urology
Dean (emeritus)
Faculty:
Akhil Das, MD
Professor of Urology
Roshan M. Patel, MD
Associate Professor of Urology
Director, Kidney Stone Center
Pengbo Jiang, MD
Assistant Professor of Urology
Sohrab Ali, MD
Assistant Professor of Urology
Overview
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 HoLEP. The directors of this program were responsible for creating the first Endourology fellowship in 1984. 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 which equips the fellow to pursue an excellent career at a major university.
Faculty
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. Pengbo Jiang, Dr. Roshan Patel and Dr. Sohrab Ali who are fellowship trained in minimally invasive urology (ultrasound and fluoroscopic guided PCNL, single and multi-port upper and lower urinary tract robotics, and laparoscopy). In addition, the fellow works closely with Dr. Akhil Das who was one of the first urologists in the United States to perform holmium laser enucleation of the prostate (HoLEP). The laboratory also includes Dr. Xiaolin Zi, PhD, and Dr. Michael Wu, PhD who run an NIH and Department of Defense supported basic science laboratory through the Department of Urology.
Program Description
The two-year fellowship is divided such that the first year is 70% laboratory based and 30% clinical while the second year is 30% laboratory based and 70% clinical. As a clinical instructor the fellow is part of a one in six-week faculty call rotation during both years.
Year 1: Laboratory/teaching (70%) and Clinical (30%)
In the laboratory, the first-year fellow is considered a team leader for all laboratory and clinical research and assists in organizing 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 peer-review 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). Intellectual property and patent law support for medical device development is also provided by UCI Applied Innovation. Opportunities are available for supplementary formal training in medical innovation are available through UCI Applied Innovation.
The laboratory is comprised of four distinct training facilities: a vivarium with 6 surgical stations, a non-survival surgical suite, a training center that contains a da Vinci Si robot and 6 laparoscopic trainers, and a fresh tissue cadaver laboratory with 4 operative stations.
At any given time, there are upwards of 20 clinical trials, 20 laboratory studies and 5 educational projects. Among our current projects are: immersive/interactive virtual reality surgical simulation for partial nephrectomy, development of novel minimally invasive devices (e.g. a force sensor for safe passage of ureteral access sheaths), detailed mapping of the nerves of the urinary tract, advances in ablation technologies, pharmacological manipulation of the ureter, bladder prosthetics, novel laser technologies, and development of a novel, disposable flexible aspiration ureteroscope.
Each week, there is a laboratory meeting held by Drs. Clayman and Landman on Thursday from 7:00–8:30AM focused on the various laboratory projects. There are also scheduled biweekly one-on-one sessions with Dr. Clayman 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 administrative aspect of running an effective endourology 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 develop their own research projects and establish their own university-based laboratory.
During this year, the fellow works with Dr. Ralph Clayman gaining a comprehensive understanding of metabolic stone evaluation in the office and developing expert skills in ureteroscopy and percutaneous nephrolithotomy (especially nephrostomy tract development).
Year 2: Clinical (70%) and Laboratory/teaching (30%)
In year two, the majority of time is spent mastering all clinical aspects of endourological skills. The fellow works at UC Irvine Douglas Hospital, Irvine Medical Campus, as well as the Long Beach Veterans Administration 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 Dr. Landman learning laparoscopy, robotics, ureteroscopy, and percutaneous nephrolithotomy. The fellow also works closely with Drs. Roshan Patel, Sohrab Ali, and Pengbo Jiang learning ultrasound guided percutaneous nephrolithotomy, ureteroscopy (including aspiration endoscopy), single-port and multi-port robotic surgery (prostatectomy, partial nephrectomy, radical nephrectomy, pyeloplasty etc.). Robotic surgery is strongly emphasized in the UC Irvine minimally invasive urology program with over 200 cases annually; there are multiple dedicated clinical robotic da Vinci Xi systems including a DV5 and single-port robotic system. The fellow will also work with Dr. Akhil Das, who performs over 250 HoLEP procedures annually.
During this year, the fellow will continue to prepare manuscripts regarding the basic/animal/translational/clinical research completed during the initial year of the program and will continue to attend the weekly Thursday laboratory meeting from 7-8:30AM.
Also, biweekly one-on-one meetings continue with Dr. Clayman with regard to manuscript preparation, research progress, and leadership topics. During this second year there is a major emphasis on the fellow’s future job plans. Drs. Clayman and Landman work with the fellow to insure the fellow obtains a suitable position at an academic institution.
Additional Aspects
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.
Principal Accountabilities
Research:
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 (70%) during this first 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. It is typical for the fellow to be primary author or co-author on between 5 and 10 peer reviewed publications annually.
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 Activities:
The major focus (70%) 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 Irvine Medical Campus. The fellow has active involvement in a wide range of laparoscopic, robotic, ureteroscopic, percutaneous, and HoLEP 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 during both years of the fellowship. Historically, the fellow has been able to generate a significant number of minimally invasive urology cases through his/her own office practice; faculty discussion/support are available as requested. 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, typically 1 in 6 weeks.
Academic Meetings:
It is anticipated that the first-year fellow will attend the AUA annual meeting and that the second-year fellow will attend both 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 mandatory preparation of a manuscript for submission to the Endourology Society essay contest. The submitted manuscript is reviewed by the editorial board of the Journal of Endourology and must be assessed as suitable for review for possible publication in the Journal of Endourology in order for the fellow to receive an official diploma from the Endourology Society. Graduation from the UC Irvine Endourology Fellowship program is contingent on obtaining Endourological Society approval.
Credentials:
Applicants must be board eligible or diplomats of the American Board of Urology or have recently passed the FLEX exam with application made for Urology Board eligibility. All fellows must obtain a valid California medical license prior to beginning the fellowship.
Administrative Support:
Administrative support is available to the fellow via Dr. Landman’s and Dr. Clayman’s administrative assistant and from the department personnel analyst.
Physical Demands:
Must be able to assist in patient handling during emergencies and fulfill all of the previously stipulated duties.
Vacation and Educational Leave Policy:
The fellow is required to notify Dr. Landman, in writing, 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 service. The fellow should plan 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.
All reasonable expenses for the World Congress of Endourology during the clinical training program year and for the annual AUA meeting will be paid by the Department of Urology, assuming the fellow has abstracts accepted for presentation.
Salary:
The fellows are paid through UC Irvine according to UC policies and procedures. The annual training program salary is $78,900 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
Distinguished Professor / Dean (emeritus) Professor and Chair of Urology
Department of Urology Department of Urology
Office: 714 456 6567 Office: 714 456 3330
Email:
Cell: 949 677 5797
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, Roshan M. Patel, Shlomi Tapiero, Pengbo Jiang, Sohrab Ali, Zachary Tano)