Description of Training

The Endourology Stone / Minimally Invasive Surgery Fellowship at the University of North Carolina offers prospective candidates a customizable one-year training experience focused on endourology, stone disease, BPH and advanced benign robotic surgery. Our goal is to provide trainees with the opportunities to develop the clinical, surgical, and research skills needed to jump start their career in endourology. The Endourology Fellowship at UNC transitioned from a one-year robotics fellowship to a one-year endourology stone / combined fellowship after 2021.

Fellows will have the opportunity to work with four Endourology fellowship trained faculty, David Friedlander MD, MPH, Gopal Narang MD, Mathew Raynor MD and Davis Viprakasit, MD in different clinical, surgical, and research capacities. The Fellowship is structured to encompass a combination of clinical/surgical (90%) and research (10%) training over a one-year period. There is the potential opportunity to increase the research experience within the one-year period or through an additional fellowship year based on individualized applicant goals and interests.

Clinical/Surgical Training
The Fellow’s case mix is generally divided as 50% stone disease, 25% BPH and 25% advanced benign robotics. However, Fellows can individualize / customize their clinical rotations to some degree based on specific career goals and interests. Fellows work primarily with Drs. Friedlander, Narang and Viprakasit to develop the skills to clinically evaluate and surgically manage all facets of complex kidney stone disease. Fellows learn the fundamentals of metabolic stone prevention including training with dedicated faculty in Nephrology and Nutrition Services through the UNC Multi-disciplinary Kidney Stone Clinic. Surgical experience is centered on all areas of stone treatment with particular emphasis on complex standard and miniaturized percutaneous surgery with development of fluoroscopic, ultrasound and endoscopic guidance in supine and prone positions and some experience in tubeless and same day discharges. For benign prostatic diseases, Fellows work primarily with Drs. Narang and Viprakasit for training in holmium laser enucleation of the prostate (HoLEP) and with Drs. Friedlander and Raynor with robotic simple prostatectomy. Fellows will also have exposure to other BPH treatments including MIST and prostate artery embolization. For advanced benign robotics, Fellows work primarily with Drs. Friedlander, Narang and Raynor on partial nephrectomy and upper and lower urinary tract complex ureteral stricture reconstruction with particular focus on both transperitoneal and retroperitoneal approaches. 

The Fellow will be employed as a junior faculty member. Fellows will maintain an autonomous weekly clinic which encompasses general urology, endourology, men’s health, oncology and procedures. Fellows share call amongst the entire UNC Urology faculty and will be responsible for approximately 4 weeks of faculty call per year.

Teaching Expectations

The Fellow is an important part of the Endourologic training program for our residents including assisting in teaching basic and advanced ureteroscopic and percutaneous procedures and contributing to grand rounds, journal clubs and teaching conferences. Additionally, Fellows are expected to participate in the department Endourologic skills lab for residents and medical students.

Research Expectations
Health services research activities in Endourology occur under the direction of David Friedlander MD, MPH. Additional research opportunities are available with other Endourology faculty or within the UNC Department of Biomedical Engineering. Departmental and university support is available. Fellows are expected to complete at least one abstract submission and one original manuscript to the Annual Endourologic Essay Contest.