Department of Urology: School of Medicine: University of California, Irvine
Education

Fellowship Program

UC Irvine Endourology Fellowship Program

Advanced Training: Leadership, Innovation Translational Science and Minimally Invasive Surgery:

Laparoscopy, Endoscopy, Robotics & Image Guided Therapy

Endourology Fellowship Program

For your information we have provided this informative brochure.

Download Here (PDF)

Co-Directors

Ralph V. Clayman, MD
Professor of Urology
Dean Emeritus

Jaime Landman, MD
Professor of Urology and Radiology
Chairman, Department of Urology

Faculty

Thomas E. Ahlering, MD
Professor of Urology
Vice Chair, Department of Urology

Edward Uchio, MD
Director of Urologic Oncology

Ramy Yaacoub, MD
Associate Professor of Urology

Overview

Fellowship

The Minimally Invasive Urology Training Program at University of California, Irvine is an Endourology Society approved training program specifically and carefully tailored to train future academic leaders in the world of minimally invasive and noninvasive urology. The directors of this program have been training fellows in Endourology longer than any other academic center world‐wide.

Graduates of the program when it was first initiated at Washington University and then continued by Drs. Landman, McDougall, and Clayman at UC Irvine include 4 current Chairs of Urology. Upon graduation, over 75% (23/30) of the fellows have gone into academic urology. While many endourology fellowship programs have gone to a one year experience, it is our firm belief that academic urology is becoming, more rather than less complicated. As such the skill set for success includes a firm grounding in research and leadership as well as extensive specialty training.

Accordingly, the UCI fellowship includes a masters curriculum in Biomedical and Clinical Translational Science; this degree program is directed by world renown leaders in Health Policy Research, Dr. Sherri Kaplan and Dr. Shelly Kaplan. Also, a leadership training program has been established through the Merage School of Business at UC Irvine in order to further provide the administrative leadership and know ‐how that will equip the fellow with tools/knowledge for a successful career in academia.

The intensive two year program is designed to train highly skilled leaders in research and in all aspects of endourology. The initial year is largely spent in the laboratory with a 20% participation in clinical activities. The endourology laboratory is well‐ established and includes both basic and opportunities; a one year degree granting masters program in basic and translational science is part of the first fellowship year. In addition to the endourology laboratory, there is a UC Irvine Surgical Education Laboratory for conducting studies in training and the development of teaching modules and models. Research training is focused on creative and dynamic innovation, study design and execution, and proper presentation.

Further, during the two years, the fellow participates in leadership training and executive coaching exercises to provide the administrative leadership skills necessary for success in the academic realm.

During the second year, the majority of time is spent in mastering clinical skills in all aspects of minimally invasive Urology; these include robotic, laparoscopic, percutaneous, ureteroscopic, and needle ablative surgeries. In addition, there is focus on the use of GU ultrasonography, especially as it would apply to in – office ultrasound guided biopsy of renal masses and operating room initiation of the percutaneous nephrostomy tract.

The training program has, additionally incorporated highly skilled and well trained urologic oncologists, Dr. Thomas Ahlering and Dr. Edward Uchio, who are an important part of the minimally invasive training program and laboratory. Additionally, the training program is quite unique as the close working relationship we have with interventional radiology allows our fellows to work closely with our interventional radiologists in order to optimize the fellows’ experience with percutaneous ablation and other related procedures.

The technical training and investigative components of the training program are enhanced by unique world‐class laboratory resources. The laboratory incorporates four distinct training facilities: a survival operative suite and animal vivarium, a non‐ survival operative suite with 6 operative stations, a surgical simulation and laparoscopic trainer suite with 6 laparoscopic pelvic trainers, and a fresh tissue laboratory with an additional 4 operative stations. In addition, the program is one of the few in the country with a dedicated laboratory da Vinci (Si) surgical robot for both training and perfecting new procedures. Further, the education laboratory also includes: laparoscopic virtual reality trainers, robotic virtual reality trainers, a percutaneous renal access and ureteroscopy simulator, and a full complement of endourology equipment. The available facilities and advanced surgical equipment allow the potential for a broad array of experiments to be designed and performed.

Indeed, the only limits on the fellow’s productivity during the fellowship is the range of her/his creative/innovative capabilities. Expert full‐time Urology dedicated staff is available to optimize productivity in the four laboratories. Staff dedicated to the minimally invasive urology team includes a full time research coordinator, a full time laboratory director, full time associate lab director, and the services of a statistician for study design and execution. UCI is a highly collaborative campus and the endourology laboratories have ongoing projects with fellow interventional radiology, nephrology, and the School of Engineering. The fellow will have close interaction with engineering teams from Cal IT2. www.calit2.uci.edu. The endourology laboratory works actively on numerous projects with engineers to optimize biomedical innovation. Projects routinely result in the development of important intellectual property.

Current research includes surgical education and training, surgical simulation, development of novel minimally invasive surgical energy technologies, novel anastomotic techniques and devices, surgical pharmaceuticals, materials development for use within the urinary tract, novel ablation technologies, improved radiographic targeting and imaging for endourological procedures, surgical optics and digital technologies, the transfer of renal biopsy from the hospital into the office realm, and novel mechanisms for the protection of the kidney during warm ischemia. The UC Irvine Minimally Invasive Urology Training Program 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 in minimally invasive urological oncology, and with Dr. Ramy Yaacoub who is fellowship trained in minimally invasive urology. We also collaborate very closely with our interventional radiological colleagues in ablation techniques. The laboratory also works closely with Dr. Xiaolin Zi, PhD, who runs an NIH and Department of Defense supported basic science laboratory through the Department of Urology. Current active clinical projects are ongoing in collaboration with Dr. Zi including novel work evaluating the molecular significance of perinephric adipose tissues with regard to prostate and renal malignancy.

Program Description

Fellowship

This is an all encompassing two‐year training program. The fellow is granted a clinical instructor appointment. During the two years of fellowship the fellow is expected to take call on the faculty rotation usually once every 6 weeks. (In the second year, would be 80% clinical and 20% research. The clinical component of this year includes time spent at the Long Beach Veterans Administration hospital as well as at UC Irvine Douglas Hospital.

The robust resources and large number of students participating in the laboratory allow for the fellow to remain clinically active while maintaining a strong laboratory experience. The fellow is considered the team leader for laboratory and clinical research and directly manages/organizes the work of the undergraduate students, medical students, as well as international visiting scholars. The fellow leads the section of the weekly laboratory devoted to the latest progress of existing projects and to brainstorm new ideas for study.

In the laboratory the fellow will be leading and supervising the laboratory experiments and researchers. The focus of the laboratory efforts is on endourological, laparoscopic, robotic, training and translational research. We encourage the fellow to tailor projects that stimulate his/her interest and expand her/his technical skill sets in order to create an extremely productive scientific experience. effective presentation of data and results.

The clinical component of the training program includes a focus on the development of advanced technical skills in the operating room, developing familiarity and dexterity with advanced instrumentation, and expanding surgical judgment and experience. The breadth of procedures cover needle ablative, percutaneous, ureteroscopic, laparoscopic, and robotic techniques. Additionally, the fellow participates in the design and implementation of clinical trials, aids in the enrollment of patients in clinical studies, and is involved in the interpretation and effective presentation of data and results. This collaborative effort in the laboratory invariably leads to multiple manuscripts and presentations during the fellowship experience. In year two, the fellow has her/his own clinic one half day per week and will therefore be able to generate his/her own cases as well as be very involved with the cases of the attendings that compose the endourology service.

Research Facilities

Fellowship

There are four independent facilities that compose the UC Irvine Surgical Education Center Laboratory: a survival operative suite and animal vivarium, a non‐survival operative suite with 6 operative stations, a surgical simulation and laparoscopic trainer suite, and a fresh tissue laboratory with an additional 4 operative stations. The animate and inanimate laboratory is a facility managed by the Department of Urology and used in conjunction with other school of medicine departments.

The laboratory incorporates a wide range of high end specialized equipment. Presently, this includes: inanimate laparoscopy trainers, a laparoscopic virtual reality trainer, a percutaneous and ureteroscopic virtual reality trainer, as well as a dedicated daVinci Si robot. Lastly, staffing includes a full time laboratory manager and assistant manager who are members of the minimally invasive urology team to assist with technical training in this facility. The fellow interacts closely with the laboratory director; they work together to run the laboratory and minister to the various projects.

Robotic surgery is currently strongly emphasized in the UC Irvine minimally invasive urology program due to its clear relevance in the future of all urologic surgery. We currently have three dedicated clinical robotic systems (in addition to the laboratory system), two da Vinci‐S robots and a da Vinci Si. All three are high definition robotic systems which are very actively used by all minimally invasive urology faculty members for over 200 cases per year.

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. Dr. Jaime Landman is the founding and ongoing 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 (cryoablation, radiofrequency ablation, high‐ frequency focused ultrasound, etc. which allows for a remarkable range of academic and clinical innovative opportunities. For more information on the University of California, Irvine Ablative Oncology Center please visit ‐ www.ablativeoncology.uci.edu/.

At UC Irvine, the minimally invasive urology group has a well‐funded and supported minimally invasive urology laboratory for both basic science and animal laboratory studies. Besides the full time laboratory manager and assistant manager, we have available veterinary technicians and UC Irvine veterinarians to assist with the planning of survival surgeries and the post‐ surgical recovery of animals.

Our laboratory and training facilities are located within a few hundred yards of the hospital and thus it is a short walk to help coordinate our clinical and research activities. In addition, at any given time there are typically 1 to 3 international scholars who observe surgery and help facilitate the team's research endeavors. Undergraduate students and graduate students (eg. School of Engineering) from the University of California campus are frequent collaborators in the minimally invasive urology laboratory. Additionally, there are continuous interactions with other University of California, Irvine resources such as the Beckman Laser Institute www.bli.uci.edu/. This provides a unique opportunity for the fellow to serve in an administrative leadership role as the medical director of the laboratory. Indeed, the administration of the laboratory is an important part of the training of the fellow and prepares him/her well to lead their own laboratory in the future.

Principal Accountabilities

Basic/Clinical 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 during this year is spent doing translational or clinical research in minimally invasive urology. Each fellow "inherits" a series of ongoing projects which the laboratory always has in progress. 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 during the second year of the fellowship or sooner. Combining the primary project with ongoing projects, it is typical for the fellow to be primary author or co‐author on between 5 and 10 peer reviewed publications. Of note, a favorably reviewed manuscript submitted for the annual World Congress of Endourology essay contest is an essential component of the graduation requirements. During this year, all laboratory supplies and additional needs would be provided through the laboratory.

All laboratory projects are closely supervised by Drs. Landman and Clayman. Laboratory meetings occur on a weekly basis (7:00‐ 9:00am Thursday mornings) to review progress and future directions; these meetings are attended by the entire faculty and staff of the minimally invasive urology team. 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 a team to help that individual’s project be successful. In this manner, all of the people in the laboratory are interconnected and tuned in to the collective success of the group and of the individual. The fellow participates as a major proponent/supporter of this culture of collaboration.

Clinical Component of Training Program (Year Two)

The major clinical responsibility during the year is the clinical care of minimally invasive surgery patients at UC Irvine Medical Center. The fellow will have active involvement in a wide range of laparoscopic, robotic, ablation and endourology procedures. The fellow will also work with the faculty and residents on minimally invasive oncology cases. The fellow will also have his/her own clinic one half day per week at our University urology patient care center. Historically, the fellow has been able to generate a significant number of minimally invasive urology cases through his/her own clinic; these sessions are initially scheduled with faculty discussion/support as needed. Later in the year, it is expected that the fellow will be able to perform the cases generated from his/her own clinic independently while also training residents in these endourological procedures.

Responsibilities: The fellow will be expected to perform clinical duties in preparation for all cases he/she performs. Chart review to understand each patient's history, obtaining and evaluating all relevant radiographic studies, and review of relevant laboratory results are all responsibilities of the fellow who should consider each case as if he/she were the primary physician. The fellow should present cases for the coming week at an indications conference. 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. In addition, ongoing or new clinical research protocols will likely be initiated, advanced, and/or completed. It is anticipated that the fellow will attend the World Congress of Endourology during his/her second year in order to present his/her accepted abstracts. The fellow will also be required to fulfill all of the responsibilities of the Endourological Society 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 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 will be contingent on obtaining Endourological Society approval. Administrative support will be available to the fellow via Dr. Landman's administrative assistant and with the department personnel analyst.

Teaching and Training

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.

Physical Demands

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 (eg. 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 substantial material to present at the meeting.

Salary

The participants are paid through UC Irvine as per their policies. The annual training program salary is $60,000 per year. All participants are employees of University of California, Irvine with benefits provided through UC Irvine.

Interested parties should contact:

Jaime Landman, MD
Professor of Urology and Radiology
Chairman, Department of Urology
Office: 714.456.3330
E-mail: landmanj@uci.edu

Visit the Endourological Society web site

www.endourology.org/

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International Minimally Invasive Urology Fellowship

Overview

Fellowship

The International Minimally Invasive Urology Fellowship at the University of California, Irvine offers training, of varying lengths, to urologists from around the world. International fellows range from residents interested in learning basic minimally invasive technique to established urologists who wish to update their minimally invasive skills. The minimum length of stay is two months and the maximum is two years. If the fellowship is extended for a period of three months or more, fellows are invited to participate in the animal laboratory, where they can get hands on experience with minimally invasive technique. International fellows are also granted access to the Surgical Training Center where they can work with standard box trainers as well as virtual reality training devices to improve laparoscopic and endoscopic skills. International fellows are also welcome to observe all procedures in the Department of Urology as well as procedures in associated disciplines. The combination of training in the skills laboratory, working with the research team in the animal laboratory, and observation in the operating room and cystoscopy suites has allowed many international fellows to develop laparoscopic and endoscopic skills which have been used to initiate minimally invasive urology programs in their home countries.

Please note that international fellows will not have any clinical responsibility.  Additionally, we are unable to provide salary support or insurance for international fellows.

Fellowship Application Instructions

Initial Step
To initiate application a proposal must be submitted to Dr. Jaime Landman, chairman of the Department of Urology and Program Director at landmanj@uci.edu. A letter of intent describing the applicant's goals, length of proposed fellowship, curriculum vitae, and three letters of support should be included in the proposal. Fellowship opportunities are granted by a review committee on the basis of merit and space availability.  An application fee of $150 (US) is required. The check should be made payable to University of California, Irvine

Second Step
After acceptance into the international fellowship program, securing the fellowship will require payment in the amount of an administrative fee of $500 (US). The check should be made payable to University of California, Irvine. Limited scholarships to help defer the administrative costs may also be available.

This check can be mailed to:
University of California, Irvine
Dr. Jaime Landman
Department of Urology
333 City Blvd, West, Suite 2100
Orange, CA 9268
Attn: Griselda Zuno

Third Step
After finalizing your application, you may contact Ms. Griselda Zuno at gzuno@uci.edu for assistance with obtaining a VISA and the completion of other required documents. Information regarding a VISA can also be found at the web site of International Center www.ic.uci.edu The "J" VISA is for educational and cultural exchange programs designated by the U.S. Department of State, entitled "Exchange Visitor Program." Please be advised that the processing time for a J-1 Visa is currently 3 months.

Prior to arrival in the United States, Please complete Form A with prior approval from Dr. Jaime Landman and return it as soon as possible to the address listed below. The International Center Office will send you the original copy of the DS 2019 which you should keep with you at all times. Your program should begin within 30 days of your specified start date on your DS-2019 form.

Office Address:
Griselda Zuno
Department of Urology
333 City Blvd, West, Suite 2100
Orange, CA 92868

To obtain the J-1 VISA, you must apply at the U.S. Embassy or Consulate with jurisdiction over your place of permanent residence. To do so, you will need the following documentation:

  • Form DS-2019. The exchange visitor must complete and sign the bottom portion of the DS-2019
  • If your family is applying for J-2 visas, they will
    need a DS-2019 issued for J-2 dependents
  • Evidence of financial ability to meet expenses
  • Evidence of residence abroad and intent to depart the U.S. after completion of the program
  • Valid Passport
  • “Non-immigrant Visa Application”
  • Photographs
  • Visa fee
  • SEVIS fee ($100)
  • Visa reciprocity fee (if applicable)

The U.S. Embassy or Consulate may require additional documentation. You should verify requirements with the embassy or consulate where you will be applying.
Upon arrival at the U.S. port of entry, you and your accompanying family members must present a valid passport with visa and Form DS-2019.  Be sure to carry all immigrations documents with you on the plane (not in your luggage) as you will need them at the inspection station.

Fourth Step
You must arrive two weeks prior to your start date for a Medical Clearance. Please coordinate your appointment for medical clearance with Ms. Griselda Zuno via email at gzuno@uci.edu
 
The documents Ms. Zuno will need to submit include:

  • Clinical Observer Form Signed by Visiting Fellow
  • Copy of your Curriculum Vitae
  • Copy of Passport
  • Copy of Health Insurance Card (The Department of Urology is unable to provide health insurance for international fellows)

Fifth Step
Upon arrival in the United States:

1. Report to the International Center before the start date of your program. Upon your arrival in the US, and before the start date on your DS 2019 (found in section 3), you must check in with the UCI International Center (IC) so that your SEVIS record can be validated.  Please complete a CHECK IN FORM (found at NEW SCHOLARS) and make photo copies of the important immigration documents listed below (and those of J-2 dependents) and bring to the IC:

  • Biographical page of your passport
  • J visa
  • I-94 card (small white card given at port of entry)
  • Stamped DS 2019 
  • J Orientation receipt (see Step 2 below)

IC Check-In hours: M, Tu, Th, F between 9am and 12pm. 
* Please note the International Center is closed on Wednesdays.

Office Address:
International Center
University of California, Irvine
500 E. Peltason Drive
Irvine, CA
Tel: (949) 824-7249
Fax: (949) 824-3090

In addition to reporting to the International Center you must contact Ms. Griselda Zuno. After checking in with the IC, you will receive written confirmation of your successful check-in to take to Ms. Zuno to initiate the employment process required for you to have access to UCI facilities and resources.  

2.   Complete J-1 Scholar Orientation   
The US Dept. of State requires that all J scholars attend a J Orientation which is available at the International Center website .
When you have completed the orientation, you must print out a receipt which you include when you check in at the IC.

3.   Apply for a Social Security Number
You must apply for a Social Security number if you do not have a Social Security number from a previous U.S. visit. Instructions can be found on the IC website.
NOTE: Your SEVIS record must be validated prior to applying for the Social Security Number otherwise your record will not appear in the Social Security database.

Accommodations

The Department of Urology is unable to provide housing for international fellows. However, prior fellows have had success working with several organizations. Information on accommodations can be obtained from many web sites. The International Newsletters has valuable information about J-1 Visa, taxes, and maps. Please visit the link below: http://www.ic.uci.edu/forms/ScholarNewsletter.pdf

Housing

Housing in the Irvine area may be expensive. We recommend that you make your housing arrangements prior to coming to Irvine, if at all possible.  Your UCI department will likely provide some assistance to you.  Below are some links that may assist you.
Off-Campus Housing
UCI Irvine Campus Housing Authority
The Irvine Apartment Communities
Craig's List

 

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