Institution University of Rochester Medical Center Subspecialty Endourology Address Department of Urology University of Rochester Medical Center 601 Elmwood Avenue Box 656 Rochester, New York 14642 Salary Equivalent to University of Rochester Medical Center PGY 7 level. Prerequisites Completion of an approved ACGME urology residency or foreign urologic training program equivalent. Valid New York State License Interested applicants should forward their application (obtained throughEndourological Society), CV, and 2 to 3 letters of recommendation with a cover letter to the attention of: Ahmed Ghazi M.D., FEBU, MHPE University of Rochester Medical Center 601 Elmwood Avenue, Box 656 Rochester, NY 14642 Phone: 585-756-5469 Education coordinator Email:stephany_greenough@urmc.rochester.edu Listing of Key Faculty Jean Joseph, MD, MBA, Professor of Urology and Oncology, Department Chair. (Program Director) Ahmed Ghazi, MD, Associate Professor of Urology, Director of Simulation Innovation Laboratory, (Associate Program Director) Guan Wu, MD, Associate Professor of Urology, Director of Oncology (Associate Program Director) Rajat Jain, MD, Assistant Professor of Urology Fellow 2018-2020: Pratik Gurung, M.D. (email:Pratik_Gurung@URMC.Rochester.edu) Facilities Strong Memorial Hospital is a 665-bed academic medical center equipped with state-of-the-art operating rooms designed for advanced laparoscopic procedures. The fellow will also have opportunities to operate at Highland Hospital as well. This a 238-bed hospital located less than 2 miles from Strong Memorial Hospital, which is part of URMC. The University of Rochester School of Medicine is intimately involved with URMC and with the department. There is a lot of collaboration between the two with regards to research and education. The CTSI is an extremely active entity which provides a plethora of resources to clinicians. In addition, there is a very active animal research facility with several full-time veterinarians and technicians, to allow laparoscopic animal surgeries. Goals and Objectives Training in Robot-assisted procedures and advanced procedures for treatment of malignant and benign urological diseases Training in endourology and advanced procedures for treatment of urolithiasis, benign prostatic hyperplasia and other benign urological diseases. Provide a foundation for the development, evaluation, and delivery of emerging technologies and their educational curricula. Provide resources and mentorship for research in endourology, including clinical research, simulation, and device testing and validation. Structure Two-year fellowship with adherence to Endourological Society clinical and research completion requirements. This includes completing the requisite number of index operations as well as research protocols, presentations and manuscripts. Year 1 Three days clinical Two days academic (research and teaching activities) Year 2 Four days clinical One day academic (research and teaching activities Clinical responsibilities University of Rochester Medical Center (URMC) is an academic urology department with a wide catchment area for patient referrals. As such, it attracts a large volume of the most complex patients in the northwest NY region. The main clinical goal is for the fellow to be intimately involved in the preoperative planning, intraoperative treatment and postoperative care of patients presenting to the robotic and endourology service at URMC. Specifically, this includes performing (1) robotic procedures including; prostatectomy, partial and radical nephrectomy, cystectomy with intracorporeal diversion, pyeloplasty and other reconstructive surgeries and (2) endourology procedures including; ureteroscopies, percutaneous nephrolithotomy, various procedures for BPH as well as minimally invasive treatment for benign urologic pathologies. Our program performs over 300 minimally invasive urologic surgeries annually. The fellow will work and learn with four urologists to maximize their exposure to all aspects of minimally invasive urologic surgery. The fellows main involvement is in the complex or innovative procedures. At Strong Memorial Hospital alone, more than 500 ureteroscopies were performed for stone disease and upper tract pathology in 2016. PCNL volume is increasing with the addition of a third subspecialist endourology faculty. The fellow will work and learn with three dedicated endourologists to maximize their exposure to all aspects of advanced endourology. Teaching and Educational service The fellow will be expected to attend and contribute to monthly departmental journal clubs. This will include identification of new studies in the field prior to each meeting as well as critical analysis and participation in discussion. The fellow will give a minimum of 2 lectures to the residents or the department at weekly academic study meetings or weekly grand rounds regarding the latest literature relevant to the subspecialty. Participation in wet lab training sessions for residents will be part of the teaching requirement. Finally, hands-on teaching of residents and students during operative time is expected. Simulation training The Department of Urology at the University of Rochester has a Simulation Center for Advanced Surgical Training (Sim-CAST), a ~250 square-foot simulation training center. It includes a da Vinci Xi Surgical System (surgeon console, patient side cart, vision cart and skills simulator) placed in a dedicated fully equipped MOCK operating room. This will give the fellow exposure to a fully dedicated training facility providing the ideal environment to teach fundamental and advanced surgical technical skills and procedures. Using these facilities, the fellow will complete a proficiency based, 3-tier simulation curriculum that consists of basic skills training, followed by procedural simulation on realistic full procedural endourology models developed in the departments Simulation Innovation Lab. These facilities will be used as an adjunct to the fellows ongoing clinical and operative education. As he or she becomes more proficient in live cases, it would be expected that the fellow participates in projects involving simulation-based surgical education and training. Research The fellow will have protected time to pursue clinical and basic science research opportunities. The Department of Urology has facilities and faculty available to facilitate both basic science and clinical research. Completion requirements as set by the Endourological Society will be followed. Clinical research Databases in Minimal invasive surgery and Stones. We are in process of adopting a robust end-to-end database and registry software which will integrate with the EMR as well as RedCAP database software. We anticipate that this will very quickly lead to a robust repository of endourology data which we will then use in both prospective and retrospective clinical research. The Clinical and Translational Science Institute (CTSI) is a wonderful resource in the development of research ideas. It hosts workshops and mentoring sessions with regards to research ideas, grant applications, and career development in the academic medicine world. Further, the department has dedicated contacts for the development of health services research and statistical analysis within the CTSI which It would be expected that the fellow would develop relationships within the CTSI for research project development and execution. The department has a strong commitment to involvement in high quality, and often multi-institutional, prospective trials. The clinical trial staff will assist the fellow in participating in ongoing studies. It is required that the fellow, with mentorship and guidance from the endourology attendings, would develop research protocols which would be submitted to the IRB. Monthly meetings will be scheduled with endourology staff to supervise ongoing research as well as develop new ideas. Simulation-based research (www.sil.urmc.edu) Our team at the Simulation Innovation Laboratory are generating the most high-fidelity models of genitourinary organs in the field. These models have been used extensively in resident training as well surgery rehearsal. The fellow will participate in ongoing and new research projects studying the value and efficiency of these models in training residents critical skills without the high pressure situation or patient safety concerns of a live surgery. As the model technology and fidelity improve, so too will the applicability to training and rehearsal concepts.