|Minimally Invasive Urology Training Program|
Jaime Landman, MD
Ralph V. Clayman, MD
Thomas E. Ahlering, MD
Edward Uchio, MD
Laura Findeiss, MD
The Minimally Invasive Urology Training Program at University of California, Irvine is an Endourology Society sanctioned training program specifically and carefully tailored to train future leaders in the world of minimally invasive urology. This intensive year long program is designed to allow the graduating participant to have advanced technical skills in robotics and laparoscopy or endoscopy and ablation surgery to optimize patient outcomes with minimally invasive surgical technique. The training program also focuses of developing minimally invasive thinking processes such that the participant, after graduation, can advance the future of minimally invasive urology. Research training is focused on creative and dynamic innovation, study design and execution, and proper presentation.
The training program incorporates all of the traditional elements of minimally invasive urology including laparoscopy, robotics, endoscopy, ablation, ESWL, and stone disease. The training program has, however, 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. The UC Irvine Surgical Education Laboratory is designed to be academically productive as well as a fertile training ground for future leaders of minimally invasive urology. Additionally, the training program is quite unique as the close working relationship we have with interventional radiology allows our participants to work closely with Dr. Laura Findeiss, chief of interventional radiology, to optimize the participants’ 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, and a fresh tissue laboratory with an additional 4 operative stations. The available facilities and advanced surgical equipment allow the potential for any and all experiments to be performed. Within the surgical simulation and laparoscopic trainer suite, we have 6 laparoscopic pelvic trainers with accompanying laparoscopic instruments, laparoscopic virtual reality trainers, robotic virtual reality trainers, a percutaneous renal access simulator, an endoscopy simulator, and almost every item of endourology equipment. 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, and the services of a statistician for study design and execution.
The focus of the laboratory is dynamic and innovative research that can often rapidly be translated into clinical practice. The extensive laboratory resources lend itself well to collaborative projects with faculty from other departments within UC Irvine allows participants to realize and extend their creative potential. The laboratory has ongoing collaborations with interventional radiology, nephrology, the department of engineering and other UC Irvine resources.
Current research includes surgical education and training, surgical simulation, minimally invasive surgical energy technologies, novel anastomotic techniques and devices, surgical pharmaceuticals, urinary tract materials and physiology, novel ablation technologies, novel applications of ablation technologies, improved radiographic targeting and imaging, surgical optics and digital technologies, and novel mechanisms for the protection of the kidney due to warm ischemia. The team has already developed techniques and concepts that have changed minimally invasive urologic surgery (intrarenal cooling technique, improved understanding of cryoablation candidacy, understanding ureteral peristalsis physiology, robotic natural orifice translumenal surgery). Our team has also worked with industry to create novel strategies for biopsy of kidney tumors that will be performed in the office, and we are even working on novel strategies for dialysis.
The UC Irvine Minimally Invasive Urology Training Program is unique in the depth and breadth of the dedicated faculty. Currently, the training program is directed by Dr. Jaime Landman. In addition, the participant works closely with Dr. Edward Uchio and Dr. Thomas Ahlering in minimally invasive urological oncology, with Dr. Laura Findeiss in interventional radiology, surgical simulation, and surgical education, and with Dr. Ralph Clayman in endourology.
This is an intensive one-year training program with a clinical instructor appointment. During this year the participant is expected to take call on the faculty rotation usually once every 6 weeks. 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 participant to remain clinically busy while maintaining a robust laboratory experience. The participants are considered the team leaders for laboratory and clinical research and will directly manage undergraduate students, medical students, as well as international visiting scholars. The participants lead their section of the weekly laboratory meeting to communicate the latest progress of existing projects and to brainstorm new ideas for study.
In the laboratory the participant will be leading and supervising the laboratory experiments and researchers. The focus of the laboratory efforts will be on endourological, laparoscopic, robotic, and translational research. We encourage each individual participant to tailor projects that stimulate his/her interest and expand his/her technical skill sets in order to create an extremely productive year. The projects are aimed at addressing existing clinical challenges in urology and surgery, but may be of any realm in medicine.
The clinical component of the training program includes a focus on the development of advanced technical skills in the operating room, develop familiarity and dexterity with advanced instrumentation, and expanding surgical judgment and experience. The breadth of procedures will cover oncologic, endourological, laparoscopic, and robotic techniques. Additionally, the participant will be responsible for the design and implementation of clinical trials, for the enrollment of patients in clinical studies, and for the interpretation and effective presentation of the data and results. This typically leads to multiple manuscripts being produced during the year. The clinical participant will also run their own clinic one half day per week and will therefore be able to generate their own cases as well as be involved with the cases of the three attendings that compose the endourology service.
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 used in conjunction with other school of medicine departments. The facility incorporates inanimate trainers and laparoscopy virtual reality training systems to optimize pre-clinical training. There is a full time lab manager who is a member of the minimally invasive urology team to assist with technical training in this facility.
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 two dedicated robotic systems, a da Vinci-S and a da Vinci Si. Both are high definition robotic systems which are very actively used by all minimally invasive urology faculty members for over 200 cases per year.
Ablation is clearly an important direction in minimally invasive urology. The minimally invasive urology team has one of the world's active clinical and research programs in cryoablation. Dr. Jaime Landman developed and is the director of the UCI Ablation Center in conjunction with Dr. Laura Findeiss, the chief of interventional radiology. This is one of the only multi-disciplinary ablation programs in the nation, and Dr. Landman and Dr. Findeiss are among the world's leaders in this field. Additionally, Dr. Landman and Dr. Findeiss perform a large volume of percutaneous and laparoscopic renal ablation, and the minimally invasive urology team continues to innovate in the technology and technique of renal ablation. 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, 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 near 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/.
Basic/Clinical Research: Upon the initiation of the training program the participant 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 participant will "inherit" a series of ongoing projects which the laboratory always has in progress. Typically, one major project and several minor projects are in progress. The major project is usually set in motion prior to arrival by the outgoing team, and will incorporate the incoming participant’s particular area of interest(s). This project is designed and prepared such that it can be completed during the training program year with a goal of providing data worthy of presentation and publication. Combining the primary project with ongoing projects, it is typical for the participant to be primary author or co-author on between 5 and 10 peer reviewed publications. During this year, all laboratory supplies and additional needs would be provided through the laboratory. In addition, the laboratory has a full time lab manager and dedicated technicians to help support the participant in all research projects. All laboratory projects are closely supervised by Dr. Landman. 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 and typically last between 1.5 to 2 hours. The participant’s primary responsibility is to learn laparoscopic and endoscopic technique in the inanimate facility as well as while performing laboratory experiments. However, as a team, we all share responsibility for all our team's activity.
Clinical Component of Training Program: The major clinical responsibility during the year is the clinical care of minimally invasive oncology patients at UC Irvine Medical Center. The participant will have active involvement in a wide range of laparoscopic, robotic, ablation and endourology procedures. The participant will work with the faculty and residents on minimally invasive oncology cases. The participant will also have his/her own clinic one half day per week at our urology patient care center. Historically, the participant has been able to generate a significant number of minimally invasive urology cases through this clinic which are initially scheduled with proper faculty support. Later in the year, it is expected that the participant will be able to perform the cases generated from his/her own clinic independently while teaching residents to perform these cases.
The participant 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 participant who should consider each case as if he/she were the primary physician. The participant will be on the faculty call rotation; usually 1 in 6 weeks. During this year, it is anticipated that the participant will be preparing manuscripts regarding the basic research completed during the training program. In addition, ongoing or new clinical research protocols will likely be initiated, advanced, and/or completed. The participant 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. Graduation from the UC Irvine minimally invasive urology training program will be contingent on obtaining Endourological Society credentialing. Administrative support will be available to the participant 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.
Must be able to assist in patient handling during emergencies and fulfill all of the duties outlined above.
Vacation and Educational Leave Policy
The participant is required to notify Dr. Landman, in written form, for of 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 participant 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 participant 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 endourology international meeting during the clinical training program year and for the annual AUA meeting during year assuming the participant has substantial material to present at the meeting.
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
Visit the Endourological Society web site
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|International Minimally Invasive Urology 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
This check can be mailed to:
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:
The U.S. Embassy or Consulate may require additional documentation. You should verify requirements with the embassy or consulate where you will be applying.
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:
IC Check-In hours: M, Tu, Th, F between 9am and 12pm.
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
3. Apply for a Social Security Number
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 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.
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