Urology Fellowship Guide: Oncology

Urologic Oncology Fellowships

Urologic Oncology fellowships are generally either one or two years in length. One year is clinical and the other is a research year. For the rare three year program, there are two years of research. The clinical goals of these fellowships include a high level understanding of medical, radiation, pathologic, and surgical oncology, as well as surgical skills which include proper decision making and technical ability. The expectation is that you will be able to comprehensively manage highly complex oncologic patients at the conclusion of the fellowship. Additionally, the research component is often required with the goal of sparking interest in an academic career and to teach basic research skills. For many individuals, this is the launching point for a junior faculty position.

The main segregation of these fellowships is into the accredited and the non-accredited varieties. The accrediting agency is the Society of Urologic Oncology (SUO), which sets very specific requirements for programs to garner accreditation. These include: 2 year fellowship commitment split into 12 months each of clinical and research experience, a significant educational program, sufficient funds for fellows to attend meetings, sufficient urologic oncology faculty and patient load, and access to experts in other oncologic specialties. Currently, there are 14 SUO-accredited fellowships. There are around 14 non-accredited fellowships (programs can appear and disappear from year to year). Many of these are very good fellowship opportunities. Most are purely clinical (often 1 year in duration), though many have research opportunities available if so desired.

Why do a urologic oncology fellowship?
This fellowship should offer good surgical training both in terms of open and laparascopic/robotic skills, typically with a lot of volume. It allows clinical and surgical subspecialization which can be narrowed down as much or as little as you want. Some may go into academics and become pure "prostatologists" or even testis specialists, while others may still practice relatively broad-based urologic oncology in the community. Of course, this training would still be well-utilized as a general urologist in the community. Additionally, for those interested in an academic research-oriented career, the lab year provides a potentially important launching point.

Why not?
As with any fellowship, the commitment of 1-2 years is significant and some may feel they do not need the extra clinical and surgical training. Many programs are very rigorous--some are harder than residency. You can't ignore that many oncologic cases are very long and complex, so this needs to be considered as well. Finally, for those without any academic inclinations, realize that most urologic oncology programs have a significant academic bent.

Duke University
Program Director: Judd W. Moul, MD
Professor and Chief, Division of Urologic Surgery
PO Box 3707, Room 1572C
White Zone Duke South
Durham, NC 27710
Phone: 919-684-5057
judd.moul@duke.edu

Program Director: David Y.T. Chen, MD
Department Chair: Robert G. Uzzo, MD
Fox Chase Cancer Center
333 Cottman Avenue
Philadelphia, PA 19111-2497
Phone: (215) 728-2548
david.chen@fccc.edu

Mayo Clinic
Program Director: Bradley C. Leibovich, MD
Associate Professor of Urology
Mayo Clinic
200 First Street, SW
Rochester, MN 55905-2981
507-284-3981
leibovich.bradley@mayo.edu

MD Anderson Cancer Center
Program Director: Ashish M. Kamat, MD
University of Texas MD Anderson Cancer Center
1515 Holcombe Blvd. Unit 1373
Houston, TX 77030
Phone: 713-792-3250
akamat@mdanderson.org

National Cancer Institute
Program Director: W. Marston Linehan, MD
National Cancer Institute
Bldg. 10, Room 2B47
9000 Rockville Pike
Bethesda, MD 20892
Phone: 301-496-6353
linehanm@mail.nih.gov

UCLA Medical Center
Program Director: Arie Belldegrun, MD
UCLA School of Medicine
66-118 CHS 173818
10833 Le Conte Ave.
Los Angeles, CA 90095
Phone: (310) 206-1434 or (310) 825-5056
abelldegrun@mednet.ucla.edu

University of Chicago Medical Center (click to expand)

University of Chicago Medical Center (link)

Comments by Gary D. Steinberg, M.D.

Our Program is a 2-year SUO-accredited fellowship.

What are the strengths of your fellowship program (please provide an idea about the volume and the type of cases that are done at your institution): The major strength of our program is the broad-based, comprehensive training provided. A full spectrum of major open, laparoscopic, and robotic cases are performed on a regular basis. Specifically, over 500 robotic prostatectomies and over 100 radical cystectomies are performed annually. In addition, we have a large volume of laparoscopic and open renal surgery. Greater than 150 laparoscopic and 50 open renal surgeries are performed annually. Fellows are trained by 5 to 6 faculty with expertise in urologic oncology and minimally invasive surgery.

What do you look for in applicants who apply? Applicants who have demonstrated an interest in urologic oncology during their residency are encouraged to apply. It is our goal to train the future leaders in urologic oncology, and, therefore, we encourage our fellows to pursue a career in academic urology. Clinical and basic-science research are both performed during the fellowship, so an interest in these areas is recommended. As such, previous research experience is looked upon favorably.

What research opportunities are available? Clinical research is available through various channels. Comprehensive databases for prostate, renal, and bladder cancer are maintained, allowing for outcomes research projects. In addition, Institutional-Review-Board (IRB) approved clinical studies are ongoing. Fellows are encouraged to write and direct an IRB-approved study. The fellows also work in the urologic oncology basic science laboratories. Projects are ongoing for bladder and prostate cancer. The Division of Urology also actively participates in large animal research studies and the fellows have the opportunity to collaborate on these projects. The research in the animal laboratory focuses on renal physiology and different technical aspects of laparoscopic renal surgery.

What career paths have your program's alumni chosen in the past 5 years? The first SUO fellow began training in 2007 and will graduate in 2009. He plans to pursue a career in academic urologic oncology.

University of Chicago Medical Center (link)

Program Director: Gary D. Steinberg, MD
5841 South Maryland Avenue, MC 6038
Chicago, IL 60637
Phone: 773-702-3080
Fax: 773-702-1001
gsteinbe@surgery.bsd.uchicago.edu

University of Indiana
Program Director: Michael Koch, MD
University Urologists P.C., Inc.
Indiana Cancer Pavilion/Dept. of Urology
535 N. Barnhill, Suite 420
Indianapolis, IN 46202
Phone: 317-274-7338
miokoch@iupui.edu

University of Michigan
Program Director: David Peter Wood, Jr. MD
Professor of Urology
1500 East Medical Center Dirve
3875 Taubman
Ann Arbor, MI 48109
(734) 763-9269
davwood@umich.edu

University of Toronto
Program Director: Laurence Klotz, MD
Sunnybrook and Women's College Health Sciences Centre
2075 Bayview Dr., Suite #A140
Toronto, Ontario, Canada M4N 3M5
Phone: 416-480-4673
Laurence.klotz@sunnybrook.ca

Washington University (click to expand)

Washington University (link)

Comments by Adam S. Kibel, M.D.

Our program is a 2-year SUO-accredited fellowship offering comprehensive training in translational and clinical research and minimally invasive and traditional approaches to urologic malignancies. .

What are the strengths of your fellowship program (please provide an idea about the volume and the type of cases that are done at your institution):
The major strength of our program is the comprehensive clinical training which encompasses not only surgical training but exposure to medical oncology and radiation oncology as part of the NCI-Designated Siteman Cancer Center.
- Our institution performed over 600 major oncologic procedures in the last year, over half of them using minimally invasive procedures. We have a strong history of minimally invasive surgery including:
  - Robotic prostatectomy, cystectomy and partial nephrectomy
  - Laparoscopic prostatectomy, retroperitoneal lymph node dissection, partial and radical nephrectomy.
- The clinical fellow will spend time with medical and radiation oncologists to receive training in a comprehensive approach to urologic malignancies.

What do you look for in applicants who apply?
We are looking for applicants with a demonstrated interest in urologic oncology and a strong interest in clinical or translational research. Experience in these areas is helpful, but not required. It is our goal to train fellows who will develop a focus on urologic oncology in their surgical practice and continue to participate in research to advance the field of urologic oncology. Applicants must BC/BE urologists who will have completed an accredited residency program and be eligible for licensure in the state of Missouri.

What research opportunities are available?
Washington University offers an abundance of research opportunities during the research year. The fellow will have the chance to participate in any of the numerous ongoing clinical trials at the Siteman Cancer Center or to develop and direct their own clinical trial protocols. Additionally, there are large databases in kidney, bladder and prostate cancer to perform clinical research. There are laboratories which focus on basic and translational research in prostate and bladder cancer. There is a large animal research facility with technicians to assist large animal studies and development of technical innovations.

What career paths have your program's alumni chosen in the past 5 years? The fellowship is newly accredited as of 2007. Our first fellow will graduate in 2009 and plans to pursue a career in academic urologic oncology.

Washington University (link)

Program Director: Adam S. Kibel, M.D.
Washington University School of Medicine
Division of Urology
4960 Children's Place
Campus Box 8242
St. Louis, MO 63110
Phone: (314) 362-8295
kibela@wudosis.wustl.edu

Brigham and Women's Hospital, Boston, MA (click to expand)

Brigham and Women's/Dana Farber Cancer Institute Fellowship (link)

An emphasis of the fellowship will be minimally invasive approaches to urologic malignancies, as more than half of the clinical time will be spent performing robotic assisted laparoscopic radical prostatectomies, lap partial and radical nephrectomies, and robotic cystectomies. We currently have 2 Da Vinci robots, and are performing 6-8 robotic assisted laparoscopic radical prostatectomies a week.
Furthermore, there will be clinical research opportunities in outcomes and health services research with dedicated time. These include opportunities to work with BWH urologists, Anthony D'Amico, Phil Kantoff, and others.
If interested, please send a CV and coverletter to jhu2@partners.org.

Roswell Park Cancer Institute, Buffalo, NY (click to expand)

Roswell Park Cancer Institute (link)

The Department of Urologic Oncology at Roswell Park Cancer Institute is accepting applications for three different fellowships:
- One (1) year clinical fellowship
- Two (2) year fellowship that includes a one (1) year clinical fellowship in minimally invasive urologic oncology and one (1) year fellowship in translational science.
- Three (3) year academic fellowship that includes a one (1) year clinical fellowship in minimally invasive urologic oncology and two (2) year fellowship in translational science.
Surgical training will focus upon: robotic radical prostatectomy and cystectomy and laparoscopic nephrectomy, partial nephrectomy, adrenalectomy and nephroureterectomy. The Department performed 94% of its urologic oncology cases using minimally invasive procedures and has a virtual reality training laboratory and education program.
Research training can be one or two years duration. An NIH T32 grant supports two years of full-time laboratory cancer research in one of 5 areas of scientific study: 1) molecular & cellular biology, 2) immunology, 3) genetics, 4) pharmacology & experimental therapeutics, or 5) cancer prevention & epidemiology. An institutional grant supports one year of full time research in translational research, clinical trials, or outcomes research.
Trainees attend a multidisciplinary course in Oncology, biostatistics and ethics. Applicants should be US Citizens, enrolled in, or have completed, a Urology residency in an accredited program and be eligible for licensure in the state of New York. Minority and female applicants are strongly encouraged to apply. Please send a letter of interest and curriculum vitae to:

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